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Introduction: The use of chemical agents has dramatically increased and holds a great promise for the prevention of dental plaque, of which chlorhexidine is considered the gold standard. New novel probiotic mouthrinses are being developed to combat the adverse effects of chlorhexidine mouthrinse. Objective: The objective of this study was to compare the effectiveness of probiotic mouthrinse with chlorhexidine mouthrinse for the treatment of chronic periodontitis as an adjunct to scaling and root planing. Materials and Methods: The patients were randomly divided into two groups of 7 subjects each. Group A (Control) and Group B (Test) had scaling and root planing along with chlorhexidine mouthrinse and probiotic mouthrinse, respectively. Clinical parameters measured at baseline and 45 days were gingival index, plaque index, probing pocket depth, and clinical attachment loss. Microbial analysis was done by collecting plaque samples at baseline and 45 days. Paired t-test was used for intragroup and intergroup comparisons, whereas independent t-test was used for intergroup comparisons. Keeping the level of significance at 5%, the significant difference was adjusted at P ≤ 0.05. Results: The mean clinical parameters were significantly reduced for both treatment groups posttherapy. The microbiological data analysis (colony-forming units/ml) showed that after the therapy, there was a significant reduction in both the groups with Group B > Group A. Conclusion: Probiotics can in the near future and with more research serve to be as natural candidates to substitute antibiotics and their derivatives.

Artificial intelligence (AI) is a technological breakthrough that is rapidly progressing all over the world. AI has a variety of uses in medicine and dentistry, ranging from data analysis to using neural networks for diagnosis. AI has received enormous attention and has gone through a transition stage from being a pure statistical tool to being one of the main drivers of modern medicine. We are at the dawn of a new era, and AI is undoubtedly the future of dental practice management. This aim article is to review the various applications of AI in all the specialties of dentistry.

Background: Oral cancer is the sixth most common cancer, with India having the largest burden. Oral potentially malignant disorders (OPMDs) refer to oral mucosal disorders with increased risk for malignancy. Tumour markers aid in cancer diagnosis and tumor burden evaluation, while serum proteomics uses quantitative protein level measurements that characterizes biological processes. Objectives: To evaluate variance in levels of total serum proteins, albumin, globulin, A/G ratio across healthy individuals, tobacco and areca nut users and in patients with oral potentially malignant disorders (OPMDs) and whether it can be used as a diagnostic marker in those that develop OPMDs. To assess whether there is a variance in the protein markers in different OPMDs like leukoplakia, oral submucous fibrosis and tobacco pouch keratosis. Methodology: 70 individuals were considered in the study out of which 10 patients were healthy individuals, 30 were oral habitudes and 30 were oral habitudes and OPMDs. Results: Among the individuals, total serum proteins and globulin showed variance among habitudes and OPMDS, albumin and A/G did not show any statistically significant results. Conclusion: Study provides evidence that serum proteomic analysis of total serum proteins and globulin can be used as a diagnostic marker to facilitate detection of OPMDs.

Introduction: Digitalization has revolutionized dentistry in the last decade. Current application in digitization has increased which includes use of various systems such as cone-beam computed tomography for implant purpose, temporomandibular joint disease diagnosis, utilization of computer-aided design–computer-aided manufacturing system (CAD-CAM system) for prosthodontics. The usage of digital dentistry is made right from diagnosis to treatment planning which reduces the time consumption & human efforts to a great extent & increases accuracy for treatment planning. Therefore, this review focuses on analysis of implementation of digitization in dentistry from 2011 to 2021. Objectives: This study aims to analyze the scientific literature on digitization in dentistry by examining the origin of manuscripts, study types, and levels of evidence. Materials and Methods: The study retrieved data from journals indexed in Scopus. Subsequently, a descriptive analysis was conducted on bibliographic data, collaboration network, and keyword co-occurrence. The articles were then classified based on their field of interest, main research question, study type, and level of evidence. Results: The study has identified 203 original papers on digital dentistry, published in 112 journals, and co-authored by 1436 individuals affiliated with 89 institutions from 45 countries. While the majority (81.4%) of these papers were from a single country, we observed high collaboration among institutions from the United States, Britain, and Brazil. The primary focus of these papers was on the potential uses of digital technology in dentistry. Regarding study type, most articles were systematic reviews, cross-sectional studies, and original research papers. Conclusion: Integrating digital technology in dentistry has brought numerous benefits, including a more organized and streamlined approach to medical records and thorough investigation and treatment planning within a shorter timeframe. Furthermore, digital technology enables the accurate detection of even the minutest details, minimizing errors and eliminating human bias. The use of three-dimensional imaging techniques allows for the precise determination of objects' geometrical characteristics and spatial orientation, resulting in the accurate placement of implants and prosthetics. Clinical Relevance: Digitization in dentistry has opened a whole new world for practitioners to focus on the patient satisfaction approach. Digital platforms can help optimize diagnosis and consulting and provide an excellent base for treatment planning.

