Effects of online marketplace-sourced over-the-counter tooth whitening products on the colour, microhardness, and surface topography of enamel: an in vitro study.

OBJECTIVES: This study compared the whitening effect, microhardness, and enamel surface alterations of over-the-counter (OTC) tooth bleaching products with those of a dentist-prescribed at-home bleaching agent. MATERIALS AND METHODS: The products available on a popular online marketplace were comprehensively searched and then rated using a specific formula. The effects of the lowest-rated OTC agent (LRA) and the highest-rated OTC agent (HRA) were compared with those of a dentist-prescribed bleaching agent (DPA) on the enamel of extracted human teeth. The bleaching efficacy, post-bleaching microhardness changes, and morphological alterations were assessed by spectrophotometric analysis, Vickers hardness testing, and scanning electron microscopy (SEM) respectively. Statistical analyses included one-way ANOVA and post hoc tests, maintaining a significance level of P < 0.05. RESULTS: The search of the online marketplace revealed 15 products. The LRA (Teeth Whitening Serum Gel, GEN, China) and the HRA (Bright White-Lovely Smile Premium Teeth Whitening strips, Ray of Smile, USA) were identified on the basis of their ranking. DPA resulted in significantly better tooth whitening than did LRA. The enamel microhardness was lower in the LRA treatment group (14.2%) than in the control and HRA treatment groups (8.84% and 7.26%, respectively). LRA also caused severe topographical alterations to the enamel. CONCLUSION: Compared with the poorly rated product, the dentist-prescribed tooth bleaching product resulted in greater colour improvement, less microhardness reduction, and surface changes. The highest-rated product was comparable with the dentist-prescribed agent in this study.

A comparative analysis of sphenoid and frontal sinuses using cone beam computed tomography for sex determination.

Objectives: This study aimed to evaluate linear measurements of the frontal sinus (FS) and sphenoid sinus (SS) for sex identification on cone beam computed tomography (CBCT) images. Methods: A comparative CBCT analysis was conducted on 200 full field of view (FOV) scans taken as part of routine dental investigations. Dimensions of the bilateral frontal and sphenoid sinuses were measured. Intra- and interobserver reliability were calculated. Independent t tests were used to compare the various parameters between sexes. Stepwise discriminant function analysis was used to determine sex. Additionally, the receiver operating characteristic (ROC) curve, area under the curve (AUC), sensitivity, and specificity were also determined. A p value < 0.05 was considered significant. Results: A total of 200 CBCT scans were included in the study. The mean age (±SD) among males was 25.66 (±7.11) and that among females was 24.64 (±5.12). The ROC curve revealed that the right length of the frontal sinus showed the greatest accuracy in sex identification in comparison to other linear measurements of the FS and SS. The results of our study indicated that the equation obtained from stepwise discriminant function analysis can aid in sex determination with an accuracy of 76.5 %. Conclusion: Our findings support the sexual dimorphism of linear measurements of FS and SS. There was an improvement in the accuracy of sex prediction when the linear measurements of FS and SS were considered in combination rather than in isolation. The derived equation can be an adjunctive tool for sex identification for the representative population.

Effects of Water Sorption and Solubility on Degradation of Silorane and Methacrylate-Based Dental Composites.

INTRODUCTION: Wet oral environment may have deleterious effects on performance of the composites due to influences of water sorption and solubility. The study evaluated the hydrolytic degradation caused because of water sorption and solubility of silorane and methacrylate-based dental composites. METHODS: Ten disc samples (2 mm × 10 mm) were prepared. Samples were analyzed for water solubility and sorption according to ISO 4049:2000 regulations and tested for mass gain or loss following immersion in water or in artificial saliva at 1 day, 15 days, and 30 days period. Student's 't' test, repeated measures analysis of variance (ANOVA), and Tukey's post-hoc tests determined statistical significance of the experimental results with global significance set at P = 0.05. RESULTS: Considerable sorption and solubility was observed with time in both materials on immersion. Silorane composites showed lower water sorption and solubility than methacrylate-based composite (MBC). Artificial saliva demonstrated higher sorption and solubility compared to distilled water. CONCLUSION: Silorane composites display enhanced hydrolytic stability even after a month of immersion in contrast to conventional methacrylate-based composites (MBCs), making it a better alternative to MBC resins clinically.

