Dental Research Journal
Volume:9 Issue: 6, Nov 2012

Periodontal disease is now increasingly believed to play a significant part in various systemic conditions. Likewise these systemic diseases and their severity have been found to have an impact on the morbidity of periodontal disease. A number of mechanisms specific to such interlink have been proposed and later established in numerous studies. The disorders with such bidirectional link with periodontal disease include cardiovascular, respiratory, neurological, and connective tissue diseases. The periodontal – systemic interlink has a vibrant effect on the management aspects and is of paramount topical interest to clinicians. We review the pertaining literature (Google scholar and pubmed).

Clinical audit is a quality improvement process that aims to improve patient care through a systematic review of care against explicit criteria. It is a cyclic and multidisciplinary process which involves a series of steps from planning the audit through measuring the performance to implementing and sustaining the change. Although audit contains some facets of research, it is essential to understand the difference between the two. Auditing can be done right from the record maintaining, diagnosis and treatment and postoperative evaluation and follow‑up. The immense potential of clinical audit can be utilized only when open‑mindedness and innovativeness are encouraged and evidence‑based work culture is cultivated.

Periodontal disease is a major public health issue and the development of effective therapies to treat the disease and regenerate periodontal tissue is an important goal of today’s medicine. Regeneration of periodontal tissue is perhaps one of the most complex process to occur in the body. Langer and colleagues proposed tissue engineering as a possible technique for regenerating the lost periodontal tissues. Tissue engineering is a multidisciplinary field, which involves the application of the principles and methods of engineering and life sciences to help in the development of biological substitutes to restore, maintain or improve the function of damaged tissues and organs. A Google/Medline search was conducted and relevant literature evaluating the potential role of the tissue engineering in periodontal regeneration, which included histological studies and controlled clinical trials, was reviewed. A comprehensive search was designed. The articles were independently screened for eligibility. Articles with authentic controls and proper randomization and pertaining specifically to their role in periodontal regeneration were included. The available literature was analyzed and compiled. The analysis indicate tissue engineering to be a promising, as well as an effective novel approach to reconstruct and engineer the periodontal apparatus. Here, we represent several articles, as well as recent texts that make up a special and an in‑depth review on the subject. The purpose behind writing this brief review has been to integrate the evidence of research related to tissue engineering so as to implement them in our daily practice.

Based on the previous national oral health survey in India, some variation was observed in oral health status and behavior between the urban and rural population. Thus, the present study aimed to assess the dental caries experience in deciduous dentition of 6‑year‑old urban and rural schoolchildren of Udaipur district and to evaluate the influence of socio behavioral characteristics on dental caries experience. A combination of multi stage and cluster sampling procedure was executed to collect a representative sample of 875, 6‑year‑old school children. Clinical examination for caries was conducted using dmft (decayed, missing and filled teeth) index. Socio ‑ demographic information was collected prior to clinical examination in addition to information on oral health behavior by personal interviews. Only 7.8% children reported of brushing their teeth twice or more than twice daily. Rural children visited the dentist less often than the urban children (P < 0.05). Greater proportion of boys (62.2%) experienced caries than girls (55.1%), decayed component constituted a major contribution for dmft. Multivariate analysis demonstrated the influence of gender, urbanization, tooth brushing frequency, dental visits, parent’s education and occupation on caries occurrence. Rural children and boys experienced greater caries than their urban and girl counterparts. Caries experience was related to the parent’s occupation and education. Moreover, caries occurrence was influenced by brushing frequency and dental visiting habits.

