Asian Journal of Dental Sciences

Survey Questionnaire: Perio-Esthetics in Periodontology of PG Students Perspectives

2026-01-13T09:40:26+00:00

Background: Periodontal esthetics has become an essential component of modern periodontology, reflecting a shift toward patient-centered care that emphasizes both functional and esthetic outcomes. Despite increasing demand for esthetic periodontal procedures, challenges related to patient awareness, cost, and training exposure may influence their adoption in routine practice. Understanding postgraduate students’ perspectives is crucial for identifying educational gaps and future directions in perio-esthetics.

Aim: To assess the perceptions of postgraduate students in Periodontology regarding challenges in patient motivation, adequacy of training resources, clinical confidence in perio-esthetic procedures, and views on the present and future scope of perio-esthetics in India.

Materials and Methods: A cross-sectional, questionnaire-based survey was conducted among 114 postgraduate students in Periodontology across multiple dental institutions in India. A validated, self-administered questionnaire comprising 10 close-ended questions evaluated patient-related challenges, procedural confidence, training adequacy, preferred learning resources, advanced technologies, cost-effectiveness, and future outlook. Data were analyzed using SPSS version 27. Descriptive statistics were calculated, and chi-square tests were applied to assess the distribution of responses, with p < 0.05 considered statistically significant.

Results: Lack of patient awareness (48.2%) and high treatment cost (29.8%) were identified as the major barriers to patient acceptance. Crown lengthening was the procedure in which students reported the highest confidence, while confidence in advanced soft tissue grafting was limited. Training resources were perceived as inconsistently sufficient across institutions. Most respondents anticipated moderate to high growth of perio-esthetics in India over the next decade, with lasers and microsurgical instruments considered the most useful advanced technologies.

Conclusion: Postgraduate students perceive perio-esthetics as a promising and expanding domain within periodontology; however, limited patient awareness, economic constraints, and variable training exposure hinder its optimal clinical integration. Strengthening postgraduate training, enhancing patient education, and emphasizing cost-effective approaches may improve the adoption and outcomes of perio-esthetic care in India.

Effectiveness of 980 nm Diode Laser in Enhancing Periodontal Treatment Outcomes in Tobacco Users: A Randomized Controlled Trial

2026-01-19T09:39:59+00:00

Background: Periodontal disease is a significant public health concern influenced by multiple local and systemic risk factors. Tobacco chewing adversely affects periodontal tissues by altering inflammatory responses and impairing healing, which may compromise outcomes of conventional non-surgical therapy. Scaling and root planing (SRP) remains the standard treatment for periodontitis; however, adjunctive diode laser therapy using Laser-Assisted New Attachment Procedure (LANAP) has been proposed to enhance clinical outcomes. Evidence regarding its effectiveness in tobacco chewers with Stage II Grade B periodontitis is limited.

Materials and Methods: This randomized split-mouth clinical study included eight tobacco chewers aged 30–60 years diagnosed with Stage II Grade B periodontitis. Each participant received SRP alone in one quadrant and SRP followed by LANAP using a 980-nm diode laser in another quadrant. Clinical parameters assessed were Plaque Index, Gingival Index, Probing Pocket Depth, Clinical Attachment Level, Sulcus Bleeding Index, and the Fagerström Nicotine Dependence Scale for Smokeless Tobacco. Measurements were recorded at baseline, one month, and three months post-treatment. Statistical analysis was performed using paired tests with significance set at p < 0.05.

Results: Both treatment modalities showed significant improvements in plaque accumulation, gingival inflammation, bleeding scores, probing depth, and attachment levels over three months. Adjunctive diode laser therapy demonstrated superior outcomes.

Conclusion: Within study limitations, adjunctive 980-nm diode laser therapy with SRP provides additional clinical benefits over SRP alone for managing Stage II Grade B periodontitis among tobacco chewers. Larger studies with longer follow-up are recommended, clinically meaningful.

Revolutionizing Root Biomodification: SEM Insights into Glycolic Acid Vs. EDTA

2026-02-03T12:34:49+00:00

Background: Mechanical instrumentation of periodontally diseased root surfaces results in the formation of a smear layer containing organic debris and microorganisms, which may interfere with periodontal regeneration. Root biomodification (RB) aims to remove this smear layer and enhance the biologic compatibility of the root surface.

Aim: To evaluate and compare the effectiveness of 5% and 10% glycolic acid (GA) with 17% ethylenediaminetetraacetic acid (EDTA) on smear layer removal, dentinal tubule surface characteristics, and dentinal erosion on periodontally affected root surfaces using scanning electron microscopy (SEM).

Materials and Methods: Thirty extracted periodontally affected human teeth were used to prepare 60 root specimens, which were randomly allocated into four groups: Group I (control), Group II (5% GA), Group III (10% GA), and Group IV (17% EDTA). Root biomodification agents were applied for 3 minutes using active burnishing. SEM analysis at ×2000 magnification was performed to assess smear layer removal, dentinal tubule surface area, and dentinal erosion using a standardized scoring system. Statistical analysis was carried out using one-way ANOVA with post-hoc analysis, and p < 0.05 was considered statistically significant.

Results: The 5% GA group showed the highest smear layer removal score (3.86 ± 0.66), followed by 10% GA (3.14 ± 0.66) and 17% EDTA (2.43 ± 0.51), with significant intergroup differences (p < 0.001). Dentinal tubule surface area was significantly greater in the 5% GA group (45.7%). Dentinal erosion was observed only in the 10% GA group.

Conclusion: Within the limitations of the study, 5% glycolic acid demonstrated superior smear layer removal and increased dentinal tubule surface area without causing dentinal erosion, suggesting its potential as an effective root biomodification agent.

Comparative Evaluation of Dentinal Tubule Occlusion Using Diode Laser and Potassium Oxalate Gel: An in vitro Scanning Electron Microscopic Study

2026-02-05T10:49:46+00:00

Background: Laser therapy has gained increasing attention in recent years as a treatment modality for dentinal hypersensitivity due to its ability to induce morphological alterations in dentin without the need for restorative intervention. Scanning electron microscopy (SEM) is a highly sensitive and reliable technique for evaluating dentinal surface morphology and the degree of dentinal tubule occlusion following various desensitizing treatment.

Aim: The present in vitro study aimed to compare the effectiveness of diode laser and potassium oxalate gel in achieving dentinal tubule occlusion using scanning electron microscopy (SEM).

Materials and Methods: Extracted human permanent teeth were used to prepare standardized coronal dentin discs following smear layer removal. The specimens were randomly allocated into three groups: Group I—diode laser treatment, Group II—potassium oxalate gel application, and Group III—control. Diode laser irradiation and potassium oxalate gel application were performed using standardized protocols, while control specimens received no treatment. All samples were evaluated under SEM at 5000× magnification. Dentinal tubule occlusion was assessed using a five-point scoring system. Statistical analysis was performed using SPSS software version 27. Intergroup comparisons were carried out using the Kruskal–Wallis test followed by Mann–Whitney U test. A p-value ≤0.05 was considered statistically significant.

Results: SEM analysis revealed completely open dentinal tubules in the control group. Potassium oxalate-treated specimens demonstrated partial and superficial tubule occlusion with predominantly patent tubules. In contrast, diode laser-treated specimens showed marked narrowing and partial to near-complete occlusion of dentinal tubules due to surface melting and resolidification of dentin. The diode laser group exhibited significantly higher dentinal tubule occlusion scores compared to the potassium oxalate and control groups (p ≤0.05).

Conclusion: Within the limitations of this in vitro study, diode laser treatment demonstrated superior dentinal tubule occlusion compared to potassium oxalate gel. The findings suggest that diode laser therapy may provide more uniform and stable dentinal tubule sealing and may be a more effective modality for the management of dentinal hypersensitivity.

Comparison of Three Different Distraction Techniques to Allay Dental Anxiety During La Procedures: A Comparative Study

2026-02-17T13:41:06+00:00

Background: Among the numerous approaches employed in the management of anxiety in pediatric dentistry, one of the most well-known and practical behavior control techniques for children is distraction. The current research set out to assess and compare the impact of three distraction devices—Pop-it toy, Kaleidoscope, and Fidget spinner—on the anxiety of children receiving local anesthesia (LA) administration.

Methods: A comparative investigation was done between 36 children in the age group of 6–10 years who needed LA for various dental procedures and fulfilled the inclusion criteria. Participants were randomly assigned into four groups (n=9 each): Group 1 – Pop-it toy, Group 2 – Kaleidoscope, Group 3 – Fidget spinner, and Group 4 – Control (no distraction). The levels of anxiety were evaluated on a Visual Analogue Scale (VAS) at two points of time—pre- and post-LA administration. Statistical analysis was performed using SPSS version 21, utilizing paired t-tests and one-way ANOVA to evaluate pre- and post-LA anxiety scores between the groups.

Results: Post-LA mean anxiety levels were lower for Groups 1, 2, and 3 than in the control group, although the difference was only statistically significant for the Pop-it toy group (p = 0.012). There was no significant difference between the groups in pre-LA anxiety levels (p > 0.05).

Interpretation: Application of fidget spinner, kaleidoscope, and Pop-it toy as a distraction tool may be useful in the reduction of anxiety when using local anesthesia on children. Such straightforward and interactive distraction methods can be advocated as strong adjuncts in pediatric dentistry.

Effect of Shelf Storage Temperature and Curing Time on the Microhardness of Zirconium Containing Nano-Hybrid Resin Composite: An in Vitro Study

2026-02-19T12:04:19+00:00

Background: Adequate polymerization is essential for attaining optimal mechanical strength and ensuring improved clinical performance of composite restorative materials. Surface hardness is a critical characteristic of resin composites, as it determines their ability to withstand plastic deformation, indentation, and surface abrasion. This property is essential for maintaining esthetic integrity and also reflects the material’s suitability for efficient finishing and polishing procedures.

Objective: The purpose of this study is to evaluate the effect of shelf storage temperature and different curing time on microhardness of composite.

Materials and methods: Specimens were divided into 3 groups. Group I storage at room temperature, Group II storage in refrigerator and Group III: 30 minutes post removal from refrigeration. A total of 36 disc-shaped resin-based composite (RBC) specimens, each measuring 2 mm in thickness and 5 mm in diameter, were prepared using a single restorative material (ESCOM 250). Again, specimens were divided into 2 subgroups. Subgroup A underwent light curing for 10 seconds, whereas Subgroup B was light cured for 20 seconds using an LED curing unit through a Mylar strip and glass slide. The prepared specimens were then subjected to Vickers microhardness testing.

Results: For Group I and Group III, curing for 20 seconds results in significantly higher microhardness for both top and bottom surfaces (P- Value < 0.05). This suggests that a 20-second curing time is more effective than 10 seconds. Specimens that were refrigerated and cured for 10seconds exhibited the lowest microhardness suggesting that both factor storage temperature and curing duration are interdependent.

Conclusion: Temperature and light-curing time significantly impact the surface microhardness of composite materials, with variations in these factors affecting microhardness values.

A Comparative Study on Effectiveness of Music Distraction Versus Conventional Behaviour Management Technique in Reducing Anxiety and Stress in Children Aged 6-12 Years

2026-03-02T12:26:36+00:00

Introduction: Dental fear and anxiety are common problems for children visiting the dentist and may impact on the success of dental treatment. Behaviour management techniques without medication have been shown to be effective in decreasing anxiety and stress for children during dental treatments. Owing to the limited availability of proven and conclusive studies, this research was chosen to address the existing research gap.

Objective: The aim of this research was to compare the effectiveness of music distractions vs conventional behaviour management (CBM) techniques on reducing anxiety and stress for children under dental treatment.

Methods: This project used a comparative study with 50 children aged between 6 to 12 years who were receiving dental treatment at the Paediatric Dentistry Department. The children were placed into one of two groups (Group 1 – Conventional behaviour management, Group 2 - Music Distraction). Anxiety levels were measured using MCDAS and VPT at two points of time-pre and post dental treatment; Pulse rate was assessed as a measure of stress. Both assessments were made prior to the commencement of treatment and again at completion of treatment. Statistical analyses were performed using SPSS version 21, utilizing Mann-Whitney U test and chi-square test to evaluate pre and post anxiety levels during dental treatment between the two groups.

Results: The results indicate that both groups have substantially lowered their respective pre-operative and postoperative anxiety scores on the MCDAS and VPT instruments after undergoing dental treatment; the mean postoperative anxiety scores on the MCDAS and VPT for patients in Group 1 (Music Distraction Group [MDG1]) were lower p=0.430, than those of Group 2 (Conventional Group [CG]); however the p-values were greater than or equal to 0.05; as such, the findings are not statistically significant. No patients in the MDG1 demonstrated high levels of post-operative anxiety.

Conclusions: Music distraction (MD) has been shown to reduce the level of dental anxiety experienced by paediatric patients; however, MD is not statistically superior to other conventional behaviour management techniques. Music distraction can be recommended as an easy to use, safe and effective option for additional behavioural management for paediatric patients in dentistry.

A Comparative Evaluation of Flexural Strength, Microhardness and Fracture Toughness of a Polymer-infiltrated Ceramic and a Lithium Disilicate Glass Matrix Ceramic: An in vitro Study

2026-03-04T11:35:41+00:00

Introduction: The study aims to compare the flexural strength, hardness, and fracture toughness of polymer-infiltrated ceramics to lithium disilicate to assess clinical suitability.

The past two decades have witnessed an evolution in the use of all ceramic restorations, opted for by both clinicians as well as patients.The increasing use of dental CAD/CAM systems has ushered in the development of novel CAD/CAM machinable ceramics with superior physical properties needed for permanent dental restorations.

Material and Methods: 20 specimens each of polymer-infiltrated ceramic and lithium disilicate glass matrix ceramic were prepared per ISO standards, on which mechanical and thermal tests (using Universal Testing Machine and Vickers Microhardness Tester) were conducted in metallurgical labs according to ISO reference standards.

