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Chitosan is a biopolymer with numerous biological properties such as antibacterial, anti-inflammatory, and wound healing. Chitosan also stimulates cell proliferation and osteogenesis and thus used as a scaffold material in tissue engineering. The physical proprieties of chitosan such as biocompatibility and biodegradability give promising results in periodontal therapies. This review gives an updated explanation of the applications of chitosan in dentistry and periodontics. Furthermore, the review demonstrates the actions of chitosan in detail and its role in the regeneration of periodontal structures.

Keloids are unorganized proliferation of fibrous tissue, usually arising from a site of injury, due to an aberrant healing process. Clinically, it presents as an ugly scar tissue on the skin and shows genetic predilection. They cause esthetic, physical, and psychological disturbances in the affected individuals. Such patients require special precautions during the normal surgical procedures. Keloid treatment is prone to a high degree of resistance and recurrence. In this article, one such a case is reported along with a review of the literature discussing the nature of the lesion, treatment options, and the recommended precautions.

From a periodontal point of view, various factors contribute to facial aesthetics. In the recent past, studies have revealed that excessive gingival display is a factor that influences an individual’ smile line. Some literature exists to support that more than excessive gingival display of more than 3mm is considered unaesthetic and termed a ‘gummy smile’ (GS). The prevalence of 'gummy smile’ has been 10% and to be more common in females. Gingival hyperplasia altered passive eruption, vertical maxillary excess, and upper-lip hypermobility can all result in excessive gingival display when a patient smile.To select the correct treatment protocol, accurate diagnosis is essential. Various techniques have been used to treat gummy smile which includes surgical and non-surgical methods. Recently a non-surgical method using Botulinum toxin gained popularity considering that the method is minimally invasive.

Introduction: Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder commonly found in the Southeast Asian region, classically characterized through restricted mouth opening and burning sensation in the mouth on consuming spicy food. The etiopathogenesis and treatment aspects of OSMF have been extensively researched and reviewed. However, the effect of this condition on the Quality of Life (QoL) of patients has not gained much consideration. The aim of our case report is to highlight the importance of evaluating the QoL in an OSMF patient by using discipline-specific questionnaire and also to present to the readers a review of the recently published research articles on the application of QoL questionnaires in OSMF patients. Results: It was observed that most of the researchers used generic and discipline-specific questionnaire for evaluating the quality of life in OSMF patients. Conclusion: Evaluation of QoL is recommended during the treatment of OSMF patients. There is a need to develop and employ more of disease-specific QoL instruments for OSMF patients.

Three-dimensional (3D) bioprinting of cells is an emerging area of research but has not been explored yet in the context of periodontal tissue engineering. Objetive: This study reports on the optimization of the 3D bioprinting scaffolds and tissues used that could be applied clinically to seniors for the regenerative purpose to meet individual patient treatment needs. Material and Methods: We methodically explored the printability of various tissues (dentin pulp stem/progenitor cells, periodontal ligament stem/progenitor cells, alveolar bone stem/progenitor cells, advanced platelet-rich fibrin and injected platelet-rich fibrin) and scaffolds using 3D printers pertaining only to periodontal defects. The influence of different printing parameters with the help of scaffold to promote periodontal regeneration and to replace the lost structure has been evaluated. Results: This systematic evaluation enabled the selection of the most suited printing conditions for achieving high printing resolution, dimensional stability, and cell viability for 3D bioprinting of periodontal ligament cells. Conclusion: The optimized bioprinting system is the first step towards the reproducible manufacturing of cell laden, space maintaining scaffolds for the treatment of periodontal lesions.

