Aim: One of the fundamental aims in endodontics is complete disinfection of the root canal. Medicinal plant extracts had effective antibacterial activity with less side effects and low cost. The aims of this study were to compare and evaluate the in vitro and in vivo antibacterial activity of different plants extracts (Ficus carica latex [FX], F. carica leaves [FL], olive leaves [OL], and Salvadora persica [SP] roots) and 2% chlorhexidine against Enterococcus faecalis when they are used as intracanal medicaments. Materials and Methods: The antibacterial effect of FX, (2%, 4%, and 8%) FL, (2%, 4%, and 8%) OL, (2%, 4%, and 8%) SP, 2% chlorhexidine (CHX), and normal saline (NS) were evaluated in vitro against E. faecalis by broth microdilution method. Sixty single-rooted teeth were selected for the in vivo study. First pretreatment sample was obtained immediately after access opening. After the instrumentation of the canals, second post-instrumentation sample was taken. Then, teeth were divided into six groups (n = 10/group), Group I: NS, Group II: 2% CHX, Group III: FX, Group IV: 8% FL, Group V: 8% OL, and Group VI: 8% SP. After 7 days, post-medication sample was collected. Analysis of variance and Tukey post hoc tests were used for statistical analysis at P ≤ 0.05. Results: All plant extracts at 8% and 2% CHX showed significant antibacterial effect against E. faecalis both in vitro and in vivo, and significantly not different. Conclusion: Under the limitation of this study, it can be concluded that FL and ethanolic extracts of 8% FL, 8% OL, and 8% SP roots were effective for the elimination of E. faecalis. Therefore, they can be used as alternative intracanal medicaments.

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Schwannoma (also known as neurilemmoma, neurolemmoma, neurinoma, perineural fibroblastoma, peripheral glioma, and peripheral nerve sheath tumor) is a slow-growing, benign neoplasm derived from Schwann cells, which are sheath cells that cover myelinated nerve fibers The presented case was of schwannoma in a 20-year-old male patient, who presented with painless swelling at the left side angle of the mandible. Clinically, no symptoms other than facial deformity were noted. Panoramic radiograph showed radiolucency presenting as secondary erosion at left angle of mandible region. Fine needle aspiration cytology suggested cytomorphology of benign spindle cell lesion, which was then confirmed histologically as nerve sheath tumor. It was difficult to diagnose the condition clinically due to the rare clinical presentation of the peripheral nerve sheath tumor. The lesion was completely excised. Postoperative follow-up of one year was taken without any recurrence. We attempt to present the versatility of presentation of such tumor and its effect on adjacent bone. Also, we found out that fine needle aspiration cytology can play a significant role in diagnosing clinically perplexing presentations of rare tumors.

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Ankyloglossia or “tongue-tie” is a congenital anomaly disorder caused by a thick and tight lingual frenulum abnormality that limits tongue movement. Ankyloglossia causes speech disorders and the inability to extend the tip of the tongue beyond the vermillion border of the mandibular lips. A 25-year-old woman presented with limited tongue movement and difficulty in reciting specific letters. On the clinical examination, insertion distance of the lingual frenulum to the tip of the tongue was 4–7 mm; ankyloglossia was classified as class III utilizing Kotlow’s assessment. The tongue did not cross the vermillion border. Frenectomy was performed as a surgical treatment option, under local anesthesia using the two hemostat method to control bleeding. Frenectomy is a good treatment option for ankyloglossia without any complications followed by speech therapy rehabilitation.

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Aim: Posterior composites are commonly used restorative materials in recent times. Common problem with composite resins is shrinkage and discoloration. Assessment of color stability has been commonly used outcome measurement tools for rating the success and failure of composite resin restorations. The aim of this study was to evaluate the effects of food colorants on the color stability of posterior nanocomposites. Materials and Methods: Five commercially available posterior composite resins tested were divided into five groups: A––SureFil SDR, B––Clearfil Majesty (CFM), C––Ever X, D––Tetric Evo Ceram (TEC) bulk-fill, and E––Filtek Z350. After initial baseline color measurement, beverages such as red wine, coffee, and coca cola were used to condition the samples for a dwell time of 30s each day for 3 months. The conditioned samples were then air dried and subjected to evaluation for reflectance value using reflective spectrophotometer. Results: Significant differences were observed among composite restorative resins tested. In this study, Z350 and CFM showed less color changes and TEC and SDR showed better results than Ever X. The difference between the mean color stability at baseline and after 3 months was found to be statistically significant for all the five resin-based composites. Conclusion: The resin-based composites when subjected to different solutions after 3 months showed changes in their color stability and it reduced with time. The color stability of the composite materials depended on the type of beverages exposed, exposure time, and composition of the tested composite material.

