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Dental pulp-capping is done to preserve vital teeth when the pulp is exposed due to caries, trauma or instrumentation. Various materials are used as pulp-capping agents. The introduction of newer materials requires scientific studies to assess their clinical efficacy. The study was designed as a split-mouth randomized analysis of four pulp-capping agents (calcium hydroxide, mineral trioxide aggregate (MTA), Biodentine and EndoSequence root repair material (ERRM)). Based on selection criteria, 15 orthodontic patients requiring the extraction of four premolars (60 teeth total) were included in the study. After pulp-capping, the teeth were extracted after 8 weeks. We analyzed the extracted teeth using cone-beam computed tomography (CBCT) and histological sections to determine the quality of the dentinal bridge and the pulpal response. Ordinal scores were given based on the completeness of the dentinal bridge, the type of bridge and the degree of pulpal inflammation. Results were analyzed using a Kruskal–Wallis test (p < 0.05) with post hoc Conover values being used when applicable. All four pulp-capping materials elicited dentinal bridge formation (60/60). MTA had the highest scores (10/15) in dentinal bridge formation followed by ERRM (8/15). Both materials showed more samples with complete dentinal bridges (9/15 each) and a favorable pulpal response (15/15). Teeth capped with calcium hydroxide showed more cases of incomplete bridge formation (9/15) and pulpal inflammation. These differences in dentinal bridge formation and pulpal inflammation were statistically significant (p 0.001 and p 0.00005, respectively), with post hoc tests revealing no significant differences between MTA and ERRM (p 0.49 and p 0.71, respectively). MTA and ERRM performed better than the other pulp-capping materials but did not differ significantly from each other. The individual preference for a pulp-capping material may be based on clinical efficacy and handling characteristics.

Dentigerous cyst is a fairly common odontogenic cyst with an uncomplicated prognosis. However, reports of odontogenic and nonodontogenic tumors arising from the cysts have been published for many years. Therefore, the importance of thorough histopathological examination and regular follow-up cannot be overemphasized. Here is a case report of a possible development of desmoplastic ameloblastoma from a dentigerous cyst. This case is unique for two main reasons. Firstly, to our knowledge such a case has not been reported previously. Secondly, the tumor seemed to arise from the capsule and not from lining of the dentigerous cyst. Transformation of odontogenic rests into cysts is known to occur in the syndromic cases of odontogenic keratocysts (resulting in recurrent and daughter cysts) but not in dentigerous cysts. This case report may prompt greater interest in the role of the supposedly inactive odontogenic nests in the capsule of these cysts.

Introduction: Antibiotics are considered the most commonly sold drugs in developing countries. In India, these drugs are very much accessible without a prescription. This irrational and misuse of antibiotics results not only in the emergence of resistance of bacterial strains but also leads to adverse reactions. Aim: The aim of this study was to investigate the level of knowledge, attitude, and practice of antibiotics usage among dental patients. Materials and Methods: Study design: This study was a cross-sectional design; a prevalidated structured questionnaire comprising 24 questions was used. Sample Size: Six hundred and ten patients visiting a dental hospital, Chennai, Tamil Nadu, India, were included in the study. Results: The dental patients involved in self-medication were more than 70%. 80.2% of the study group opted selection of antibiotics from their previous prescription from dental or medical professional. Adverse effects were faced by 7.8% of patients on taking self-medication. The study group was aware of the common dental procedures such as extraction and root canal treatment in which antibiotics were commonly prescribed. Half of the patients (53.8%) do not know the term antibiotic misuse, and 43.3% of the group opted antibiotic misuse to be unacceptable. Conclusion: The study revealed the knowledge, attitude, and practice of the patients about self-medication in the Indian scenario. There is need for health-care professionals and government bodies to enlighten the public about the harmful effects of self-medication with antibiotics to overcome the antibiotic resistance.

Developmental anomalies in the hard tissue are seen frequently in dental practice. Gemination and fusion are the most commonly encountered anomalies, and distinction between the two is always challenging. Gemination, also called double tooth, is an anomaly exhibiting two joined crowns and usually a single root. It represents an incomplete attempt of a single tooth germ to split. It is considered multifactorial in etiology, with genetic and environmental causes. This paper discusses a rare example of bilateral gemination (prevalence 0.04%) of maxillary central incisors with completely separated roots. Multidisciplinary care ensured a successful esthetic and functional outcome.

Odontomas are the most commonly occurring odontogenic tumors, which are considered by many to be hamartomas rather than neoplasms. These clinically asymptomatic tumors are classified into complex and compound odontomas. They are usually discovered in radiographs and rarely cause bony expansion or infection. This paper discusses a case report of a complex odontoma exhibiting all the structural features and defects of enamel, dentine, and cementum in succession, with an overview on its etiology.