Result: On testing the specimen, it was observed that IPS e.max CAD had statistically highly significant (p<0.001) greater flexural strength (343.78 MPa), microhardness (22.0 VHN) and fracture toughness (2.32 MPa√m) as compared to VITA Enamic (145.91 MPa, 7.7 VHN, 1.34 MPa√m respectively).

Conclusion: The presence of weaker polymer infiltration in VITA Enamic attributes towards its lower microhardness and flexural strength. It can also be deduced that the infiltration of a polymer phase into the ceramic structure does not improve its mechanical properties when compared to glass-matrix ceramics. It can be inferred that clinically IPS e.max CAD can tolerate higher values of mechanical load until fracture.

Assessment of Knowledge, Attitude, and Practice toward Oral Cancer Screening among Dental Practitioners in Chengalpattu, Tamil Nadu: A Cross Sectional Study

2026-03-06T12:13:00+00:00

Background: Oral cancer is a significant public health issue in India, especially in areas with high tobacco use. Early detection through routine oral screening significantly improves survival outcomes. Dental professionals are essential for diagnosing the disease early.

Aim: To evaluate the knowledge, attitude, and practice toward oral cancer screening among dental practitioners in the Chengalpattu population.

Materials and Methods: A cross-sectional questionnaire-based study was conducted among 105 dental practitioners practicing in and around Chengalpattu. Data were analyzed using descriptive statistics, Chi-square test, one-way ANOVA, and Pearson correlation.

Results: Most dental practitioners in the Chengalpattu population showed good knowledge of the risk factors and early signs of oral cancer. They had a positive attitude toward screening, but their routine screening practices were inconsistent.

Conclusion: Knowledge levels among dental practitioners in the Chengalpattu population were satisfactory; however, training programs are needed to improve clinical practice.

Attitude among Dental Students towards Choosing Public Health Dentistry as a Career Option: A Cross Sectional Study

2026-03-10T07:29:10+00:00

Background: Public Health Dentistry plays a vital role in improving oral health at the population level through prevention, education, and policy advocacy. Despite its importance, this specialty often receives less attention compared to clinical branches, with students’ career choices frequently influenced by financial and clinical factors. Understanding students' perceptions and motivations can help guide educational strategies to strengthen interest in PHD and ensure a workforce equipped to address community oral health needs.

Aim: To examine the attitude of dental students towards selecting Public Health Dentistry (PHD) as a career.

Methods: A descriptive cross-sectional study was conducted among third-year, fourth-year, and CRRI dental students at Adhiparasakthi Dental College and Hospital. A self-administered questionnaire evaluated motivations for choosing dentistry, career aspirations, and views on PHD. Data were analyzed using SPSS software (version 23.0, IBM Corp., USA). Descriptive statistics (frequencies, percentages) and Chi-square tests were applied to determine associations between academic year and responses (p < 0.05).

Results: Among 253 participants (68 males, 185 females), 73% viewed PHD as emotionally and socially rewarding. Career preference was significantly associated with perceived ease of employment (p = 0.027), personality development opportunities (p = 0.041). Over 92% acknowledged PHD’s role in oral health awareness, and 85% identified strong prospects in teaching and research.

Conclusion: Dental students demonstrated a positive attitude toward PHD, valuing its social impact and academic potential. Integrating mentorship, community-based education, and structured career guidance could further foster interest in this specialty.

Comparative Evaluation of Ofloxacin Incorporated T-PRF vs Metronidazole Incorporated T-PRF as an Adjunct to Non Surgical Periodontal Therapy: A Randomized Controlled Clinical Trial

2026-03-10T10:15:47+00:00

Introduction: Non-surgical periodontal therapy (NSPT) remains the cornerstone in the management of periodontitis; however, complete elimination of subgingival pathogens through mechanical debridement alone is often limited. Local drug delivery systems combined with biologically active scaffolds may enhance therapeutic outcomes. Titanium-prepared platelet-rich fibrin (T-PRF), owing to its dense fibrin architecture and sustained release of growth factors, has emerged as a promising autologous biomaterial. Incorporation of antimicrobial agents such as ofloxacin and metronidazole into T-PRF may provide combined antimicrobial and regenerative benefits.

Aim: To evaluate and compare the clinical efficacy of ofloxacin-incorporated T-PRF and metronidazole-incorporated T-PRF as adjuncts to scaling and root planing (SRP) in the treatment of periodontitis.

Methodology: This randomized controlled clinical trial included thirty systemically healthy patients diagnosed with periodontitis were randomly allocated into three groups (n=10): Group I—SRP alone; Group II—SRP with ofloxacin-loaded T-PRF; and Group III—SRP with metronidazole-loaded T-PRF. Antimicrobial-loaded T-PRF membranes were placed sub-gingivally following SRP. Clinical parameters including plaque index, bleeding index, probing depth, and clinical attachment level were recorded at baseline, one month, and three months.

Results: All groups demonstrated significant improvement in clinical parameters over time with no adverse events reported. Both antimicrobial-loaded T-PRF groups showed greater reductions in probing depth and gains in clinical attachment compared to SRP alone. Ofloxacin-incorporated T-PRF demonstrated marginally superior outcomes compared to metronidazole-incorporated T-PRF at three months.

Conclusion: Antimicrobial-loaded T-PRF serves as an effective adjunct to NSPT, with ofloxacin-incorporated T-PRF showing enhanced clinical benefits in managing periodontitis.

Knowledge of Diabetes Mellitus and Periodontal Disease among Undergraduate Dental Students: A Cross-sectional Study

2026-03-13T12:28:27+00:00

Background: Periodontal disease is a chronic inflammatory infection of the gums and bone supporting the teeth, while diabetes mellitus is a metabolic disease characterized by high blood sugar. They share a bidirectional, two-way relationship: uncontrolled diabetes increases the severity of gum disease, while severe gum disease makes managing blood sugar harder.

Aim: To assess the knowledge of diabetes mellitus, periodontal disease, and their bidirectional relationship among undergraduate dental students.

Methodology: A study using a cross-sectional questionnaire was carried out with undergraduate students from different academic fields. Demographic information, knowledge of diabetes mellitus, awareness of periodontal disease, comprehension of the relationship between diabetes and periodontal disease, and oral health practices were all evaluated using a structured, self-administered questionnaire. Informed consent was obtained from each participant, and participation was entirely optional. A cross-sectional survey was conducted among 142 undergraduate dental students at Adhiparasakthi Dental College and Hospital.

Results: The overall mean knowledge score was 13.59 ± 3.72. Knowledge scores increased significantly with advancing academic year (F = 9.07, p < 0.001). A study using a cross-sectional questionnaire was carried out with undergraduate students from different academic fields. Demographic information, knowledge of diabetes mellitus, awareness of periodontal disease, comprehension of the relationship between diabetes and periodontal disease, and oral health practices were all evaluated using a structured, self-administered questionnaire. Informed consent was obtained from each participant, and participation was entirely optional. Interns demonstrated the highest mean score (14.88 ± 3.04), while first-year students showed the lowest (10.71 ± 4.27).

Conclusion: Education links between diabetes and periodontal disease improve early early diagnosis, patient safety, chronic disease control and it transforms dentistry into a systemic health partner. Early curriculum integration of systemic–oral health concepts may further enhance competency.

Awareness, Knowledge and Practices Regarding Antibiotic Prescription Guidelines among Dental Students and Practitioners – A Cross-sectional Study

2026-03-14T06:45:10+00:00

Background: Inappropriate antibiotic prescribing contributes significantly to antimicrobial resistance. Dental professionals play a crucial role in promoting rational antibiotic use. This study aimed to assess awareness, knowledge, and practices regarding antibiotic prescription guidelines among dental students and practitioners.

Aim: To evaluate awareness, clinical knowledge, and antibiotic stewardship practices related to antibiotic prescription guidelines across different academic levels.

Materials and Methods: A cross-sectional questionnaire-based study was conducted among 200 dental students and practitioners. Data regarding awareness, knowledge, and prescribing practices were collected using a structured questionnaire. The Chi-square test was used to assess the association between academic level and antibiotic-related variables. A p-value <0.05 was considered statistically significant.

Results: Most participants demonstrated high awareness of antibiotic prescription guidelines (99.5%). No significant association was found between academic level and awareness or attitude variables (p>0.05). However, significant associations were observed between academic level and knowledge of correct antibiotic indications (p=0.024), prescribing antibiotics for irreversible pulpitis (p=0.022), knowledge of penicillin alternatives (p=0.010), attendance at continuing dental education programs (p<0.001), and frequency of updating knowledge (p=0.012).

Conclusion: Although awareness regarding antibiotic prescription guidelines was high, clinical knowledge and antibiotic stewardship practices improved with higher academic training.

Continuous education programs are essential to promote rational antibiotic use among dental professionals.

Unveiling the Smoking - Periodontitis Link for Diverse Patient Group

2026-03-14T12:45:05+00:00

Background: Periodontitis is a chronic inflammatory disease affecting the supporting structures (periodontium) of teeth and progress to tooth loss. Smoking is a well-established modifiable risk factor that influences periodontal disease through altered immune response and changes in the oral environment. Due to demographic and behavioral factors impact of smoking on periodontal health may vary among diverse patient group.

Objective: This study aims to investigate the relationship between smoking and periodontitis in diverse patient groups, with special importance on salivary pH changes and breath analysis (Exhaled Carbon Monoxide) as an additional diagnostic indicators used in this study.

Methodology: A cross-sectional analytical study was conducted among diverse patient groups from varied demographic backgrounds. Periodontal parameters such as probing depth, clinical attachment loss, bleeding on probing and mobility of tooth were recorded. Smoking status, duration were assessed using structured questionnaires. Unstimulated saliva samples were collected to measure salivary pH, and breath analysis was performed to assess carbon monoxide associated with and without periodontal disease. Comparative and statistical analyses were carried out between smokers and non-smokers across different patient groups.

Results: Smokers demonstrated significantly increased periodontal destruction, altered salivary pH levels, and higher levels ofexhaled carbon monoxide compared to non-smokers. Periodontal health is compromised positively with smoking, among diverse patient groups.

Conclusion: Smoking adversely affects periodontal health by altering both clinical parameters and oral biochemical markers. Incorporating salivary pH and breath analysis (Exhaled Carbon Monoxide) may enhance Early detection and management of smoking-related periodontitis can enhanced by salivary pH and breath analysis(Exhaled Carbon Monoxide).

Oral Manifestations Associated with Hypertensive Patients: A Clinical Observational Study

2026-03-14T13:04:03+00:00

Background: Hypertension is a major chronic systemic disease affecting a large population worldwide. It has numerous oral implications either due to the disease process itself or as adverse effects of antihypertensive medications. Early identification of oral manifestations can improve diagnosis, quality of life, and comprehensive management.

Aim: To evaluate the prevalence and types of oral manifestations in hypertensive patients.

Materials and Methods: A clinical observational study was conducted on 100 hypertensive patients visiting the outpatient department of Oral Medicine and Radiology in a private dental institute located in Melmaruvathur over a period of six months. Detailed case histories were recorded, including demographic data, duration and hypertension, and antihypertensive medications. Comprehensive intraoral examinations were performed to assess oral soft tissue and hard tissue changes. The collected data were analyzed statistically to determine the frequency of various oral findings.

Result: Periodontal disease was the most frequently observed oral condition, with periodontitis affecting 70% of the study population. Gingivitis was identified in 29% of patients, while acute necrotizing ulcerative gingivitis was noted in 1%. The highest prevalence of periodontal disease was observed in individuals aged between 60 and 79 years. Various oral mucosal lesions, including gingival hyperplasia, leukoplakia, lichen planus, and hyposalivation, were also documented.

Conclusion: Oral manifestations were commonly observed among hypertensive patients, with periodontal disease being the predominant finding.Regular oral screening and interdisciplinary collaboration are essential for optimal management of hypertensive individuals.

Knowledge, Attitude and Awareness of Dental Radiographic Waste Management Among Dental Students: A Questionnaire -Based Survey

2026-03-18T13:10:11+00:00

Background: Dental radiography significantly contributes to the generation of radiographic waste such as lead foils and silver-containing fixer solutions. Improper disposal of these materials may pose serious risks to human health and the environment. Dental students, as future practitioners, play a vital role in ensuring safe and responsible waste management practices.

Aim: To assess the knowledge, attitude, and awareness of dental students regarding dental radiographic waste management.

Materials and Methods: A cross-sectional questionnaire-based study was conducted among 200 dental students including undergraduate students, interns, and postgraduate students. A structured self-administered questionnaire was used to collect demographic information and assess knowledge, attitude, and awareness regarding radiographic waste management. Data were analyzed using descriptive statistics. The Shapiro–Wilk test was used to assess data normality, and the Mann–Whitney U test was used for group comparison. Results were expressed as frequencies, percentages, mean, and standard deviation.

Results: The total knowledge scores ranged from 13 to 18 with a mean score of 16.32 ± 1.20, indicating an overall satisfactory level of knowledge among the participants. Most participants demonstrated good awareness regarding environmental and health hazards associated with radiographic waste (90.0%) and correct disposal of fixer solutions (89.0%). However, knowledge regarding proper disposal of lead foils was comparatively lower (44.5%), and only 25.0% of participants had received formal training in radiographic waste management.

Conclusion: Dental students demonstrated satisfactory knowledge and positive attitudes toward radiographic waste management. However, procedural gaps and limited formal training highlight the need for strengthened educational interventions and institutional reinforcement to promote environmentally responsible dental practice.

Knowledge and Attitude toward the Cone Beam Computed Tomography among Dental Students – A Cross Sectional Questionnaire Based Study

2026-03-21T09:02:22+00:00

Background: Cone Beam Computed Tomography (CBCT) has transformed dental imaging by providing three-dimensional visualization with increased accuracy and CBCT provides three-dimensional visualization with lower radiation doses than conventional medical CT. Adequate awareness and a good attitude toward CBCT are necessary for its effective and responsible application in a clinical setting. This study sought to evaluate dental students' knowledge and attitudes about using CBCT.

