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Abstract Objective This study aimed to investigate the normal volumetric space and variations in the measurements of different landmarks in adults with different skeletal relations of the maxilla and the mandible based on CBCT data. The study also analyses these landmarks to locate any correlations. Background Numerous studies in orthodontics have found a relationship between orthodontic treatment and changes in the anatomy and function of the airway. Severe changes in airway morphology can cause breathing difficulties, lower quality of life, and even result in life-threatening conditions such as obstructive sleep apnoea. Consequently, orthodontic diagnosis and treatment planning require a thorough understanding of the airway space and its function. Methods The present retrospective study was conducted using CBCT records of 120 adult patients, containing 40 samples of each skeletal class (20 males and 20 females). The boundaries were defined for the 3 major regions: the nasopharynx, the oropharynx, and the hypopharynx. Various measurements were recorded across these regions, as well as selective cephalometric landmarks. The obtained data was used to calculate average and standard deviation, while regression analysis was used to evaluate correlations and t-test was used to test statistical significance of gender differences. Results The results demonstrate that skeletal Class III individuals exhibit a reduced airway volume in the nasopharynx compared to other groups, whereas skeletal Class II individuals displayed a diminished airway volume in the hypopharynx. A strong correlation was observed for Sella turcica parameters. There were no significant differences in skeletal parameters across genders. Nasopharynx cavity volume demonstrated significant differences between skeletal Class I–Class III as well as between skeletal Class II–Class III. Hypopharynx cavity volume also demonstrated significant differences between skeletal Class I–Class II and between skeletal Class II–Class III. Conclusion The major findings are the presence of a reduced nasopharyngeal volume in skeletal Class III malocclusions while skeletal Class II individuals displayed a diminished hypopharyngeal volume, making these critical areas to consider during the diagnostic and orthodontic treatment planning stages. This study also revealed a consistent correlation between Sella turcica parameters across various facial skeletal profiles, with skeletal Class II patients exhibiting a distinct pattern and skeletal Class I and Class III demonstrating an average relationship.

Abstract Objective This study aimed to develop a deep learning model to predict skeletal malocclusions with an acceptable level of accuracy using airway and cephalometric landmark values obtained from analyzing different CBCT images. Background In orthodontics, multitudinous studies have reported the correlation between orthodontic treatment and changes in the anatomy as well as the functioning of the airway. Typically, the values obtained from various measurements of cephalometric landmarks are used to determine skeletal class based on the interpretation an orthodontist experiences, which sometimes may not be accurate. Methods Samples of skeletal anatomical data were retrospectively obtained and recorded in Digital Imaging and Communications in Medicine (DICOM) file format. The DICOM files were used to reconstruct 3D models using 3DSlicer (slicer.org) by thresholding airway regions to build up 3D polygon models of airway regions for each sample. The 3D models were measured for different landmarks that included measurements across the nasopharynx, the oropharynx, and the hypopharynx. Male and female subjects were combined as one data set to develop supervised learning models. These measurements were utilized to build 7 artificial intelligence-based supervised learning models. Results The supervised learning model with the best accuracy was Random Forest, with a value of 0.74. All the other models were lower in terms of their accuracy. The recall scores for Class I, II, and III malocclusions were 0.71, 0.69, and 0.77, respectively, which represented the total number of actual positive cases predicted correctly, making the sensitivity of the model high. Conclusion In this study, it is observed that the Random Forest model was the most accurate model for predicting the skeletal malocclusion based on various airway and cephalometric landmarks.

Objective: To evaluate the infrazygomatic crest (IZC) bone and develop guidelines for the optimum placement of orthodontic miniscrew implants (OMSIs) along the distobuccal root of the permanent maxillary first molar. Methods: Bone thickness of the IZC region of 50 young adults (25 males and 25 females) aged 18-30 years were evaluated using cone-beam computed tomography images. The infrazygomatic bone thickness along the distobuccal root of the permanent maxillary first molar was assessed at various insertion angles (40° to 75° i.r.t the maxillary occlusal plane) with an increment of 5°. Student’s t-test was used to compare the IZC bone thickness and height at the orthodontic miniscrew insertion site for males and females on the right and left sides. Results: The bone thickness of the IZC region above the distobuccal root of the permanent maxillary first molar was estimated between 4.39±0.25 mm and 9.03±0.45 mm for insertion angles from 40° to 75° to the maxillary occlusal plane. The corresponding OMSI insertion heights were 17.71±0.61 mm to 13.69±0.75 mm, respectively, above the maxillary occlusal plane. There were statistically significant gender and side-wise variations in bone thickness at the IZC area and insertion height. Conclusion: The safe position for OMSI placement at the IZC was 13.69-16 mm from the maxillary occlusal plane with an insertion angle between 55° and 75°. These parameters provide the optimum placement of OMSIs along the distobuccal root of the permanent maxillary first molar.

Key Clinical Message The primary cause of complex AOB malocclusion is typically a combination of dental, skeletal, functional, and habitual factors. Open bite correction is a challenging treatment due to its complexity and the requirement for long‐term stability, therefore, multidisciplinary treatment is often the best option for achieving stable esthetic outcomes.

Objectives. This study aimed to analyze the inter-molar width and skeletal base class to predict maxillary canine impaction in permanent dentition. Methods. This cross-sectional study was carried out between September 2021 to March 2022. Patients aged between 13 and 20 years were recruited. These patients’ cone-beam computer tomography(CBCT), lateral cephalogram, and dental casts were collected and analyzed. For statistical analysis, T -test and Chi-square tests were applied. Results. A total of 92 patients were enrolled in this study. Inter-molar width was significantly decreased in patients with impacted canine( P

Abstract Background During the last decades, in patients with periodontitis, periodontal treatment has been shown to reduce the potential release of local and systemic biomarkers linked to an early risk of systemic inflammatory disorders. This study evaluated the efficacy of non-surgical-periodontal treatment (NSPT) on growth differentiation factor 15 (GDF-15) and related circulating biomarkers such as glutathione peroxidase 1 (GPx-1), c-reactive protein (hs-CRP), and surfactant protein D (SP-D) in periodontal patients and explored whether subjects who had high GDF-15 levels at baseline showed increased clinical benefits following NSPT at 6-months follow-up. Methods For this two-arm, parallel randomized clinical trial, patients with periodontitis were randomly allocated to receive quadrant scaling and root-planing (Q-SRP, n = 23, median age 51 years old) or full-mouth disinfection (FMD, n = 23, median age 50 years old) treatment. Clinical and periodontal parameters were recorded in all enrolled patients. The primary outcome was to analyse serum concentrations changes of GDF-15 and of GPx-1, hs-CRP, and SP-D at baseline and at 30, 90, and 180-days follow-up after NSPT through enzyme-linked immunosorbent assay (ELISA) and nephelometric assay techniques. Results In comparison with FMD, patients of the Q-SRP group showed a significant improvement in clinical periodontal parameters (p