Due to high prevalence of tuberculosis (TB) in India, presence of Mycobacterium tuberculosis in oral samples might influence the periodontal status of patients and also might pose a risk of transmission of TB during dental procedures through aerosols. Hence, this study aims to compare the periodontal status between TB and non‑TB patients and to detect the presence of M. tuberculosis in plaque and saliva of TB and non‑TB patients. A total of 25 TB and 25 non‑TB systemically healthy patients (age 21-49 years) were selected for this Clinico‑Microbiological study. The oral hygiene and periodontal status of the patients were measured by using clinical indices and were compared using Mann–Whitney test (P < 0.05 = Significant). Pooled plaque and unstimulated salivary samples were collected and subjected to microbiological evaluation of M. tuberculosis by nested polymerase chain reaction. The detection rates were compared using Chi‑square test (P < 0.001 = Highly significant). No significant difference was observed in periodontal clinical parameters measured between the groups. M. tuberculosis was detected in 92% of saliva and 68% of plaque samples of tuberculosis group, and even in 12% of saliva samples in nontuberculosis group patients. The TB status of the patient did not influence the periodontal status. However, the presence of M. tuberculosis in plaque and saliva as detected in this study might pose a grave risk of transmission of the disease through aerosols during dental procedures.

Chitosan compounds have been shown to be suitable bone replacement materials. To evaluate the accelerating effects of chitosan on the bone regeneration process and assessing its histopathological adverse effects, we conducted this study on rat tibias. In a laboratory experimental study, micro‑drilled bone defects were created in the upper tibia of each leg in 15 adult male rats. The defect in the right leg, filled by the chitosan powder, was compared with the untreated defect in the left leg in each rat at 1, 2, and 4 weeks after surgery. Bone repair and inflammation in each specimen was blindly graded by a pathologist. Reaction to the foreign body and the amount of the remaining chitosan were studied in chitosan‑treated specimens at the three stages of the study. Statistical analysis was performed using Fisher’s exact test and kappa test. A P value less than 0.05 was considered as significant. Bone repair was significantly faster in the chitosan group, 1 week (P = 0.01) and 4 weeks (P = 0.038) after surgery, while the difference was not significant at the 2‑week stage (P = 0.197) between chitosan and control groups. Chitosan‑induced inflammation was not significant in any stage of the study. Reaction to the foreign body was seen in one case at 2 weeks and one case at 4 weeks postoperation. Chitosan significantly accelerated the bone regeneration process in rat tibias. Regarding its biocompatibility and osteoinductivity, it can be studied as a biomaterial in human bone healing.

An appropriate bond between glass‑ionomer and the superficial resin materials is very important for the success of sandwich technique. The aim of the present in vitro study was to evaluate the effect of three surface treatments of conventional glass‑ionomer on its shear bond strength to giomer. Sixty cylindrical specimens of a conventional glass‑ionomer (GC Fuji II) were prepared and randomly divided into three groups (n = 20). The specimens in groups 1 and 2 were treated with total‑etch adhesive resin (Single Bond) along with acid etching, and self‑etch adhesive resin (FL‑Bond II) on the set glass‑ionomer, respectively. Specimens in group 3 were treated with self‑etch adhesive resin (FL‑Bond II) before initial setting of the glass‑ionomer was complete. Then a giomer restorative (Beautifil II) was added to the specimens. Subsequent to thermocycling, the specimens were subjected to shear bond strength test. Failure modes were evaluated under a stereomicroscope. Data were analyzed by one‑way analysis of variance and a post hoc Tukey test at a significance level of P < 0.05. There were statistically significant differences in bond strengths between the groups (P < 0.0005). Differences in bond strengths between group 2 and other groups were significant (P < 0.0005) while the differences between groups 1 and 3 were not significant. Failures were predominantly of the cohesive type in all the groups. Based on the results of this study, the use of self‑etch adhesive resin (FL‑Bond II) on the set glass‑ionomer yielded the highest bond strength in the glass‑ionomer/giomer sandwich technique.

This study was to evaluate the effects of calcium hydroxide premedication on the marginal adaptation of the calcium‑enriched mixture (CEM) cement as an apical plug. In this in vitro study, forty single rooted teeth were prepared and apical portion of the roots were immersed in sulfuric acid to produce open apices. The teeth were divided into 2 experimental groups. In medicated group, calcium hydroxide was placed in all canals for 1 week and in non‑medicated group no dressing was used. Then, a 4‑mm apical plug of CEM cement was placed in canals; each root was prepared for observation using scanning electron microscope and the maximum distance between CEM cement and surrounding dentin was measured. The data were analyzed by t‑test, and significance level was set at a = 0.05. The mean width of gap in medicated and non‑medicated groups was 158/1 μm and 147/1 μm, respectively. There was no significant difference between the two groups (P > 0.05). Calcium hydroxide premedication had no adverse effect on the marginal adaptation of CEM cement apical plug.