Methods: A cross-sectional descriptive study was conducted with undergraduate dental students, using a structured self-administered questionnaire. The survey consisted of questions about demographic data, indications for CBCT, awareness of radiation safety, and attitudes toward CBCT in the clinical setting. Descriptive statistics were used to summarize the data and chi-square tests were conducted to identify associations between academic level, knowledge, or attitude scores.

Results: A total of 230 undergraduate dental students and interns participated in this study. The majority of students (94%) indicated they were familiar with CBCT, and this was especially true for senior students (97%). Notably, 66% of respondents recognized dental and maxillofacial imaging as the primary reason for obtaining a CBCT scan. More than half of the students (53%) correctly recognized higher radiation dose as advantages of CBCT, and almost all the participants (93%) agreed that CBCT is a valuable addition to modern dental care. However, there were gaps regarding safety; only about 69% were aware of radiation safety practices. There were statistically significant differences for several questions across years of study related to having knowledge of CBCT advantages, knowledge of safety practices, and having exposure to training. Only 43% reported having attended a presentation or formal training on CBCT.

Conclusion: The study revealed that knowledge and attitude toward CBCT improve with increasing academic level among dental students. Despite overall awareness, deficiencies remain in areas such as radiation safety and appropriate clinical indications. Incorporating focused training programs and practical learning in the undergraduate curriculum may improve students understanding and promote the judicious use of CBCT in clinical practice.

Knowledge, Perception, and Attitude towards Pulp Revascularisation among Dental Students and Private Practitioners: A Questionnaire-based Study

2026-03-23T04:35:17+00:00

Aims: To assess awareness, clinical understanding, and attitudes toward pulp revascularisation among dental students and private practitioners.

Study Design: Original study.

Methodology: A cross-sectional questionnaire survey was conducted among 196 respondents. The questionnaire included demographic details and items assessing familiarity with pulp revascularisation, indications, clinical protocol, materials used, perceived reliability, barriers to practice, and educational needs. Data were analysed using descriptive statistics and expressed as frequencies and percentages.

Results: Most participants were younger than 24 years (76.5%) and female (61.7%). Although 70.9% were somewhat or very familiar with pulp revascularisation, only 27.0% had actually performed the procedure. Immature permanent teeth with necrotic pulp were correctly identified as the most suitable indication by 41.0% of respondents. Limited clinical exposure (44.4%) and lack of knowledge (25.5%) were the most frequently reported barriers.

Conclusion: The findings reveal moderate theoretical awareness but limited clinical exposure to pulp revascularisation. Incorporation of hands-on workshops and clinical postings into undergraduate and postgraduate training could improve competence and acceptance of regenerative endodontic procedures.

Prevalence of Mandibular Lingual Frenum Attachment in Children Aged 3–6 Years: A Cross-Sectional Pilot Study

2026-03-26T13:02:32+00:00

Background: An essential anatomical component that may affect gingival health, dental hygiene, and the development of dentition is the mandibular lingual frenum. Gingival recession and plaque retention may be predisposed by differences in frenal attachment. The incidence of mandibular lingual frenal attachment types in preschoolers, however, has not been well documented.

Aim: Using the Coryllos classification, ascertain the prevalence of mandibular lingual frenal attachment types in children under the age of six and assess how they relate to age and gender.

Materials and Methods: One hundred children with complete primary teeth, aged three to six years, participated in a cross-sectional study in a single institution. Clinical evaluation and Coryllos classification (Types 1–4) were used to classify mandibular lingual frenal attachment. In order to analyze the data, descriptive statistics were used. The Chi-square test was used to evaluate the relationship between demographic type, gender, and age group. P-values less than 0.05 were regarded as statistically significant.

Results: Of the 100 children who were assessed, 60% were females, while 40% were males. The commonest type of frenal attachment was Coryllos Type 3, accounting for 75%, while Type 2 was 14%, Type 4 was 10%, and Type 1 was 1%. There was no statistically significant relationship between gender (p = 0.54) and age (p = 0.12) groups and the type of frenal attachment.

Conclusion: The commonest type of mandibular lingual frenum was Coryllos Type 3. There was no relationship with age and gender. Early detection of variations is important for preventive pediatric dental care.

Effectiveness of Magic Trick Distraction, Play Therapy, Virtual Reality, and Tell-Show-Do on Dental Anxiety and Behaviour in Paediatric Patients: A Cross-sectional Comparative Study

2026-03-28T06:03:02+00:00

Background: Dental anxiety and uncooperative behaviour in children aged 4–9 years remain significant challenges in paediatric dental practice. Non-pharmacological distraction techniques have gained increasing recognition as safe and effective behaviour management strategies.

Aim: The present study aimed to compare the effectiveness of four distraction techniques: Tell-Show-Do (TSD), Virtual Reality (VR) immersion, Crocodile Teeth play therapy, and Magic Trick distraction in managing anxiety and behaviour during dental restorative procedures in children aged 4–9 years.

Materials and Methods: A cross-sectional comparative study was conducted at the Department of Paediatric Dentistry, Adhiparasakthi Dental College and Hospital, Chengalpattu, Tamil Nadu, India. A total of 40 children aged 4–9 years requiring dental restorative treatment were enrolled and allocated into four equal groups of 10 each. Behavioural and anxiety responses were assessed at three stages — pre-assessment, during procedure, and post-assessment using the Facial Image Scale (FIS), Root Mean Square (RMS) Scale, Chhota Bheem and Chutki Scale (CCS), and Dental Anxiety Scale (DAS). Inter-group comparisons were performed using the Kruskal-Wallis test, with statistical significance set at p ≤ 0.05.

Results: Statistically significant inter-group differences were observed at the pre-assessment and post-assessment stages across all four outcome scales, while intra-procedural comparisons were non-significant. On the FIS, significant differences were observed at pre-assessment (p = 0.034) and post-assessment (p = 0.000). The Control (TSD) group consistently recorded the lowest post-assessment scores across all scales (FIS: 1.00 ± 0.000; RMS: 1.00 ± 0.000; CCS: 1.00 ± 0.000; DAS: 0.00 ± 0.000). Among distraction groups, Crocodile Teeth recorded the highest post-assessment scores on FIS (2.60 ± 0.516), RMS (2.40 ± 0.699), and CCS (2.00 ± 0.471), while Magic Trick and Crocodile Teeth groups recorded equal DAS post-assessment scores (1.50 ± 0.527 each). On the RMS scale, significant differences were noted at pre-assessment (p = 0.001) and post-assessment (p = 0.000). The CCS demonstrated significant inter-group differences at pre-assessment (p = 0.009) and post-assessment (p = 0.001). The DAS showed significant differences at all three stages, including during the procedure (pre-assessment p = 0.003; during procedure p = 0.017; post-assessment p = 0.000). The VR group recorded the highest DAS score during the procedure (2.60 ± 1.074), while the Control group recorded the lowest (1.40 ± 0.516).

Conclusion: All four non-pharmacological behaviour management techniques demonstrated varying degrees of effectiveness in reducing dental anxiety in children aged 4–9 years. The Tell-Show-Do technique achieved the most consistent post-procedural anxiety reduction across all outcome measures, affirming its role as the cornerstone of paediatric behaviour management. Among the distraction techniques, Virtual Reality and Magic Trick distraction demonstrated comparable and clinically meaningful anxiety attenuation at post-assessment, while Crocodile Teeth play therapy showed greater utility in reducing anticipatory anxiety. The choice of distraction technique should be individualised based on the child's age, temperament, and baseline anxiety level.

Assessing Parental Awareness Regarding the First Dental Visit of Children: A Cross-sectional Study

2026-03-28T11:46:07+00:00

Background: Early dental visits play a crucial role in preventing oral diseases and establishing positive dental attitudes in children. Despite professional recommendations advocating the first dental visit by the age of one year, parental awareness regarding this guideline remains limited.

Aim: To assess parental awareness, beliefs, and attitudes regarding the first dental visit of children.

Materials and Methods: A cross-sectional questionnaire-based study was conducted among 151 parents. Data regarding child demographics, parental education, awareness of the recommended age for the first dental visit, beliefs about primary teeth, and attitudes toward dental visits were collected. Data were analyzed using SPSS version 26.0. Descriptive statistics were expressed as frequencies and percentages. Chi-square test was used to assess associations between variables, with the level of significance set at p < 0.05.

Results: Most parents believed that early dental visits are beneficial; however, awareness regarding the recommendation of the first dental visit by one year of age was inadequate. A statistically significant association was observed between parental education level and awareness of the appropriate timing for the first dental visit (p < 0.05). Fear of pain and dental instruments were the most common concerns related to dental treatment.

Conclusion: Although parents demonstrated a positive attitude toward child oral health, a significant gap exists in guideline-based awareness regarding the first dental visit. Targeted oral health education strategies and interdisciplinary reinforcement are essential to improve timely utilization of preventive dental services.

Circadian Misalignment, Lifestyle Disruption, and Oral Health Outcomes among Day and Night Shift IT Professionals: A Cross-sectional Comparative Study

2026-03-30T09:15:37+00:00

Introduction: Shift work, particularly in the Information Technology (IT) sector, has become increasingly prevalent, often leading to disruption of the circadian rhythm. Such disturbances can adversely affect biological homeostasis, influencing lifestyle behaviours including sleep patterns, dietary habits, and oral hygiene practices. Emerging evidence suggests that these alterations may have significant implications for oral health outcomes. Therefore, the present study aims to assess the relationship between circadian rhythm disruption, associated lifestyle factors, and oral health status among day-shift and night-shift IT professionals.

Methods: A cross-sectional study was conducted among 176 IT professionals using a pre-validated online questionnaire assessing sleep patterns, lifestyle behaviours, and self- reported oral health symptoms. Participants were categorized as day-shift and night-shift workers, and data were analysed using Chi-square tests with a significance level of p < 0.05.

Results: Night-shift workers reported significantly delayed sleep onset, poorer sleep quality, and higher night-time caffeine consumption compared with day-shift workers. Gingival bleeding and bruxism were significantly more prevalent among night-shift workers, while other symptoms such as xerostomia and halitosis were reported more frequently but were not statistically significant.

Conclusion: Circadian rhythm disruption associated with night -shift work may negatively affect lifestyle patterns and oral health among IT professionals, emphasizing the importance of targeted preventive and occupational health strategies

Histopathological Validation of Clinical Palpation vs. Ultrasonography for Cervical Lymphadenopathy in Oral Squamous Cell Carcinoma: An Ambi-directional Cohort of 1,690 Nodes from Rural Karnataka, India

2026-03-30T10:24:10+00:00

Background: Cervical lymph node metastasis reduces OSCC 5-year survival by 50%; accurate preoperative detection via clinical palpation vs. grayscale ultrasonography (USG) remains critical for treatment planning. It is established that better diagnostic resources are available that provide a more accurate assessment of cervical lymphadenopathy; however, they may not be feasible in low resource regions where the incidence of OSCC is high.

Aim and objective: The study aims to assess the diagnostic accuracy of clinical palpation with Gray-scale 2-D USG using the Histopathology assessment as the benchmark. The objective is to ascertain if USG is required in addition to clinical palpation in low-resource centers.

Methods: Retro-prospective analysis of 300 patients with biopsy-proven OSCC undergoing tumor resection and neck dissection at a Karnataka tertiary center; clinical palpation and USG (7-12MHz linear probe) assessed 1,690 cervical lymph nodes, correlated with post-operative histopathology (gold standard) to assess sensitivity, specificity, NPV and PPV.

Results: Of all subsites, buccal mucosa (61%) was most common subsite; the mean age 45-55 years, male:female ratio of predilection was 2.4:1. USG demonstrated superior sensitivity (73.8%) compared to palpation (58.3%), NPV 92.7% vs. 87.0% respectively, with specificities 63.4% vs. 67.8% and PPV 27.9% vs. 30.8% respectively. The lymph node Level Ib/II demonstrated largest accuracy in assessment.

Conclusion: Grayscale USG can act as an added supplement to clinical palpation for reliable N0 neck identification in OSCC, supporting AJCC 8th staging protocols in resource-limited settings.

Understanding Parental Preferences and Concerns Regarding Dental Radiography in Pediatric Dentistry: A Cross-sectional Study

2026-03-31T09:22:51+00:00

Background: Dental radiographs are essential diagnostic tools in pediatric dentistry; however, parental concerns regarding radiation exposure can influence their acceptance. Understanding parental perceptions is important for improving communication and clinical decision-making.

Aim: To assess parental knowledge, attitudes, preferences, and concerns regarding dental radiographic procedures in children.

Materials and Methods: A cross-sectional questionnaire-based study was conducted among parents using a structured and validated survey. Data were collected on demographic characteristics, awareness of dental radiography, perceived risks, and communication preferences. The responses were analyzed using appropriate statistical methods.

Results: The majority of parents recognized the importance of dental radiographs for diagnosis and treatment planning. However, a considerable proportion expressed concerns about radiation exposure and its potential long-term effects. Most parents preferred to receive clear explanations from the dentist prior to the procedure and favored minimizing the number of radiographs taken. Trust in the dentist played a key role in acceptance of radiographic procedures.

Conclusion: Although parents generally acknowledge the diagnostic value of dental radiographs, concerns about radiation exposure persist. Effective communication and patient education are essential to address misconceptions, improve acceptance, and ensure adherence to radiation safety principles in pediatric dental practice.

Assessment of Awareness for Orthodontic Treatment Regard for Fixed Orthodontic Mechanotherapy and Aligners Therapy in Young Adults in Tamil Nadu

2026-04-01T06:09:24+00:00

Background: Malocclusion and misaligned teeth can negatively affect oral health, facial aesthetics, and quality of life. Advances in orthodontics have introduced various treatment options, including conventional fixed orthodontic appliances and clear aligner systems. Awareness of these treatment modalities among young adults is essential, as it influences treatment preferences and utilization of orthodontic care.