Abstract Background The Bolton analysis is one of the commonly used tooth size analysis or diagnostic tools in deriving a treatment plan for orthodontic patients. Many studies have indicated and concluded that normal measurements for one group should not be considered normal for other ethnic groups. The aims and objectives of this study were to investigate the applicability of Bolton’s ratios in the orthodontic population of Malaysian main ethnics, Malay, Chinese, and Indians. Comparisons were made in terms of size and distribution of tooth size discrepancy in the Malaysian orthodontic population and the findings were converted in terms of millimeters. Methods Hundred fifty pre-orthodontic study casts comprised of 52 Malay, 54 Chinese, and 44 Indian patients were selected. Digital calipers (Fowler Pro-Max) linked to Hamilton Tooth Arch Software were used to measure the tooth width and ratios. Statistical analysis was carried out to test for gender differences (independent t-test), to identify the effects of malocclusion and ethnic groups (Two-way ANOVA), and to compare the means of the current study with Bolton’s standards (one sample t-test). Results This study showed that there was no significant difference between the genders of the sample of each ethnicity. There was no correlation found between ethnic groups and malocclusion classes. There was a significant difference when comparing Bolton values with the Malay sample for both ratios. It was found that more Malay subjects presented with maxillary excess contrary to Chinese and Indians who presented more maxillary deficiency for the anterior and overall ratio. Conclusion There was a significant difference found between the TSD of the three major ethnicities in Malaysia. The Bolton standards can be applied to Malaysian Chinese and Indians but not to Malays orthodontic populations for both anterior and overall ratios. Subsequently, a specific standard should be used for the Malays orthodontic population. It was found that more Malay subjects presented with maxillary excess contrary to Chinese and Indians who presented more maxillary deficiency for the anterior and overall ratio.

Key Clinical Abstract Multidisciplinary treatment options can help provide good clinical outcomes if these are appropriately sequenced and carried out correctly. This case exemplifies interdisciplinary involvement to ensure the patient received an improved esthetic outcome. Abstract The presence of anterior diastemas may compromise the esthetics of a patient's smile, causing mental, and social trauma in many patients. After careful evaluation Periodontal, surgical, and prosthodontic treatments are sometimes required to ensure successful treatment outcomes using a multidisciplinary staged treatment approach. These approaches must be carefully planned to ensure timely treatment progress. Surgical intervention must be planned at the right point in treatment to ensure adequate healing before placement of esthetic restorations.

Objective: Alveolar osteitis is a painful complication that often arises after tooth extraction, presenting a significant clinical challenge. It is imperative to gain a comprehensive understanding of both its occurrence and the contributing factors to enhance the quality of dental care. The aim of this study was to assess the frequency and prevalence of alveolar osteitis among patients and compare these variables based on demographic characteristics (age and sex), the number of teeth extractions, operator experience, health status, and smoking habits in the target population. Methods: This cross-sectional observational study was conducted from May 2019 to April 2020. It included all patients above 16 years of age, of both genders, who underwent permanent tooth extraction for various reasons. Patient demographics, smoking habits, health status, operating dental surgeon’s clinical experience, extraction technique, and the number of teeth extracted were recorded. Statistical analysis was performed using SPSS version 25. Chi-square test and regression analysis were used to assess differences between age, sex, smoking habit, dentist category, and the number of teeth extractions in relation to alveolar osteitis. Results: A total of 679 permanent tooth extractions were performed in 438 patients. Alveolar osteitis was observed in 107 cases (15.7%) following tooth extractions. Among these, 36 cases (33.6%) occurred in single tooth extraction cases, while 71 cases (66.4%) were present in patients with multiple extractions. Moreover, 67 cases (62.6%) of alveolar osteitis were found in cigarette smokers. In addition, 61 cases (57%) of dry sockets were reported after tooth extractions performed by dental interns, while 46 cases (43.0%) were noted in extractions performed by experienced dental surgeons and specialists. Conclusion: The study found a 15.7% incidence of alveolar osteitis in tooth extraction patients in the Al-Jouf region. Alveolar osteitis was more prevalent in males and the age group of 56–77 years. Multiple tooth extractions were associated with higher alveolar osteitis incidence, while operator inexperience increased post-extraction complication risks. In addition, a promising novel protocol and risk assessment scoring system have been devised which require further validation and future research.

Key Clinical Message A well‐customized prosthesis with a life‐like esthetic and function are the primary determining factors for its acceptance and success. RTV silicones can prove to be very effective and useful in fabricating such prosthesis. Abstract Complete or partial finger amputations impact an individual's psychological and physical well‐being and are considered the most frequently observed pattern of hand loss. A customized prosthesis offers the patient rehabilitative, functional, and psychological advantages. Retention is the key to the success of such prosthetic restoration. The present case report describes a novel technique that utilizes passive vacuum fit and mechanical retention to restore controlled function movements as a metal wire framework. The procedure was economical, most importantly, produced life‐like anatomy of the missing digit and restored the function to some extent.