Perceptions and challenges of online teaching and learning amidst the COVID-19 pandemic in India: a cross-sectional study with dental students and teachers.

BACKGROUND: Online education has emerged as a crucial tool for imparting knowledge and skills to students in the twenty-first century, especially in developing nations like India, which previously relied heavily on traditional teaching methods. METHODS: This study delved into the perceptions and challenges experienced by students and teachers in the context of online education during the COVID-19 pandemic. Data were collected from a sample of 491 dental students and 132 teachers utilizing a cross-sectional research design and an online-validated survey questionnaire. RESULTS: The study's findings revealed significant insights. Internet accessibility emerged as a major impediment for students, with online instruction proving more effective for theoretical subjects compared to practical ones. Although most teachers expressed comfort with online teaching, they highlighted the absence of classroom interaction as a significant challenge. CONCLUSION: This study comprehensively examines the perspectives of both students and teachers regarding online education during the pandemic. The results carry substantial implications for the academic community, underscoring the need to address internet access issues and explore ways to enhance engagement and interaction in online learning environments.

Comparative evaluation of arch form among the Nepalese population: A morphological study.

Aims: The study aims to identify sexual dimorphic features in the arch patterns based on tooth arrangement patterns and the maxillary and mandibular arches using Euclidean Distance Matrix Analysis (EDMA). Settings and Design: A total of 96 Nepalese subjects, aged 18 to 25 were assessed using casts and photographs. Materials and Methods: Thirteen landmarks representing the most facial portions of the proximal contact areas on the maxillary and mandibular casts were digitised. Seventy-eight possible, Euclidean distances between the 13 landmarks were calculated using the Analysis ToolPak of Microsoft Excel®. The male-to-female ratios of the corresponding distances were computed and ratios were compared to evaluate the arch form for variation in the genders, among the Nepalese population. Statistical Analysis Used: Microsoft Excel Analysis ToolPak and SPSS 20.0 (IBM Chicago) were used to perform EDMA and an independent t-test to compare the significant differences between the two genders. Results: The maxillary arch's largest ratio (1.008179001) was discovered near the location of the right and left lateral incisors, indicating that the anterior region may have experienced the greatest change. The posterior-molar region is where the smallest ratio was discovered, suggesting less variation. At the intercanine region, female arches were wider than male ones; however, at the interpremolar and intermolar sections, they were similar in width. Females' maxillary arches were discovered to be bigger antero-posteriorly than those of males. The highest ratio (1.014336113) in the mandibular arch was discovered at the intermolar area, suggesting that males had a larger mandibular posterior arch morphology. At the intercanine area, the breadth of the arch form was greater in males and nearly the same in females at the interpremolar and intermolar regions. Female mandibular arch forms were also discovered to be longer than those of males from the anterior to the posterior. Conclusions: The male and female arches in the Nepalese population were inferred to be different in size and shape. With references to the landmarks demonstrating such a shift, the EDMA established objectively the presence of square arch forms in Nepali males and tapering arch forms in Nepalese females.

Evaluation of the surface characteristics and antibacterial properties of Titanium dioxide nanotube and methacryloyloxyethylphosphorylcholine (MPC) coated orthodontic brackets-a comparative invitro study.

OBJECTIVES: White spot lesions are the most common iatrogenic effect observed during orthodontic treatment. This study aimed to compare the surface characteristics and antibacterial action of uncoated and coated orthodontic brackets. MATERIALS AND METHODS: Sixty commercially available stainless steel brackets were coated with TiO2 nanotubes and methacryloyloxyethylphosphorylcholine. The sample was divided into Group 1: uncoated orthodontic brackets, Group 2: Stainless steel brackets with TiO2 nanotubes coating, Group 3: Stainless steel brackets with methacryloyloxyethylphosphorylcholine coating, and Group 4: Stainless steel brackets with TiO2 nanotubes combined with methacryloyloxyethylphosphorylcholine coating. Surface characterization was assessed using atomic force microscopy and scanning electron microscopy. Streptococcus mutans was selected to test the antibacterial ability of the orthodontic brackets, total bacterial adhesion and bacterial viability were assessed. The brackets were subjected to scanning electron microscopy to detect the presence of biofilm. RESULTS: The surface roughness was the greatest in Group 1 and least in Group 2 followed by Group 4 and Group 3 coated brackets. The optical density values were highest in Group 1 and lowest in Group 4. Comparison of colony counts revealed high counts in Group 1 and low counts in Group 4. A positive correlation between surface roughness and colony counts was obtained, however, was not statistically significant. CONCLUSIONS: The coated orthodontic brackets exhibited less surface roughness than the uncoated orthodontic brackets. Group 4 coated orthodontic brackets showed the best antibacterial properties. CLINICAL RELEVANCE: Coated orthodontic brackets prevent adhesion of streptococcus mutans and reduces plaque accumulation around the brackets thereby preventing formation of white spot lesions during orthodontic treatment.