Aim: The present study aimed to evaluate the level of awareness and knowledge regarding fixed orthodontic mechanotherapy and clear aligner therapy among young adults in Tamil Nadu.

Materials and Methods: A cross-sectional survey was conducted among young adults using a structured questionnaire designed to assess awareness, perception, and knowledge of orthodontic treatment options. The questionnaire included items related to familiarity with fixed appliances, understanding of aligner therapy, and reasons for considering orthodontic treatment. The responses obtained were compiled and analyzed using descriptive statistical methods.

Results: The findings revealed that most participants were familiar with conventional fixed orthodontic treatment, whereas awareness of clear aligner therapy was comparatively lower. Aesthetic improvement emerged as a major motivating factor for seeking orthodontic care among the respondents. However, knowledge regarding the broader functional benefits of orthodontic treatment and newer treatment modalities varied among participants.

Conclusion: Within the limitations of the study, it can be concluded that awareness of fixed orthodontic treatment is relatively higher among young adults, while knowledge of aligner-based therapy is still developing. Enhancing patient education and increasing public awareness through dental professionals and reliable information sources may help individuals better understand available orthodontic treatment options and make informed decisions regarding their oral health.

A Comparative Evaluation of Treatment Related Outcome in Patients Treated with Clear Aligners and Fixed Orthodontic Appliances

2026-04-02T08:21:49+00:00

Background: Pain and discomfort are common during the initial phase of orthodontic treatment and can affect patient cooperation and satisfaction. Clear aligners are increasingly used as an alternative to fixed appliances, requiring a comparison of patient experiences. The manuscript focuses on the role of patient-centered outcomes in the early stages of orthodontic treatment by comparing clear aligners and fixed appliances. It also provides evidence for pain, discomfort, and quality of life, making it more significant in making decisions and counseling patients. It also discusses the increasing role of clear aligner therapy and the need for more research to improve treatment outcomes.

Aim: To compare initial pain, discomfort, and oral health-related quality of life between clear aligner and fixed appliance patients.

Materials and Methods: A cross-sectional questionnaire study was conducted among 120 adult orthodontic patients treated with clear aligners or fixed appliances from November 2025 to February 2026. A structured self- administered Google Forms questionnaire assessed pain intensity, duration, functional limitations, psychosocial impact, pain management, and treatment preference during the first week. Descriptive statistics and Chi- square test were used, with p < 0.05 considered significant.

Results: More than half of the participants experienced pain within 24 hours, mostly moderate in intensity. Pain was commonly worse at night and lasted one to five days. Eating difficulty, tooth soreness, and soft tissue irritation were frequently reported. Most patients did not use medication, and ice packs were commonly used. Clear aligner patients reported significantly higher satisfaction and preference.

Limitations: This study is limited by its cross-sectional design and reliance on self-reported questionnaires, which may introduce response bias. Additionally, the unequal sample distribution and relatively small sample size may limit the generalizability of the findings.

Conclusion: Pain and discomfort are common initially. However, clear aligners provide greater comfort, satisfaction, and better oral health-related quality of life compared to fixed orthodontic appliances.

Clinical Spectrum of Oral Mucosal and Periodontal Alterations in Tobacco Users

2026-04-02T13:35:33+00:00

Introduction: Tobacco consumption, whether in smoked or smokeless forms, is a well-established risk factor for oral mucosal and periodontal disorders. Continuous exposure to tobacco products can result in inflammatory changes, keratotic lesions, and potentially malignant alterations within the oral cavity.

Aim: The present study aimed to evaluate the spectrum of oral mucosal and periodontal changes among tobacco users and to analyse their association with different types of tobacco habits.

Methods: A cross-sectional observational study was carried out among 150 individuals with a documented history of tobacco use attending a dental outpatient department. Participants were classified into three groups: smoking, smokeless tobacco use, and combined habits. Demographic details and habit characteristics were recorded. Comprehensive intraoral and periodontal examinations were performed. The collected data were analysed using descriptive statistics and the chi-square test to assess associations between age and tobacco habits.

Results: Of the total participants, 85.3% were males and 14.7% were females, with smoking identified as the most common habit. Frequently observed findings included chronic gingivitis, chronic periodontitis, leukoplakia, oral submucous fibrosis, tobacco pouch keratosis, leukoedema, smoker’s melanosis, and dental caries with periapical involvement. Smoker’s melanosis and smoker’s palate were predominantly associated with smoking, whereas leukoplakia and oral submucous fibrosis were more frequent among smokeless tobacco users. Individuals practising combined habits demonstrated more extensive mucosal involvement and advanced periodontal destruction. A statistically significant association was observed between age and smoking (p = 0.000) as well as smokeless tobacco use (p = 0.009), while no significant association was noted for combined habits (p = 0.495).

Conclusion: The study highlights a strong relationship between tobacco use and a wide range of oral mucosal and periodontal alterations, with greater severity seen in individuals with dual habits. Early clinical screening and structured tobacco cessation interventions are essential to limit disease progression and reduce the risk of malignant transformation.

Assessment of Facial and Dental Esthetic Parameters in Smile Analysis: A Cross Sectional Study

2026-04-07T12:56:40+00:00

Background: Smile harmony is greatly influenced by facial and dental aesthetics, which also have an impact on patient satisfaction and prosthodontic treatment results. A scientific foundation for esthetic rehabilitation is provided by the objective evaluation of smiling components.

Aim: To evaluate selected facial and dental esthetic parameters related to smile harmony and analyze their distribution among the study population.

Materials and Methods: A cross‑sectional observational study was conducted using standardized frontal smile photographs. Esthetic parameters including facial and dental midline congruence, relation between angulation of maxillary central incisors and facial midline, parallelism of canine line–bipupillary line, Exposure of upper front teeth by upper lip during smiling, parallelism of lower lip line dental arch of upper anterior teeth, relation of gingival contour, interdental papilla position, continuity of upper dental arch, angulation of upper teeth, proximal contact position, and width‑height ratio of maxillary central incisors were assessed using a validated scoring system. Descriptive statistics were used for analysis.

Results: The majority of participants demonstrated favorable esthetic characteristics, particularly parallelism of the canine line with the bipupillar line (83.3%), ideal exposure of maxillary anterior teeth during smiling (76.7%), and acceptable angulation of maxillary anterior teeth (73.3%). Variations were noted in gingival contour and interdental papilla position, indicating areas of esthetic compromise.

Conclusion: Smile esthetics are multifactorial, with most individuals exhibiting acceptable facial and dental harmony. However, subtle discrepancies in gingival and interdental parameters highlight the need for comprehensive esthetic evaluation during prosthodontic and restorative treatment planning.

Comparative Evaluation of Water Sorption in High-Strength Denture Base Resin Reinforced with 5% Silanized Titanium Dioxide Nanoparticles Using Microwave and Conventional Polymerization Methods: An In-vitro Study

2026-04-13T10:05:41+00:00

Background: Water sorption is a critical determinant of the dimensional stability and long-term clinical performance of polymethyl methacrylate (PMMA) denture base resins. Absorbed water acts as a plasticizer within the polymer matrix, causing volumetric expansion and deterioration of mechanical properties. Titanium dioxide (TiO₂) nanoparticle reinforcement, particularly with silane surface treatment, has attracted considerable interest for improving the physical properties of PMMA. However, the combined influence of silanized TiO₂ incorporation and polymerization technique on water sorption in high-strength PMMA has not been comprehensively characterized.

Aim: To evaluate and compare the water sorption behavior of high-strength PMMA denture base resin reinforced with 5% silanized TiO₂ nanoparticles when processed using conventional water bath and microwave polymerization techniques.

Materials and Methods: Thirty standardized disc-shaped specimens (n = 15 per group) were fabricated in accordance with ADA Specification No. 12. Group A underwent conventional water bath polymerization (74°C/2 h + 100°C/1 h) and Group B underwent microwave polymerization (500 W/3 min). Water sorption was calculated gravimetrically after 7-day distilled water immersion at 37 ± 2°C and subsequent desiccation. Statistical analysis included the Shapiro–Wilk test, Levene’s test, and independent samples t-test (p < 0.05) with Cohen’s d effect size.

Results: Group A demonstrated significantly lower mean water sorption (3.74 ± 2.33 µg/mm³) versus Group B (9.00 ± 5.52 µg/mm³; p = 0.002; Cohen’s d = 1.243).

Conclusion: Conventional water bath polymerization conferred superior resistance to water sorption compared to microwave polymerization in TiO₂-reinforced high-strength PMMA. The polymerization technique remains a critical determinant of material behavior even when nanoparticle type and concentration are held constant.

Dental Treatment of Disabled People under General Anaesthesia at the Dental Department of General Hospital of Thessaloniki “O Agios Dimitrios”: A Retrospective Study

2026-04-17T12:15:41+00:00

Aim: This retrospective study evaluate the modification of waiting time throughout time for disabled dental patients, who required treatment under general anaesthesia at “O Agios Dimitrios” Hospital of Thessaloniki, Greece.

Study Design: Retrospective study based on the medical records of all dental cases treated within the examined period of time.

Place and Duration of Study: Dental Department of the General Hospital of Thessaloniki “O Agios Dimitrios”, between June 2015 and June 2024.

Methodology: In total, 166 dental patients were treated within the examined period, but for 16 of them the time of first diagnosis had not been reported. As this prohibited the calculation of their waiting time, these 16 patients were excluded. The waiting time since the first examination for each case was calculated, using the weighted average value of waiting time to see if it shortened or lengthened throughout time.

Results: 100 out of the 166 (60.24%) patients derived from Thessaloniki, but patients from other districts of Northern Greece were also referred to the hospital for dental care under general anaesthesia. Each case was classified in an urgency scale of K1 to K5 (K1: most urgent, K5: less urgent), following the guidelines given by the Greek Ministry of Health. The majority of dental patients, namely 140 out of 166, were classified as K5 (84.34%). Our calculations revealed a rapid increase of waiting time from 1.94 semesters up to 4.66 semesters. In period 2015 – 2018 a dental patient would be treated within almost 2 semesters since diagnosis, while in period 2019 – 2024 the average waiting time was a bit more or less than 4.5 semesters.

Conclusion: Integrating dental care into broader public health policies and disability support programs is vital for ensuring comprehensive and equitable care for disabled individuals.

Comparative Assessment of Triclosan-Coated, Chlorhexidine-Coated, and Un-Coated Resorbable Sutures: An in-vitro Observational Study

2026-04-24T12:22:43+00:00

Purpose: The study aimed to standardize the effective antimicrobial dose per unit length of suture and evaluate the antimicrobial efficacy of coated resorbable Vicryl sutures against oral commensals responsible for surgical-site infections.

Methods: The study used three types of commercially available 3-0 Vicryl sutures (uncoated, triclosan-coated, chlorhexidine-coated) each cut into 5-centimetre piece, and immersed in bacterial suspension (S. aureus, Streptococcus, P. aeruginosa, E. faecalis). Bacterial counts on Days 3, 5, and 7 evaluated both the overall efficacy and specific antimicrobial activity of coated versus uncoated sutures.

Result: The study included 241 samples. For all tested bacterial species, uncoated sutures consistently showed the highest bacterial growth by Day 7 [S. aureus: 223.94 ± 34.19; Streptococcus: 225.77(28.9); P. aeruginosa: 229.49(27.45); E. faecalis: 207.84(47.65)], while antimicrobial-coated sutures significantly inhibited growth, with triclosan-coated sutures demonstrating the lowest counts for S. aureus [74.68(10.8)], Streptococcus [77.93(14.44)], and E. faecalis [83.34(9.71)], and chlorhexidine-coated sutures showing the lowest for P. aeruginosa [81.73(11.67)] by Day 7.

Conclusion: Triclosan and chlorhexidine-coated sutures showed sustained antimicrobial efficacy, with triclosan being more effective against gram-positive bacteria and chlorhexidine against gram-negative, while 5 cm of coated suture sufficed for effective action.

Knowledge and Awareness about Biomedical Waste Management among Undergraduate Dental Interns: A Cross-sectional Descriptive Study

2026-05-02T12:18:42+00:00

Biomedical waste (BMW) generated in dental clinics poses significant infection-control and environmental challenges. Dental interns, as frontline healthcare providers, are routinely exposed to various categories of BMW, yet their formal training and practical compliance with BMW management guidelines remain insufficiently characterised. The present study aimed to assess the level of knowledge, awareness, and self-reported practices regarding biomedical waste management among undergraduate dental interns. A cross-sectional descriptive study was conducted among 100 undergraduate dental interns using a pre-validated, structured online questionnaire comprising 50 closed-ended questions spanning knowledge, awareness, and practice domains. Descriptive statistics were expressed as frequencies and percentages; a seven-item knowledge score was computed and categorised as Low, Moderate, or High. The Chi-square test was applied to examine associations between categorical variables. A p-value < 0.05 was considered statistically significant. The majority of interns had received formal training on BMW segregation (87.0%) and were aware that improper BMW disposal contributes to environmental pollution (91.0%). However, only 46.0% correctly identified the four standard colour-coded container system, and 51.0% knew the maximum permissible on-site storage duration. The mean knowledge score was 4.78±1.63 out of 7; 42.0% of participants attained a High knowledge level. Concerning practices, 72.0% admitted to recapping used needles and 38.0% reported bending or breaking needles by hand. While awareness levels are generally satisfactory, significant knowledge gaps remain, particularly regarding colour coding and storage regulations. The high prevalence of unsafe needle-handling practices underscores the need for structured, simulation-based BMW training embedded within the dental internship curriculum.