Background: The accumulation and maturation of bacterial plaque at the gingival margin is widely recognized as the primary etiological factor in the development of chronic periodontitis. With the rise in bacterial resistance to antibiotics, there is considerable interest in the development of other classes of antimicrobials for the control of infection. Aim: The aim of this study was to evaluate the efficacy of Psidium guajava (guava) and Allium sativum (garlic) on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Materials and Methods: Aqueous guava extract (AGvE), ethanolic guava extract (EGvE), aqueous garlic extract (AGE), and ethanolic garlic extract (EGE) were prepared. The inhibitory effects of these extracts for the periodontal pathogens were tested by agar well diffusion method. Minimal inhibitory concentration (MIC) of the aqueous and ethanol extracts of guava and garlic was determined by macrobroth dilution method. Minimum bactericidal concentration (MBC) was done to observe the bactericidal effect of the guava and garlic extracts against the organisms. Results: Of the AGE, 25, 50, and 75 μL showed 16, 20, and 25 mm zone of inhibition, respectively, on P. gingivalis. The AGE showed greater bacteriostatic activity against the P. gingivalis with MIC determined at 16.6 μL/mL. MIC determined for AGvE and EGvE was at 75 μL/mL concentration for P. gingivalis, whereas EGvE showed the activity at 75 μL/mL on P. gingivalis. MIC determined for AGvE was at 50 μL/mL, whereas MIC determined for EGvE was at 3.12 μL/mL for A. actinomycetemcomitans. Conclusion: P. guajava and A. sativum displayed a significant antibacterial effect. A. sativum was found to be most effective against P. gingivalis, whereas P. guajava showed the highest efficacy on A. actinomycetemcomitans.

Background: Restricted mandibular growth is observed in Class II Div 2 malocclusions. The fixed functional appliances are used to effect the skeletal changes in patients with end stages of skeletal maturity. Aim: This cephalometric study aimed to distinguish the skeletal and dental corrections done in the mandible on skeletal Class II Div 2 subjects when treated with PowerScope appliance (American Orthodontics, Sheboygan, WI). Materials and Methods: This is a cephalometric study based on the retrospective data. The patients selected for this study were with Class II Div 2 malocclusion and assessed to be in decelerating phase of skeletal growth. A total of 12 patients were selected after applying inclusion and exclusion criteria. A PowerScope was placed after incisor correction and followed up till Class I molar relation was achieved. The initial values (T1) at the time of placement of the appliance and the final values at the end of the molar correction (T2) were noted. The cephalometric parameters at T1 and T2 were assessed using sagittal occlusal (SO) analysis by Pancherz. The paired Student’s t-test was used to analyze pre- and posttreatment changes. Results: There was sufficient lengthening of the mandible (4.38 mm). Both the dental and skeletal alterations were observed in the mandible. These changes were marked compared to the maxilla. The pre- and posttreatment changes were statistically significant for the mandibular skeletal changes (P < 0.001) as well as mandibular incisor proclination (P < 0.001). Conclusion: The PowerScope can be used as a propeller for sagittal mandibular correction in Class II Div 2 patients.

Objective: To determine linear regression equation to predict the mesiodistal widths of the permanent canines and premolars based on the sum of the widths of the two permanent mandibular first molars and two mandibular central incisors. Material and Methods: The sample consisted of 800 (400 males and 400 females) permanent dentition casts of Chhattisgarh population. Mesiodistal crown widths of teeth were measured with digital caliper. The correlation and linear regression equations between the calculated four teeth (two permanent mandibular first molars and two central incisors) and the canine-premolars segments of both the arches were developed. Results: No significant differences were found in right and left side of the arch. Sexual dimorphism was significant in teeth sizes with higher mesiodistal dimension in males. A good correlation values varying from 0.51 to 0.67 was found. New standardized regression equations were formulated for the prediction of the mesiodistal widths of unerupted canines and premolars for Chhattisgarh population. Conclusion: Calculating mesiodistal widths of unerupted canine and premolars with help of two permanent mandibular molars and two mandibular central incisors, which erupt early in the oral cavity, can be an alternative and best predictor for the mixed dentition analysis.

Objective: To develop and propose a new regression for mixed dentition analysis in Chhattisgarh, Central India population. Material and Methods: The permanent dentition dental casts of 800 (400 males and 400 females) Chhattisgarh subjects were selected. Digital caliper was used to measure the mesiodistal crown widths of teeth. The linear regression equations and correlation between four mandibular incisors and the canine-premolars segments of maxillary and mandibular arches were developed (modified Tanaka-Johnston equation) and proposed for Chhattisgarh population. Results: New standardized regression equations were formulated to predict the mesiodistal widths of unerupted canines and premolars especially for Chhattisgarh, Central India population. The equation in males for maxillary arch was Y = 11.90 + 0.39 (X) and for mandibular arch was Y = 12.23 + 0.36 (X). Similarly, the equation in females for maxillary arch was Y = 14.40 + 0.26 (X) and for mandibular arch was Y= 10.26 + 0.43 (X). A significant sexual dimorphism in teeth sizes was seen with higher mesio distal dimension in males in Chhattisgarh population. Conclusion: Sum of the mesiodistal diameter of permanent mandibular incisors can be used reliably to predict/estimate the sum of mesiodistal diameters of unerupted canines and premolars with the new regression equations.