Genetic analysis has become the mainstay of forensic identification protocols. Oral fluids including saliva are invariably present in crime and disaster scenarios; their availability probably exceeding that of conventional sources like blood. Due to the intrinsic nature of fluids, the substrates may be degraded due to time delay and environmental exposure. Therefore, a review of the reliability and practicality of saliva in forensic analysis is warranted. This review is designed and planned to present and critically analyze the most relevant clinical trials on the application of saliva in forensic settings in order to assess the reliability of saliva for DNA analysis. Thorough literature search was performed via Pubmed/Medline database, the Cochrane Trial register and Clinical Trial registry of India. Only the clinical trials that specifically mentioned the use of saliva for DNA analysis were eligible and included. Eight trials were included for the analysis. Customized data collection were generated and compiled by two independent evaluators. Risk assessment and qualitative synthesis was performed. Using qualitative thematic synthesis, it was observed that saliva, especially whole saliva, collected in specific kits under stabilization, was a sufficient source of DNA, especially for PCR and genotyping methods, irrespective of environmental conditions and time delay. The observations indicate that saliva is a reliable and practical source of DNA for forensic settings. [ABSTRACT FROM AUTHOR]

Immunological disorders are observed in various clinical presentations in the oral cavity. The pathophysiology of these disorders include but are not limited to primary oral auto-immune disease, systemic disease with oral findings, malignancies, hypersensitivity reactions, drug-induced, and infection-related. Many of these disorders have overlapping oral features, making it difficult for the clinician to diagnose and treat the disorder. There is a need to provide a simple and practical decision-making algorithm to the clinicians and provide them guidance on laboratory investigations. The present review provides a diagnostic algorithm that might minimize outpatient process delays and lead to early management. This is crucial in many cases where oral findings may be the first sign of the disorder, and early treatment can preclude dissemination and complications of the disorder. [ABSTRACT FROM AUTHOR]

The talon cusp is a projection of tooth structure, usually of the cingulum of maxillary incisors (rarely in mandibular incisors), analogous to the dens evaginatus of posterior teeth. It is often associated with various syndromes, signifying its diagnostic importance. We report a rare presentation of facial and lingual talon cusps along with fusion in mandibular incisors. Presence of double talon cusps (facial and lingual) along with synodontia (fusion) in mandibular incisors is an extremely rare phenomenon, and has not been reported before. The teeth in question were fused in an unusual manner creating projections on the labial and lingual surfaces. Patient had no other clinical/radiological abnormalities. Radiographs revealed crowns fused via dentin, with separate roots and distinct root canals. The talon cusps were composed of enamel and dentin. Management is planned to alleviate occlusal disturbance, trauma, and to improve cosmetic appearance. [ABSTRACT FROM AUTHOR]

Abstract: A number of approaches have been used to improve the impact damage resistance and tolerance of composite materials. These include control of fibre/matrix interfacial adhesion, laminate design and through the thickness reinforcement. One of the techniques of arresting delamination is providing through-the-thickness reinforcement like stitching. The objective of this work is to understand the influence of fibre orientation and stitching on the mechanical response of the laminate. In this paper, the drop weight impact properties and mode I interlaminar fracture toughness of stitched and unstitched glass fibre epoxy laminate are were studied experimentally. The ultrasonic C-Scan image of the damaged impact specimen is used to find the damage area. A detailed comparison between the stitched and unstitched laminates experimentally confirmed that the stitching effectively suppressed the out of plane impact damage and increased the interlaminar fracture toughness. [Copyright &y& Elsevier]

Human immunodeficiency virus-infected patients have depleted CD4 lymphocyte counts and are susceptible to a plethora of infections of bacterial, viral, and fungal etiology. In addition to a wide range of systemic manifestations, human immunodeficiency virus-infected patients also display several characteristic oral manifestations. Studies have shown a correlation between some of the oral manifestations and CD4 lymphocyte counts which in turn is an independent prognostic indicator. To tackle the human immunodeficiency virus numerous drugs have been discovered and implemented. To overcome any potential resistance, human immunodeficiency virus patients are prescribed highly active antiretroviral therapy, wherein a combination of antiretroviral regimens are used. Studies have shown that in addition to controlling the viral activity, the treatment regimen, has a significant effect on the oral manifestations of the human immunodeficiency virus-infected patients. The present paper highlights the effects of highly active antiretroviral therapy on periodontal diseases in human immunodeficiency virus-infected individuals. [ABSTRACT FROM AUTHOR]

Tooth agenesis is one of the most common anomalies of the human dentition characterized by the developmental absence of teeth. Missing one or more teeth is common, but absence of multiple teeth is rare. The present case report describes multiple missing permanent teeth in a non syndromic familial tooth agenesis patient and an overview of the genetic concepts involved in tooth agenesis. [ABSTRACT FROM AUTHOR]