Comparative Evaluation of Push-out Bond Strength between Surface-Treated Glass Fiber Reinforced Composite Resin Post and CAD/CAM Milled Polyetheretherketone Post: An In vitro Study

2026-05-15T04:12:03+00:00

Background: Endodontically treated teeth with extensive coronal structure loss require dependable post-and-core restorations. Prefabricated glass fiber reinforced composite resin (FRC) posts are in routine use, while custom CAD/CAM milled polyetheretherketone (PEEK) posts are an emerging alternative with potentially superior bonding and biomechanical characteristics.

Aim: To evaluate and compare the push-out bond strength of surface-treated FRC posts and CAD/CAM milled PEEK posts across coronal, middle, and apical root thirds.

Materials and Methods: Twenty-two extracted human maxillary central incisors were endodontically treated and randomly allocated to Group I (n = 11, prefabricated FRC posts) and Group II (n = 11, CAD/CAM milled PEEK posts). Both groups underwent identical surface treatment — 50 µm Al₂O₃ sandblasting followed by silane application — and cementation with dual-cure self-adhesive resin cement. Cemented specimens were stored in distilled water at 37°C for 24 hours prior to testing (no thermal cycling or fatigue loading). Three transverse 2 mm slices per specimen (coronal, middle, apical) were tested on a universal testing machine. Descriptive statistics, independent samples t-test, one-way ANOVA for intragroup regional comparisons, and Bonferroni post hoc analysis were performed (SPSS v28.0.1; significance threshold p < 0.05).

Results: Group II (PEEK) demonstrated significantly higher push-out bond strength than Group I (FRC) at all three root thirds: coronal (11.86 ± 1.14 vs 7.74 ± 1.60 MPa; t = −6.968; p < 0.001), middle (12.33 ± 0.75 vs 7.53 ± 0.92 MPa; t = −13.382; p < 0.001), and apical (10.99 ± 0.69 vs 6.36 ± 0.80 MPa; t = −14.536; p < 0.001). One-way ANOVA revealed significant intragroup regional variation in both Group I (F(2,30) = 4.497; p = 0.020) and Group II (F(2,30) = 6.566; p = 0.004). Bonferroni post hoc analysis identified the middle-to-apical contrast as the only significant pairwise difference within each group (Group I: p = 0.014; Group II: p < 0.001). Coronal-to-middle and coronal-to-apical comparisons were not significant after correction in either group.

Conclusion: CAD/CAM milled PEEK posts exhibit significantly superior push-out bond strength compared with prefabricated FRC posts following equivalent dual surface treatment. The apical third represents the consistently weakest bonding zone in both post systems. These findings support the clinical use of CAD/CAM milled PEEK posts as a viable alternative for restoring endodontically treated teeth, with clinical implications for improved retention and reduced root fracture risk in heavily restored endodontically treated teeth.

Accuracy of Complete-Arch Digital Implant Impressions with and Without Modular E-Chain Splinting: An in vitro Study

2026-05-15T05:17:01+00:00

Background and Objectives: The long-term success of full-arch implant-supported restorations depends on the precision of the impression-making process. Intraoral scanners (IOS) offer clinical advantages, yet capturing accurate complete-arch impressions in edentulous patients remains challenging due to cumulative stitching errors and limited stable landmarks. This study evaluated a novel stabilization method—the modular E-chain splinting technique—for improving digital impression accuracy.

Materials and Methods: A prospective in vitro study was conducted using a standardized PMMA mandibular edentulous model in an “All-on-Four” configuration with four Noris implants (3.75×10 mm). Intraoral scan bodies (Noris C9010) were attached and 15 digital scans were acquired using Dentsply Sirona Primescan, both with and without modular E-chain splinting. STL files were compared against a laboratory reference scan (Dentsply Sirona inEos X5) using Geomagic Studio 12. Linear (x, y, z axes), angular, and distance deviations were measured. Statistical analysis was performed using IBM SPSS v25 (independent student t-test, p < 0.05).

Results: Modular E-chain splinting significantly improved all measured accuracy parameters (p < 0.001). Mean linear deviations were reduced along all three axes (x: 1.12 vs. 1.19 μm; y: 2.15 vs. 2.24 μm; z: 2.55 vs. 2.61 μm). Angular deviation improved from 0.33° to 0.32°. Distance deviation decreased from 1.49 to 1.39 μm, and the global measure of linear absolute error (GMLAE) reduced from 2.01 to 1.94 μm.

Conclusions: Modular E-chain splinting significantly enhances the accuracy of complete-arch digital implant impressions. This technique is time-efficient, passive, and clinically adaptable. Further in vivo studies are warranted to validate these findings in oral conditions.

Effect of Heat-treated and Conventional Retreatment Files on Removal of Gutta Percha and Remaining Dentin Thickness by CBCT Analysis: An in vivo Study

2026-05-21T07:46:23+00:00

The success of endodontic treatment depends on effective canal shaping, thorough chemo-mechanical debridement, and the achievement of a three-dimensional hermetic seal. Despite a reported success rate of up to 97%, failures may occur, often necessitating endodontic retreatment. Complete removal of gutta-percha while preserving radicular dentin is critical for the long-term prognosis of retreated teeth.

Aim: To evaluate and compare the efficiency of ProTaper Universal Retreatment files, Solite RS3 retreatment files, and R-Endo retreatment files in the removal of gutta-percha and their effect on remaining dentin thickness using CBCT analysis.

Materials and Methods: Sixty extracted human single-rooted mandibular premolars diagnosed with post-treatment apical periodontitis were included in this study. Samples were randomly allocated into three groups (n = 20 each) using a sealed envelope technique:

Group 1 – ProTaper Universal Retreatment files,

Group 2 – Solite RS3 Retreatment files,

Group 3 – R-Endo Retreatment files.

Preoperative CBCT scans were obtained to assess baseline dentin thickness. Standardized access cavity preparation was performed under rubber dam isolation using a sterile high-speed round diamond bur. Retreatment procedures were carried out according to the respective manufacturer’s instructions for each file system. Final irrigation was performed using normal saline. Postoperative CBCT analysis was conducted to evaluate the amount of remaining filling material and changes in dentin thickness.

Results: All experimental groups demonstrated residual filling material following retreatment procedures. However, Solite RS3 and R-Endo systems showed significantly greater efficiency in gutta-percha removal compared to the ProTaper Universal Retreatment system. Additionally, the R-Endo group exhibited significantly greater preservation of remaining dentin thickness when compared to the Solite RS3 group.

Conclusion: Within the limitations of this study, none of the retreatment systems achieved complete removal of gutta-percha. However, R-Endo and Solite RS3 systems were more effective than ProTaper Universal Retreatment files. R-Endo demonstrated superior preservation of dentin thickness, suggesting it may be a safer and more conservative option for endodontic retreatment.

Perception of Dental Health Care Use Services in Relation to Oral Health Care Seeking Behavior among Patients Visiting Selective Health Care Center in Bangladesh

2026-05-21T09:03:26+00:00

Background: Bangladesh, one of the world’s most densely populated countries, faces major challenges in oral health service delivery. With approximately 2,000 dentists graduating annually, only a small proportion provide care in rural communities. Limited evidence exists on oral health seeking behavior and utilization patterns within primary care settings in low resource countries.

Objectives: This study aimed to assess oral health seeking behavior, patient profiles, and patterns of dental material use among individuals attending community health camps in Bangladesh.

Materials and Methods: A cross sectional, multi site observational study was conducted at health camps organized by the Department of Dental Public Health, City Dental College and City General Hospital, Dhaka, Bangladesh, from January 2020 to December 2020. Ethical approval was obtained from the institutional review board. A total of 139 participants (majority aged 25–30 years; 63.3% female) were enrolled to examine oral health complaints and associated treatment behaviors.

Results: Dental pain from untreated caries was the most frequent complaint, affecting 25.0% of female and 19.5% of male participants. Other common conditions included gingival problems and tooth loss (15.3%), dentinal hypersensitivity (18.0%), and food impaction (8.3%). Cost was the primary determinant driving care seeking (53.3%), followed by convenient service hours (30.7%) and proximity to home (22.7%). A majority of respondents reported that available dental services did not meet their needs.

Conclusions: Findings reveal significant gaps in access to and utilization of oral healthcare in Bangladesh, particularly among young adults and women. Strengthening primary dental services, expanding rural practice, and improving affordability are critical to enhance service uptake and oral health outcomes.

Comparative Assessment of Tooth Size and Arch Dimension in North Indian Population

2026-05-26T11:52:30+00:00

Dental crowding is a common malocclusion resulting from a discrepancy between tooth size and the available space within the dental arch. The present cross-sectional study aimed to evaluate mesiodistal tooth size and arch width in Class I normal occlusion and Class I and Class II crowded dentitions in a North Indian population, with emphasis on gender differences. The study sample comprised 80 subjects aged 12–35 years. Dental casts were obtained using alginate impressions, and measurements were recorded using a digital vernier caliper. Statistical analysis was performed using an independent t-test with significance set at p ≤ 0.05.

Results demonstrated significantly greater maxillary and mandibular tooth widths in the crowded group compared to the normal occlusion group (p < 0.001), while most arch widths were reduced in crowded dentitions. Maxillary inter-canine width showed no significant difference, whereas posterior arch widths were significantly smaller. Sexual dimorphism was evident, with males exhibiting larger tooth dimensions and wider arches than females.

The study concludes that dental crowding is primarily attributable to increased tooth size rather than reduced arch dimensions, confirming tooth size–arch size discrepancy as the principal etiological factor. Arch width plays a secondary role, with variations influenced by gender. These findings highlight the importance of individualized and gender-sensitive orthodontic diagnosis and treatment planning.

Evaluation of Anterior Alveolar Dimension in Association with Vertical Facial Pattern in Skeletal Class I Subjects among North Indian Population: A Retrospective Cephalometric Study

2026-06-06T10:05:34+00:00

Introduction: The anterior alveolar bone determines the biological limits of orthodontic tooth movement and may vary with vertical facial pattern and gender.

Objective: The study aims to evaluate anterior alveolar dimensions in relation to vertical facial pattern and gender among skeletal Class I subjects from the North Indian population.

Materials and Methods: This retrospective cephalometric study included 90 skeletal Class I subjects (45 males and 45 females), classified into hyperdivergent, hypodivergent, and normodivergent groups based on the SN–MP angle. Lateral cephalograms were manually traced and analyzed to assess anterior alveolar dimensions. Statistical analysis was performed using SPSS version 24, and an independent t-test was applied with significance set at p < 0.05.

Results: Significant differences in anterior alveolar dimensions were observed among vertical facial patterns and between genders. Hyperdivergent subjects demonstrated increased alveolar height with reduced alveolar width, whereas hypodivergent subjects exhibited increased alveolar width. Gender-based differences were also noted in alveolar dimensions.

Conclusion: Anterior alveolar dimensions vary significantly with vertical facial pattern and gender in skeletal Class I individuals. These variations should be considered during orthodontic diagnosis and treatment planning to avoid biological limitations.

Sustainable Restorative Dentistry: Integrating Life Cycle Assessment, Minimally Invasive Dentistry, and Bioactive Material Innovations

2026-01-09T05:39:19+00:00

Sustainability has emerged as a critical priority in healthcare systems due to their substantial contribution to global environmental degradation, with dentistry—particularly restorative dentistry—playing a notable role through intensive material consumption, chemical discharge, energy use, and waste generation. This narrative review synthesizes current evidence on sustainable restorative dentistry by integrating Life Cycle Assessment (LCA), minimally invasive dentistry (MID), and recent advances in bioactive and smart restorative materials. A structured but non-systematic literature review was conducted using major scientific databases, including PubMed, Scopus, and Web of Science, focusing on sustainability, restorative materials, LCA methodologies, and conservative clinical approaches. Evidence from LCA studies demonstrates marked variability in the environmental performance of restorative materials. Dental amalgam exhibits the highest ecological burden due to mercury toxicity and associated environmental risks, leading to its phase-down under the Minamata Convention. Resin-based composites are associated with considerable carbon emissions related to energy-intensive manufacturing processes, polymerization, and packaging waste, whereas glass ionomer cements (GICs) consistently demonstrate lower environmental impacts owing to their water-based composition and favorable life cycle profiles. Minimally invasive strategies, particularly prioritizing repair over complete replacement of restorations, substantially reduce clinical waste, energy consumption, and loss of sound tooth structure while extending restoration longevity. In addition, bioactive and smart materials—including GICs, calcium silicates, and ion-releasing systems—actively promote remineralization, inhibit secondary caries, and support tissue regeneration, thereby aligning clinical performance with sustainability goals. The integration of LCA-informed decision-making, digital workflows, and the 4R framework (Reduce, Reuse, Rethink, Recycle) into clinical practice and dental education fosters a systems-based approach to sustainability. Sustainable restorative dentistry thus represents an ethical, evidence-based paradigm that aligns oral healthcare delivery with environmental responsibility and defines a future-oriented standard for restorative dental practice.

Bridging Periodontics and Forensics: Emerging Trends and AI-Driven Innovations

2026-01-21T09:01:34+00:00

Forensic odontology plays a crucial role in human identification by analysing dental structures that remain resilient even under extreme postmortem conditions. Within this domain, periodontics contributes significantly by offering key morphological and pathological indicators that support age estimation, biological profiling, and individual identification. This review explores the collective relevance of periodontal tissues—periodontal ligament, cementum, alveolar bone, and gingival architecture—in forensic investigations, while also highlighting the expanding integration of artificial intelligence (AI) in forensic periodontology. Periodontal structures can be used as markers for chronological assessment since they experience predictable age-related changes. In both antemortem and postmortem situations, techniques including Gustafson's criteria, gingival recession analysis, alveolar bone loss assessment, and tooth cementum annulation (TCA) offer useful information. Additionally, dental implants are trustworthy identifiers in times of severe decomposition and mass disasters because of their thermal stability and traceable batch numbers. AI has become a potent tool in forensic odontology as a result of technical developments. When dental records are not available, machine-learning algorithms can help with morphological comparisons, forecast age more accurately, and identify pathological changes in radiographs. Additionally, implant-recognition software speeds up the classification of implant systems, and AI-assisted 3D printing and reconstruction provide precise visualisation of broken remains.In order to demonstrate the transdisciplinary importance of periodontology in forensic practice and the revolutionary potential of AI in enhancing accuracy, efficiency, and standardisation, this review summarises recent research. A potential future for forensic identification is represented by the merging of traditional periodontal assessment with AI-driven computational tools, strengthening the vital connection between dental science and the legal system.