OBJECTIVES The objective of this study was to explore current trends in undergraduate fixed prosthodontics teaching at undergraduate dental level education. METHODS This cross-sectional descriptive study included close-ended questions to inquire about the teaching practices of fixed prosthodontics at Bachelor of Dental Surgery level education. Electronic copies of the survey forms were sent to the heads or directors of department of prosthodontics responsible for undergraduate dental students teaching and learning in various institutes of Sindh by the help of Google forms in December 2020. The form included questions on sociodemographic details and questions inquiring the theoretical and clinical teaching practices in undergraduate fixed prosthodontics course. Data was entered and analyzed using SPSS 25. Frequency distribution and percentages of categorical variables were recorded. RESULTS Out of total 18 dental institutes of Sindh, 15 returned the completely filled form, giving a response rate of 83.3%. Seven (46.7%) schools teach various fixed prosthesis in the preclinical years to their students. All 15 colleges carry out didactic teaching and provide exposure by live clinical demonstrations for various fixed prosthesis. Faculty of 12 (80%) dental colleges where fixed prostheses are being constructed in the dental outpatient department mentioned that their students observe or assist the clinical procedures during their clinical rotation; but none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. CONCLUSION Didactic teaching and live clinical demonstrations of fixed prosthodontics is being carried out in all dental colleges of Sindh. Almost half of the dental schools teach crown preparation on phantom teeth during their preclinical course. Contrary to this, none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. As these procedures are not included in the current undergraduate curriculum, recommendations should be forwarded to governing educational body of the country to include cases of fixed prosthesis in their skill set prior to their graduation.

Objective: To study the effect of using a combination of Channa Striata gel and hyperbaric oxygen therapy on pressure areas during orthodontic treatment. Material and Methods: The study was conducted using the ARRIVE Essential 10 guidelines. In this study, 35 3-4 months male guinea pigs (Cavia Cobaya) weighing 300-400 grams were used and divided into 5 groups (n=7). Decalcification was performed to dissolve the dental calcium and jawbone to cut the tissue properly. The decalcification was performed for 30 days. Then preparations were made with HE (Hematoxylin Eosin), observed using a microscope, and counted the number of osteoclasts and macrophages on a light microscope with 400 times magnification. The results of the preparations were analyzed using the SPSS program. Results: The Kruskal-Wallis test of macrophage cells and the ANOVA test of osteoclast cells showed significant results between all groups (p

Key Clinical Message Clinicians should be aware of the variations in the number of roots and root canals and the peculiar or eccentric location of root canals. An intraoperative CBCT can be very useful in improved visualization of the anatomical variations. Abstract This case report describes the unusual location of the distobuccal root canal in a maxillary second molar with root fusion. On access opening, three distinct root canal orifices, the mesiobuccal canal, palatal canal, and a third orifice closer to the palatal canal, were seen, giving an illusion of an additional palatal canal. An attempt was made to search for the distobuccal canal in its usual position, leading to the gouging of the pulp chamber floor. An intraoperative limited field of view cone‐beam computed tomography (CBCT) revealed the root orifice adjacent to the palatal canal was the distobuccal canal. CBCT also revealed fusion of both the buccal and palatal roots in the root's coronal and middle third region, but they were not fused apically.

Abstract The rehabilitation of the cleft requires a multidisciplinary approach involving a pediatrician, surgeon, otolaryngologist, speech therapist, orthodontist, prosthodontist, and psychologist. The present case report illustrates the rehabilitation of a 12‐day‐old neonate with a cleft palate. Since the palatal arch of the neonate was very small, a feeding spoon was innovatively modified to obtain the impression. The obturator was fabricated on the same day and delivered in one appointment.

Bitemark analysis is a challenging procedure in the field of criminal case investigation. The unique characteristics of dentition are used to find the best match between the existing patterned injury and the suspected perpetrator in bitemark identification. Bitemark analysis accuracy can be influenced by various factors, including biting pressure, tooth morphology, skin elasticity, dental cast duplication, timing, and image quality. This review article discusses the potential of a smartphone camera as an alternative method for 3D bitemark analysis. Bitemark evidence on human skin and food should be immediately recorded or duplicated to retrieve long-lasting proof, allowing for a sufficient examination period. Various studies utilizing two-dimensional (2D) and three-dimensional (3D) technologies have been developed to obtain an adequate bitemark analysis. 3D imaging technology provides accurate and precise analysis. However, the currently available method using an intraoral scanner (IOS) requires high-cost specialized equipment and a well-trained operator. The numerous advantages of monoscopic photogrammetry may lead to a novel method of 3D bitemark analysis in forensic odontology. Smartphone cameras and monoscopic photogrammetry methodology could lead to a novel method of 3D bitemark analysis with an efficient cost and readily available equipment.

Introduction. This study reports two rare cases of avulsion of permanent mandibular incisors with their sequelae after being reimplanted by two contrary methods. The relevant literature regarding the avulsion of permanent mandibular incisors is also being discussed. Case Presentation. In Case I, a 9-year-old girl reported an avulsion of the permanent mandibular left lateral incisor that was immediately reimplanted within 20 minutes after injury, whereas in Case II, all four permanent mandibular incisors were avulsed and reimplanted after a prolonged extraoral dry time of 36 hours in an 18-year-old female. Both cases missed their scheduled follow-up visits and were reported after 3.5 years and 7 months, respectively, with severe root and alveolar bone resorption that was confirmed by clinical examination and Intra oral periapical radiograph (IOPA) radiographs. Discussion. Avulsion of permanent mandibular incisors is rare. The similar unfavorable outcome of contrary cases at a variable duration of time after missed follow-up illustrates the role of the appropriate treatment protocol and regular follow-up visits for the long-term success of reimplanted teeth.

Abstract The volumetric change that occurs in the pulp space over time represents a critical measure when it comes to determining the secondary outcomes of regenerative endodontic procedures (REPs). However, to date, only a few studies have investigated the accuracy of the available domain-specialized medical imaging tools with regard to three-dimensional (3D) volumetric assessment. This study sought to compare the accuracy of two different artificial intelligence-based medical imaging programs namely OsiriX MD (v 9.0, Pixmeo SARL, Bernex Switzerland, https://www.osirix-viewer.com ) and 3D Slicer ( http://www.slicer.org ), in terms of estimating the volume of the pulp space following a REP. An Invitro assessment was performed to check the reliability and sensitivity of the two medical imaging programs in use. For the subsequent clinical application, pre- and post-procedure cone beam computed tomography scans of 35 immature permanent teeth with necrotic pulp and periradicular pathosis that had been treated with a cell-homing concept-based REP were processed using the two biomedical DICOM software programs (OsiriX MD and 3D Slicer). The volumetric changes in the teeth’s pulp spaces were assessed using semi-automated techniques in both programs. The data were statistically analyzed using t-tests and paired t-tests (P = 0.05). The pulp space volumes measured using both programs revealed a statistically significant decrease in the pulp space volume following the REP (P 0.05). The mean decreases in the pulp space volumes measured using OsiriX MD and 3D Slicer were 25.06% ± 19.45% and 26.10% ± 18.90%, respectively. The open-source software (3D Slicer) was found to be as accurate as the commercially available software with regard to the volumetric assessment of the post-REP pulp space. This study was the first to demonstrate the step-by-step application of 3D Slicer, a user-friendly and easily accessible open-source multiplatform software program for the segmentation and volume estimation of the pulp spaces of teeth treated with REPs.