Dental caries among preschool children is still a major public health problem in many developing countries including India. Hence the aim of the present study was to find out the prevalence of Early Childhood Caries among 3-5 year old pre‑schoolers in schools of Marathahalli, Bangalore. A cross sectional study was conducted on 717 pre‑schoolers in 6 schools of Marathahalli. Clinical examination was performed and deft index was recorded using Gruebell’s criteria. Early Childhood Caries was diagnosed using Early Childhood Caries Diagnostic Criteria, consistent with the NIDCR workshop statement. Data was analysed using SPSS 15.0 and descriptive statistics was applied. Chi‑square test was used to find out the significant differences. The level of significance was taken at P value < 0.05. Prevalence of early childhood caries was 40% with a mean deft of 1.89 (+3.3) and Significant Caries Index score was 5.51. 44.8% of 3 year old had Early Childhood Caries, 35% of 4 year old children and 41% of 5 year old had Early Childhood Caries. Almost, all of deft was due to untreated caries. The results of the present study calls for a need to focus on pre‑schoolers’ oral health and parental education for prevention and early detection of Early Childhood Caries. A high Significant Caries Index in this study population indicates a more targeted approach for high risk pre‑schoolers.

Iron deficiency is estimated to be the most common nutritional deficiency in both developed and underdeveloped nations. Iron supplements at early age may prevent iron deficiency. The aim of this study was to assess the knowledge and management of parents about using iron supplements related to dental caries and staining among Iranian children (6 months to 2 year‑old) and to identify some factors underlying these attitudes. This randomized cross sectional study was carried out on the parents of 220 children (6 months to 2‑year‑old) evaluated in health services centers in Mashhad in 2008. Parents filled questionnaires assessing their opinions on the risk of using iron supplement on tooth staining and dental caries. The results were statistically analyzed by descriptive‑analytical, Mann Whitney and Kruscal Wallis tests. According to this study the relation between iron supplement application with tooth staining and its effect on dental caries, it must be noted that most parents (82.7%) had a moderate range of knowledge. Major of the parents (72.7%) had a moderate level of behavior. There was a significant difference between the knowledge level of fathers with their level of education (P = 0.01). The finding of this study indicates that parental knowledge about consumption of iron supplements by their children (6 months to 2‑year‑old) has been moderate. But their behavior was poor and needs more attention.

One of the factors that dissuade patients needing tooth replacement from choosing dental implants is the prohibitive cost. Willingness to pay (WTP) is a useful tool to determine the ideal cost of an expensive procedure. The aim of this study was to study the factors that influence the willingness to pay (WTP) among patients attending a private clinic and compare them to those attending a government setup. A total of 100 patients (38 male, 62 female) who had one or more missing teeth were presented with different cost‑benefit scenarios and then asked if they were willing to pay the median cost of a single implant in Riyadh city. The mean WTP price was compared using the one way‑ANOVA, factors which could possibly influence patients’ WTP were grouped together in a Binomial logistic regression model. Of the 100 individuals surveyed 67% said they would be willing to pay the median price for the placement of an implant. A comparison of socio‑demographic factors showed that significant differences were found between gender, income groups and setting of the clinic in the mean WTP price of the patients (P < 0.05). We also found that there was a significant difference in the mean WTP price between groups with regard to the area of the missing tooth, the patients’ perception of their oral health and the their desire to want an implant (P < 0.05). The majority of the patients surveyed were willing to pay the median price for an implant. Willingness to pay (WTP) is a multifactorial variable which is significantly influenced by the income of the patient, the setting of the clinic and the gender; the most significant factor being the acceptability of the implant to the patient.