Evaluation of salivary tumor necrosis factor α as a diagnostic biomarker in oral submucosal fibrosis and squamous cell carcinoma of the oral cavity and oropharynx: a cross sectional observational study.

Introduction: Tumor necrosis factor α (TNF-α) is known to be associated with chronic inflammation, and its expression has been shown to increase in advanced cancers. Chronic inflammation is a characteristic feature of oral submucous fibrosis (OSMF), which is a potentially malignant disorder (PMD). Squamous cell carcinoma (SCC) is associated with considerable mortality and morbidity and an early detection or monitoring would greatly help in achieving an effective cure. TNF-α was thus evaluated for use as a biomarker in the present study according to the stage of OSMF and histological grade of SCC in the oral cavity and oropharynx. Methods: This study included 45 patients divided into 3 groups-OSMF group, SCC group and control group-each comprising 15 participants. Saliva samples were collected from each patient, and salivary TNF-α levels were estimated using an ELISA kit. Results: Statistical analysis revealed no significant differences in TNF-α levels among the OSMF, SCC and control groups; however, there was an increase in the salivary TNF-α level in patients with stage 3 disease according to the clinical stage of OSMF, for which the p value was 0.027. Discussion: An increase in the TNF-α concentration with increasing clinical stage suggested a role for TNF-α in the spread of OSMF involvement in anatomical structures of the oral cavity and oropharynx. No significant difference in salivary TNF-α levels was noted among the OSMF, SCC and control groups. Conclusion: The study showed a positive correlation of TNF-α with increasing stages of OSMF but was not a reliable biomarker in the categorization of the same.

A comparative evaluation of concordance and speed between smartphone app-based and artificial intelligence web-based cephalometric tracing software with the manual tracing method: A cross-sectional study.

Background: This study compared the accuracy and speed of cephalometric analysis using an artificial intelligence web-based method and a smartphone app-based system with manual cephalometric analysis as the reference standard. Material and Methods: In this cross-sectional study, the lateral cephalograms were analysed using four methods: manual tracing, smartphone app tracing, artificial intelligence web-based automated tracing without manual landmark identification correction and artificial intelligence web-based automated tracing with manual landmark identification correction. The principal investigator obtained linear and angular cephalometric measurements to compare the accuracies of the four methods being assessed. Additionally, the duration required for landmark identification and subsequent analysis was recorded. Results: The analyses included 40 lateral cephalograms that were selected based on the inclusion and exclusion criteria. Very good to excellent agreement was observed in the accuracies of the artificial intelligence web-based and smartphone app-based systems compared with manual tracing (interclass correlation coefficient values ranging from 0.707 to 0.9, p< 0.001). Of the artificial intelligence web-based systems, the method without correction of automated landmark detection showed less reliable measurements than the other methods. Cephalometric analysis using artificial intelligence web-based and smartphone app-based systems consumed less time than manual tracing (p< 0.001). Conclusions: Artificial intelligence web-based automated tracing with manual landmark identification correction and smartphone-based app provide results that are comparable to those from the manual tracing method. However, artificial intelligence web-based systems require improvements in terms of automated landmark identification to obtain results that are similar to those from the other methods being assessed. Key words:Artificial Intelligence, Cephalometry, Computer software, Mobile application.

Efficacy of Glutathione Biomolecule in Reducing the Tooth Discoloration Associated with Silver Diamine Fluoride: A Split-mouth In vivo Study.