Objective: To assess oral healthcare-seeking behaviors during the COVID-19 lockdown period in eastern Saudi Arabia. Methods: A cross-sectional questionnaire-based study was conducted from October 2020 to December 2020 at Dental Clinic Complex, College of Dentistry, King Faisal University Al Ahsa, Saudi Arabia. Three hundred and sixty patients who visited the Dental Clinic Complex after relaxation of lockdown and consented to participate were included in this study. Participants were instructed to complete a questionnaire on oral health and dental care during the lockdown period, consisting of five sections. Results: Out of 360 participants, 168 reported requiring dental help during the lockdown period; however, only 27 participants contacted a dentist to emergency advice on phone, and 102 participants visited a dentist. ​Most participants used ​toothpaste for sensitive teeth, followed by over-the-counter pain killers, and ​clove oil. In this regard, 72.8% of females used toothpaste for sensitive teeth. A considerable number of participants needed filling, followed by root canal treatment, ​denture repair, and dental extraction. Most participants were treated with pain killers, followed by antibiotics, and referral to a hospital. More than 80% of them expressed that regular visits to the dentist are beneficial. Conclusion: A substantial proportion of participants sought oral health care during the lockdown period, mainly for restorative treatment. This was mostly achieved by visiting a dentist, or via telephone consultation to a lesser extent. Analgesics were the most common prescriptions, followed by antibiotics. Dental patients should be encouraged to regularly visit dentists to mitigate the drawbacks that lockdowns may cause in the provision of oral healthcare services.

Abstract Oligodontia or absence of teeth such as the Canines is rare and is often accompanied with several other missing teeth. This condition may also be accompanied with morphological and growth related changes in the teeth and the maxillofacial complex. Complete agenesis of the permanent canines in the maxilla and the mandible is extremely rare and occurs in association with syndromic oligodontia. Non‐syndromic absence of canines however, is extremely rare and has only been reported twice. Studies have shown that the incidence of missing canines is more in females. This report describes a sporadic case of congenital absence of maxillary and mandibular bilateral canines. The patient reported to the clinic with a chief complaint of crowding and wanted alignment. On intra‐oral examination it was observed that the patient had all permanent canines missing with no prior history of extractions, crowding in both the arches and class I molars on both sides. With no other symptoms fixed orthodontic therapy was planned for the patient with premolars substituted for the canines.

Objective: To review existing literature and provide an update on the current use of Bio-Inks and potential future use. Material and Methods: A MeSH keyword search was conducted to find out relevant articles for this short review. Results: Bio inks used in 3D printing grafting require various properties essential for the selection. Combining multiple methods and improved properties is essential for developing successful bio-inks for 3D grafting of functional tissues and tooth pulp regeneration from stem cells. To date, researchers have made many efforts to grow teeth based on stem cells and inculcate regeneration of teeth along with surrounding tissues like alveolar bones and periodontal ligaments. Conclusion: 3D printing with Bio-Inks requires strict adherence to safety protocols for successful outcomes, making it difficult to employ this routinely.

Since the dental treatment involves the use of various instruments and machines, there is ample presence of both distracting as well as destructive noise, and these are defined based on various parameters. With an increase in safety measures incorporated into dental practices, such as extra-oral suction devices and respirators, there has also been a corresponding rise in noise levels usually present in a clinic. Previous clinical experiments and trials have shown that the noise in a dental office can permanently bring about hearing damage. In addition to this, working with added safety measures during the pandemic, such as the use of personal protective equipment, respirators, and face shields can decrease operator efficiency and the ability to communicate normally. Dentistry has already been demonstrated to be one of the most hazardous occupations because of the high risk of infections. An Orthodontist must protect their eyes and mouth from potentially hazardous situations and the ears to prevent hearing damage.

Objective: To evaluate the marginal adaptation of computer-aided designing and computer-aided machining (CAD/CAM) fabricated cobalt-chromium and zirconium-oxide-based ceramic crowns compared to those produced by a conventional method. Material and Methods: The study consists of three groups; 45 crowns fabricated from cobalt-chromium (CAD-CoCr) and 45 crowns manufactured from zirconium CAD/CAM technology (CAD-Z), and 45 control (C) which consists of conventional metal-ceramic crowns. The marginal discrepancies in vertical dimensions were assessed utilizing a microscope in four surfaces (mesial, distal, vestibular, and oral) for each crown. On completion of the microscopic evaluation, multivariate analysis of variance (MANOVA) was used to study the difference in the four surfaces, considered altogether. Two-way ANOVA revealed the effect of three systems used for gap measurements of each landmark. The differences observed were considered significant at p

Over the past year and a half dental education has been conducted primarily online due to the SARS-CoV-2 pandemic. During the pandemic, we have spent many hours a day on our computers, mobile phones, and tablets to gather information and participate in online seminars and classrooms. Health consequences resulting from the overuse of these devices include carpal tunnel syndrome as well as computer vision syndrome (CVS). Computer vision syndrome, also known as digital eye strain, has several associated features such as eye burning, strained vision, dry eye, blurred vision, and associated neck and shoulder pain. Several predisposing factors have been linked with CVS, but often this problem gets ignored. The management of this syndrome is aimed at educating dentists on computer use, position, and the surrounding environment. Considering all this, we must ensure that we spend some time away from these devices every day to avoid any significant vision problems. The objective of preparing this manuscript was to provide a brief overview of the increased prevalence of computer vision syndrome and its associated features.