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Aim: To compare the microleakage of novel materials containing glass ionomer, which are applied to standard class V cavities prepared by Er,Cr:YSGG (erbium, chromium-doped yttrium, scandium, gallium, and garnet) laser and by conventional diamond bur in primary teeth. Materials and Methods: Fifty non-carious primary molar teeth were randomly divided into five main groups and restored with various materials containing glass ionomers (Group 1: Equia System; Group 2: Fuji IX GP; Group 3: Fuji II LC; Group 4: Dyract Extra; and Group 5: Giomer). Each group was divided into two subgroups according to laser and conventional preparation methods. Results: As for the gingival margin, in terms of leakage values, no statistically significant difference was observed between drill and Er,Cr:YSGG laser although less microleakage values were obtained in Er,Cr:YSGG laser groups 1 and 4 (P > 0.05). Among groups prepared by drill, the lowest leakage rates observed at the gingival margin are Equia System, Giomer, Dyract Extra, Fuji II LC, and Fuji IX GP, respectively. Among groups prepared by Er,Cr:YSGG laser, the lowest leakage rates observed in the gingival edge are Equia System, Giomer = Dyract Extra, Fuji IX GP, and Fuji II LC, respectively. Conclusion: Occlusal and gingival microleakage scores were the lowest in the groups restored with Equia system in the cavities prepared by both diamond bur and laser system. Equia system consisting of high-viscosity glass ionomer cement and nano-filled surface coat G-Coat Plus materials could be used successfully in pediatric dentistry.

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Aim: To compare pharyngeal airway dimensions (PADs) between orthodontic malocclusions. Materials and Methods: This retrospective analytical study was carried out on pretreatment cephalometric X-rays of total 45 individuals with Class I, II, and III malocclusions aged between 15 and 17 years (±1.16). Each group comprised 15 patients (eight girls and seven boys). The PAD was evaluated with cephalometric X-rays of Arnett–Gunson (A/G)-face airway bite -surgery using Dolphin Imaging software 11.7 (Dolphin Imaging & Management Solutions, Charsworth, California). The data were statistically analyzed using the Statistical Package for the Social Sciences software, version 22.0 (IBM, Armonk, New York). Comparison of chronological age and gender of the groups was made by Student t test. The differences between the three groups were compared by analysis of variance test and the differences between the two groups were compared by Tukey test. Intra-observer reliability was evaluated using the intraclass coefficient. Results: PADs at (A/G)-B and (A/G)-Pog decreased in Class II, whereas PAD at (A/G)-A decreased in Class III, as compared to control (P < 0.05 and P < 0.001). PADs at (A/G)-A, (A/G)-B, and (A/G)-Pog were statistically significant in Class II as compared to Class III (P < 0.05 and P < 0.001). Soft palate lengths were similar in all groups. Conclusion: The upper and lower PADs are affected by different dental and skeletal malocclusions. There was a decrease in lower airway measurements in Class II, whereas there was a decrease in upper airway measurements in Class III, as compared to Class I control group. Mandibular sagittal growth stimulation in Class II, maxillary palatal expansion, and maxillary protraction in Class III may be effective in expanding PAD, which decreases the potential risk of obstructive sleep apnea.

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Aim: Treatment of dentin hypersensitivity is a challenging procedure; the evolution of many materials dictates the necessity of comparing them to choose the one with rapid and sustained effect.The aim of this study was to compare between calcium sodium phosphosilicate (Ca-Na-P) containing toothpaste and nanohydroxyapatite (n-HA) containing toothpaste in treatment of dentin hypersensitivity by occlusion of dentinal tubules using a novel intraoral appliance in situ. Materials and Methods: A total number of 42 patients were assigned randomly to receive intraoral appliances holding sterilized dentin specimens on the upper first molars to one of the two groups:; either calcium sodium phosphosilicate-containing or n-HAnanohydroxyapatite-containing toothpastes. A total of 63 lower premolars were used to obtain dentin specimens. Dentin specimens were examined under scanning electron microscope. Dentinal tubules were counted visually to determine the percentages of their occlusion:; pretreatment and after 24 hours, six weeks, and eight weeks of toothpastes’ application. Data wereas collected and analyzed using Kruskall-Wallis test and Mann-Whitney test. Results: There was a significant increase in dentinal occlusion scores for both materials at a P value of ≤0.001. n-HA showed significant higher scores compared to Ca-Na-P at all follow-up periods (P ≤ 0.001). Conclusion: Biomimetic zinc n-HAcontaining toothpaste proved immediate dentinal tubule occlusion; moreover, both toothpastes provided long-term tubules occlusion.