Aim: This in vitro study was done to evaluate and compare the frictional forces produced by a passive self-ligating bracket (SLB) and two types of elastomeric ligatures (unconventional elastomeric ligatures [UELs] and conventional elastomeric ligatures [CELs]) on a conventional bracket used with four types of wires. Materials: In this in vitro study, 8 numbers of conventional preadjusted edgewise appliance stainless steel brackets and 4 numbers of passive SLBs were tested. Four types of archwires and two types of ligatures were tested. Brackets were divided into three groups – Group I, Group II, and Group III. All the three groups were further divided into four subgroups based on different archwires. Methods: Custom-made mounting jig was specially constructed for this study – upper member and lower member. After the samples were mounted, traction test was conducted using universal testing machine and readings were tabulated for all specimens. The variables in each group were subjected to one-way analysis of variance. Results: All the three groups were tested for its total friction, static friction, and kinetic friction. SLBs showed a static mean little lower and had kinetic mean little greater than conventional bracket with unconventional module. Conclusion: UELs on conventional brackets and SLBs are able to produce lower frictional force when compared with CELs on conventional brackets.

Objective: This study compared the biofilm formation pattern on Polytetrafluoroethylene (PTFE) coated orthodontic brackets with that of uncoated ones. Methods: Fifteen teen aged patients were enrolled for eight weeks with their second premolar symmetrically bonded with uncoated and PTFE-coated orthodontic brackets. Upon completion, the elastomeric ligatures were deboned and removed. Rutherford backscattering detection (RBSD) method was adopted and the RBSD photographs were validated. Results: Analysis showed a total surface area of 21.7 ± 0.7 mm2 per bracket. The biofilm formation was noticed in 4.0 ± 3.6 % (0.9 ± 0.8 mm2) of the bracket surface in case of PTFE-coated brackets versus 22.2 ± 5.4 per cent (4.8 ± 1.2 mm2) on uncoated brackets and in case of PTFE-coated brackets highest amount of biofilm formation was evident in ‘mesial surfaces’ (6.58 ± 4.4 %) and the lowest on the occlusal surfaces (1.29 ± 1.2 %). The comparisons of the 2 interventions/procedures showed significant differences in all the 5 views (p=0.001 for all). Conclusion: The research findings suggest that coating the brackets with PTFE reduces biofilm adhesion to a larger extent and minimizes iatrogenic side effects. Key words: Biofilm formation, Polytetrafluoroethylene coating, Orthodontic brackets, RBSD photographs.

Coronavirus originated from Wuhan, China in December 2019 was designated initially as an epidemic but later in a short period it was declared as a pandemic. Currently, this pandemic has spread to 210 countries. There is a steady increase in the number of people getting infected with COVID and a surge in mortality as well. It is an alarming situation for health-care professionals. Dental professionals, by the very nature of treatment (direct contact with the patient’s mouth, saliva, aerosols, and droplets), carry a potential risk of getting infected or transmitting infection. Various associations have developed guidelines for an approach to the dental treatment in COVID crisis. With current knowledge, prevention and isolation seem to be the best method reiterating the old-age saying “Prevention is better than cure.” In this review, we will discuss with the help of flowcharts various preventive measures to decrease the spread of infection and precautions for the dental practice.

Edentulous spaces can be closed with dental implants, prosthesis, and orthodontic space closure. As mandibular bone is dense, protraction of molars is time taking and challenging. Temporary anchorage devices play a vital role in providing anchorage. Translation of molars can be achieved with power arms which are placed near to the centre of resistance. This is a case with bilaterally missing mandibular first molars and lower central incisor. Ridge defect is seen in molar region on right side. Class II molar relation was achieved bilaterally with second molar moving into first molar space followed by the third molar. Translation was achieved bilaterally and 10mm of space closure was done with the help of TAD’s and power arms.