Objective. The aim of the study is to identify the normal vertical positions of sella (S) and nasion (N) points in subjects with a normal inclination of anterior cranial bases. Materials and Methods. Lateral cephalograms of 117 subjects who had a normal ∠SN-FH plane (7° ± 1°), ∠SN-palatal plane (9° ± 2°), ∠FH-palatal plane (1° ± 1°), and cranial base angles (131° ± 4°) were included in the study. Various linear and angular parameters and ratios were evaluated to determine the normal vertical positions of S and N points. An unpaired t-test was used to identify any significant differences between males and females. The P value of 0.05 was considered as the level of significance. Results. Among subjects with the normal inclinations of SN, FH, and palatal planes and cranial base angle, the mean values of ∠Ar-S-Ptm, ∠S-Ptm-Ar, and ∠S-Ar-Ptm were 59.38° ± 3.52°, 59.70° ± 3.21°, and 60.84° ± 3.56°, respectively, forming an almost equilateral triangle between S, Ar, and Ptm points. The mean values of ∠Ba-S-PNS, ∠S-PNS-Ba, and ∠S-Ba-PNS were 59.56° ± 3.17°, 59.72° ± 3.47°, and 60.76° ± 3.11°, respectively, forming another approximate equilateral triangle between S, Ba, and PNS points. The mean S-FH to N-FH ratio was 0.67 ± 0.06% for the whole sample, but it was significantly greater in males (0.69 ± 0.07%) compared to females (0.65 ± 0.06%) (P=0.002). Conclusions. Two approximate equilateral triangles were formed between S, Ar, and Ptm points; and S, Ba, and PNS points in subjects with normal inclinations of SN, FH, and palatal planes and cranial base angle. The S-FH to N-FH ratio was an excellent guide to locating the normal vertical position of S and N points.

Indonesia is an archipelagic country bordered by tectonically active zones with intense seismicity and volcanism. This condition is often associated with a high-risk situation of disasters in Indonesia. Forensic identification is a necessary procedure to reveal an individual’s identity. An identity, including sex and age, is needed to build a conclusion of human identification. Dental age estimation is a subfield of forensic odontology which focuses on establishing an individual’s age. Tooth development, biochemical, and postformation changes are the parameters for estimating dental age. This review discusses the applicable dental age estimation method for children and adolescents in Indonesia. Several articles that have previously studied dental age estimation in Indonesia were reviewed for this manuscript. On reviewing these articles, it was found that the Demirjian method, the Willems method, and the Al Qahtani method are useful in this population with higher accuracy than other methods.

The cementation of indirect restoration is one of the most important steps in prosthetic and restorative dentistry. Cementation aims to bond the prosthetic restoration to the prepared enamel or enamel and dentine. Successful cementation protocols prevent biofilm formation at the margin between tooth and restoration and minimize mechanical and biological complications. With the advancements in dental cements, they have been modified to be versatile in terms of handling, curing, and bond strengths. This review presents updates on dental cements, focusing on the composition, properties, advantages, limitations, and indications of the various cements available. Currently, dental restorations are made from various biomaterials, and depending on each clinical case, an appropriate luting material will be selected. There is no luting material that can be universally used. Therefore, it is important to distinguish the physical, mechanical, and biological properties of luting materials in order to identify the best options for each case. Nowadays, the most commonly used dental cements are glass-ionomer and resin cement. The type, shade, thickness of resin cement and the shade of the ceramic, all together, have a tangible influence on the final restoration color. Surface treatments of the restoration increase the microtensile bond strength. Hence, the proper surface treatment protocol of both the substrate and restoration surfaces is needed before cementation. Additionally, the manufacturer’s instructions for the thin cement-layer thickness are important for the long-term success of the restoration.

This observational study was conducted to evaluate the clinical signs and symptoms of maxillary sinus tumors and to propose a clinical examination sieve and a unique risk alarm score to be used for timely patient referral and vigilance. The study consisted of 70 patients between 20 to 82 years of age from both sexes. The clinical information gained was collected from the upper dentoalveolar segment, orbit, and nasal sites. Regarding the early clinical sign and symptoms of patients, nasal obstruction was found in 67 patients (95.7%), facial swelling in 69 patients (98.6%), paresthesia in 41 patients (58.6%), and epistaxis in 50 patients (71.4%). Furthermore, in terms of the late signs and symptoms, a palpable mass in buccal sulcus was observed in 65 (92.9%) of the patients, lymphadenopathy in 24 (34.3%), paresthesia in 38 (54.3%), and diplopia in 22 (31.4%). Furthermore, general sign and symptoms like exophthalmos was present in 35 patients (50%), anosmia was observed in 37 patients (52.9%), and oroantral fistula was noted in 37 patients (55.9%). Additionally, 67 (95.7%) of the patients complained of nasal obstruction. Similarly, facial asymmetry was observed in 69 (98.6%) of the patients and double vision was observed in 24 (34.4%). Tumors of the maxillary sinus have a very insidious course of spread and uncertain clinical signs and symptoms. What makes diagnosis worse is the fact that the symptoms of these tumors are so well hidden in the sponge-like nature of the midfacial region that they are easily misinterpreted by patients. Therefore, diagnoses must be made early, dentists must be vigilant, and patients must be fully investigated at the slightest suspicion of a tumor, albeit benign.

Shape memory polymers (SMPs) are emerging smart materials that have the ability to change to a shape and revert to their permanent shape on application of external stimulus. SMPs can be divided into four types based on their permanent shape, elasticity origin, and temporary shape fixing mechanism: chemically cross-linked glassy thermosets, chemically cross-linked semi-crystalline, physically cross-linked glassy copolymers, and physically cross-linked block copolymers. The broad overview of recent developments on SMPs for biomedical applications proves their wide applicability in the field of general medicine, drug delivery, regenerative medicine, dentistry, neuromedicine, cancer therapy, orthopedics, and corrosion protection. Herein, a comprehensive analysis of SMPs and their composites with focus on their types, mechanism, functionality and biomedical applications is presented. Relevant biomedical technologies based on SMPs and their future advancement towards biomedical applications are also discussed.

Objective: To evaluate the difference in working conditions as perceived by dentists during the pandemic and their professional satisfaction levels. Material and Methods: An online survey was conducted using the convenience and snowball sampling methods. Two hundred seventy-two respondents across various countries answered information related to socio-demographic data and work satisfaction levels during the SARS-CoV-2 pandemic. Results: 40.1% of dentists reported dissatisfied with their current work, while another 13.6% of dentists fell in the extremely dissatisfied category. 22.8% of dentists were significantly dissatisfied with their current income. Furthermore, 38.4% of the dentists were dissatisfied with physical working conditions, while 33.5% reported dissatisfaction with the freedom of working methods. Conclusion: This study was focused on the connection between various intrinsic and extrinsic factors affecting working conditions, social interactions, and psychological stresses. From the findings of this multicultural study, we can see that dentists across different countries have been affected and have varying levels of dissatisfaction. Therefore, regulatory authorities must plan for support and interventional programs to help dental professionals pass this difficult period.