Background: Cone-beam computed tomography (CBCT) allows for volumetric analysis of the mandibular condyle which can help us to improve the understanding of the pathophysiological alterations affecting the condyles during the growth phase and later. Objectives: Evaluation of volume of mandibular condyle across gender and various age groups. Method: Retrospective volumetric analysis of CBCT scans obtained from 130 patients—260 condyles performed using a semiautomatic segmentation with the program ''ITK-Snap.” The mean condylar volume was then determined according to age group, gender, and laterality. Results: Significant differences were found across age groups in the left side condyle but not on the right. The condylar volume in males on both the right and left sides was found to be larger than that of females. It was noted that the right condylar volume was larger in all age groups and genders as compared to the left. Conclusion: The risk of development of skeletal malocclusions or temporomandibular disorders (TMD) can be determined by dimensional changes of the condyles. The data gathered may be clinically relevant in developing condylar volume diagnostic criteria for the Indian population.

The innate immune response is the body's first line of defense against pathogens. The innate immune system recognizes pathogens, including bacteria and viruses by engagement of the germline-encoded pattern recognition receptors (PRRs). There are five families of PRRs which are able to sense vast families of microbial components, referred to as pathogen-associated molecular patterns and damage-associated molecular patterns (DAMPs), they are host cell components produced during inflammation or environmentally derived. Although PRRs are predominately expressed by innate immune cells, many of the PRRs are also found on other cells including epithelial, endothelial, and cells of the adaptive immune system. PRR engagement by its ligand induces downstream signaling cascades that induce multiple effects, including activation of innate immune cells and cytokine/chemokine production for the recruitment of immune cells to the site of infection or tissue damage. There are multiple inflammasomes that are formed, which are named for their sensor PRR that induces its activation. It is still not clear how many sensors are capable of forming inflammasomes, with strong literature support for over 10 different inflammasomes, including NLRP1, NLRP3, NLRP6, NLRP12, pyrin, NAIP/NLRC4, RIG-I AIM2, IFI16, NLRC3, and NLP6 5,7 which are recently reviewed. The study of periodontal disease thus represents an excellent model to study the role of inflammasomes due to the abundance of Microbe Associated Molecular Patterns (MAMP) and DAMPs and the elevated proportion of macrophages in the tissue microenvironment.

Mucormycosis is an opportunistic fulminant fungal infection that can cause significant morbidity and frequent mortality in susceptible patients. Common predisposing factors include diabetes mellitus and immunosuppression. Even though this fungus is ubiquitous, the immune system usually prevents the disease, and it is rare. But in the present pandemic era, Mucormycosis has become a prevalent disease among immunocompromised patients and individuals with systemic pathosis. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. The fungus invades the arteries leading to thrombosis that subsequently causes tissue necrosis. The infection can spread to orbital and intracranial structures by direct invasion of blood vessels. Here, we describe an interesting and rare case of sino-nasal mucormycosis in a seropositive, uncontrolled diabetic and suspected Covid positive individual to emphasize early diagnosis and treatment of this fatal fungal infection.

Mucosal fenestration is a rare entity wherein apex of the tooth is exposed in the oral cavity due to breakdown of the overlying bone and mucosa. This leads to accumulation of plaque and if left untreated can hamper the further prognosis of the tooth. Although there are few evidences regarding mucosal fenestrations in posterior region of maxilla, treatment of the same have been challenging for the clinicians. This case report describes the management of mucosal fenestrations in the posterior maxilla by regenerative periodontal flap surgical approach using xenograft (Osseograft) and platelet-rich fibrin membrane.