Biosynthesized Silver Nanoparticle Containing Herbal Mouth Rinse in Dentistry: A Comprehensive Narrative Review

2026-02-14T07:47:02+00:00

The integration of nanotechnology with herbal medicine has led to the development of biosynthesized silver nanoparticle (AgNP)–herbal mouth rinses for dental applications. This narrative review summarizes current evidence on the synthesis methods, classification, antimicrobial mechanisms, dental applications, safety considerations, and clinical relevance of biosynthesized AgNP–herbal mouth rinses. Green synthesis using medicinal plant extracts produces silver nanoparticles with antimicrobial, anti-inflammatory, and antioxidant properties while improving biocompatibility and reducing chemical residues. When combined with herbal constituents, these formulations demonstrate activity against oral pathogens associated with dental caries, periodontal diseases, oral candidiasis, and halitosis. The review highlights potential advantages over conventional chemical mouth rinses, including broader antimicrobial action and reduced adverse effects, while also discussing limitations related to standardization, safety, and clinical evidence. Current knowledge gaps and future research directions are identified to support the rational development and clinical evaluation of AgNP–herbal mouth rinses in dentistry.

Decoding Epigenetic Regulation in Periodontal Disease

2026-02-27T12:55:04+00:00

Periodontal disease is a chronic inflammatory condition initiated by dysbiotic microbial biofilms and sustained by a dysregulated host response that culminates in connective tissue destruction and alveolar bone loss. While microbial challenge and classical risk factors such as smoking, diabetes, and aging shape disease susceptibility and severity, they do not fully explain the heterogeneity in clinical presentation, progression rates, or treatment responsiveness. Epigenetic regulation provides a biologically plausible bridge between environmental exposures and durable, context-dependent changes in gene expression in periodontal tissues. This review synthesizes contemporary evidence on the epigenetic architecture of periodontal disease, focusing on DNA methylation and demethylation dynamics, histone modifications and chromatin reader mechanisms, non-coding RNA networks, and emerging epitranscriptomic processes such as N6-methyladenosine RNA modification. We discuss how these layers influence inflammatory signaling, innate and adaptive immune crosstalk, osteoclastogenesis, extracellular matrix remodeling, and resolution pathways, and how periodontal pathogens can modulate host epigenetic machinery. Finally, we evaluate translational opportunities for epigenetic biomarkers in saliva, gingival crevicular fluid, gingival tissue, and blood, and the potential of host-modulation strategies targeting histone deacetylases and bromodomain proteins, while emphasizing methodological considerations, causal inference challenges, and priorities for multi-omics and longitudinal studies. Translational opportunities are strongest in biomarker development and adjunctive host modulation targeting histone acetylation pathways, provided that future research improves cellular resolution, standardization, longitudinal validation, and causal interpretation.

Nanoparticles in Endodontic Sealers: Current Evidence, Mechanisms, and Clinical Perspectives

2026-03-05T12:37:57+00:00

Recent advancements in nanotechnology have introduced a myriad of potential applications in dentistry, with nanomaterials playing an increasing role in endodontics. These nanomaterials exhibit distinctive mechanical and chemical properties, rendering them suitable for various dental applications in endodontics, including obturating materials, sealers, retro-filling agents, and root-repair materials. Endodontic sealers are central to root canal obturation because they occupy irregularities, interface with dentine, and may contribute to suppressing residual microorganisms. Persistent or recurrent infection—often associated with biofilm survival in anatomically complex spaces—continues to motivate material-level innovations intended to improve antimicrobial activity without compromising handling, sealing, or biocompatibility. Over the past decade, nanoparticle-enabled strategies have emerged as a prominent line of investigation. These strategies include the incorporation of metallic nanoparticles (notably silver-based systems), polymeric nanoparticles such as chitosan, and ion-releasing or bioactive particulate phases, including bioactive glasses, nano-calcium phosphate, and hybrid fillers engineered for adhesive or redox functionality. This narrative review synthesises current evidence on nanoparticles incorporated into, or designed to function alongside, endodontic sealers, focusing on mechanistic rationales, laboratory outcomes, and clinically relevant trade-offs. The literature indicates that nanoparticles can enhance antibiofilm effects through contact-killing or controlled ion release, promote mineral interfacial activity, and tune physicochemical properties such as flow, radiopacity, and microhardness. However, evidence remains predominantly in vitro, with heterogeneity in microbial models, ageing protocols, sealer chemistries, nanoparticle loading and dispersion, and outcome measures. Studies also report that benefits are concentration- and formulation-dependent, and some nanoparticle additions do not improve leakage resistance under relevant conditions. Translational barriers include reproducible nanoparticle dispersion, predictable release kinetics, toxicity and environmental considerations, retreatability, and regulatory classification. Future research that aligns antimicrobial claims with clinically meaningful endpoints, standardised ageing, and robust biocompatibility assessment will be essential before nanoparticle-enhanced sealers can be confidently recommended beyond selected indications.

A Narrative Review on Guided Endodontics: Novel Treatment Approach for Teeth with Pulp Canal Calcification

2026-04-16T08:12:14+00:00

Pulp canal calcification (PCC), also referred to as pulp canal obliteration or calcific metamorphosis, represents one of the most formidable challenges in contemporary endodontic practice. The progressive deposition of mineralised tissue within the root canal system renders conventional access cavity preparation and canal negotiation technically demanding, time-consuming, and associated with an elevated risk of iatrogenic complications, including root perforation. Guided endodontics has emerged as an innovative digital workflow that integrates cone beam computed tomography (CBCT) data with digital surface scanning to fabricate patient-specific drill guides, enabling precise and minimally invasive access to calcified root canals.

This narrative review comprehensively evaluates the current evidence base for guided endodontics, encompassing its conceptual framework, digital workflow, technical execution, clinical accuracy, dentinal substance preservation, and the inherent limitations of the technique. A structured search of major electronic databases was conducted, incorporating studies published between 2005 and 2026, supplemented by seminal older literature. The review examines the aetiology and pathophysiology of PCC, outlines diagnostic challenges, and critically appraises both static guide-based and dynamic real-time navigation modalities of guided access. Evidence indicates that guided endodontics affords significantly improved accuracy of canal location and substantially reduced iatrogenic dentinal removal compared with conventional approaches, particularly in severely calcified anterior teeth.

Nevertheless, the technique demands a sophisticated digital infrastructure, carries cumulative procedural errors from each step of the workflow, and is associated with higher costs and a considerable learning curve. Future developments integrating artificial intelligence-assisted planning, augmented reality navigation, and refined guide fabrication materials hold considerable promise for broader clinical application. Overall, guided endodontics represents a paradigm shift in the management of calcified root canals, with growing evidence supporting its role as a reliable, tooth-conserving treatment modality.

Cross-Sectional Analysis of Oral Health Indicators in India and the United States: A Comparative Narrative Review

2026-04-17T10:00:38+00:00

Oral health constitutes a fundamental dimension of overall human wellbeing, yet oral diseases remain among the most prevalent non-communicable conditions affecting populations worldwide. This narrative review presents a cross-sectional comparative analysis of key oral health indicators in India and the United States, two nations that, despite their contrasting levels of economic development, share substantial burdens of dental caries, periodontal disease, oral cancer, and tooth loss, albeit with markedly different aetiological profiles, healthcare access structures, and policy responses. Drawing on peer-reviewed literature and authoritative international health reports published between 2000 and 2025, this review synthesises evidence across the domains of disease prevalence, risk factor distribution, social determinants, healthcare access, and policy frameworks. The global burden of oral disease, as documented by successive iterations of the Global Burden of Disease study, forms the contextual backdrop for this analysis. Evidence indicates that India bears a disproportionately high burden of oral cancer, largely attributable to the widespread use of smokeless tobacco and areca nut products, while the United States demonstrates significant disparities in dental caries and periodontal disease prevalence across racial, ethnic, and socioeconomic groups. Both nations face structural challenges in integrating oral health into primary healthcare systems and extending equitable access to dental services. The review highlights the utility of the common risk factor approach as a unifying framework for designing oral health interventions that address shared upstream determinants. It concludes by identifying convergent research priorities, including the need for standardised surveillance, integration of oral health into universal health coverage frameworks, and the expansion of community-based preventive programmes.

From Monolayer to Biomimetic Mastery: The Multilayer Injection Concept

2026-04-20T13:19:18+00:00

The evolution from conventional monolayer cell culture to sophisticated biomimetic multilayer constructs represents one of the most consequential paradigms shifts in contemporary biomedical engineering and regenerative medicine. Monolayer systems, whilst foundational to cell biology research, are increasingly recognised as inadequate surrogates for native tissue architecture, owing to their inability to recapitulate the three-dimensional, compositionally graded, and mechanically heterogeneous environments that govern cellular behaviour in vivo. The multilayer injection concept emerges as a transformative strategy that addresses these limitations by enabling the sequential or simultaneous deposition of compositionally distinct, bioactive material layers via injection-based platforms, thereby recreating the stratified complexity inherent to biological tissues. This review examines the conceptual progression from monolayer paradigms to biomimetic multilayer injectable architectures, exploring the biological rationale, material platforms, crosslinking strategies, and gradient engineering principles that underpin this approach. Applications spanning osteochondral tissue engineering, vascular repair, neural regeneration, and dermal reconstruction are critically evaluated, alongside an assessment of prevailing challenges related to vascularisation, mechanical integration, scalability, and clinical translation. The multilayer injection concept is contextualised within the broader trajectory of biofabrication, and future research priorities are identified to guide the field towards clinically viable biomimetic constructs capable of recapitulating not merely the gross composition but the full spatial and functional complexity of native tissues.

Sticky Bone: Stability Meets Biology in Periodontal Regeneration- A Narrative Review

2026-04-21T11:51:48+00:00

Periodontal regeneration is a therapeutic procedure aimed at re-establishing the lost tooth-supporting tissues—alveolar bone, periodontal ligament, and cementum—by promoting the formation of new, functional attachment. It is biologically driven, cell-selective phenomenon in which the nature of healing is determined by the specific cell population that repopulates the root surface. Among these, cells derived from the periodontal ligament possess the distinctive capability to form new cementum, alveolar bone, and functionally oriented Sharpey’s fiber’s, thereby enabling true regenerative attachment. Various methods include guided tissue regeneration, bone graft, tissue engineering and enamel matrix derivative. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate that has gained growing recognition in recent years for its applications in regenerative procedures. Sticky bone is created by combining autologous platelet concentrates with particulate bone graft materials, thereby integrating persistent growth factor release with structural scaffold support.

Bridging the Gap: Emerging Orthodontic Strategies in Cleft Lip and Palate Regeneration

2026-04-23T16:29:57+00:00

Cleft lip and palate (CLP) is a common congenital craniofacial anomaly that significantly affects facial aesthetics, oral function, and overall quality of life, requiring long-term multidisciplinary management. Conventional treatment approaches, including presurgical orthopedics and surgical repair, have improved outcomes but are often associated with limitations such as graft resorption, scarring, altered growth patterns, and the need for repeated interventions. From an orthodontic perspective, challenges persist in achieving stable alveolar bone continuity, optimal tooth eruption, and long-term occlusal harmony.

Recent advances in regenerative medicine and digital technology are transforming cleft care toward a more precise and patient-specific approach. Innovations such as tissue engineering, stem cell therapy, 3D and 4D bioprinting, nanotechnology, and artificial intelligence–assisted planning have demonstrated potential in enhancing alveolar bone regeneration, improving eruption guidance, and maintaining arch form. Digital workflows and telemedicine further improve accessibility and treatment efficiency.

This review highlights these emerging strategies and their orthodontic implications, emphasizing their role in improving treatment predictability and reducing intervention burden. Despite promising outcomes, challenges related to cost, accessibility, and long-term clinical validation remain. The integration of regenerative and digital approaches represents a significant step toward personalized, growth-adaptive cleft management.

Effect of Antimicrobial Drug Regimens in Mandibular Third Molar Extraction: A Narrative Review

2026-05-05T12:24:46+00:00

Surgical extraction of impacted mandibular third molars is one of the most common procedures in oral and maxillofacial surgery, often associated with postoperative complications such as pain, swelling, trismus, alveolar osteitis, and infection. The use of antimicrobial regimens to prevent these complications remains controversial, particularly in healthy patients undergoing uncomplicated extractions. This narrative review aims to critically evaluate the effectiveness, indications, timing, and duration of antimicrobial therapy in mandibular third molar extraction, while emphasizing evidence-based prescribing and antimicrobial stewardship. A comprehensive literature search was conducted across PubMed/MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science databases for studies published between 2010 and 2025. Studies evaluating antimicrobial regimens in mandibular third molar extraction, including randomized controlled trials, cohort studies, and systematic reviews, were included. Clinical outcomes such as postoperative infection, alveolar osteitis, pain, swelling, wound healing, and adverse drug reactions were analyzed. A total of 67 relevant articles were selected following screening and eligibility assessment. The findings suggest that postoperative infection rates are generally low in healthy individuals when appropriate surgical techniques are followed. Prophylactic antibiotics provide only modest benefits, with evidence supporting single-dose preoperative administration as effective as extended postoperative regimens in most cases. Multi-day antibiotic use does not significantly improve outcomes but increases the risk of adverse effects and antimicrobial resistance. Therapeutic antibiotics are justified in cases of active infection or high-risk patients. Routine antibiotic use in uncomplicated mandibular third molar extraction is not recommended. Rational prescribing, guided by patient-specific risk assessment and evidence-based protocols, is essential to optimize clinical outcomes while minimizing antimicrobial resistance.

