The Influence of Nickel-Titanium (Ni-Ti) Rotary Instrument Systems on Debris and Smear Layer Formation in Endodontic Procedures: An In Vitro Scanning Electron Microscopy Study.

Background Successful endodontic treatment relies on the effective removal of debris and the prevention of smear layer formation within the root canals. The choice of nickel-titanium (Ni-Ti) rotary instrument systems can significantly impact these outcomes. Aim This study aims to evaluate and compare the debris and smear layer formation in root canals of extracted mandibular second premolar teeth following instrumentation with the ProTaper Universal (Dentsply Sirona, Charlotte, NC) (Group II), Twisted File (Kerr Endodontics, Gilbert, AZ) (Group III), and XP Endo (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (Group IV) Ni-Ti rotary instrument systems. Methods In this in vitro study, 60 extracted mandibular second premolar teeth were randomly divided into four groups, each containing 15 teeth. Group I served as the control with no instrumentation. Groups II, III, and IV were instrumented with the ProTaper Universal rotary file, the Twisted File, and the XP Endo file systems, respectively. Debris and smear layer formation were evaluated through scanning electron microscopy (SEM), and photomicrographs were scored using a standardized index. Results Group II (ProTaper) exhibited the highest mean debris and smear layer scores, with values of 3.50 and 2.70, respectively. Group IV (XP Endo) demonstrated the least debris and smear layer formation, with mean scores of 2.65 and 2.08, respectively. Statistical analysis confirmed significant differences among the groups for both debris and smear layer formation. Conclusion The results highlight the practical importance of selecting appropriate Ni-Ti rotary instrument systems to minimize debris and smear layer formation during endodontic procedures. The XP Endo file system showed promise as a favorable choice in this regard, but further clinical research is needed to validate these findings.

Impact of Orthodontic Treatment on the Incidence of Dental Caries in Adolescents: A Prospective Cohort Study.

BACKGROUND: Orthodontic treatment is a widely embraced intervention aimed at enhancing dental aesthetics and correcting malocclusions among adolescents. However, concerns persist regarding its potential impact on oral health, particularly on the development of dental caries. This study aimed to systematically investigate the relationship between orthodontic treatment and the incidence of new carious lesions among adolescents. METHODS: A prospective cohort design involving adolescents aged 12-18 years was employed. A total of 82 patients met the inclusion criteria. In addition, an age-matched control group of 82 participants who did not undergo orthodontic treatment was included. The study included both a treatment group undergoing orthodontic treatment (braces or aligners) and an age-matched control group that did not undergo any orthodontic intervention. Demographic characteristics, orthodontic treatment details, and oral hygiene practices were documented at baseline and throughout the study period. Dental examinations at six-month intervals post-treatment were conducted to track the incidence and progression of carious lesions. RESULTS: The demographic characteristics, baseline oral health status, orthodontic treatment details, and oral hygiene practices were comparable between the treatment and control groups. Post-orthodontic treatment assessment revealed a slightly higher incidence of new carious lesions in the treatment group (14.6%) than in the control group (9.8%), although this difference was not statistically significant (p = 0.15). Dental examinations at six-month intervals demonstrated a gradual increase in caries incidence over time in both groups, with no substantial disparities observed. CONCLUSIONS: This study provides a comprehensive examination of the relationship between orthodontic treatment and the incidence of new carious lesions among adolescents. While a trend towards higher caries incidence in the treatment group was observed, the difference was not statistically significant. These findings contribute to the existing body of knowledge and emphasize the need for ongoing research to guide clinical practice.

Dry Socket Prevalence and Risk Factors in Third Molar Extractions: A Prospective Observational Study.