Background: Einstein's photoelectric amplification theory provided the template for the development of lasers. With recent technological advancements, the increasing use of lasers in dentistry has had a meaningful impact on the diagnosis and management of oral mucosal lesions. This case series highlights lasers' impact. Case Reports: Five patients with diagnoses of arteriovenous malformation, homogeneous leukoplakia, mucocele, traumatic fibroma, and erosive lichen planus were treated with a diode laser (1,200 J/s; wavelength of 940 nm; 1.5 W; pulse mode). The patients were followed up to evaluate lesion healing and complete healing of the lesion was rapidly achieved with minimal discomfort. Conclusion: Soft-tissue lasers are trending in the management of various oral mucosal lesions due to their advantages of providing higher precision, a clean surgical field with minimal blood loss, accelerated wound healing, and fewer postoperative complications.

Oral vesiculobullous lesions are highly dynamic in their presentation making the current treatment strategies fall short of expected complete remission. With continuing research on the various treatment modalities of these lesions it is suggested that treating a disorder by following the biological and physiological behavior of the various bodily enzymes and hormones and their circadian rhythm helps in alleviating the symptoms faster with lesser or no side effects. This concept is termed “Chronotherapy.” It works by timing the treatment with the intrinsic timing of illness.

Background: Precise anatomy and course of mandibular canal is important to obtain the desired outcome of different mandibular surgical procedures and circumvent various surgical complications. This study aimed to document the presence, frequency, and type of mandibular canal variations using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of 100 patients with a total of 200 sides (right and left) were obtained retrospectively from the database of Government Dental College and Hospital, Mumbai. The presence and type of mandibular canal variation were evaluated and classified according to Naitoh et al. classification (2009) along with Rashsuren et al. modification (2014). Prevalence rates were determined according to gender, side of the mandible, and type. Morphometric analysis of the mandibular canal variations was made. Statistical analysis with Chi-square, analysis of variance (ANOVA), and Scheffe's tests were performed. Results: Mandibular canal variations were found in 13% of patients and 8% of total sides. Type I dental canal (37.50%) was the most common type of accessory canal followed by Type II retromolar canal (31.25%), Type III forward canal type (25%), Type V trifid canal (6.25%), and Type IV buccolingual canal (0%). The retromolar canal had the maximum length and diameter and most of the accessory mandibular canals (60%) had a diameter of more than 50% of that of the main canal. Conclusion: Bifid mandibular canal was the most common anatomical variation of the mandibular canal found in this study with dental canal type being the most frequent type. To avoid iatrogenic injuries, a presurgical detailed evaluation of the mandibular canal using CBCT was suggested.

Background: “L.A.S.E.R” an acronym for “Light Amplification by Stimulated Emission of Radiation” works as an alternative to conventional surgical systems. It has many advantages and is widely used in the treatment of both oral hard and soft tissues. One of the most popular uses of lasers in the field of dentistry is in the treatment of precancerous lesions and conditions. Aim: This paper is based on the comparison of two laser techniques, carbon dioxide and diode lasers to assess the efficacy in the treatment outcome of oral homogeneous leukoplakia. Setting and Design: The study is a prospective pilot study and the study design is a hospital-based randomized clinical trial. Method and Material: The study compared two treatment groups; carbon dioxide laser on group A and diode laser on group B. The patients were assessed on the basis of postoperative signs and symptoms. Also, the rate of recurrence of oral homogeneous leukoplakia following two techniques was assessed. Statistical Analysis: One-way analysis of variance (ANOVA) test was applied and P value was measured. Study showed statistical significance with P value >0.05 for evaluation parameters such as pain, erythema, swelling, burning, and rate of recurrence. Result and Conclusion: The study concludes that carbon dioxide and diode lasers can be used as alternative treatment modalities for the excision of oral soft tissue lesions. Intraoperative and postoperative complications are rare, with minor bleeding being the only complication observed during the surgeries.

Central ossifying fibroma is a rare, benign fibro osseous lesion that arises from the periodontal ligament. Odontoma is one of the most common odontogenic tumors containing enamel, dentin, cementum, and pulpal tissue. A 15-year-old boy came to our department with the chief complaint of missing teeth and malocclusion. On complete clinical and radiological investigations, we suspected a fibro osseous lesion and an odontoma occurring in the same site in the mandible, which was confirmed histopathologically to be complex odontoma and central ossifying fibroma. The patient was treated with en bloc resection and iliac crest graft. Such hybrid tumors where there is a synchronous occurrence of two tumors have been rarely reported in literature. There has been no established correlation in such cases but reporting more such cases may help in the establishment of a relationship.