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Aim: Gingival recession leads to root surface exposure and dentin hypersensitivity, which might cause an aesthetic impairment. This randomized trial was carried out for comparison and evaluation of the utility of bioresorbable collagen membrane (CM) and platelet-rich fibrin (PRF) membrane in the treatment of localized gingival recession. Materials and Methods: A total of 36 subjects having localized gingival recession were randomly allocated from Department of Periodontology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital, Mysuru, Karnataka, India, in two treatment groups, namely coronally advanced flap (CAF) combined with bioresorbable CM and CAF combined with PRF membrane. Plaque index, recession height (REC) and width of keratinized gingiva, and clinical attachment level were recorded at baseline, 1, 3, and 5 years. Results: The primary outcomes of the study were REC and complete root coverage (CRC). In the CAF + CM group, at the baseline, the residual REC was 3.01 ± 0.98 mm, after 1 year, it was 1.15 ± 0.88 mm, and 5 years later, it was 1.10 ± 1.04 mm; and in the CAF + PRF group, at the baseline, REC was 2.90 ± 0.52 mm, after 1 year, it was 0.45 ± 0.67 mm, and after 5 years, it was 0.38 ± 0.56 mm. Follow-up of 5 years showed statistically significant differences between the groups. After 5 years of follow up, in CAF + CM group, 60% of teeth showed CRC, and in CAF + PRF membrane group, 70% of teeth showed CRC. When we considered REC, statistical significant difference was observed between both the groups for the localized recession treatment; after 5 years, percentage of teeth presenting CRC showed no significant difference. Follow-up of 5 years showed differences, which was statistically significant between the groups. Conclusion: Though the usage of both the membranes showed satisfactory results, the PRF membrane promised to be a better alternative to CM. Also, PRF membrane could be a cost-effective alternative in the treatment of localized gingival recessions.

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Aim: Condylar hyperplasia (CH) is an alteration of condylar development, which causes mandibular asymmetry and dentofacial deformity in different magnitudes. The aim of this investigation was to determine the relationship of the condylar size and mandibular asymmetry in patients with type 1B CH through analysis of cone beam computer tomographies (CBCT). Materials and Methods: The research was a quasi-experimental study. Thirty subjects were studied using a CBCT. Patients were recruited from the Dental Service of the Oral and Maxillofacial Surgery Unit of the Hospital Guillermo Almenara Irigoyen, Lima, Peru, between 2016 and 2018. Anteroposterior, upper–lower, and middle–lateral distance measurements of the condyle head were obtained and correlated with the difference of the measurements obtained. Spearman correlation coefficient was used and established a level of significance of P < 0.05. Results: The results showed a correlation between condylar size and mandibular asymmetry. In addition, it was found that the greater the difference in the upper–lower part of the hyperplastic (CH) and nonhyperplastic (NCH) condyles, the greater the magnitude of the mandibular asymmetry, finding a positive correlation r = 0.331 with significant value (P = 0.037). Conclusion: There was a positive correlation between upper–lower difference and mandibular asymmetry. Similarly, in the middle–lateral measurement, a negative correlation was found between the condylar difference and the mandibular symmetry in the anteroposterior measurement.