Background Third molar extraction is a routine oral surgical procedure that is often complicated by the development of a dry socket (alveolar osteitis). This prospective observational study aimed to investigate the prevalence of dry sockets and identify associated risk factors and causes, contributing to a comprehensive understanding of the postoperative outcomes of oral surgery. Methods This study employed a prospective observational design with a 12-month follow-up period. Participants aged 18-40 years scheduled for third molar extraction were included, whereas those with coagulopathies, pregnant or lactating women, patients with vitamin deficiencies, and individuals on medications affecting healing were excluded. Data collection involved comprehensive assessments at baseline, intraoperative details, and postoperative evaluations at 48 hours, one week, and two weeks. Statistical analyses included descriptive statistics, chi-square tests, t-tests, or Mann-Whitney U tests, and logistic regression for the risk factor analysis. Results A total of 238 participants with diverse demographic characteristics were enrolled in this study. The prevalence of dry sockets increased progressively from 20.6% at 48 hours to 41.2% at two weeks post-extraction. Smoking, poor oral hygiene, and surgical technique emerged as significant risk factors, with corresponding odds ratios of 6.41 (95% CI: 2.86-14.36, p < 0.001), 9.53 (95% CI: 2.12-42.84, p = 0.003), and 3.27 (95% CI: 2.08-5.15, p < 0.001), respectively. Pain intensity, measured using a Visual Analog Scale, gradually decreased from 48 hours to two weeks post-extraction. Conclusion This study provides valuable insights into the prevalence and risk factors associated with dry sockets following third molar extractions. Smoking, poor oral hygiene, and poor surgical techniques were identified as significant contributors, emphasizing the importance of preoperative counseling and targeted interventions.

Comparison of Histological Changes in Tissue Specimens Kept in Tap Water, River Water and Seawater for Different Intervals of Time.

BACKGROUND: Forensic pathologists find it difficult to ascertain the actual reason for death and the actual mode of death in drowning cases. It is commonly acknowledged that not all people whose dead bodies are found in water perished from drowning. The medico-legal inquiry includes an important component that examines dead bodies collected from the water. The corpse's time in the water continues to be the main concern. This aids in determining the time of death, which is crucial to any medico-legal investigation. The traditional histological analysis of hematoxylin and eosin (H&E)-stained oral soft tissue can be crucial in the assessment of this feature. Hence, this study was done to compare histological changes in the tissue specimens kept in tap water, river water, and seawater for different intervals of time. MATERIALS AND METHODS: One hundred eighty specimens were obtained from 180 dead bodies and divided randomly into three categories. Category A consisted of 60 specimens submerged in tap water, Category B of 60 specimens submersed in river water, and Category C consisted of 60 specimens submerged in seawater. The specimens underwent routine histological processing and H&E staining. The microscopic evaluation of specimens was carried out at two hours and on the first, second, third, fourth, and fifth days of submersion. Details were recorded regarding the structural changes, cellular changes, connective tissue changes, changes in the basement membrane, and intensity of H&E staining. Once the process of routine histological processing and H&E staining was completed for each study specimen, an evaluation of microscopic changes in the tissue was made. RESULTS: The present study revealed that seawater preserved tissue best and for a longer period than river water and tap water. River water preserved tissue better than tap water. In pathologic tissue, details were preserved for much longer. It was noted that in squamous cell carcinoma, connective tissue was destroyed earlier than epithelium, in contrast to normal tissue where epithelium was destroyed before connective tissue. CONCLUSION: This study indicates that the medium of submersion in drowning victims affects the histopathological features. The time of death is an important aspect of forensic investigation. Considering this, all cases of drowning should be very carefully evaluated, and the medium taken into consideration while determining the time of death, as tissue degrades faster in freshwater than in seawater.

Comparative Evaluation of Dentinal Defects After Root Canal Preparation Using Various Nickel Titanium Files: An In Vitro Study.

AIM: This study set out to compare the damage done to dentin by three distinct titanium file brands - the Hyflex EDM, the ProTaper Next, and the Waveone Gold Nickel - in order to draw conclusions about which one is the most effective. MATERIALS AND METHODS: Forty-first premolars in the mandible with straight canals and single roots were instrumented using Hyflex EDM, Waveone Gold, and Protaper Next. Dentinal flaws after endodontic treatment were studied by sectioning specimens using a hard tissue microtome and analyzing them under a stereomicroscope. RESULTS: There was no discernible variation between the groups in the coronal third (p=0.312) or apical third (p=0.076). Hyflex EDM and Protaper Next differed significantly in the middle portion of the tape (p=0.016). The Hyflex EDM sample had the fewest cracks. There was no statistically significant difference between Hyflex EDM and Waveone Gold; however, Hyflex EDM had fewer fractures in the middle third of the sample than Waveone Gold did. CONCLUSION: Electric discharge machining (EDM) files made from Hyflex proved to be far superior to their Protaper Next and Waveone Gold counterparts as they induced the fewest cracks in the middle third of the root dentin.

Incidence and Intensity of Pain Following Endodontic Treatment by Different Instrumentation Techniques in Teeth With Periapical Lesion.