Objective: To evaluate the association of MMP-9 promoter gene polymorphism in generalized chronic periodontitis patients of an Indian population. Material and Methods: Eighty patients were selected and divided into case and control groups (n=40). Patients included were aged 15-60 years of both genders and diagnosed with chronic periodontitis. Peripheral venous blood samples were obtained, and genomic DNA was isolated by a 'salting out' method. Three possible genotypes were distinguished by three distinct banding patterns, depending on the presence or absence of the Sph I restriction site: CC as allele 1, TT as allele 2, and CT, respectively. Statistical analysis was carried out by applying the Chi-squared test and One-way ANOVA. Results: There was a significant difference in MMP-9 genotypes between Chronic periodontitis patients and healthy controls. Odds ratios for CT genotype and combination of CT and TT genotypes were 3.125 (95% confidence interval, p=0.028) and 3.667 (95% confidence interval, p=0.006) relative to subjects with CC genotype, respectively. Conclusion: The present study revealed an association of MMP-9 (-1562 C/T) gene polymorphism with generalised chronic periodontitis.

Background: Various biochemical and histological methods are available for human age determination which are invasive and may require extraction of teeth. The present study aims to assess the accuracy of age estimation from tooth-coronal index (TCI) of known age and sex individuals and to present a noninvasive method for age estimation. Materials and Methods: This retrospective study comprised 88 patients, which included 54 males and 34 females. An orthopantomogram of these individuals were taken, and premolars and molars in the same were evaluated. The height of the crown (coronal height [CH]) and the height of the coronal pulp cavity (coronal pulp cavity height [CPCH]) was digitally measured on the computer screen. The TCI given by Ikeda et al. in 1985 (TCI = [CPCH × 100]/CH.) was computed on each tooth and regressed on real age of the sample. The mean, median, range, and standard deviation of the computed index were calculated. The correlation between the actual age and the estimated age was calculated using t-test. P < 0.05 was considered significant. Results: Results revealed that there is a significant correlation between the TCI with age. Increase in TCI observed with age; however, it showed no significant sex difference. Conclusion: TCI is a precise, noninvasive and easily used reliable biomarker for age estimation and is applicable to both living and dead individuals.

Introduction: Cone beam computed tomography (CBCT) is a noninvasive method which has gained broad acceptance in dentistry in 10 years. CBCT has been designed as an improvement of the diagnostic tools available for dental applications. It aids in the diagnosis of variations of root canal morphology, endodontic and nonendodontic pathosis, assessing vertical root fractures, analysis of root resorption defects, and presurgical assessment of apicoectomy procedures. Methods: CBCT images of 400 mandibular second premolars, 400 first molars, and 400 second molars were collected from 200 patient's (bilaterally) using their CBCT images. The images were acquired retrospectively and studied for anatomy of root canals and their number. Results: In the present study type IV (89.7%) and type I (77.8%) canal configurations were the most commonly seen in the mesial and distal roots of first and second molars. They were seen in both males and females. Bilateral symmetry was noted in most of the mandibular second premolars for the males and females. They did not show any significant variations in their roots and root canal morphology; however, rare variations were noted in some cases. Conclusion: Present study indicated that we are able to provide more accurate diagnosis and treatment planning with this imaging modality, thereby limiting out any sort of missed canals and overlapping of anatomical structures.

Aim: To evaluate the relationship between stress and periodontal disease. Materials and Methods: This study included fifty chronic periodontitis subjects. The clinical parameters assessed for the full-mouth periodontal examination were as follows: Plaque index (PI), probing depth (PD), and clinical attachment level (CAL). The subjects were provided with a questionnaire for the assessment of stress based on the Zung's self-rating depression and anxiety scale, the scores of which were correlated with the periodontal findings. Results: The number of subjects showing depression and anxiety were significantly less and the severity of depression and anxiety was mild in them. The clinical parameters (PI, PD, CAL) showed no significant differences among the subjects with varying levels of stress. There was no statistical significance for stress to be contributing toward the periodontal disease. Conclusion: The present study showed no association between stress and periodontal disease, and future longitudinal studies directed at larger population, might yield conclusive results.