The aim of this study was to record the relative frequency of odontogenic tumors (OTs), evaluate and analyze the epidemiological features of the lesions in patients referring to dental faculty of Isfahan and compare these data with previous studies. In this study, we reviewed the records of 6,860 lesions from 1988 to 2010 archived in the oral pathology department of dental faculty of Isfahan retrospectively and using criteria for histological typification published by the WHO in 2005. Age, sex, site and extent of tumors were analyzed. Among recorded lesions 260 were OTs (3.79%). Of these, 259 were benign and just 1 was malignant. The most common lesions were ameloblastomas (n = 95) followed by odontomas (n = 86), odontogenic myxomas (n = 24) and others. There were a few more female patients (n = 133, 51.15%) than male and the mean age of patients was 27.8 years (range 1.5-80 years). The posterior of mandible was the most common site (n = 86, 33%). According to accumulated data, odontogenic tumors are uncommon lesions and malignant tumors are very rare.

Oral health is an integral component of pre‑school health and well‑being. Unfortunately, many children are afflicted with dental caries at an early age, even those as young as 12 months of age. The purpose of this study is to determine the association between Early Childhood Caries (ECC), Streptococcus mutans and genetic sensitivity levels to the bitter taste of, PROP among the children below 71 months of age. Total of 119 children belonging to the age group of 36 to 71 months of both sexes, were recruited from A. J. Institute of Dental Sciences, Mangalore (Karnataka). PROP sensitivity test was carried out to determine the inherent genetic ability to taste a bitter or sweet substance. One who tasted bitter as taster and one who was not able to differentiate/tasted like paper as non‑tasters. Facial expression was observed during the tasting to support the verbal response. Estimation of S. mutans level and caries experience was recorded. The results were statistically analyzed using Mann’Whiteney‑U Test and Kruskal value test. In the total of 119 children, the mean DMFS was definitely higher in non‑taster children compared to tasters and also had a high S. mutans level. Tasters had low ECC experience, low S. mutans level. The tasters had a mean DMFS value of 9.5120 (S.D. 7.0543) and non‑tasters had a value of 7.7250 (S.D. 8.33147), which was statistically significant. Children who had higher level S. mutans had ECC and were non tasters. The PROP sensitivity test (filter paper test) proved to be a useful diagnostic tool in determining the genetic sensitivity levels of bitter taste. Age and low socio‑economic status of pre‑school children suggest a complex multifactorial relationship between S. mutans colonization, ECC and taste perception.

Adequate polymerization of resin composites could be considered as a crucial factor in obtaining good clinical performance, particularly in stress‑bearing areas. An insufficient curing degree affects the resin composite’s chemical properties The current in vitro study evaluated the influence of polymerization time and depth of cure of six commercial resin composites by Vickers microhardness (VK). Six resin composites were selected: Three microhybrid (Esthet.X HD, Amaris, Filtek Silorane), two nanohybrid (Grandio, Ceram.X mono), and one nanofilled (Filtek Supreme XT). The VK of the surface was determined by a microhardness tester using a Vickers diamond indenter and a 200 g load applied for 15 s. The bottom to top mean VK ratio was calculated using the formula: Hardness ratio = VK of bottom surface/VK of top surface. Vickers hardness values of test materials during exposure time of 20 and 40 s and depths of cure of 2 and 3 mm were determined and compared. Data were analyzed using analysis of variance (ANOVA) test. For all the tested materials and with all the exposure time periods, hardness ratio was higher than the minimum value indicated in literature (0.8). Exposure time and depth of cure did not affect hardness ratio values for Filtek Silorane, Grandio, and Filtek Supreme XT. Among the materials tested, the nanofilled and the nanohybrid resin composites were rather insensible to thickness variations. Miicrohybrid composites, instead, had features different from one another.