AIM AND OBJECTIVES:  This study was carried out to compare the effectiveness of hand and rotary instrumentation techniques on postoperative pain in asymptomatic necrotic premolars with periapical lesions and instrumented by a modified step-back technique using a K file, crown down by continuous rotary motion technique using ProTaper Universal (Dentsply Mailefer, Ballaigues, Switzerland), and with the reciprocation technique using WaveOne (Dentsply Sirona, Charlotte, NC, USA). MATERIALS AND METHODS:  For this study, 66 premolars with single roots and canals were chosen. The procedure was completed in a single visit. Following access opening, the working length was initially determined using an apex locator and then confirmed after inserting K file #10 by radiograph. The canal was cleaned and shaped using a grouping system. After the master apical preparation, the canal was dried by paper point and obturated with gutta-percha and AH plus sealer, an epoxide-amine resin pulp canal sealer. In order to confirm the obturation, a radiograph was taken. After that, a permanent restoration material was used to seal the access cavity. Following that, patients to whom the visual analog scale (VAS) had already been explained were contacted by phone at six, 12, 24, and 48 hours. RESULTS:  In this study, compared to a stainless steel instrumentation technique, WaveOne instrumentation caused more noticeable pain. The results of the current study showed that, on average, postoperative pain scores decreased over the course of the 12 to 48-hour period, reaching a minimum or a maximum at 48 hours (p<0.01). CONCLUSION:  Postoperative pain was produced by all instrumentation methods used in the study. In comparison to ProTaper and WaveOne, instrumentation using the modified step-back technique with K files caused less pain, especially over the course of a 24-hour period.

An In-Vitro Analysis of Root Fracture Strength Using Single File Systems.

Aim Root canal obturation during endodontic therapy supports the root canal space and helps the extra tooth structure resist fracture. Some believe endodontic-treated teeth are more likely to break than natural teeth. The most common causes of tooth decay are endodontic treatment's extensive tooth structure loss and coronal and radicular dentin drying. Materials and methods Two hundred removed human permanent mandibular first molars were allowed to be stored in isotonic saline solution for a maximum of 72 hours. The collection, storing, sterilizing, and handling of the samples were done per the Occupational Safety and Health Administration (OSHA) and Centers for Disease Control and Prevention (CDC) guidelines. Out of a total of 200 newly removed mandibular first molars, 120 teeth were finally gathered, sterilized, and kept in 1% thymol in normal saline at 30 degrees Celsius. The access cavity was prepared, and the pulp chamber was cleaned and debrided using an ultrasonic scaler tip while being irrigated with regular saline. A digital radiograph was taken after a 6# K file was placed to the working length in the mesiobuccal canal. Based on their weights, the samples were dispersed equally across the six groups (n=20). They looked inside them to ensure that the root morphology was normal and that the canal was open and free of any abnormalities, damage, or fillings. They looked at the curvature of the mesial root and chose samples with a curvature of 20-35 degrees. The mesial roots were dissected, labeled, and put in a different location. Results Overall, the experimental group's incidence of buccolingual fractures was 55%, making it the most prevalent fracture type. The mesiodistal type of fracture had a 35% incidence rate, which was the second most prevalent. We found that comminuted and transverse fractures occurred in only 15% and 5% of patients, respectively, of all fractures. Both the test and the control groups had a disproportionately high number of buccolingual fractures. When comparing the root fracture loads of the two experimental groups, there was no significant difference (p>0.05) Conclusion Within this study's restrictions and standardization techniques, it can be concluded that the single file system-prepared roots' resistance to fracture was comparable to that of the control group. It is recommended to conduct additional research on these single file systems using different metrics and to assess them in a clinical setting.

A Comparison Between Comma Incision and Ward's Incision in Third Molar Extraction in Terms of Postoperative Sequel.

Aim We aim to look at the differences between the standard Ward's incision and the comma-shaped incision and how they affect complications after surgery to remove an impacted mandibular third molar. Materials and methods Mandibular third molars had to be carefully extracted from a total of 40 patients who were randomly divided into two groups of 20 patients each. At first, patients were evaluated before surgery. In group A, a standard Ward's incision was made, and in group B, a comma incision was made to match the mucoperiosteal fold. Afterward, the impacted third molars were carefully removed. The evaluation criteria for pain, swelling, lockjaw, and healing of wounds were done before surgery, after three hours, and on the first, third, and seventh day after surgery. Result The pain scores that were recorded right after surgery, three hours later, and on days 1, 3, and 7 in the surgical area with comma-shaped incision were all lower than the pain scores that were recorded in the area where standard incisions were made. Enlarging was less with comma entry point than with standard Ward's incision. After surgery, there was a big difference between the two entry points in how the mouth opened and how the wounds were fixed. These findings showed that the comma incision is better than the standard Ward's incision when it comes to pain, enlargement, lockjaw, and healing of wounds. Conclusion The study results showed that the comma-shaped incision was better than the traditional method (Ward's incision) because there were fewer problems after surgery.