Emerging Role of Hydrogels in Endodontics: Current Applications, Regenerative Potential, and Future Perspectives

2026-05-16T12:25:20+00:00

Hydrogels are increasingly important in endodontic research because they combine high water content, tuneable physicochemical behaviour, injectability, biological compatibility and the capacity to deliver antimicrobial or regenerative signals within the complex root canal environment. Their relevance reflects a wider shift in endodontics from purely debridement-and-filling approaches towards biologically informed repair and regeneration of the dentine–pulp complex. This narrative review examines the current applications of hydrogels in endodontics, with emphasis on antimicrobial intracanal medication, injectable regenerative scaffolds, cell-delivery systems, decellularised extracellular-matrix hydrogels, drug-delivery platforms, dentine–pulp complex repair and emerging hydrogel-based obturation concepts. The literature search covered publications since 1 January 2000, while allowing inclusion of older classic studies only when necessary to explain foundational concepts. The principal databases searched were PubMed/MEDLINE, Web of Science Core Collection, Scopus and Google Scholar. Additional searches were performed in Embase, the Cochrane Library, Dentistry & Oral Sciences Source, Europe PMC and SciFinder-n. The review evaluates the regenerative potential of hydrogels in relation to vascularisation, odontogenic differentiation, immune modulation, innervation and cell homing. Hydrogels have shown considerable promise in preclinical studies because they can be formulated to conform to irregular canal anatomy, retain therapeutic molecules, protect encapsulated cells and support tissue-like matrix formation. However, translation into routine endodontic practice remains limited by persistent challenges, including microbial biofilm control, compatibility with irrigation protocols, standardisation of degradation and mechanical behaviour, variability in natural and decellularised matrices, sterilisation, storage, regulatory complexity and the scarcity of long-term human clinical evidence. Future progress is likely to depend on clinically simple but biologically instructive hydrogels that integrate disinfection, tissue guidance, controlled degradation and compatibility with existing endodontic procedures. Hydrogels should therefore be viewed not as a single replacement material, but as a diverse family of adaptable biomaterial systems with the potential to reshape regenerative and minimally invasive endodontics.

Intra-Articular Injections as a Treatment Option for Internal Derangement of the Temporomandibular Joint: A Review

2026-01-15T09:26:05+00:00

Internal derangement (ID) of the temporomandibular joint (TMJ) is one of the most prevalent intra-articular disorders of the masticatory system and is characterized by an abnormal positional or functional relationship between the articular disc, mandibular condyle, and temporal component. Patients commonly present with pain, joint sounds, restricted mouth opening, and functional impairment. While conservative management remains the first-line approach, a considerable proportion of patients fail to achieve sustained symptom relief and require minimally invasive interventions. Intra-articular (IA) injections have gained significant attention as effective intermediate therapeutic options that bridge the gap between conservative therapy and surgical intervention. Over recent years, advances in regenerative medicine have expanded IA treatment modalities beyond traditional corticosteroids to include hyaluronic acid (HA), platelet-rich plasma (PRP), and other biologically active agents. This comprehensive review elaborates on the pathophysiology of TMJ internal derangement, critically analyzes the mechanisms of action, clinical efficacy, safety profiles, and comparative outcomes of commonly used IA injectables, and highlights the adjunctive role of arthrocentesis. Evidence from randomized controlled trials, systematic reviews, and recent clinical studies till 2025 suggests that PRP and HA provide superior medium‑ to long‑term outcomes compared with corticosteroids, which are best reserved for short‑term inflammatory control. Botulinum toxin A (BoNT‑A) remains investigational for intra-articular use. A thorough understanding of indications, limitations, and biological rationale is essential for evidence-based management of TMJ internal derangement.

Soft Tissue Calcifications in the Orofacial Region: A Review

2026-02-16T08:57:15+00:00

Soft tissue calcifications in the orofacial region are relatively frequent and are often observed unexpectedly during standard radiographic evaluations. They represent a broad group of conditions arising from abnormal calcium salt deposition, which may occur through dystrophic, metastatic, or idiopathic pathways. While most calcifications are asymptomatic and benign, certain cases can reflect underlying local or systemic disorders that require additional clinical assessment. Radiographic interpretation is crucial, focusing on factors like anatomical site, size, morphology, and distribution of the calcified deposits. This review provides a detailed discussion of soft tissue calcifications affecting the orofacial complex, with particular focus on their etiological factors, classification, radiological features, and clinical relevance. By synthesising evidence from existing literature, the article highlights the significance of proper identification and interpretation of these entities for dental clinicians and radiologists, thereby improving diagnostic accuracy and patient management.

Comparative Effectiveness of Arch Bar Techniques in Maxillomandibular Fixation for Midface Fractures: A Systematic Review and Meta-analysis

2026-01-23T10:22:57+00:00

Introduction: Midface fractures constitute a substantial portion of maxillofacial trauma and often require maxillomandibular fixation (MMF) for stabilization and occlusal realignment. While Erich Arch Bars (EABs) have traditionally been used for over a century, they are associated with prolonged operative times, increased glove perforation risks, and patient-related complications. Contemporary alternatives—including Hybrid Arch Bars (HABs), Screw-Retained Arch Bars (SRABs), and Embrasure Wires—offer promising advantages in surgical efficiency and safety.

Methods: This PRISMA-compliant systematic review and meta-analysis (PROSPERO: CRD420251031357) compared EABs with modern MMF techniques. A total of eight comparative studies were included. Primary outcomes analyzed were operative time, glove perforation rate, complication rate, and fixation stability. Data were pooled using random-effects models, and study quality was assessed using the Newcastle-Ottawa Scale and Cochrane RoB 2 tool.

Results: Alternative MMF systems significantly reduced operative time compared to EABs, with a pooled mean difference of −40 minutes (95% CI: −55 to −25). Glove perforation risk decreased by 52–75% with HABs, SRABs, and Embrasure Wires. Postoperative complication rates were similar across all systems, with no statistically significant differences. These findings remained consistent across subgroup and sensitivity analyses.

Conclusion: HABs, SRABs, and Embrasure Wires provide effective alternatives to conventional EABs, offering improved surgical efficiency and reduced occupational risk without compromising clinical outcomes. Adoption of these newer systems may enhance operating room safety and performance, particularly in high-acuity trauma settings. Further multicenter trials with standardized outcome measures are recommended.

Lipswitch Vestibuloplasty Using the ‘Lock & Glide’ Technique: A Case Report

2026-01-03T07:22:54+00:00

Shallow vestibular depth in the anterior mandible compromises oral hygiene and predisposes to mucogingival problems. Conventional lipswitch vestibuloplasty often suffers relapse due to muscular tension from the mentalis muscle. This case report presents a 25yearold male with a thin gingival phenotype and inadequate vestibular depth, treated using a dualsuturing approach that combines simple interrupted sutures for periosteal fixation with interlocking and pterygiuminspired anchoring sutures in the lip mucosa. The technique provided immediate flap adaptation and longterm resistance against relapse. At six months, the patient demonstrated stable vestibular depth, improved oral hygiene, and absence of gingival recession. This case report highlights the potential of integrating ophthalmic suturing principles into periodontal surgery to achieve predictable outcomes in complex clinical scenarios.

Functional Reconstruction Following Maxillofacial Trauma from a Hippopotamus Bite: Challenges and Management

2026-01-09T06:06:16+00:00

Animal bite injuries are a common cause of emergency trauma, while wild animal bites are rare but associated with high morbidity due to severe mechanical damage and polymicrobial contamination. We report a rare case of a hippopotamus bite causing complex maxillofacial, thoracic, abdominal, and gluteal injuries in a 58-year-old zoo caretaker. Clinical and radiologic evaluation revealed a displaced mandibular ramus fracture with extensive soft-tissue trauma. Early multidisciplinary management included wound debridement, rabies and tetanus prophylaxis, chest drainage for hemo-thorax, and planned multidisciplinary surgical intervention. Open reduction and internal fixation of the mandible achieved complete functional recovery. Microbiological cultures demonstrated polymicrobial infection, necessitating targeted antibiotic therapy. No long-term complications occurred. This case highlights the aggressive nature of hippopotamus bite injuries, the potential for complex infection patterns, and the importance of prompt, coordinated multidisciplinary care in achieving favourable outcomes.

Application of High-concentration 35 kDa Hyaluronic Acid Fragment Gel in the Treatment of Mild Gingival Recession and Periodontal Inflammation: A Case Series

2026-01-23T10:30:27+00:00

Background: Periodontal disease is a chronic inflammatory condition characterized by gingival redness and bleeding in its early stages, which can progress to gingival recession and tooth mobility in severe cases. Increasing evidence suggests that periodontal disease represents a systemic chronic inflammatory disorder often associated with cardiovascular diseases. Therefore, its effective management is crucial for overall health. Hyaluronic acid (HA), an essential component of gingival connective tissue, possesses anti-inflammatory and tissue-repairing properties. Low-molecular-weight HA fragment has been proven effective in reducing inflammation in skin and mucosal applications; however, their role in gingival repair remains unclear.

Methods: This case series included four male patients with mild gingival recession (Miller Class I or II) and chronic gingival or radicular pain associated with periodontal disease. All participants applied a 10% high-concentration 35 kDa HA fragment gel twice daily—to the teeth and gingiva—over a 42-day treatment period. Gingival growth was measured visually by comparing root exposure length before and after treatment. Standardized pain and discomfort scales were used to assess changes in gingival pain, redness, swelling, itching, and bleeding induced by tooth brushing.

Results: After 42 days of treatment, the average gingival regrowth was 1.2 mm, with the exposed dark root surface decreasing from 1.4 ± 0.2 mm to 0.2 ± 0.1 mm. The average chronic gingival or radicular pain score dropped from 2.4 to 0. Gingival itching and discomfort disappeared within 30 seconds of application, redness and swelling improved markedly within 4 days, and brushing-induced bleeding stopped within 2 days. All patients demonstrated excellent compliance, and no adverse reactions were observed.

Conclusion: Topical application of a 10% HA35 gel was associated with improvement in mild gingival recession and periodontal inflammatory symptoms in this small case series. This formulation shows promising potential for periodontal-related gingival repair and home oral care, warranting further clinical investigation.

Pyogenic Granuloma Mimicking Vascular Tumour: Report of an Unusual Case

2026-01-27T13:31:23+00:00

Pyogenic granuloma is a benign, rapidly proliferating vascular lesion of the oral cavity, commonly affecting the gingiva but rarely occurring in the floor of the mouth. We present a case of a 70-year-old male with a pedunculated bluish-pink growth in the anterior floor of the mouth, initially suspected to be a vascular tumor based on clinical and radiological findings. Contrast-enhanced computed tomography revealed a well-defined hypervascular lesion. Complete surgical excision was performed, and histopathological examination confirmed the lesion as a pyogenic granuloma. Healing was uneventful with no recurrence during follow-up. This case underscores the diagnostic challenge of differentiating pyogenic granulomas from vascular tumors in uncommon sites and highlights the importance of histopathological confirmation and complete excision for definitive management.

Clinicopathologic Variability and Spectrum of Dentigerous Cysts: A Case Series

2026-01-29T10:23:54+00:00

Background: Dentigerous cysts are developmental odontogenic cysts associated with impacted or unerupted teeth and are usually asymptomatic, though occasional aggressive behaviour has been reported.

Case Series: Three patients with uncommon presentations of dentigerous cysts were managed at a tertiary care centre, including a large mandibular lesion with root resorption in an elderly patient, bilateral mandibular cysts in a paediatric patient, and an incidentally detected maxillary cyst. Surgical enucleation with or without extraction was performed. Histopathology confirmed infected dentigerous cysts. Six-month follow-up showed satisfactory healing without recurrence.

Conclusion: Dentigerous cysts may show variable clinical behaviour, ranging from incidental findings to aggressive lesions causing bone destruction. The cases presented here highlight the diversity in age, location, and clinical presentation of dentigerous cysts. Early diagnosis and complete surgical enucleation in these patients resulted in favourable outcomes, emphasizing the importance of individualized management to prevent recurrence or potential complications.

Buried Beneath the Surface: CT Limitations in Detecting Dry Wooden Facial Foreign Bodies

2026-02-03T12:38:54+00:00

Background: Organic foreign bodies in the maxillofacial region are often missed due to their radiolucent nature. Dry wood is particularly challenging as its density on CT scans can mimic air or fat.

Case Description: A 62-year-old female presented with persistent facial swelling and pus discharge two weeks after colliding with a tree. Despite clinical suspicion, a preoperative CT scan showed no detectable foreign object.

Management: Based on the traumatic history and persistent infection, surgical exploration was performed. A 3.5 cm wooden fragment was identified and extracted from the subcutaneous tissue. The patient recovered fully following debridement and antibiotic therapy.

Discussion: Dry wood typically exhibits low Hounsfield Units, making it nearly invisible on standard CT settings. While adjusted CT windowing or MRI can improve detection, these materials are frequently overlooked during initial assessment.

Conclusion: A negative CT scan does not rule out wooden foreign bodies. Clinicians must maintain a high index of suspicion in organic trauma cases; surgical exploration remains the definitive diagnostic and therapeutic approach.

Comparative Evaluation of Probiotic Strips and Tetracycline Fibres as Adjuncts to Non-surgical Periodontal Therapy: A Case Series

2026-02-06T07:20:13+00:00

Introduction: Probiotics have gained attention in periodontal therapy due to their potential to modulate the oral microbiota and improve periodontal health. This study wants to evaluate the effectiveness of probiotic strips VS tetracycline fibres in non-surgical pocket reduction in periodontitis patients.

Objectives: The primary objective is to assess the reduction in pocket depth following the use of probiotic strips compared to a tetracycline fibres.

Secondary objectives include evaluating changes in clinical attachment level, bleeding on probing in the periodontal pockets.