Available restorative space and bar height is an important factor in stress distribution of implant‑supported overdentures. The purpose of this study was to evaluate the effect of different vertical restorative spaces and different bar heights on the stress distribution around implants by 3D finite element analysis. 3D finite element models were developed from mandibular overdentures with two implants in the interforaminal region. In these models, four different bar heights from gingival crest (0.5, 1, 1.5, 2 mm) with 15 mm occlusal plane height and three different occlusal plane heights from gingival crest (9, 12, 15 mm) with 2 mm bar height were analyzed. A vertical unilateral and a bilateral load of 150 N were applied to the central occlusal fossa of the first molar and the stress of bone around implant was analyzed by finite element analysis. By increasing vertical restorative space, the maximum stress values around implants were found to be decreased in unilateral loading models but slightly increased in bilateral loading cases. By increasing bar height from gingival crest, the maximum stress values around implants were found to be increased in unilateral loading models but slightly decreased in bilateral loading cases. In unilateral loading models, maximum stress was found in a model with 9 mm occlusal plane height and 1.5 mm bar height (6.254 MPa), but in bilateral loading cases, maximum stress was found in a model with 15 mm occlusal plane height and 0.5 mm bar height (3.482 MPa). The reduction of bar height and increase in the thickness of acrylic resin base in implant‑supported overdentures are biomechanically favorable and may result in less stress in periimplant bone.

Family violence, including child abuse, neglect, and domestic violence, is a public health problem. The aim of this study was to provide data on prevalence and factors of Orofacial lesions relating child abuse in Iran to lend evidence to support preventing child abuse. The overall approach was a case‑note review of children having child abuse note, recording by personnel of social services. Research ethical approval was sought from the Central social service organization. This study was conducted in Isfahan, Iran (2011). The mean age of children, when abuse had been occurred was 8 years (SD = 1.68), and there were approximately an equal number of boys and girls. Children had a high physical experience (66.1%).Of these children, at least 60% sustained trauma to the face and mouth. Emotional abuse was 77.1%, neglect was 64.1%, and lower experience of sexual abuse which was 4.1%. There was a strong relationship between gender and abuser which shows girls have been affected by stepfathers (P = 0.001). Preliminary data suggest that there are strong evidence regarding the incidence of child abuse relating orofacial lesions which dentists should be aware of them. Future trials may draw on these useful baseline data to help their study design.

Osteoclastogenesis is coordinated by the interaction of three members of the tumor necrosis factor (TNF) superfamily: Osteoprotegerin (OPG)/receptor activator of nuclear factor kappa B ligand (RANKL)/receptor activator of nuclear factor kappa B (RANK). The aim of this study was to investigate RANKL and OPG levels, and their relative ratio in gingival crevicular fluid (GCF) of patients with chronic and aggressive periodontitis, as well as healthy controls. In this analytical study, GCF was obtained from healthy (n = 10), mild chronic periodontitis (n = 18), moderate chronic periodontitis (n = 18), severe chronic periodontitis (n = 20), and generalized aggressive periodontitis (n = 20) subjects. RANKL and OPG concentrations were measured by enzyme‑linked immunosorbent assay. Statistical tests used were Kruskal–Wallis test, Mann–Whitney U rank sum test, and Spearman’s rank correlation analysis. The level of statistical significance was set at P < 0.05. Mean RANKL concentration showed no statistically significant differences between groups (P = 0.58). There were also no significant differences between mean OPG concentration in the five groups (P = 0.0.56). Moreover, relative RANKL/OPG ratio did not reveal a significant difference between the three study group subjects: healthy, chronic periodontitis (mild, moderate, severe), and aggressive periodontitis (P = 0.41). There was statistically significant correlation between the concentration of sRANKL and Clinical Attachment Level (CAL) in moderate chronic periodontitis patients (R = 0.48, P = 0.04). There was also negative correlation between OPG concentration and CAL in moderate chronic periodontitis patients, although not significant (R = –0.13). RANKL was prominent in periodontitis sites, especially in moderate periodontitis patients, whereas OPG was not detectable in some diseased sites with bleeding on probing, supporting the role of these two molecules in the bone loss developed in this disease.

