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Aim: To determine the changes in Ca2+ release before and after the application of Riva Star, AgNO3 and to analyse the changes in surface roughness of the samples. Methods: The Riva Star, AgNO3 were used to measure their effects on the demineralisation processes of the windowed human enamel in 50ml pH4.0 acetic solution under 370C. The sound human enamel samples were sliced and varnished using nail polish and 5mm2 was left on the surface of enamel sample in order to make windowed-type enamel. The demineralised enamel samples were treated by these agents after 4hours of demineralisation, and later put back into the same acetic acid solutions for further 4hours of demineralisation to detect the changes. Results: The results demonstrated that Riva Star (SDF/KI) treatment exerted the inhibition ability in demineralisation remarkably. However, when the silver nitrate was applied alone, it slightly accelerated the demineralisation firstly and then followed a straight line. The treatment of silver nitrate alone also caused black staining. Reducing agent such as potassium iodide following the treatment of silver nitrate can inhibit the demineralisation instantly without causing the initial acceleration in demineralisation and the final black staining. Conclusions: Riva Star (SDF/KI) is an effective demineralisation inhibition agent for up to 48 hours following the topical application. The potassium iodide application following the treatment of silver nitrate can not only accelerate the inhibition performance, but also effectively avoid black staining. Keywords: Silver ions, Demineralization, Caries, Riva Star, SDF, Surface roughness

Background: Oral cancer represents a significant component of the global cancer burden. It develops as a result of multiple risk factors. The main histological form of oral cancer is oral squamous cell carcinoma (OSCC). The disintegration of the extracellular matrix (ECM) is one of the key hallmarks of cancer progression, which stimulates the invasion of tumoral cells into the neighbouring tissue. Matrix metalloproteinases-9 (MMP-9) can degrade different elements of the ECM and basement membrane. Methods: A total of 35 histologically diagnosed cases of OSCC (n=25) and healthy individuals (n=10) as control were included. Immunohistochemical staining was performed on all cases. The results were analysed using SPSS version 20. Results: Increased expression of MMP-9 was observed in OSCC cases (n=23/25; 92%) as compared to healthy individuals. Statistically, a significant relation was observed while comparing the grade of staining intensity and MMP-9 expression among OSCC cases (p=0.001). Conclusion: The present study is planned to assess the immunohistochemical expression of MMP-9 in diagnosed cases of OSCC and healthy individuals. Increased expression of MMP-9 was observed in OSCC as compared to healthy individuals. Evaluation of MMP-9 could be of clinical importance in OSCC and can be used as a diagnostic predictive marker of OSCC. Keywords: Oral squamous cell carcinoma; Matrix Metalloproteinase -9; Immunohistochemistry

Aim: To measure the anxiety and fear in children while visiting dentist and to observe effectiveness of audiovisual assistance to overcome anxiety Study design: Qualitative study Place and duration of study the study is done in Rehmat Memorial Hospital Abbottabad department of operative dentistry, affiliated with Women Medical and Dental College Abbottabad, from December 2014 to February 2017. Methods: Total two hundred children were observed aged between 5-8 years at Rehmat Memorial Hospital Abbottabad under controlled conditions showing cartoons on TV screen by using wireless headphones. There were two main groups divided into the controlled group and uncontrolled group containing one hundred participants in each group. Each patient's pulse rate, heart rate was recorded and live pulse rate was in sight by using wristband with pulse rate detector. Venham's picture test was used to check the correct reaction of the patient for the assessment of degree of anxiety more realistically. Results Controlled group n=100 and uncontrolled group n=100 patient aged 5-8 years treated for various procedures in different appointments. With mean age 6-7 years, Male to female ration of participants in controlled group was 34% and 66% and in uncontrolled group male and female ration was 45% and 55%. Significant reduction in anxiety was noted in controlled group distracted by audio visual stories and rhymes. Conclusion: Both groups were statistically evaluated and the result showed that audiovisual distraction can decrease the anxiety level in the controlled group but couldn't eliminate completely. This issue needs more studies and experiments to resolve anxiety in children completely. Keywords: Dental anxiety, Venham’s picture test, child behaviour