Impaction of maxillary lateral incisor with odontome and retained deciduous tooth is not often seen in regular dental practice. Impaction of anterior teeth cause generalized spacing which affects the esthetics of the face. Here we report a case of an 18-year-old patient with horizontally impacted dilacerated lateral incisor, which was bought into occlusion with the help of orthodontic tooth movement within a span of 18 months.

Orthodontic therapy is no longer restricted only for healthy patients. With the better management of serious medical problems and increased quality of life expectations, medically compromised individuals are now regular visitors to the orthodontic clinics in every part of the world. As such, there is no absolute contraindication of orthodontic treatment in most of these conditions. A slight modification of the normal orthodontic treatment protocol is obligatory in such patients according to their medical condition. This article reviews and suggests the orthodontic treatment protocol for some common medical conditions. Key Words: Medically Compromised; Orthodontic patients; Treatment protocol DOI: 10.3126/ajms.v1i2.2937Asian Journal of Medical Sciences 1 (2010) 68-74

Imaging and laboratory test are vital components for accurate diagnosis of any medical condition. In the current scenario, computerized tomography and magnetic resonance imaging (MRI) have dominated the field of imaging. Although much is spoken and written about the radiation hazards of computerized tomography, safety aspect of MRI hardly receives any importance. A recent accident involving a diagnostic MRI unit in Mumbai highlights the importance of safety aspects being neglected in MRI. The authors of this article have made an attempt to highlight the facts about MRI-related fatal accidents and briefly review the safety protocol and procedures.

Objectives: The objective was to estimate the level of alkaline phosphatase (ALP) in gingival crevicular fluid (GCF) during en-masse retraction stage of orthodontic tooth movement. Materials and Methods: 10 patients in the age group of 15-20 years participated in this study. GCF was sampled from the distal surface of the canine and mesial surface of the second premolar on day 0, 1, 7, 14, 21, and 28 postorthodontic treatment. Results: A marked fall in the level of ALP was evident following force application. A progressive decreasing trend in ALP activity on both distal aspect of canine and mesial aspect of the second premolar was observed. The fall in ALP was more on distal aspect canine when compared to the mesial aspect of the second premolar. Conclusions: Measure of ALP activity in GCF could be an indicator of the biochemical and cellular alterations in bone turnover and hence rate the amount of tooth movement following orthodontic force application.

Introduction: The main reason for seeking orthodontic treatment for Class II malocclusions is aesthetic improvement. Growth modification treatment procedures offer better results for a patient with significant potential growth. Aim: The aim of this cephalometric clinical study was to distinguish skeletal and dental corrections on skeletal class II division I growing subjects with Twin Block therapy (TB) and the changes were assessed using SO-analysis by Pancherz. Materials and Methods: Strict diagnostic protocol viz. growing individuals with horizontal growth pattern, skeletal class II due to retrognathic mandible with positive VTO, bilateral class II molar relation, minimal crowding in either arch or overjet more than 5mm was used. Out of 28 selected cases,17 patients received TB therapy and 11 patients were maintained as control group. Standard removable TB appliances with lower incisor capping were delivered to treatment group. The horizontal advancement was about 8mm and 2-3mm vertical opening between the upper and lower central incisors were maintained for all the cases. The mean time interval between the initial (T1)and post treatment (T2) cephalograms of Twin-Block group was 11 month,with a range of 8 month to 13 month. In the control group, the mean time interval between the first (C1)and second (C2) cephalometric films was 12 month,with a range of 10 month to 14 month. T1and T2 cephalograms were traced and S-O analysis was used to segregate dental and skeletal effects. Statistical Analysis: SPSS software was used for statistical analysis. Results: Skeletal Changes: In this study, the mean movement of maxilla was 0.67mm which represents significant restriction of forward maxillary growth in contrast to control groups. Dental Changes: In this study the maxillary molars appear to move distally with a mean value of 0.13mm. Comparing this to the movement of maxillary jaw base itself, maxillary distal movement of molar is less. But still it contributes to Class II correction. Conclusion: The overjet reduction and molar relation correction are more skeletal in nature.