Case Presentation: A split-mouth design was employed, with 10 participants receiving both interventions in different quadrants of the mouth. Pocket depths was measured at baseline and after treatment with either probiotic strips or tetracycline fibres. The primary outcome measure was the reduction in pocket depth following treatment. Secondary outcomes, including changes in clinical attachment level and bleeding on probing, was also be assessed.

Discussion: The study results will be presented in terms of changes in probing pocket depth, clinical attachment level, bleeding on probing, between the site A and site B. Statistical analysis will be conducted to determine the significance of these changes. Both probiotic strips and tetracycline fibres showed comparable improvements in pocket depth, CAL, and bleeding on probing. These findings align with previous reports on probiotics as host-modulating agents and tetracycline fibre therapy. The study provides valuable insights into adjunctive therapies for periodontal disease.

Conclusion: The findings of this study provided valuable insights into the effectiveness of probiotic strips and tetracycline fibres in non-surgical pocket reduction in patients with periodontal disease. If proven effective, it could serve as a promising adjunctive therapy in periodontal treatment protocols.

Comprehensive Dual-Arch Prosthetic Rehabilitation with a Convertible Mandibular Cast Partial Denture and Maxillary Overdenture: A Case Report

2026-02-21T06:58:57+00:00

Preservation of the residual alveolar ridge is a primary goal in prosthodontic rehabilitation. Overdentures represent a proven treatment modality that aids in alveolar bone preservation while maintaining proprioceptive feedback through retained natural teeth. Hemisectioned molars can serve as effective abutments for overdenture support. This case report describes rehabilitation using a maxillary tooth-supported overdenture and a convertible mandibular cast partial overdenture, using a hemisectioned molar as an abutment. A 62-year-old male patient reported with multiple missing teeth and difficulty in chewing. As the patient was not willing for extractions, a preventive prosthodontic approach involving tooth-supported overdentures was planned. The present case report highlights use of hemisectioned molar as an overdenture abutment. A convertible cast partial overdenture was designed to allow future modification in situation of abutment loss. This approach improves esthetics, mastication and overall patient satisfaction.

A Case Report on Burning Mouth Syndrome

2026-02-28T12:11:09+00:00

Burning mouth syndrome (BMS), a chronic orofacial pain disorder with the presence of burning sensation in the oral cavity without any specific oral disease. It commonly affects elderly aged and middle aged women with significant psychological disorders or hormonal changes. Patients also complain of altered taste sensation, pain in oral mucosa, and dry mouth. It is usually idiopathic in nature and its etiopathogenesis is not yet clear. Following the clinical evaluation, treatment strategies include pharmacological management and reassurance of patients.

Herpes Zoster Involving the Hard Palate – A Case Report

2026-03-14T12:53:23+00:00

Herpes zoster of the oral cavity is a rare manifestation, typically presenting with unilateral painful ulcerations confined to the affected dermatome. Effective antiviral therapies and vaccines are available for both varicella and herpes zoster, significantly reducing disease severity and preventing Varicella-zoster virus (VZV) associated complications. This case report presents a rare instance of herpes zoster involving the hard palate in a middle-aged male patient, emphasising the importance of early diagnosis and prompt management of oral manifestations. A 40-year-old male presented with a five-day history of severe burning sensation on the left hard palate, preceded by mild intermittent fever and fatigue. Intraoral examination revealed multiple clustered shallow ulcers with irregular margins, strictly confined to the left side, with surrounding erythema and tenderness. The right palate and underlying bone were unaffected. A provisional diagnosis of oral herpes zoster was made. The patient was managed with oral acyclovir (400 mg three times daily), paracetamol (500 mg three times daily), and multivitamins for one week, along with advice on hydration. Complete resolution of lesions and associated symptoms was observed within seven days. This case emphasises the importance of early recognition and antiviral therapy in managing oral herpes zoster to ensure rapid symptom relief and prevent complications.

Herpes Zoster Infection Involving the Mandibular Division of the Trigeminal Nerve: A Case Report with Review of Complications

2026-05-22T12:22:13+00:00

Herpes Zoster Virus (HZV) is a neurotropic virus that, upon reactivation, causes a characteristic unilateral dermatomal eruption not crossing the midline, limited to the area supplied by the affected nerve. The condition, known as Shingles or Herpes Zoster (HZ), has increasing incidence with immunosenescence, particularly in individuals above the age of 50 years, HIV-infected individuals, patients with malignancies, or those on protracted corticosteroid therapy. Involvement of the mandibular division of the Trigeminal nerve, though rare (1.7–2%), produces a distinctive constellation of unilateral intraoral vesicles, odontalgia, and cutaneous eruptions on the affected side. Serious complications associated with mandibular zoster include post-herpetic neuralgia, osteonecrosis of the jaw, tooth exfoliation due to vasculitis, Bell's Palsy, and Ramsay–Hunt syndrome. Here we report a case of a 50-year-old female presenting with painful rashes and vesicles on the left side of the face and left half of the oral cavity, diagnosed with Herpes Zoster infection involving the mandibular division of the left Trigeminal Nerve via Tzanck test. She was treated with Acyclovir and followed up with no complications. This report discusses the incidence, clinical manifestations, rare complications including vascular and neurological sequelae, diagnosis, treatment, and prevention of Herpes Zoster infection with mandibular involvement.

Stability of Lip Print Patterns in a Patient with Recurrent Aphthous Stomatitis (RAS) for Forensic Identification: A Clinical Case Report

2026-06-20T10:10:34+00:00

Recurrent aphthous stomatitis (RAS) may temporarily alter the surface characteristics of the labial mucosa and can therefore influence lip print recording in cheiloscopy. This clinical case report aimed to assess the stability of lip print patterns in a 24-year-old woman with recurrent minor RAS affecting the inner aspect of the left lower lip. Lip prints were recorded at three observation points: before lesion onset, during the active lesion phase and after complete healing. The lipstick-and-transparent adhesive tape method was used, and the obtained prints were transferred to white paper and photographed digitally. Lip print patterns were analysed using the Suzuki and Tsuchihashi classification after division of the lips into eight quadrants. At baseline, 199 grooves were recorded, with Type I′ being predominant (53.2%), followed by Type II (29.6%), Type V (8.5%), Type I (7.5%) and Type IV (1.0%); Type III was absent. During the active lesion phase, 115 grooves were identified, with an increased proportion of Type II (36.5%), reduced Type I′ (28.7%) and the appearance of Type III (0.9%), along with higher proportions of Type IV (12.2%) and Type V (10.4%). After healing, 80 grooves were recorded, and Type I′ again predominated (48.75%), followed by Type I (21.25%), Type II (12.5%), Type V (10%), Type IV (5%) and Type III (2.5%). These findings suggest that the basic lip print pattern in this case remained broadly stable, although active RAS was associated with temporary local distortion. Cheiloscopy may remain useful for forensic identification when the clinical condition of the lips at the time of recording is carefully considered.

Knowledge, Attitude and Awareness of Aerb Guidelines among Dental Undergraduates

2026-03-21T16:46:54+00:00

Introduction: The Atomic Energy Regulatory Board's (AERB) guidelines for radiation safety in dental radiography serve as guidelines (Atomic Energy Regulatory Board, 2021, AERB, 2021). Ionizing radiation poses biological risks due to its stochastic and deterministic effects (Mallya & Lam, 2019, U.S. Food and Drug Administration, 2004). For safe clinical practice, dental trainees must have adequate knowledge as well as a good attitude toward these standards. This study evaluated dentistry students' and interns' awareness, knowledge, attitudes, and exposure to instruction regarding the AERB dental radiography suggested modifications.

Materials and Methods: A cross-sectional questionnaire-based survey was conducted among 182 dental trainees. The instrument captured demographic details, knowledge of guideline content, attitudes toward radiation safety practices, perceived implementation confidence, and prior training exposure. Descriptive statistics were used to summarize responses.

Results: Of the 182 participants, 57.7% were third-year students, 29.7% final-year students, and 12.6% interns. Mean age was 21.57 ± 1.40 years (n=175). Knowledge levels were generally high: 72.5% correctly identified the comprehensive primary purpose of the guidelines, 75.3% recognized key aspects correctly, and 76.4% selected all recommended radiation-minimization measures. Monthly quality control testing was identified by 48.9% as the recommended frequency. Attitudes were strongly favorable, with 75.3% rating guideline adherence as very important and 82.4% considering the guidelines relevant to dental practice. Confidence in future implementation was reported as very confident by 49.5% and somewhat confident by 39.0%. A majority supported mandatory implementation in dental clinics (78.0%) and would recommend guideline training to colleagues (73.6%). Awareness of the guidelines was reported by 59.9%, while 50.5% had previously referred to them. Only 39.0% reported having received formal training or workshops on radiation safety guidelines.

Conclusions: Dental trainees demonstrated good overall knowledge and highly positive attitudes toward radiation safety guidelines, but formal training exposure was limited. Strengthening structured educational and workshop-based training may improve practical implementation readiness in dental radiography practice (U.S. Food and Drug Administration, 2004).

Evaluating the Awareness, Knowledge and Perception of Photobiomodulation Therapy Among Dental Professionals: A Cross‑Sectional Survey

2026-03-23T13:29:45+00:00

Background: Photobiomodulation (PBM) therapy has gained increasing attention in dentistry due to its potential benefits in pain management, inflammation control, and enhancement of wound healing. Despite its expanding clinical applications, the level of awareness and understanding among dental professionals remains variable.

Aim: To evaluate the awareness, knowledge, and perception of PBM therapy among dental practitioners.

Materials and Methods: A cross-sectional questionnaire-based survey was conducted among 78 dental professionals. The questionnaire assessed participants’ familiarity, knowledge level, and perception regarding PBM therapy in dental practice. The collected data were analyzed using descriptive statistics, and the association between variables was evaluated using the Chi-square test with a significance level set at p < 0.05.

Results: Among the participants, 73.1% reported being aware of PBM therapy. The average knowledge score was 51.3%, indicating a moderate level of scientific understanding. A statistically significant association was observed between professional qualification and prior awareness of PBM therapy (p = 0.037). Additionally, a majority of respondents expressed willingness to incorporate PBM therapy into clinical practice if appropriate training and guidance were provided.

Conclusion: Although general awareness of PBM therapy among dental practitioners appears satisfactory, the depth of scientific knowledge remains moderate. Strengthening educational programs and structured training initiatives may help enhance understanding and facilitate the effective integration of PBM therapy into routine dental practice.

Rooted in Complexity: A Case Series on Radix Entomolaris in Mandibular Molar

2026-02-23T13:34:47+00:00

Radix entomolaris (RE) is an uncommon anatomical variation characterized by the presence of an additional distolingual root in mandibular molars, most frequently the first molar. Its presence poses diagnostic and clinical challenges, especially during endodontic treatment. This case series presents 3 clinical cases of mandibular first molars with RE, emphasizing the importance of accurate diagnosis, modified access preparation, and careful canal negotiation. Radiographic evaluation, including angled periapical radiographs and cone-beam computed tomography (CBCT), played a crucial role in detecting the extra root. All cases were managed using magnification and enhanced illumination to facilitate identification and treatment of the RE canal. Endodontic therapy was completed successfully in all cases, with favorable postoperative outcomes observed during follow-up. This series highlights the necessity for clinicians to be aware of root canal variations such as RE and to adapt their techniques accordingly to ensure successful treatment outcomes.

Peripheral Ossifying Fibroma in a Middle-aged Man: A Rare Occurrence

2026-03-02T08:39:38+00:00

Background: Peripheral ossifying fibroma (POF) is a relatively common reactive gingival lesion that presents diagnostic and management challenges due to its clinical similarity to other gingival proliferations and its tendency to recur.

A case of a 50-year-old male patient who presented with a pedunculated gingival growth in the mandibular anterior region. The lesion measured 3×3 cm and was located on the interdental gingiva between teeth 42 and 43. Clinical examination revealed a firm, non-tender, vascular growth with a corrugated surface. Excisional biopsy was performed, and histopathological examination confirmed the diagnosis of peripheral ossifying fibroma.

Conclusion: This case highlights the importance of histopathological examination in the definitive diagnosis of gingival proliferations. Despite its benign nature, POF requires complete excision and long-term follow-up due to its recurrence rate of 8-20%.

Endocrowns as a Paradigm Shift in Post-Endodontic Rehabilitation: A Case Study

2026-05-01T06:36:48+00:00

Restorative management of endodontically treated teeth has long been a subject of debate, owing to the need to balance preservation of remaining tooth structure with adequate retention and resistance form. Traditionally, post-and-core systems have been employed to reinforce such teeth; however, these approaches often require additional removal of radicular dentin and may predispose the tooth to structural compromise. With the advent of advanced adhesive systems and improvements in restorative materials, there has been a paradigm shift toward more conservative and biomimetic treatment strategies.

Endocrowns have emerged as a contemporary and effective alternative for the rehabilitation of endodontically treated teeth, particularly in posterior regions. By utilizing the pulp chamber for macromechanical retention along with adhesive bonding for micromechanical retention, endocrowns eliminate the need for intraradicular posts and cores. This not only simplifies the clinical procedure and reduces chairside time but also preserves sound tooth structure and minimizes the risk of root fracture. Additionally, the use of high-strength ceramic and resin-based materials enhances the functional performance and esthetic outcomes of these restorations.

Consequently, endocrowns represent a reliable, minimally invasive, and clinically efficient restorative option, aligning with the principles of modern adhesive dentistry while ensuring long-term success in the rehabilitation of endodontically treated teeth.

This manuscript contributes to the scientific community by critically highlighting the clinical relevance of endocrowns as a minimally invasive and biomimetic alternative for restoring endodontically treated teeth. It supports the ongoing shift toward adhesive dentistry by emphasizing techniques that preserve tooth structure while maintaining functional durability. Additionally, it provides valuable insight into contemporary restorative strategies, aiding clinicians in evidence-based decision-making. Overall, the work helps bridge the gap between traditional concepts and modern advancements in restorative dentistry.