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Aim: The aim of this study was to determine the prevalence and to compare oral problems among musicians and nonmusicians. Materials and Methods: This cross-comparative sectional study was designed to evaluate the distribution of oral problems among musicians and nonmusicians in Ile Ife. Musicians were recruited from the Department of Music, Obafemi Awolowo University, Ile Ife, whereas the nonmusicians were volunteers within the University community. Demographic information and history of oral symptoms was collected. Oral examinations were carried out for all participants and findings were recorded in a passworded computer. Results were analyzed with STATA 14 statistical software. Qualitative variables such as numbers of subjects with oral problems were described using percentages and proportion. Continuous variables such as age, blood pressure, and pulse rate of participants were described using mean, median, and mode. Comparison of mean and proportion among various groups were carried out using Student t test and Fischer’s exalt test as appropriate. Results: A total of 211 musicians (144, 68.4% men and 67, 31.7% and women) and 100 nonmusicians (74, 74% men and 26, 26% women) participated in the study. The mean age (standard deviation) of all participants was 54.8(12.5). The majority (72.5%) were in their third decade of life. Wind instrument was the most preferred instrument. Oral lesion was seen in 167 (79.2%) musicians and 10 (10%) nonmusicians. The most frequent oral lesion was gingival swelling (87, 41.2%). Others lesions observed were xerostomia (83, 39.3%), malocclusion (44, 20.9%), Halitosis (14, 6.64%), and temporomandibular joint pain (42, 19.9%). Halitosis was significantly more prevalent in younger age group, P = 0.13. Mean pulse rate, systolic, and diastolic blood pressures were significantly higher among musicians with oral lesion, P = 0.0001, 0.0001, and 0.0015, respectively. Conclusion: Oral lesions are significantly higher among musicians, especially musicians who play wind instruments. Oral lesions are also commoner among instrumentalists who sing. Gingival swelling and xerostomia are the common oral lesions seen. Musicians with oral lesions have greater tendency for developing high blood pressure and pulse rate.

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Aim: Many physical disturbances have been related to teething. Inappropriate knowledge of mothers and their misconceptions about teething may intervene with the prompt diagnosis and management of severe illnesses. The aim of this study was to evaluate the knowledge of mothers about teething, to determine how they used to manage its problems, and to investigate the association between the education status of mothers and their management of teething problems. Materials and Methods: A cross-sectional survey was performed using a self-administered questionnaire conducted on mothers of children aged 1–3 years, recruited from the outpatient clinic. The questionnaire consisted of four sections. Results: The needed sample size was derived to be 120 mothers. All mothers revealed that their children had at least one of the symptoms that were presented in the questionnaire. Response to teething was wrongly accompanied with fever (76%), diarrhea (80%), and sleep disturbances (86%). The mothers in the age-group 20–24 years showed significantly higher level of knowledge than those in other age-groups. Regarding mother’s education, university and diploma groups had significantly higher level of knowledge than others. Conclusion: Among 120 mothers, 50.8% and 35.8% had poor and moderate level of knowledge about teething, respectively. Furthermore, only 13.3% had good level of knowledge regarding teething.

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Aim: Hormonal contraception, either pill or injection, has been known to prevent pregnancy. Hormonal changes are known to affect the keratinization of oral epithelial cells. Cytokeratin 5 (CK5) is expressed in all keratinized and nonkeratinized basal cells. The aim of this study was to determine the effect of hormonal contraception on the maturation and expression of CK5 in the epithelial cell of the buccal mucosa. Materials and Methods: This cross-sectional observational analytical study involved 30 healthy female subjects that were divided into three groups: pill, contraceptive injection, and no hormonal contraception as a control; each group included 10 women. The inclusion criteria consisted of healthy women who were using contraception for more than 3 months, not currently undergoing orthodontic treatment, and not using a prosthesis or crown. Buccal epithelial cells were swabbed using cytobrush. Sample epithelial cells were stained using Papanicolaou to analyze maturation and immunocytochemistry to observe expression of CK5. Results: The analysis of variance result showed a significant difference in the expression of CK5 in the buccal epithelial cells of the injection, pill, and control groups (P < 0.05). The highest expression of CK5 was obtained in the contraceptive injection group, followed by the pill and control groups. The Pearson result between basal cell and expression of CK5 was 0.945. Conclusion: It was concluded that hormonal contraception may increase the expression of CK5 in the epithelial oral cell, and that there is a strong correlation between epithelial maturation and CK5 expression.

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Aim: In most of the times, sublingual varices (SLV) are noticed during aging process, cardiovascular disease, and smoking. The aim of this study was to find the relation of SLV and the presence of hypertension. Materials and Methods: A total of 215 dental patients were enrolled for the study, of which 14 were dropped, and the status of tongue and blood pressure of a total of 201 study subjects was recorded. The patients with an average blood pressure (at home) of ≥85 mm Hg (diastolic) and ≥135 mm Hg (systolic) were reported to the hospital, where three hypertension measurements were recorded with an interval of 1 week. Student t test and Pearson chi-square test were used for the analysis. Results: An association was found between hypertension and SLV (odds ratio = 2.16, P < 0.001). The systolic blood pressure was found to be 121.2 mm Hg and 138.1 mm Hg in subjects with grade 0 and grade 1 SLV, respectively (P < 0.001). The mean diastolic blood pressure was found to be 81.2 mm Hg and 85.2 mm Hg in patients with grade 0 and grade 1 SLV, respectively (P < 0.05). Conclusion: An association was observed between SLV and hypertension. Examination of lateral borders of tongue can be performed easily, and causes no harm to the patients, and can be considered as an important diagnosis method for the dentists to take an active role in preventive and primary health care.