Alveolar ridge preservation following tooth extraction has the ability to maintain the ridge dimensions and allow the implant placement in an ideal position fulfilling both functional and aesthetic results. The aim of this study was to evaluate the efficacy of the palatal connective tissue as a biological membrane for socket preservation with demineralized freeze‑dried bone allograft (DFDBA). Twelve extraction sites were treated with DFDBA with (case group) and without (control group) using autogenous palatal connective tissue membrane before placement of implants. Alveolar width and height, amount of keratinized tissue, and gingival level were measured at pre‑determined points using a surgical stent at two times, the time of socket preservation surgery and 4 months later during implantation. The significance level was set at 0.05. In both groups a decrease in all socket dimensions was found. The average decrease in socket width, height, keratinized tissue, and gingival level in case group was 1.16, 0.72, 3.58, and 1.27 mm, and in control group was 2.08, 0.86, 4.52, and 1.58 mm respectively. Statistical analysis showed that decrease in socket width (P = 0.012), keratinized tissue (P ≤ 0.001), and gingival level (P = 0.031) in case group was significantly lower than that of the control group. Results showed no meaningful difference in socket height changes when compared with case and control groups (P = 0.148). Under the limits of this study, connective tissue membrane could preserve socket width, amount of keratinized tissue, and the gingival level more effectively than DFDBA alone.

The effect of framework design modifications in all‑ceramic systems is not fully understood. The aim of this investigation was to evaluate the effect of different framework designs on fracture resistance of zirconium oxide posterior fixed partial dentures (FPD). Thirty two posterior zirconia FPD cores were manufactured to replace a second premolar. The specimens were divided into four groups; I: 3 × 3 connector and standard design, II: 3 × 3 connector and modified design, III: 4 × 4 connector dimension, and standard design and IV: 4 × 4 connector dimension and modified design. After storing for one week in artificial saliva and thermocycling (2000 cycles, 5-55°C), the specimens were loaded in a universal testing machine at a constant cross‑head speed of 0.5 mm/min until failure occurred. The Weibull, Kruskal-Wallis, and Mann-Whitney tests were used for statistical analysis (α = 0.05). The mean fracture resistance of groups with 4 × 4 mm connector was significantly higher than groups with 3 × 3 mm connector (P < 0.001). Although, the fracture resistance of the modified frameworks was increased in the present study (1.1 times), they were not significantly different from anatomic specimens (P = 0.327). The fracture resistance of the zirconia posterior‑fixed partial dentures was significantly affected by the connector size; it was not affected by the framework modification.

Several studies have hypothesized that periodontal diseases may increase the risk of preeclampsia. The purpose of this study was to compare periodontal parameters in preeclamptic and normotensive pregnant women 48 hours after delivery. A case‑control study was carried out on 26 pure preeclamptic women and 25 women with normal pregnancy. The participants did not have any systemic disease that may affect both preeclampsia and periodontal conditions. Clinical parameters measured in case and control groups include attachment loss, gingival bleeding index, and plaque index. These indices were measured in all teeth except the third molars. The data from each subject were reported in mean and finally the average amount of each group was compared to others and analyzed using SPSS software, t‑test, and Mann‑Whitney test. Mean of gestational age at delivery in preeclamptic and normotensive groups was respectively 33.2 ± 3.89 weeks and 36.5 ± 3.08 weeks. A significant difference was observed in preeclamptic women compared to controls (P = 0.01). There were no statistical differences between groups with regard to mean clinical attachment loss (P = 0.16), mean gingival bleeding (P = 0.89), and mean plaque (P = 0.95) indices. The present study showed that maternal periodontal diseases during pregnancy are not associated with preeclampsia.