Evaluation of the Impact of Different Instrumentation Techniques on the Incidence of Postoperative Pain in Patients Undergoing Root Canal Treatment.

BACKGROUND: Postoperative pain is a common concern in root canal treatment, and the choice of instrumentation technique can significantly impact patient comfort. This study aimed to evaluate the impact of different instrumentation techniques on the incidence of postoperative pain in patients undergoing root canal treatment. METHODS: A randomized controlled trial was conducted on 208 patients randomly assigned to four groups: step-back preparation, crown-down preparation, hybrid technique, and conventional instrumentation. Pain intensity was assessed using a verbal rating scale (VRS) at six, 12, 24, 48, and 72 hours postoperatively. Data were analyzed using appropriate statistical methods. RESULTS: The mean pain scores and standard deviations (SDs) were calculated for each instrumentation technique at different time intervals. At six hours, the step-back preparation group reported a mean pain score of 2.3 (SD = 0.8), the crown-down preparation group had a score of 2.8 (SD = 0.9), the hybrid technique group had a score of 2.5 (SD = 0.7), and the conventional instrumentation group had a score of 3.1 (SD = 0.1). The differences in pain scores between the groups were statistically significant at all time intervals (p < 0.05). CONCLUSION: The choice of instrumentation technique significantly influenced the incidence of postoperative pain in root canal treatment. The step-back preparation technique was associated with lower pain intensity than the crown-down preparation, hybrid technique, and conventional instrumentation. These findings highlight the importance of considering the instrumentation technique to optimize patient comfort during and after root canal treatment.

Implications of ChatGPT in Public Health Dentistry: A Systematic Review.

An artificial intelligence (AI) program called ChatGPT that generates text in response to typed commands has proven to be highly popular, as evidenced by the fact that OpenAI makes it available online. The goal of the present investigation was to investigate ChatGPT's potential applications as an outstanding instance of large language models (LLMs) in the fields of public dental health schooling, writing for academic use, research in public dental health, and clinical practice in public dental health based on the available data. Importantly, the goals of the current review included locating any drawbacks and issues that might be connected to using ChatGPT in the previously mentioned contexts in healthcare settings. Using search phrases including chatGPT, implications, artificial intelligence (AI), public health dentistry, public health, practice in public health dentistry, education in public health dentistry, academic writing in public health dentistry, etc., a thorough search was carried out on the Pubmed database, the Embase database, the Ovid database, the Global Health database, PsycINFO, and the Web of Science. The dates of publication were not restricted. Systematic searches were carried out for all publications according to inclusion and exclusion criteria between March 31, 2018, and March 31, 2023. Eighty-four papers were obtained through a literature search using search terms. Sixteen similar and duplicate papers were excluded and 68 distinct articles were initially selected. Thirty-three articles were excluded after reviewing abstracts and titles. Thirty-five papers were selected, for which full text was managed. Four extra papers were found manually from references. Thirty-nine articles with full texts were eligible for the study. Eighteen inadequate articles are excluded from the final 21 studies that were finally selected for systemic review. According to previously published studies, ChatGPT has demonstrated its effectiveness in helping scholars with the authoring of scientific research and dental studies. If the right structures are created, ChatGPT can offer suitable responses and more time to concentrate on the phase of experimentation for scientists. Risks include prejudice in the training data, undervaluing human skills, the possibility of fraud in science, as well as legal and reproducibility concerns. It was concluded that practice considering ChatGPT's potential significance, the research's uniqueness, and the premise-the activity of the human brain-remains. While there is no question about the superiority of incorporating ChatGPT into the practice of public health dentistry, it does not, in any way, take the place of a dentist since clinical practice involves more than just making diagnoses; it also involves relating to clinical findings and providing individualized patient care. Even though AI can be useful in a number of ways, a dentist must ultimately make the decision because dentistry is a field that involves several disciplines.