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Aim: To investigate the association between vitamin D/25-hydroxyvitamin D [25(OH)D] level and reproductive hormone in women with recurrent aphthous stomatitis (RAS). The reproductive hormonal change suggested contributing to development of RAS in women. Studies have also shown that vitamin D deficiency may contribute to the development of RAS. So far, there is no study that reveals the association between vitamin D/25(OH)D and reproductive hormone in RAS. Materials and Methods: A cross-sectional study was performed on 38 female patients with RAS without any systemic history, any habit, or on any medications. All subjects with RAS underwent intraoral examination and hormonal level assessment to examine reproductive hormones (follicle-stimulating hormone [FSH], luteinizing hormone [LH], estradiol, and progesterone), cortisol, and vitamin D/25(OH)D. The demographic characteristics of oral ulcers, predisposing factors, and pain (visual analog scale [VAS]) scores of RAS were also obtained from all participants. The characteristics of subjects, severity of RAS, FSH, LH, estradiol, progesterone, cortisol, and vitamin D/25(OH)D were presented descriptively. Results: All subjects had mean value of estradiol (93.99 ± 81.34 pg/mL), progesterone (0.73 [0.44 to 3.73 ng/mL]), FSH (4.24 ± 1.90 mIU/mL), LH (8.12 ± 5.76 mIU/mL), cortisol (8.13 ± 2.70 µg/mL), and had low mean value of serum vitamin D/25(OH)D (10.88 ± 3.21 ng/mL) which was categorized with vitamin D deficiency. The result of Pearson correlation test showed a significant positive correlation between mean LH and vitamin D/25(OH)D (P < 0.05). Conclusion: All subjects with RAS have vitamin D deficiency and vitamin D is correlated with LH.

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Aim: The aim of this review was to appraise the existence of any differential efficacy among different vibrational frequencies and duration of sessions on the acceleration of tooth movement. Materials and Methods: An extensive search was performed from inception to November 2019 in seven databases. Only randomized controlled trials were included. Risk of bias was assessed using Cochrane’s collaboration tool. Six different combinations of frequencies and durations were utilized by the studies including: (30 Hz: 20 min/day), (111 Hz: 20 min/day), (113 Hz: 10 min/day), (120 Hz: 5 min/day), (125 Hz: 20 min/day) and (125 Hz: 15 min/day). Results: Significant differences were found in (113 Hz: 10 min/day), (120 Hz: 5 min/day), and (125 Hz: 15 min/day) compared with control groups. Mainly, no significant differences were appreciated among other combinations. Finally, attrition bias was accounted for the principal factor affecting the methodology of current studies. Conclusion: According to the available information, a weak evidence suggests a differential efficacy on tooth movement acceleration among different vibrational frequencies and durations. Parameters of 113 Hz applied for 10 min/day, 120 Hz applied for 5 min/day and 125 Hz applied for 15 min/day seemed to be more effective than the other utilized parameter

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Background: Although many papers on the subject of supernumerary teeth are found in the dental literature, the great majority are in the form of case reports and prevalence studies. Of the supernumerary teeth found in the maxillary incisor area, those associated with the mesiodens have received attention and extensive investigation in recent years. The less common supernumerary teeth associated with the lateral incisor appears to have been overlooked and, as far as can be ascertained from the literature, no in‑depth reviews of this particular dental anomaly have been undertaken, apart from isolated case reports. Aim: This paper reviews the current literature on characteristics, prevalence, diagnosis, and management of this problem. Materials and Methods: A thorough literature search between 1974 and 2020 was done using Scopus, PubMed, and Google Scholar databases. Results were reviewed, prioritized, and findings were compiled. The keywords of the search strategy were as follows: prevalence, case reports, supernumerary, supplemental, and lateral incisors. Only articles in English published in peer‑reviewed journals were included in the review. This review underlines the fact that a supplemental lateral incisor is a rare developmental anomaly. Results: Its prevalence among various populations falls between 0.05% and 1.59%. They occur more frequently in the maxilla than in the mandible, and the majority occur unilaterally, erupted, and of the supplemental type. Conclusion: Early diagnosis and treatment are suggested to prevent orthodontic and esthetic complications. Therefore, careful clinical and radiographic examination is essential to make a correct and rational diagnosis and treatment planning for any patient.

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