Background: The necessity to modify silver diamine fluoride (SDF) to make it esthetically acceptable without affecting its beneficial properties keeps the research in this field pertinent. Aim: This study aims to comparatively evaluate the efficacy of Glutathione (GSH) in reducing tooth discoloration associated with SDF. Materials and Methods: This split-mouth in vivo study was conducted on 20 children aged 3-8 years having a minimum of 3 active carious primary teeth. The three teeth in each patient were randomly divided into Group I - 38% SDF; Group II - 38% SDF followed by application of potassium iodide; and Group III - 38% SDF mixed with 20% GSH. Standardized photographs were taken immediately after application and after 6 months, which were analyzed using Image J software. The carious lesions were clinically classified as active or arrested after 6 months. Results: When mean gray values of three groups were compared postoperative, the highest value (lighter shade) was observed for group II and least (darker shade) for group I, whereas, during the 6-month follow-up, the highest value was seen for group III and least for group I. The color change from preoperative to 6 months' follow-up was compared, and a statistically significant difference was observed between groups I and II (P = 0.003) and groups I and III (P = 0.001). When caries arresting effectiveness was analyzed, there was no significant difference found between any of the groups (P = 1). Conclusion: Mixing 20% GSH with 38% SDF was an effective measure in reducing the tooth discoloration associated with SDF, without affecting caries arresting the efficiency of the latter.

Reliability of the electric pulp tester as an indicator of pulpal anesthesia in primary maxillary posterior teeth to assess the need for supplemental injections: An observational clinical study.

Background: The primary maxillary molars occasionally remain sensitive during operative procedures even post the buccal supraperiosteal injection. This could be due to the widely flared palatal roots receiving accessory innervation from the palatal nerves. Identifying inadequate anesthesia upfront using the electric pulp test (EPT) would give vital information to the clinician on the need of a supplemental palatal injection. Aim: The aim of this study was to assess and evaluate the reliability of the EPT as an indicator of pulpal anesthesia in primary maxillary molars. Methodology: Fifty one primary maxillary molars were subjected to the EPT following a buccal supraperiosteal injection. During the operative procedure, the " Face Legs Activity Cry Consolability" (FLACC) scores were recorded. The outcome of the EPT was correlated with the results of the FLACC score using Pearson's Chi-square test.Results: The EPT results were correlated to the FLACC scores. Five out of the 10 primary maxillary second molars which responded to the EPT scored 0 on the FLACC scale. The remaining 5 teeth scored 1 on the FLACC scale. The P value was 0.056 which was not statistically significant. This infers that the EPT is not a reliable tool to assess the adequacy of pulpal anesthesia in primary maxillary second molars. Conclusion: From the results of the present study, it can be concluded that the EPT is not a reliable tool to be used as an indicator of pulpal anesthesia in primary maxillary molars.

Expression of PTCH gene in ameloblastoma and odontogenic keratocyst: A comparative study.

Aim: This is a cross-sectional comparative study, aimed to quantify the expression of patched (PTCH) gene in ameloblastoma, odontogenic keratocyst (OKC) and also the comparison of both the expressions. Materials and Methods: Genomic deoxyribonucleic acid (DNA) was extracted and quantified, and the expression of the PTCH gene was done in 17 cases of ameloblastoma and 17 cases of OKC by quantitative real-time polymerase chain reaction (RT-qPCR). Results: It was observed that there was an overexpression of the PTCH gene in both ameloblastoma and OKC with a good mean cycle threshold (CT) value of 32.71 ± 2.432 and 34.69 ± 1.875, respectively. When comparing the PTCH expression between the two, ameloblastoma showed higher expression than the OKC and the difference is statistically significant with P value of 0.025. Conclusions: Our findings suggest that there is overexpression of PTCH in ameloblastoma and OKC, but it is highly expressed in ameloblastoma when compared to OKC. Overexpression of PTCH may constitute the activation of the Sonic Hedgehog pathway and may suggest the mechanism for the development of ameloblastoma and OKC. Hence it can be used as a valuable marker for early diagnosis and in the identification of therapeutic targets.

Prognostic Nomogram for Lymph-Node Metastasis in Oral Squamous Cell Carcinoma (OSCC) Using Immunohistochemical Marker D2-40.