This study aimed to analyze the existing literature on how artificial intelligence is being used to support the identification of cephalometric landmarks. The systematic analysis of literature was carried out by performing an extensive search in PubMed/MEDLINE, Google Scholar, Cochrane, Scopus, and Science Direct databases. Articles published in the last ten years were selected after applying the inclusion and exclusion criteria. A total of 17 full-text articles were systematically appraised. The Cochrane Handbook for Systematic Reviews of Interventions (CHSRI) and Newcastle-Ottawa quality assessment scale (NOS) were adopted for quality analysis of the included studies. The artificial intelligence systems were mainly based on deep learning-based convolutional neural networks (CNNs) in the included studies. The majority of the studies proposed that AI-based automatic cephalometric analyses provide clinically acceptable diagnostic performance. They have worked remarkably well, with accuracy and precision similar to the trained orthodontist. Moreover, they can simplify cephalometric analysis and provide a quick outcome in practice. Therefore, they are of great benefit to orthodontists, as with these systems they can perform tasks more efficiently.

Recent advances in science, especially innovations in the field of biochemistry and materials science, greatly contribute to improvements in the prevention, diagnosis, and treatment of oral diseases [...]

Abstract Odontomas are common occurrences in the oral cavity and can be classified as complex or compound. Erupted peripheral compound odontomas are rare and present in the extra‐osseous soft tissues. In this case, the odontoma led to the impaction of permanent teeth, due to which removal of the lesion was advised.

Videocapillaroscopy allows the study of both the morphological and architectural structure of the microcirculation and its hemodynamic conditions; these parameters are directly involved in autoimmune and/or inflammatory pathologies. The purpose of this research, based on capillaroscopy, is to establish whether a patient who receives an anti-COVID 19 vaccine has any changes in their oral microcirculation. A complete capillaroscopic mapping of the oral cavity of the subjects examined was made; the investigated mucosa sites were the following: cheek, labial, chewing-gingival and back of the tongue. This study showed an increase in capillary density from the comparison between the mean labial capillary density of vaccinated patients and the reference mean capillary density value of the literature. The increase in capillary density is a sign that can be attributed to an increase in angiogenic activity. The EMA, GACVS and MHRA have reviewed the risk of thrombosis after vaccination, agreeing that the benefits outweigh the risks.

Aim: To assess the Knowledge and Acceptance of the COVID vaccine among the Indian population. Materials and methods: The present mixed-method study was conducted in two phases. The first phase: quantitative assessment of knowledge and acceptance for the COVID-19 vaccine using an E survey (N = 606). The second phase: qualitative assessment using semi-structured face-to-face interviews with the study participants (N = 30) and assessment was done using a thematic approach. Study participants were selected using the convenience sampling method. Results: It was found that a large proportion of subjects in the 16–25 year of age group knew the cause of disease. But knowledge about its transmission process was found to be more in >60 years of age gap and almost all the participants in all the age group preferred Covishield. The vaccine acceptance rate was found to be low as compared to the knowledge. Conclusion: Most study participants were found to have satisfactory knowledge, but acceptance rate was comparatively lesser. Hence, more information and awareness campaigns must be launched reassuring the population about vaccine safety.

Retention devices are essential after orthodontic treatment in order to avoid the risk of relapse. For this goal, vacuum-thermoformed removable retainers (VTRRs) are useful tools in clinical practice. The main limitation related to them is the accumulation of plaque. The aim of this study was to investigate the bacterial loads present on VTRRs (Essix ACE Plastic, Dentsply Sirona) in patients under retention therapy. Patients were randomly divided into three groups, depending on the product used for the cleansing of the VTRR: Geldis, Polident tablets, and simple water, respectively. Microbiological samples were taken from the retainers at the baseline, after 1 and after 2 months, with the collection of Bleeding on Probing (BoP), Plaque Index (PI), Basic Erosive Wear Examination (BEWE) and Schiff Air Sensitivity test (SAI). A total of 15 patients were recruited and for each product, 5 patients were allocated. No significant intragroup and intergroup differences were observed at any time point for PI, SAI, BoP, Red Complex, Total Pathogen and Total Saprophyte loads. A significant intragroup and intergroup difference was assessed at T1 and T2 for BEWE in the control group. According to the results of this study, the bacterial load on VTRR retainers is not influenced by the cleaning methods tested.

To investigate whether the craniofacial sagittal jaw relationship in patients with non-syndromic cleft differed from non-cleft (NC) individuals by artificial intelligence (A.I.)-driven lateral cephalometric (Late. Ceph.) analysis. The study group comprised 123 subjects with different types of clefts including 29 = BCLP (bilateral cleft lip and palate), 41 = UCLP (unilateral cleft lip and palate), 9 = UCLA (unilateral cleft lip and alveolus), 13 = UCL (unilateral cleft lip) and NC = 31. The mean age was 14.77 years. SNA, SNB, ANB angle and Wits appraisal was measured in lateral cephalogram using a new innovative A.I driven Webceph software. Two-way ANOVA and multiple-comparison statistics tests were applied to see the differences between gender and among different types of clefts vs. NC individuals. A significant decrease (p < 0.005) in SNA, ANB, Wits appraisal was observed in different types of clefts vs. NC individuals. SNB (p > 0.005) showed insignificant variables in relation to type of clefts. No significant difference was also found in terms of gender in relation to any type of clefts and NC group. The present study advocates a decrease in sagittal development (SNA, ANB and Wits appraisal) in different types of cleft compared to NC individuals.

Orthodontic pain is one of the negatives associated with fixed orthodontic treatment that cannot be avoided. This pain usually comes around the wire placement period and gradually decreases once the endogenous analgesic mechanisms start functioning. Over the years, several treatment modalities have been utilized for relief from orthodontic pain, and these include mechanical, behavior modification, and pharmacological methods. However, in the last decade, there are several newer methods employing the use of technology that have come up and are being used for alleviating pain. From computerized indirect bonding to virtual treatment planning, technology has slowly become a vital part of an orthodontist’s repertoire. The digital age is here, and orthodontics must embrace the use of technology to help improve the quality of life of patients.