The Efficacy of the Three Types of Plaque Control Methods During Fixed Orthodontic Treatment: A Randomized Controlled Trial.

BACKGROUND: When intraoral orthodontic devices are used, it becomes significantly more difficult to remove plaque effectively. Dentists and orthodontic specialists can come up with more effective preventive strategies while patients are undergoing fixed orthodontic work if they have a deeper understanding of the present scenario. In addition, individuals will become more aware of the importance of good dental hygiene habits as a result of this. OBJECTIVE: To assess and compare the effectiveness of a manual toothbrush, machine-driven toothbrush, and conventional mechanical toothbrush coupled with mouth rinse in removing plaque and maintaining gingival health in patients undergoing fixed orthodontic treatment. METHODS AND MATERIALS: In this research, a total of 222 individuals who met the eligibility and exclusion requirements were randomly selected and offered their written consent. There were a total of 74 participants for each of the three different categories. Category A used a physically driven toothbrush. Category B used a motorized toothbrush. Category C used a physically driven toothbrush together with mouthwash containing 0.2% chlorhexidine gluconate. All study participants were assessed at baseline, one-month follow-up, and two-month follow-up to document the preliminary information, including that of the modified papillary bleeding index (MPBI) by Muhlemann, plaque index (PI) introduced by Silness and Loe, and gingival index (GI) introduced by Loe and Silness. RESULTS: In this study, the mean PI scores at the one-month and two-month follow-ups were minimum in Category C, while it was maximum in Category A at the two-month follow-up. The mean GI scores at the two-month follow-up were minimum in Category C, while it was maximum in Category A at the two-month follow-up. The mean MPBI scores at the two-month follow-up were minimum in Category C, while it was maximum in Category A. It was observed that participants in this trial who only used a typical mechanical brush experienced an increase in PI and GI scores after one and two months of follow-up. At the one-month and two-month follow-ups, it was noted that the values of PI, GI, and MPBI significantly decreased in the study participants using automated toothbrushes as well as in study participants using manual toothbrushes in conjunction with chlorhexidine mouthwash as compared to baseline values. However, when the three categories were compared, it was found that the research participants utilizing both a manual toothbrush and 0.2% chlorhexidine experienced the highest decreases in PI, GI, and MPBI values. CONCLUSION: The reduction in the scores of PI, GI, and MPBI was maximum in orthodontic patients after two months when they apply manual toothbrushing along with 0.2% chlorhexidine.

Evaluation of the Impact of Chlorhexidine Mouth Rinse on the Bond Strength of Polycarbonate Orthodontic Brackets: A Case-Control Study.

BACKGROUND: Shear bond analysis is the procedure used most frequently to gauge the tensile strength of adhesives incorporated in orthodontic treatments. In shear tensile strength analysis, pressure is placed as close as feasible to the interface between the orthodontic bracket and the surface of the tooth, parallel to the long axis of the tooth. Although numerous research on extracted teeth of human and bovine teeth have been conducted, there may still be variables such as pH, humidity, temperature, and others that could affect how these materials behave in the mouth cavity. The impact of chlorhexidine (CHX) on the binding capacity for non-metallic orthodontic brackets in vivo is not well understood. OBJECTIVE: The goal of the current study is to determine how mouth rinses containing 0.12% CHX affect the adhesive strength of polycarbonate orthodontic brackets. METHODS AND MATERIALS: Thirty-four patients were part of the test category, and they were instructed to wash their oral cavity for approximately 30 seconds using 20 ml of 0.12% CHX gluconate (Septodent). Thirty-four patients made up the control category and were instructed to wash their oral cavity for 30 seconds with a placebo mouthwash of a similar hue (20 ml). Both types of mouthwash were administered to the participants by an administrator who was not specifically involved in the trial and were kept in 120 ml labeled plastic bottles. The study participants were also kept unaware of the type of mouthwash. For the mouthwash utilized by study participants, a double-blinding technique was applied. RESULTS: Thirty-four patients were evaluated in the test category. Since the orthodontic bracket broke in two patients, therefore, 32 patients were evaluated in the control category. The mean value of the strength of the shear bond in the experimental category was 15.32 megapascal (Mpa). The SD value was 2.51. The mean value of the strength of the shear bond in the control subgroup was 15.63. On statistical analysis, the t-value was 0.47. The p-value was 0.671. The difference in findings of the strength of the shear bond was statistically non-significant. CONCLUSION: The results of this investigation allow us to draw the conclusion that the shear bond properties of polycarbonate orthodontic brackets are unaffected when treated with 0.12% CHX preceding the binding. The clinically meaningful adhesion strength was likewise attained by the polycarbonate orthodontic brackets.