Introduction: Nomograms are proven in "individualized risk prediction" in sarcomas and breast and prostate cancers. Incorporating immunohistochemical markers and histopathological parameters can enhance accuracy of these graphical representations of statistical predictive models concerning metastasis. D2-40, a monoclonal antibody to podoplanin (regulator of motility expressed in malignant epithelial cells), dually predicts metastatic potential of tumour by estimating the motile tumour phenotype and by detecting lymphatic vessels/density, both essential to metastasis in OSCC. Thus, we propose a model that incorporates D2-40 immunostaining of individual tumour cells (ITC) too with other variables (seen in H+E staining) as a predictive nomogram. Methods: Sixty cases of OSCC were selected with equal number of cases (n=30) of pN0 and pN+ status. Bryne's grading of invasive front of tumour (ITF) was done on H+E-stained slides followed by D2-40 immunostaining for ITCs at ITF and lymphatic vessels. Multivariate regression analysis was used to generate the nomogram of LNM where the predictive contribution of each covariate, namely depth of invasion, D2-40-stained ITCs, gender, histological grade, and worst pattern of invasion (WPOI), was plotted on a scale of 1-100 points. Results: The nomogram showed that the strongest variable in OSCC was the WPOI in H+E-stained section followed by D2-40-positive ITCs and gender. Discussion: Our predictive nomogram for LNM in OSCC surprisingly showed that a tumour with lower score of WPOI (islands vs ITC) showed numerous D2-40-positive ITCs, drastically increasing the probability of metastasis. The concept of "individualized risk prediction" can be used to predict lymph node metastasis using a variety of histopathological criteria that can be visualized in routine and immunohistochemical staining in OSCC with the aid of a nomogram.

Effect of bleaching on color and surface topography of teeth with enamel caries treated with resin infiltration (ICON®) and remineralization (casein phosphopeptide-amorphous calcium phosphate).

Background: Dental bleaching is not recommended on teeth with enamel caries. Aim: The study aimed to assess the efficacy of in-office bleaching on demineralized enamel managed by resin infiltration (RI) as well as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). Methodology: Forty-eight sound enamel specimens were divided into four groups based on the surface treatment performed before in-office bleaching. Group I consisted of no caries and no treatment (NT); Group II had artificial caries (AC) and NT; Group III had AC treated with RI, and Group IV had AC remineralized with CPP-ACP. Pre- and postbleaching teeth color and surface topography were evaluated using spectrophotometer and scanning electron microscope (SEM), respectively. Statistical Analysis Used: One-way analysis of variance and Tukey's post hoc test were performed for inter-group comparisons. Results: The color change postbleaching was the least in Group IV; and this was significantly less than Group I (P < 0.05) and Group II (P < 0.001). The bleaching efficiency in Group III was not significantly different from the control group. In addition, the enamel topographic changes were less in the surface-treated group. Conclusion: RI can be considered a treatment modality for teeth with enamel caries requiring tooth whitening as the bleaching efficiency was like that of sound enamel.

Investigating the link between frontal sinus morphology and craniofacial characteristics with sex: A 3D CBCT study on the South Indian population.

Background: Measurement of craniofacial parameters plays an important role in sex determination in forensic science. The present study was done using cone beam computed tomography (CBCT) scans to evaluate the morphologic structure of the frontal sinuses and compare it with the width of nasal, cranial, maxillary and mandibular width which might help us in sex determination. Methods: A cross-sectional retrospective study was conducted using 142 full field of view (FOV) scans of patients archived from the department. The width of the nose, cranium, maxilla, and mandibular width was measured and compared with the frontal sinus between the two sexes. Results: A paired t-test was done to compare the linear measurements for both sexes' right and left frontal sinuses. The measurements were higher in males when compared to females. There was a statistically significant asymmetry (larger dimension on the left side) of the anterioposterior (p-value of 0.012) and superior-inferior dimensions in males (p-value of 0.135). Spearman's correlation showed that frontal sinus correlated with other craniofacial parameters like nasal, cranial, maxillary and mandibular width among both sexes. The frontal sinus, nasal, cranial, maxillary and mandibular widths were higher in males when compared to females (independent t-test). Discriminant function scores showed 66-68% accuracy to discriminate sex, using the anteroposterior dimension and mandibular width. Conclusions: The measurement of craniofacial parameters using CBCT can aid in determining the sex of unidentified and decomposed bodies.

Antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin on Enterococcus faecalis: A confocal laser scanning microscopic study.