Introduction. Patients experience various levels of discomfort during orthodontic treatment, i.e., after placement of separators, orthodontic implant placement, and archwire placement and during debonding. Various pain control methods have been developed to relive pain during debonding, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR). Aim. To analyse various pain scales commonly used to determine the effect of different pain control methods during debonding of orthodontic brackets. Study Design. A comparative cross-sectional study performed on a sample of 60 patients (n = 60) including 14 males and 46 females who were ready for debonding and who were divided into three groups, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR). Materials and Methods. A 100 mm Visual Analog Scale (VAS) was used to record the pain intensity for each tooth. Another scale known as Pain Catastrophizing Scale (PCS) was used to evaluate the patient’s general attitude towards pain perception. The armamentarium and operator were kept same for all the patients. Statistical analysis used was the Kruskal–Wallis test, used for intergroup and intragroup comparison of pain scores. Results. Lowest total pain score was recorded in the FP group (P=0.043) on intergroup comparison, while on intragroup comparison, higher pain scores were recorded in lower anterior region (P=0.02) in all three groups. There was no significant difference between the pain scores reported by the male and female subjects. Conclusion. FP is an effective method of pain control. And teeth in the anterior region of lower and upper arches are more sensitive to pain. In terms of cognitive-affective constructs, although the VAS has been widely used in previous studies, the PCS has been detailed to show the most reliable association with physical discomfort and emotional distress.

Introduction. While there are many root morphology classification systems with their own distinct advantages, there are many shortcomings that come along with each system. Objectives. The aim of this review was to compare the various root and root canal morphology classifications, their advantages, limitations, and clinical and research implications. Data Sources and Selection. An extensive literature search was conducted on PubMed and Scopus to identify the published data on root and root canal classification systems published until 1 May 2020 using keywords, root canal classification system, classification systems for root canals, and root morphology. The related literature was reviewed and then summarized. Data Synthesis. Several studies have analysed and detailed root and root canal classifications and further added new subsystems, works of Weine et al. (1969) and Vertucci et al. (1974). Besides, Sert and Bayirli (2004) added supplementary types to Vertucci’s classification system. A new classification was most recently introduced by Ahmed et al. (2017) involving the use of codes for tooth numbering, number of roots, and canal configuration. Conclusions. Weine et al. classified only single-rooted teeth, without considering multirooted teeth and complex configurations. Vertucci’s classification included complex configurations, with Sert and Bayirli adding further complex supplemental types. Ahmed et al.’s classification simplifies classifying root and canal morphology while overcoming the limitations of several previous classification systems making it beneficial for implementation in dental schools.

Regenerative endodontics has introduced numerous procedures such as pulp implantation, revascularization, and postnatal stem cell therapy. Revascularization has been successfully implemented clinically nowadays, thus providing dentists with outrageous results. Platelet-rich fibrin (PRF) used either alone or along with bone graft promotes bone growth and vascularization. This matrix promotes migration, cell attachment, and proliferation of osteoblast that leads to bone formation. PRF consists of a packed fibrin complex consisting of leukocytes, cytokines, and glycoproteins such as thrombospondin. The usage of PRF has reported high success rates in surgical cases such as sinus lift procedures, healing of extraction sockets, and management of periapical abscesses. Compared to platelet-rich plasma, PRF is more economical, easy to prepare, and feasible to use in daily clinical practices. Revascularization compromised the induction of a blood clot into the root canal space, which emerged as a clinical triumph. This further led to platelet concentrates as an autologous scaffold on which revascularization could occur. The applications of PRF in regenerative endodontics are numerous, such as an agent for repairing iatrogenic perforation of the pulpal floor and for the revascularization of immature permanent teeth with necrotic pulps. It acts as a matrix for tissue ingrowth. Evidence of progressive thickening of dentinal walls, root lengthening, regression in the periapical lesion, and apical closure was reported. Further studies are needed to clarify the precise mechanism of action of PRF for dental pulp regeneration both in vitro and in vivo. The current review aims at the present uses of PRF in regenerative endodontics dentistry and its application with future recommendations and limitations.

It is undeniable that the advent of extra-alveolar mini-implants for anchorage purposes has revolutionized the field of Orthodontics. This case report sheds light on an innovative anchorage plan using TADs, to carry out treatment for a 15-year-old female patient. The patient reported to the clinic with a chief complaint of rotated second premolars, crowding, and a deep bite. On examination, it was seen that the patient had a Class I skeletal pattern, Class II subdivision molar relationship, 90-degree maxillary second premolar rotations, crowding in both the arches, and a deep bite. In this case, the clinicians decided to use TADs for premolar derotation as it not only provides a pure rotational couple without any deleterious effects on the adjacent teeth but also helps shorten the overall treatment time. The total treatment time for this case was 10 months.

Congenital absence of more than 6 teeth except the third molar is known as oligodontia. It can affect both primary and permanent dentitions. The affected individuals usually demonstrate esthetic, functional, and psychological concerns. The present case report is about a 4-year-old female patient with multiple missing (both primary and permanent) teeth with esthetic and social problems. On extraoral examination, the patient demonstrated upper lip relapse due to missing anterior teeth. On physical examination, no other abnormality was detected in relation to the hair, appendages, or presence of a cleft. On intraoral and radiographic examination, 21 teeth were missing, which included both the primary and the permanent tooth buds. To encourage a positive behavioral change, it was decided to carry out prosthetic intervention using a modified fixed Nance appliance and acrylic teeth. After the replacement of the missing teeth, a marked improvement in the profile and esthetics was seen.

In the Southeast Asian region, various policies have been advocated by health regulatory bodies that entail protective measures such as face masks, gloves, maintaining distance in public areas, and more. These protective measures are aimed at helping reverse the growth rate of the coronavirus. Dentists in this region have incorporated several changes to their practices to help minimize risks of person-to-person transmission inside dental offices. This narrative review aimed to provide an in-depth overview of the current situation in the Southeast Asian region regarding the use of teledentistry during the pandemic. Teledentistry involves the transfer of patient information across remote distances for online consultation and treatment planning. A few years back, it used to be a lesser-known entity but has seen an exponential rise in its incorporation into dental practices all around the Association of Southeast Nations (ASEAN) region. Many clinics in the Southeast Asian region have started using online consultations to ensure that patients can be diagnosed or followed up during their treatment. Teledentistry is the clear answer in the coming months as it will help reduce the risk of virus transmission and help patients get access to oral healthcare and dentists to see their patients. This article reviews the current pandemic situation in the ASEAN region, the recent evidence, and the scope of teledentistry. It also provides recommendations for the future and sheds light on the different types of teledentistry and how it can be incorporated into practices by regulatory authorities in this region.