Aim: To determine the denture cleaning routine and habits in complete denture wearers according to cleaning frequency, patient age and life of dentures. Methods: In this cross-sectional study, a self-administered questionnaire was designed to learn about patient’s attitudes toward denture cleanliness in the Prosthodontics department. A detailed questionnaire was applied for total 130 patients visiting the Department of Prosthodontics in the Rehmat memorial postgraduate hospital Abbottabad for follow-up care. Data was recorded and analysed by using SPSS version 15.0 for results. Results: Total 130 participants including 90 males (69.3%) and 40 females (30.7%). 48.6% of participants clean their dentures every day, 32.9% once a week, and 18.5 % only occasionally. The highest percentage is seen in Group 1, which is 41.2%. Approximately 77% of Group 2 participants clean their dentures at least once a week, including both daily and once-a-week denture wearers. 71 individuals had been wearing dentures for 3-5 years. 41.2% of them clean their dentures every day, while 58.6 percent clean them twice a week. 6-8 years denture wearers do not clean them on a regular basis. Most patients 42% use only water, while 30% use a combination of water and a toothbrush. Around 20% of participants used soap and water, but only 8% of denture wearers utilised cleansing tablets in addition to water. There was significant difference among all groups (P=0.001). Conclusion: In this study it has been observed that full denture patients have trouble cleansing their dentures. A lack of regular cleaning practises and decreased use of cleaning solutions is the primary cause of poor denture hygiene among the seniors. Dentists should educate patients regarding optimal denture maintenance and materials used for cleaning verbally and in written form. Keywords: Denture Complete Denture hygiene, cleansing Habits, Denture cleaning solution.

Background Regardless of attaining adequate knowledge regarding oral hygiene, physical activity, and healthy eating habits, dental students still face oral health problems. This study was aimed to assess the association of oral hygiene habits, physical activity, and eating habits with the BMI in the dental students. Method This multi centric cross-sectional study was conducted from January to May 2021 in Pakistan. Three hundred and eighty-six study participants enrolled as undergraduate dental students, both males and females, were included in the study. A questionnaire used to gather data, was modified from a study conducted by Jouhar et al. Chi-square testing was used in order to assess the relationship between two categorical variables. Linear regression was performed to assess the association with putative confounders. Statistical significance was considered for p value Results Regarding brushing teeth, 57% of the underweight individuals brushed once daily, 69.8% of the healthy, 79.2% of overweight, and 48% of obese participants brushed twice. Horizontal brushing technique was performed by 50% of the underweight participants, followed by scrub technique. A soft bristled brush was frequently used by underweight (42.9%) and healthy (66%) individuals, while a medium textured bristle brush was used by overweight (62.3%) and obese (54.2%) participants. Majority of the underweight (64.3%), overweight (48.1%), and 45.8% of obese individuals had meals thrice a day, while healthy (62.3%) individuals had meals twice a day. Conclusion This study further intensified the contributing role of having an excessive dietary intake and sugar consumption in causing obesity and dental caries. Findings from the current study, identify a statistically significant relationship that exists between BMI levels with oral hygiene, eating habits and the physical activity.

Mucopolysaccharidosis (MPS) is an inherited metabolic disorder that can affect the tooth structure leading to defects. Synchrotron X-ray diffraction being a state of the art technique has been used to determine the enamel crystallite orientation in deciduous enamel affected by Mucopolysaccharidosis Type I and Mucopolysaccharidosis Type IVA and comparing these with that of healthy deciduous enamel. Using this technique it was observed that there is a loss of texture in deciduous enamel affected by Mucopolysaccharidosis Type I and Mucopolysaccharidosis Type IVA when compared to the healthy deciduous enamel. Generally it was observed that the incisal surface of the deciduous teeth possessed a higher texture or preferred orientation of enamel crystallites and on progression towards the cervical region there was a decrease in the texture or preferred orientation of enamel crystallites. Scanning electron microscopy showed that the presence of a poorly calcified layer between the enamel and dentine at the enamel-dentine junction (EDJ) in MPS affected samples was likely to be responsible for rendering the tooth structure weak and prone to fracture as is often the case in MPS affected deciduous enamel.

Objectives To understand the pathology of the ultrastructure of enamel affected by systemic disorders which disrupt enamel tissue formation in order to give insight into the precise mechanisms of matrix-mediated biomineralization in dental enamel in health and disease. Methods Two-dimensional synchrotron X-ray diffraction has been utilized as a sophisticated and useful technique to spatially quantify preferred orientation in mineralized healthy deciduous dental enamel, and the disrupted crystallite organization in enamel affected by a systemic disease affecting bone and dental mineralization (mucopolysaccharidosis Type IVA and Type II are used as examples). The lattice spacing of the hydroxyapatite phase, the crystallite size and aspect ratio, and the quantified preferred orientation of crystallites across whole intact tooth sections, have been determined using synchrotron microdiffraction. Results Significant differences in mineral crystallite orientation distribution of affected enamel have been observed compared to healthy mineralized tissue. The gradation of enamel crystal orientation seen in healthy tissue is absent in the affected enamel, indicating a continual disruption in the crystallite alignment during mineral formation. Conclusions This state of the art technique has the potential to provide a unique insight into the mechanisms leading to deranged enamel formation in a wide range of disease states. Clinical relevance Characterising crystal orientation patterns and geometry in health and following disruption can be a powerful tool in advancing our overall understanding of mechanisms leading to the tissue phenotypes seen clinically. Findings can be used to inform the appropriate dental management of these tissues and/or to investigate the influence of therapeutic interventions or external stressors which may impact on amelogenesis.