Background: Sealers with antimicrobial properties play an important role in endodontic therapy success especially against Enterococcus faecalis infection found in failed root canal therapy. Addition of antibiotic agents to endodontic sealers may show significant increase in their antibacterial properties both against anaerobic and aerobic microbes. The purpose of the present study was to evaluate antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin against E. faecalis and post-root canal treatment viability of Enterococcus faecalis on the first and seventh day. Methods: A total of 60 extracted human mandibular premolar teeth were decoronated after initial decontamination with 1% NaOCl. Root length standardized to 12 mm. Canal instrumentation was done using ProTaper Universal file system till size F2 using 5.25% NaOCl. It was then infected with a pure strain of E. faecalis for a period of four days. Obturation was done using plain sealer, (n=30) and sealer-antibiotic combination, (n=30). Half of the teeth were sectioned at 24 hours (S, SA) and other half were sectioned seven days after obturation (S7, SA7). All samples were stained with SYTO9 and propidium iodide for imaging under Confocal Laser Scanning microscope. Statistical analysis was performed with the statistical software SPSS v. 17.0 (SPSS for Windows; SPSS Inc, Chicago, IL). Data was analysed using One Way ANOVA and post hoc Tukey test to determine statistical significance with p value < 0.01 considered significant. Results: Statistically significant differences were observed in green to red ratio between group S (9.561976) and S7 (0.435418) (p < 0.01). There was no difference found between SA (mean of green to red ratio, (0.70431) and SA7 (mean of green to red ratio, 0.85184). Conclusions: Antibiotics added to the sealer effectively eradicated of E. faecalis 24 hours post-obturation. However, after seven days, plain sealer was as effective as sealer-antibiotic combination.

A comparative evaluation of micro shear bond strength and microleakage between the resin-modified glass ionomer cement and residual dentin following excavation of carious dentin using Carie CareTM and conventional caries removal in primary teeth: an in vitro study.

Background: The bond between the dentin and restorative material contributes to the success of the restoration. Structural changes associated with prepared dentin may influence the bonding of restorative materials. The present study evaluates the bond between the resin-modified glass ionomer cement (RMGIC) and residual dentin following excavation of carious dentin using Carie Care TM and conventional caries removal in primary teeth. METHODS: 52 primary teeth with dentinal caries were randomly grouped into group I, where caries removal was done using the conventional method, and group II which used Carie Care TM. All the teeth were restored using RMGIC. Micro shear bond strength between the residual dentin and the cement was tested using universal testing machine and the dye penetration method was used for microleakage testing. Independent t-test was performed for intergroup comparison. Pearson chi-square test was carried out to evaluate the microleakage patterns in the enamel and dentin. RESULTS: The mean micro-shear bond strength of group I was 6.03±1.6 and that of group II was 8.54±2.92; this difference was statistically significant with a p-value of 0.012. Microleakage was higher in the test group (1.38±0.51) than the control group (0.77±0.6) and was significant with a p -value of .036. CONCLUSIONS: Papain-based chemomechanical agent Carie Care TM can be used as an alternative method to conventional caries removal. However, further studies need to explore methods to improve the marginal sealing capacity of RMGIC to the residual dentin after chemomechanical caries removal.

Effect of a Submucosal Injection of Platelet-Rich Plasma on the Rate of Orthodontic Tooth Movement - A Split-Mouth, Single-Blind Randomized Controlled Trial.

Objective: To investigate the effect of submucosal injection of platelet-rich plasma (PRP) on the rate of mini-implant-supported retraction, using a split-mouth randomized clinical design. Materials and Methods: Twenty subjects of either gender between 16 and 25 years of age with bimaxillary dentoalveolar protrusion and crowding of <4 mm scheduled to undergo fixed mechanotherapy with the extraction of 1st premolars; were recruited for the study. Those with a periodontally compromised dentition, blood dyscrasias, smoking/alcoholism, or with a history of fixed orthodontic treatment were not considered. The intervention side received a submucosal injection of autologous PRP which was prepared using 10 ml of the patient's blood. The rate of extraction space closure on both sides was recorded and compared monthly for 3 months using a digital caliper. Results: Mean overall retraction was faster on the intervention side as compared to the control side by 1.5 times and was statistically significant with a P value of 0.001. There was no influence of gender on the rate of retraction. There was no reported swelling or discomfort associated with the PRP injection. Conclusions: Submucosal injection of PRP significantly accelerates orthodontic tooth movement and can therefore be used as an effective, safe, and minimally invasive method to expedite orthodontic treatment.

A study on histological grading systems of oral squamous cell carcinoma and comparison of their efficacy in determining the nature (clinical and histopathological) and prognosis of oral squamous cell carcinoma.