Initial research indicated that higher concentration of osteoprotegerin (OPG) is associated with healthy periodontium (protective) and its concentration decreases as the periodontal disease progresses. However, till date, there are no studies to investigate the levels of OPG in gingival crevicular fluid (GCF) after the treatment of periodontitis. Hence, the present study was carried out to assess its concentration in GCF to find out their association if any, and to explore its possible use as a ‘novel bone marker’ of the host modulation of periodontal disease. Sixty‑four subjects were divided into 4 groups (16 each), based on clinical attachment loss (CAL) and radiological parameters (bone loss); healthy (group I), gingivitis (group II), slight periodontitis (group III), and moderate‑to‑severe periodontitis (group IV). Moderate‑to‑severe periodontitis subjects, after nonsurgical periodontal treatment, (SRP) constituted group V. GCF samples were collected to estimate the levels of OPG using enzyme‑linked immunosorbent assay (ELISA). The Kruskal‑Wallis, Man‑Whitney U test, and Wilcoxon signed‑rank tests were carried out to compare OPG levels among groups. The Spearman rank correlation test was used to correlate OPG levels between the study groups and the clinical parameters; P < 0.05 was considered significant. The highest mean OPG concentration in GCF was obtained for group I (162.47 ± 51.171 pg/ μL) and the least for group IV (10.92 ± 1.913 pg/μL), suggesting a negative correlation between OPG concentration and CAL. OPG concentrations in GCF after the treatment of group IV increased from 10.92 ± 1.913 pg/μL to 15.63 ± 4.679 pg/μL. OPG concentration in GCF was inversely proportional to CAL and not an active progression factor for periodontal disease. Further, after the treatment of moderate‑to‑severe periodontitis subjects (group IV), OPG concentrations increased. Hence, it can be concluded that OPG could be considered as a ''novel bone marker'' the host modulation of periodontal disease.

Different surgical procedures that reduce orthodontic treatment time have been recommended. The aim of this study was to evaluate the effectiveness of a new less invasive surgical technique (called flapless bur decortications) for accelerating orthodontic tooth movement. This study was designed as a split‑mouth study. The left and right maxillary first premolars of five dogs were extracted. An A‑NiTi closed coil spring and an absolute anchorage was used for premolar protraction in both sides. In each dog, decortications were performed for one side and the other side was used as the control group. The distance between canine and second premolar was measured and the sites of decortication were evaluated histologically. The data was analyzed by paired samples t‑test and multivariate analysis of two‑way repeated measures ANOVA. The study teeth moved more than their controls in the first month and less than their controls in the third month (P < 0.05). The total difference between study and control movements was not significant (P < 0.05). (1) Corticotomy facilitated orthodontic tooth movement is achievable with flapless bur decortication technique. (2) Velocity of tooth movement decreases in later stages of treatment due to maturation of newly formed bone at decortication sites.

The purpose of this study was to perform a histological, histomorphometrical, and immunohistochemical evaluation of the effect of Enamel matrix derivative (EMD) on bone formation around titanium dental implant. In this animal study, 12 implants (10 × 3.8 mm) were inserted in the tibia bone of three dogs of Iranian breed. Two implants were placed in each tibia with EMD only on the left side. The dogs were sacrificed 2, 4, and 6 weeks after implantation. Following decalcification of the implants’ surrounding tissue and preparation of 4 μm thick sections, they were stained with hematoxylin and eosin (H and E) and immunohistochemical (IHC) stain for osteopontin (OPN) marker. Histomorphometric evaluation was performed via measurement of the percentage of the woven, lamellar, and total generated bone. Light microscopy osteoblastic intensity of OPN in osteoblasts and bone matrix was also evaluated Data were analyzed by Wilcoxon signed Ranks, and Mc Nemar tests. In both control and EMD‑applied groups, bone formation was recognized around the implants at the 4th week postimplantation. The percentage of total generated bone in the test group was higher than the control group, although being not statistically significant (P value = 0.917).Osteoclasts exhibited significantly higher proliferation activity compared the control group when stimulated by EMD (P value = 0.027). On average, the staining intensity in osteoblasts and extracellular matrix of bone, in EMD‑applied subjects was higher than those of the controls (P value = 0.167 and P value = 0.414, respectively). EMD enhanced bone formation around dental implants, but this increase was not significant.

Paramolar is a supernumerary molar usually small and rudimentary, most commonly situated buccally or palatally to one of the maxillary molars. Paramolar is a developmental anomaly and has been argued to arise from a combination of genetic and environmental factors. Reports of this entity are rarely found in the dental literature. This article presents a case report of an unusual occurrence of a paramolar in the maxilla in otherwise a healthy individual. In addition, literature review, prevalence, classification, etiology, complications, diagnosis, and therapeutic strategies that may be adopted when supernumeraries occurs have been discussed.