Background. The quantity and quality of the etching pattern produced by acids play a significant role in the wettability and contact angle of the adhesive with the enamel surface in orthodontics. The better the etch pattern, the more the surface energy of the enamel, better the penetration of the adhesive, which ultimately results in better bond strength. The present study aimed to evaluate the contact angle of the bonding agent with the enamel surface etched by five commercially available etchants and check if any difference existed between the five. Materials and Methods. Twenty-five human maxillary and mandibular central incisors and premolars extracted for orthodontic or dental purposes were used in this study as samples. The teeth were allocated into five groups based upon the etchant used to etch the enamel surface. After the samples were etched, a hard tissue microtome was used to create thin slices of the enamel surface. The samples were then exposed to bonding agent Ormco Enlight. The bonding agent was released in the form of droplets onto the enamel slices mounted on a contact angle goniometer. The contact angle values were tabulated, and statistical analysis using the one-way ANOVA test was carried out. Results. The contact angle measurements of the etchant group, DPI, were the lowest, while D-tech has the highest contact angle values. However, statistical analysis revealed no statistically significant difference between the contact angle measurements of the five groups included in the study. Conclusion. No statistically significant difference existed between the five etchant groups included in the study. However, commercially available etchant DPI showed lesser contact angle and thus better wettability in comparison to other groups. Further elemental analysis and surface analysis are required to validate these results.

Introduction. The main aims of root canal instrumentation are to provide an environment that will lead to healing and to provide a root canal shape that is comfortable to clean and seal. When working with rotary endodontic instruments, the most significant concerns are that the instrument might fracture in the root canal, thus affecting the treatment outcome. Hence, it is of immense importance to know which file systems have more cyclic fatigue resistance. Methodology. This study evaluated the effect of the curved segment length of the artificial canal (the arch), and the number of cycles necessary in fracture of Hyflex EDM, Twisted files, and ProTaper Gold were recorded. Sixty NiTi rotary instruments of 25 mm length (Hyflex EDM (20), Twisted files (20), and ProTaper Gold (20)) were tested in a metal block with simulated canal having 90° angle of curvature. The study was performed with a specific radius and degree of curvature, i.e., 8 mm radius and 90⁰ angle of curvature, and data obtained were subsequently subjected to statistical evaluation using one-way analysis of variance and Tukey’s post hoc test. Result. The Hyflex EDM (774.29) exhibited the maximum cyclic fatigue resistance compared to Twisted files (654.875) and ProTaper Gold (375.575). A statistically significant difference was observed between the tested groups. Conclusion. The Hyflex EDM files showed the highest cyclic fatigue resistance, followed by Twisted files and ProTaper Gold files.

Can the use of lasers, ozone, probiotics, glycine and/or erythritol, and chlorhexidine in combination with non-surgical peri-implant treatment have additional beneficial effects on the clinical parameters? Objectives: The non-surgical treatment of peri-implant pathologies is based on mechanical debridement to eliminate bacterial biofilm and reduce tissue inflammation; some additional therapies have been studied to achieve more detailed clinical results. Materials and methods: A literature search for publications until January 2022 was conducted. The research question is formulated following the Problem, Intervention, Comparison/Control, and Outcome. Studies investigating adjunctive therapies were included. Results: In total, 29 articles were included. Most of the studies did not show any additional benefit of these therapies in the evaluation of bleeding on probing, probing pocket depth, or plaque index; among the proposed treatments, the use of laser was the one most studied in the literature, with the achievement of a reduction of bleeding and pocket depth. More studies would be needed to assess the benefit of other therapies. Conclusions: This review showed no significant improvements in the state of health in support of mechanical debridement therapy. However, the few benefits found would deserve to be considered in new clinical studies.

Herbal products are gaining popularity in dental and medical practice nowadays due to their biocompatibility, higher antimicrobial activity, antioxidant and anti-inflammatory properties. Herbal medicine has experienced rapid growth in recent years due to its beneficial properties, ease of availability, and lack of side effects. As pathogenic bacteria become more resistant to antibiotics and chemotherapeutic agents, researchers are becoming more interested in alternative products and treatment choices for oral diseases. As a result, natural phytochemicals separated from plants and utilized in traditional medicine are suitable substitutes for synthetic chemicals. The aim of this review article is to list and understand several herbal alternatives that are currently accessible for use as efficient endodontic medicaments. The herbal products used in endodontics have several advantages, including safety, ease of use, increased storability, low cost, and a lack of microbial tolerance. However, preclinical and clinical testing and interactions with other materials and adverse effects are required for these herbal products.

Mucormycosis is a group of infections, caused by multiple fungal species, which affect many human organs and is lethal in immunocompromised patients. During the COVID-19 pandemic, the current wave of mucormycosis is a challenge to medical professionals as its effects are multiplied because of the severity of COVID-19 infection. The variant of concern, Omicron, has been linked to fatal mucormycosis infections in the US and Asia. Consequently, current postdiagnostic treatments of mucormycosis have been rendered unsatisfactory. In this hour of need, a preinfection cure is needed that may prevent lethal infections in immunocompromised individuals. This study proposes a potential vaccine construct targeting mucor and rhizopus species responsible for mucormycosis infections, providing immunoprotection to immunocompromised patients. The vaccine construct, with an antigenicity score of 0.75 covering, on average, 92–98% of the world population, was designed using an immunoinformatics approach. Molecular interactions with major histocompatibility complex-1 (MHC-I), Toll-like receptors-2 (TLR2), and glucose-regulated protein 78 (GRP78), with scores of −896.0, −948.4, and −925.0, respectively, demonstrated its potential to bind with the human immune receptors. It elicited a strong predicted innate and adaptive immune response in the form of helper T (Th) cells, cytotoxic T (TC) cells, B cells, natural killer (NK) cells, and macrophages. The vaccine cloned in the pBR322 vector showed positive amplification, further solidifying its stability and potential. The proposed construct holds a promising approach as the first step towards an antimucormycosis vaccine and may contribute to minimizing postdiagnostic burdens and failures.