Introduction: Saliva is an important diagnostic biofluid and the salivary composition is affected by various systemic conditions including pregnancy. Aims: The study was conducted to evaluate the salivary flow rate and pH in pregnant and non-pregnant Indian women and, consequently, to compare and correlate the salivary flow rate, pH, and prevalence of dental caries in both groups. Settings and Design: A cross-sectional study was conducted in our institute on a sample of 30 pregnant and 30 non-pregnant women. Materials and Methods: The clinical findings for Decayed-Missing-Filled Teeth (DMFT) index were recorded. Unstimulated whole saliva was collected to determine the salivary flow rate and pH. Statistical Analysis Used: Data were statistically analyzed using Student′s t-test. Results: Salivary flow rate was lower in pregnant women (0.63 ml/min) as compared to that in non-pregnant women (0.81 ml/min) (P < 0.05) and the pH was also lesser in pregnant women (6.56) than in non-pregnant women (6.86) (P < 0.05). DMFT index showed a strong negative correlation with pH in pregnant women and non-pregnant women (P < 0.05). Conclusion: A difference was observed between the salivary parameters of pregnant and non-pregnant women in this sample. However, all the values were within the normal range. A significant inverse relation was found between salivary pH and dental caries for both the groups.

Introduction: Treatment of advanced furcation invasion has always been questionable. The present case report used a GIC as an occlusive barrier in the treatment of maxillary Class III furcation defects. This procedure helps in saving a tooth which otherwise would have been deemed for extraction. Method: In this case report, glass ionomer cement is used as an occlusive barrier in the treatment of maxillary Class III furcation defects. One year follow-up of clinical and radiographic photo series results showed a reduction of gingival inflammation, tooth mobility and gain in attachment level with the use of glass ionomer. Conclusion: As GIC has many advantages over other restorative materials like low cost, antibacterial property, ease in use, biocompatibility with periodontal tissues, it is a good option in management of class III furcation cases.

This case reports a unique presentation of two different clinical entities amidst few similarities and differences. Usually, aggressive periodontitis and gingival fibromatosis occur independently. Their simultaneous occurrence is rarely found. This report deals with the clinical features and management aspect of such a case.

There is a high incidence of gingivitis in pregnant women due to combined effect of local and systemic factors. Chlorhexidine is an effective chemical plaque control agent by virtue of its property substantivity. Aim and Objective: In the present work we propose to study the effect of 0.2% chlorhexidine gluconate solution as a mouth rinse on gingival inflammation in pregnant women in comparison with non-pregnant women, before and after scaling and polishing procedures. Materials and Methods: A total number of seventy six healthy pregnant and non pregnant females in the age group of 20 to 30 years were included for the study. All the subjects used 0.2% chlorhexidine gluconate mouthrinse twice a day for 3 weeks. Weekly observations were made in both subgroups. Results: There was no significant reduction in plaque index, papilla,marginal gingiva and attached gingiva index and gingival bleeding index when 0.2% chlorhexidine gluconate mouth rinse was used alone without scaling and polishing procedures. When 0.2% chlorhexidine gluconate mouthrinse was used after scaling and polishing procedures at the end of 3 weeks, there was highly significant reduction in PMA index and gingival bleeding index in nonpregnant women group, whereas in pregnant women group there was only a significant reduction in the gingival bleeding index. Conclusion: 0.2% chlorhexidine gluconate used as mouth rinse twice a day for three weeks reduces gingival inflammation and gingival bleeding in both pregnant and non pregnant women, but significantly more in non pregnant women.

Aim: The study aimed at obtaining glucose readings using gingival crevicular blood (GCB) to screen for undiagnosed diabetes during routine dental visits. Materials and Methods: The present study included 50 patients who were divided into two groups, i.e. Group A and Group B, based on bleeding on probing at the site of collection of GCB. Group A participants had blood collected from sites having adequate bleeding on probing, whereas Group B participants had blood collected from sites with little bleeding on probing. GCB and capillary finger-stick blood (CFB] glucose readings were obtained using a self-monitoring glucometer. Statistical Analysis: Correlations between both the samples were done using Pearson′s correlation. Results: Group A patients′ correlations between GCB and CFB glucose readings were high, whereas in Group B patients, correlations between glucose readings were low. Conclusion: GCB can be an excellent source for screening diabetes during routine dental visits.