Tuberculosis (TB) of the hard palate is rare and usually secondary to pulmonary TB. We present a case of a 7‑year‑old boy who presented with difficulty in swallowing solid foods, low‑grade fever and loss of weight. Oral cavity examination showed perforation of the hard palate with an irregular, undermined margin and a necrotic base. Chest X‑ray showed homogeneous opacity in the right upper zone. Fine‑needle aspiration of the cervical lymph nodes showed granular caseous necrosis and granuloma composed of epitheliod cells and histiocytes. In view of the clinical presentation and evidence of pulmonary and lymph node TB, the palatal perforation was most likely due to TB. Patient was started on antituberculous therapy and is on regular follow‑up.

Temporomandibular joint and the pelvic complex are bidirectionally related. Ankylosing spondylitis (AS) is a seronegative arthropathy with the key feature of bony fusion of lumbar vertebrae. A 39 year old known case of AS was presented to private office for left lower impacted third molar surgical removal. Previously, he was rejected to receive oral care for pulpectomy and extraction due to limited mouth opening. Prior to the surgery, lateral neck radiography was obtained to exclude any subluxation of fracture of cervical vertebrae. Neck was supported to insure neck stability during surgical forces. In addition, considering consumption of immunosuppressive medications including corticosteroids, procedure was performed with a great care, with attention to higher possibility of infection and fracture. Access to the surgical site was not desirable, though surgery accomplished without any significant event and the patient discharged with routine analgesic and antibiotics recommendation. Sometimes, impaired access to the oral cavity in patients with AS leads to receive suboptimal or minimal orodental care. Long list of dental implications in these patients may be simplified by considering of careful neck and jaw support, applying at least possible forces and great attention to the infection control rules. It is wised to be performed under patient and skilled hands.

A pulse granuloma is nothing but a reaction of the foreign body to any vegetable which is characterized by a collection of the hyaline; a hyaline is a transparent substance that is formed from the pathological degeneration of the tissue. These granulomatous rings may be oral or extra‑oral. It is important to recognize such a type of granuloma because it may resemble serious pathological processes or may clinically stimulate neoplasia. It might also be confused morphologically with hyaline vasculopathy. The following manuscript presents a rare case of oral pulse granuloma. As going by the literature‑search, the following being the only case to have been occurred in a pediatric patient. The authors therefore aim to bring awareness amongst the pediatric dentists about its etiology, occurrence, clinical features and thereby management of the same.

Plasma cell granuloma, also known as inflammatory pseudotumor is a tumor‑like lesion that manifests primarily in the lungs. But it may occur in various other anatomic locations like orbit, head and neck, liver and rarely in the oral cavity. We here report an exceedingly rare case of gingival plasma cell granuloma in a 58 year old woman who presented with upper gingival polypoidal growth. The histopathological examination revealed a mass composed of proliferation of benign spindle mesenchymal cells in a loose myxoid and fibrocollagenous stroma along with dense infiltrate of chronic inflammatory cells predominantly containing plasma cells. Immunohistochemistry for kappa and lambda light chains showed a polyclonal staining pattern confirming a diagnosis of plasma cell granuloma.

Eosinophilic granuloma is a rare disease which is difficult to diagnose clinically and radiographically. Localized Langerhans’ cell histiocytosis, previously known as eosinophilic granuloma, mainly affects the skull, mandible, vertebrae, pelvis and ribs in children and the long bones of adults. We present a case report of a female who developed pain and swelling over the left mandibular region, and was later diagnosed as eosinophilic granuloma, which after administration of intralesional corticosteroid with surgical enucleation showed positive response. This disease is of importance to dental professionals because early clinical signs can occur in the jaw and can cause extensive destruction of the periodontal tissues and bone. The purpose of this case report is to describe a case of eosinophilic granuloma with emphasis on conservative approach for the treatment and the radiographic changes observed during and after the treatment.