Comparing the Effectiveness of Low-Level Laser Therapy and Topical Steroid Therapy Combination Regimen With Routine Topical Steroid Therapy in the Management of Oral Lichen Planus Symptomatic Patients.

BACKGROUND: For symptomatic oral lichen planus (OLP), a wide range of therapeutic approaches have been suggested. To minimize discomfort and symptoms among individuals with symptomatic OLP, extensive therapy is frequently needed. Therefore, finding a new therapeutic approach that may effectively manage OLP's symptoms and signs while having few adverse effects continues to be a difficult task. Recently, low-level laser therapy (LLLT) has become a popular alternative therapy option for OLP with no serious side effects. AIM: The present research was designed to compare the effectiveness of a combination regimen of LLLT in addition to topical steroids with routine topical steroid therapy separately in order to manage patients with bothersome OLP with an extended period of follow-up. MATERIALS AND METHODS: In our trial, 60 patients were chosen and given sequential numbers as they signed up to take part. The participants were divided randomly into two categories: category A (LLLT plus topical steroids) and category B (only topical steroids). The data were entered into the aforementioned prepared case template after receiving informed consent. The aforementioned prepared case template included the following criteria for evaluating the result of the treatment: pain, recurrence, burning sensation, clinical remission, and size of the lesion. Applying the visual analog scale (VAS), pain, as well as burning sensations, were assessed in both categories. With the aid of the Electronic Digital Vernier Caliper (Mitutoyo, China), these individuals were assessed for the dimension of the lesion. RESULTS: The pain score on day 21 of intervention in category A was 2.5, while it was 4.63 in category B. The difference in findings was significant statistically at day 21 (p = 0.0032). The pain score on day 28 of intervention in category A was 1.3, while it was 3.0 in category B. The difference in findings was significant statistically at day 28 (p = 0.003). The pain score was greater in the control category as compared to the intervention category. The burning sensation score on day 21 of intervention in category A was 2.5, while it was 4.5 in category B. The difference in findings was significant statistically (p = 0.0024). The burning sensation score at the follow-up phase on day 45 of intervention in category A was 1.1, while it was 3.4 in category B. The difference in findings was significant statistically (p = 0.002). CONCLUSION: Newer therapeutic techniques are becoming accessible to oral specialists for controlling oral mucosal disorders as a result of evolving dental trends. The gold standard for treating people with symptomatic OLP continues to be topical corticosteroids. The therapeutic advantages of topical corticosteroids, however, are considerably outweighed by their complementary effect when paired with newer treatment methods like LLLT.

Traumatic Bone Cyst of the Anterior Mandibular Region: A Case Report.

A traumatic bone cyst (TBC) is an unusual non-neoplastic pseudocystic cavity in the bone that is often asymptomatic and slow-growing. It is unexpectedly detected by regular radiography imaging. These lesions are more common in the mandible than they are in the maxilla, and they are often seen in patients older than 40 years of age. A radiolucent unilocular lesion with scalloped margins is the most common radiographic appearance. If the hollow is found to contain blood or straw-colored fluid, surgical exploration is the only way to make a conclusive diagnosis of this uncommon condition. We present a case of an asymptomatic, incidentally diagnosed (on radiograph) traumatic bone cyst in a young patient involving the mandibular anterior region with periapical radiolucency. The case was diagnosed by radiographs and histopathological evaluation.

Evaluation of the Histological Changes in the Structure of the Minor Salivary Glands in Patients With Oral Submucous Fibrosis (OSMF).