Purpose: Tumour-Node-Metastasis (TNM) staging has been widely used for treatment planning and prognostication of oral cancers; however, TNM staging system alone is insufficient for optimal prognostication. A combined assessment of clinical staging and cytomorphology might serve as a more specific measure for prognostication. The present study attempted to compare the efficacy of histologic grading systems (Jakobbson et al., Anneroth et al. and Bryne et al.) of malignancy in determining the nature and prognosis of oral squamous cell carcinoma (OSCC). Tumour protein (TP53) immunohistochemical marker was used to determine the aggressiveness of OSCC. Materials and Methods: Tissue sections from 24 biopsy-proven cases of OSCC were stained with anti-TP53 antibody. Hundred cells in each case were counted and tabulated. Cases were graded using three histopathological grading systems. Findings were compared and correlated with TP53 immunopositivity and clinical parameters. Results: Positive correlation was observed between TP53 immunostaining and grading scores of each system. Highest correlation was observed with Jakobbson et al. grading system (r2 value = 0.91, P < 0.001). Significant results were observed on comparing grades of Jakobsson et al., Anneroth et al. and Bryne et al. grading system with segregated groups of TP53 immunopositive cases (P = 0.004, P = 0.003, P = 0.001, respectively). No significant results were observed on comparing grades of histopathological systems with clinical parameters. Conclusion: Both, clinical and histopathological grading systems, with immunohistochemistry, should be taken into account during the assessment of OSCC, for treatment planning and better prediction of tumour prognosis.

Application of the London Atlas of Tooth Development and Eruption in Panoramic Xrays for the Age Estimation.

BACKGROUND: The age estimation of the individual by the forensic experts ascertains the chronological age of an individual. The possibility that the person being examined may be younger or older than a certain age threshold makes this process crucial, as it will establish whether or not the person is an adult under the law. The aim of this study was to test the applicability of the London Atlas of tooth development and eruption in Nepalese subset population. METHODS: The London Atlas for age estimation was tested in 350 digital panoramic radiographs from the patients between four and twenty-four years visiting Tribhuvan University Teaching Hospital, Institute of Medicine, Nepal. RESULTS: The mean values of the estimated age were higher in both the sexes, which was statistically not significant. Both the sexes showed an excellent positive correlation, and was significant with a p value of <0.001. The age estimation upto 10 years group classification was nearly accurate with less than 1 and 2.5 years variation in males and females respectively. The accuracy was good in 16-18 years group with maximum deviation of ±2.5 years. The accuracy was poor in more than 18 years group, as the variability was more than 5 years. CONCLUSIONS: The London Atlas method was best suited for less than 18 years of age and was not very accurate in the age group of 13-14 and 14-15 years where most of the polymorphisms were noted.

Evaluation of pain response in children to the SoftClamp™ as an alternative to the metal rubber dam clamp: A randomized clinical trial.

Background: The use of a rubber dam is more important than ever in today's COVID-19 era to limit cross infections. In children, the placement of the metal clamp to retain the rubber dam is perceived to be painful and often requiring a local anesthetic injection. This dissuades many clinicians from placing the rubber dam. Hence, this study evaluated the pain response of children to a SoftClamp™ compared to the conventional metal clamp. Materials and Methods: This was a randomized controlled, equal allocation ratio, split-mouth clinical trial. Forty-two children aged between 8 and 12 years, having two permanent mandibular molars in need of sealants, were divided into Groups A and B (metal clamp and SoftClamp™, respectively). The pain response was recorded using both an objective and a subjective scale i.e., the Faces Legs Activity Cry Consolability (FLACC) scale and the Wong Baker Faces Pain Rating Scale (WBFPRS). The level of significance was set at 5% (P < 0.05). The pain response recorded from the WBFPRS and the FLACC scale for the metal and the SoftClamp™ were analyzed using the Wilcoxon signed rank test. The difference in pain response between genders and between two age groups (below and above 10 years of age) was analyzed using the Mann-Whitney U-test. Results: The children reported mild discomfort to clamp placement in both the scales. The P values for the FLACC and WBFPRS scores comparing the pain response to the metal and SoftClamp™ were 0.311 and 0.149, respectively. Conclusion: There was no significant difference in the pain response of children to both the clamps. Good rubber dam application practices in children through the use of behavior guidance and a proper topical anesthesia technique may play a far more important role regardless of the clamp used. But the SoftClamp™, with its more child friendly appearance could be a viable alternative to the metal clamp in children.