BACKGROUND: The minor salivary glands (MSGs) are critical components of the mouth's delicate environment. The pre-malignant changes of oral submucous fibrosis (OSMF) have been associated with a decline in the quality of life and an uptick in the prevalence of oral malignancies. AIM: The aim was to provide evidence of the histological alterations in minor salivary gland structure seen in individuals with OSMF. METHODS AND MATERIALS: A total of 106 confirmed cases of OSMF were enrolled in the study. In order to perform an incisional biopsy, we first collected the patient's complete demographic and clinical history. Using a Vernier calliper, the inter-incisal distance was used to evaluate the mouth opening of the patients. An incisional biopsy of the buccal mucosa was carried out using a 6 mm diameter punch and local anaesthesia. After the appropriate demographic and medical information had been gathered. Acinar cells and the surrounding stroma of tissue slices were observed under a light microscope for alterations. The cytoplasm, nucleus morphology, cellular shape, mucin pooling, and acinar outline of acinar cells were all examined by the researchers. It was taken into account to classify OSMF histologically based on variations in juxta epithelial hyalinization. RESULTS: Multiple aetiologies for the symptoms of OSMF were reflected in the patient's histological abnormalities in the minor salivary glands. On the measurement of the diameter of acini, we discover that the average area of salivary gland acini in OSMF patients is smaller than in the normal group indicative of a decrease in size. The number of functional acini in OSMF is fewer than compared in the control group. CONCLUSION:  Because of the findings of this study, we now have a better understanding of the factors that play a role in the incidence of dryness of the oral and pharyngeal mucosa (OSMF), although it has to be mentioned that no major impact of OSMF on minor salivary glands was observed in our study.

Role of 3D Printing in Post-op Rehabilitation of Palatal Bone Loss by Mucormycosis: A Survey.

BACKGROUND: Three dimensions (3D) modeling, printing, and manufacturing can help in personalized and customized surgical reconstruction of complex defects in the craniofacial region with precision by manipulating tissues based on the preoperative assessment, planning the shape of metal and alloplastic materials, and reduction in the total cost and time of the surgery. AIM: The present survey study aimed to assess the approach of treating surgeons towards the role of 3D printing in post-op rehabilitation of palatal bone loss by mucormycosis. METHODS: One thousand eyes nose and throat (ENT) and maxillofacial surgeons were given a pre-formed structured survey questionnaire to be filled by subjects themselves for their view on the role of 3D printing for rehabilitation and reconstruction of palatal bone loss due to mucormycosis. RESULTS: Efficacy of 3D printing to print the pneumatic sinus design and palatal contour helping to design accurate support with a lightweight prosthesis, 67.2% (n=672) subjects whereas, exact duplication of the excised tissue, 85.4% (n=854) subjects, to detect and duplicate undercuts, 58.4% (n=584) subjects, 3D printing can be helpful as the proper extension of impression 73.2% (n=732) subjects responded positively. For reconstruction of a lost palate by prosthesis 91.2% (n=912) of study participants, in making obturators using Titanium framework and Polyetheretherketone (PEEK) was given a positive response by 82.2% (n=822) subjects, to fabricate prosthesis obturator required in palatal perforation in case of mucormycosis was given a positive response by 88.1% (n=881) subjects, the role of 3D printing to overlay zygomatic implant prosthesis was responded positively by 68.9% (n=689) study subjects. CONCLUSION: The present survey study concludes that 3D printing is a reliable and accurate method for palatal reconstruction following bone destruction by mucormycosis as reported by the majority of ENT and maxillofacial surgeons.

A Comparative Study to Evaluate the Anesthetic Efficacy of Buffered Versus Non-buffered 2% Lidocaine During Inferior Alveolar Nerve Block.

BACKGROUND: The study aimed to compare the clinical efficacy, safety, and acceptability of buffered lidocaine (8.4% sodium bicarbonate and 2% lidocaine with 1:80,000 adrenaline) versus non-buffered lidocaine (2% lidocaine with 1:80,000 adrenaline) during inferior alveolar nerve block. MATERIALS AND METHODS: Fifty patients who required bilateral extractions in a single arch were included in this study. One hundred extractions were carried out, and all of the patients had nerve blocks during the procedure. We also took note of the patient's pain level as measured on a visual analog scale, as well as the start of the action, duration of postoperative analgesia, and occurrence of any problems. The duration of anesthesia was assessed by the feeling of numbness and the first sign of pain. RESULT: All the patients in both study groups reported subjective numbness of the lips and tongue. The depth of anesthesia was evaluated by pain and comfort during the procedure with a visual analog scale and showed no significant difference between the two groups. The onset of action for the pterygomandibular nerve block was 1.240.31 minutes (buffered) and 1.710.51 minutes (non-buffered). When compared, the duration of anesthesia was 327.18102.98 minutes (buffered) and 129.0826.85 minutes (non-buffered). CONCLUSION: This study concludes that the buffered solution has a faster onset of action than the non-buffered solution. Both solutions exhibit similar intraoperative efficacy. The duration of postoperative anesthesia was prolonged with buffering. Buffering also reduced pain scores during the early postoperative period.