Assessment of Efficacy of Various Bracket Base Retention Qualities on Shear Bond Strength.

Introduction: Numerous manufacturers have improved bracket retention systems as a result of the frequent bond failure that occurs during orthodontic treatment. One of the elements affecting the adhesive's bond strength is the bracket retention mechanism. Objectives: This study's objective was to assess how various bracket base retention characters affected shear bond strength. Materials and Methods: Four distinct base features for brackets were evaluated. The basic design was examined using a scanning electron microscope. On the Universal testing equipment, brackets were glued to human teeth and then released. Results: The findings indicate that the polymer-coated base's overall mean SBS, which had a mean value of 21.64 ± 4.14 MPa, was considerably greater than that of the other brackets (P 0.05). The foil meshpad, photochemically etched base, and laser-structured base had mean SBS values of 15.12 ± 5.75 MPa, 16.86 ± 3.76 MPa, and 19.32 ± 4.23MPa, respectively. Conclusions: Following laser-structured base and photochemically etched base brackets in terms of shear bond strength were polymer-coated base brackets. The shear bond strength was the lowest in the plain foil mesh pads.

Three-Dimensional Assessment of Temporomandibular Joint Morphology and Facial Asymmetry in Individuals with Different Vertical Skeletal Growth Patterns.

The aim of the current study was to investigate, by means of Cone-Beam Computed Tomography (CBCT), condyle−fossa relationship, temporomandibular joint (TMJ) morphology and facial asymmetry in subjects with different vertical skeletal growth patterns. CBCT of 56 patients (112 TMJs) were categorized into three groups according to the mandibular plane angle (MP): Hypodivergent (MP ≤ 23°), Normodivergent (23° < MP < 30°), and Hyperdivergent (MP ≥ 30°). TMJ spaces, width and depth of the condyle and thickness of the fossa were measured. Horizontal and vertical measurements were used to assess facial asymmetry. One-way Analysis of Variance (ANOVA) and post-hoc Turkey tests were computed for the between-groups comparison. Statistical significance was set at p < 0.05. Larger anterior joint space and smaller condylar dimensions (medio-lateral diameter and medio-lateral thickness) were observed in the hyperdivergent group compared to the normodivergent and hypodivergent groups. Right condylar distances to midsagittal plane were significantly larger than left distances in all the three groups. A vertical pattern of growth in healthy individuals seems to be associated with condylar position and dimension, while facial asymmetry values do not differ among different vertical groups.

An In vitro evaluation of effect of implant abutment on human gingival epithelial keratinocytes.

Background: Abutment surfaces are being designed to promote gingival soft tissue attachment and integration. This confirms implant survival for long term by forming a seal around the prosthetics. Objectives: This study was done to compare the biocompatibility of three implant abutments: titanium uncoated, Ti-nitride coated, and modified polyetheretherketone (PEEK) with human gingival keratinocytes. Materials and Methods: The titanium-uncoated, titanium-nitride-coated, and modified PEEK discs (13 mm × 3 mm) were fabricated and compared with uncoated polyester cell culture discs, which were used as controls. These three implant abutments were evaluated for biocompatibility with respect to human gingival keratinocytes for viability, morphology, proliferation, and migration by scanning electron microscopy imaging and scratch wound healing assays. Measurements of roughness show changes between the investigated surfaces. Results: Keratinocytes cultured on all examined surfaces indicated adhesion and attachment. An assay of cell viability showed no substantial variances among the groups. The modified PEEK surface showed greater cell proliferation and migration among the three abutment materials. Conclusion: All three abutment material surface types showed similar epithelial biological responses. However, modified PEEK material showed the highest biocompatibility.

Résumé Contexte: Les surfaces des piliers sont conçues pour favoriser la fixation et l'intégration des tissus mous gingivaux. Cela confirme l'implantation survie à long terme en formant un joint autour des prothèses. Objectifs : Cette étude a été réalisée pour comparer la biocompatibilité de trois Piliers Implantaires : titane non revêtu, revêtu de nitrure de titane et polyétheréthercétone modifié (PEEK) avec des kératinocytes gingivaux humains. Matériaux et Méthodes: les disques PEEK non revêtus de titane, revêtus de nitrure de titane et modifiés (13 mm × 3 mm) ont été fabriqués et comparés à des disques de culture cellulaire en polyester non revêtus, qui ont été utilisés comme témoins. Ces trois piliers implantaires ont été évalués pour biocompatibilité vis-à-vis des kératinocytes gingivaux humains pour la viabilité, la morphologie, la prolifération et la migration par balayage électronique l'imagerie microscopique et les tests de cicatrisation des plaies. Les mesures de rugosité montrent des changements entre les surfaces étudiées. Résultats: Les kératinocytes cultivés sur toutes les surfaces examinées ont indiqué une adhérence et une fixation. Un test de viabilité cellulaire n'a montré aucune écarts entre les groupes. La surface PEEK modifiée a montré une plus grande prolifération et migration cellulaire parmi les trois matériaux de pilier. Conclusion: Les trois types de surfaces de matériaux de pilier ont montré des réponses biologiques épithéliales similaires. Cependant, le matériau PEEK modifié a montré la biocompatibilité la plus élevée. Mots-clés: Biocompatibilité, implant, kératinocytes, prothèses, microscopie électronique à balayage.

A CBCT assessment of bone density changes after accelerated orthodontic retraction of canine by microosteoperforations.

AIM: The study was conducted to assess the changes in bone density before and after performing accelerated orthodontic maxillary canine retraction by microosteoperforations (MOPs). MATERIALS AND METHODS: Forty patients (120 cone-beam computed tomography [CBCT] images) within the age group of 15 to 25 years undergoing fixed orthodontic treatment with bilateral maxillary first premolar extraction were enrolled in this study. The right and left sides of the maxillary jaw in the same patients were selected as experimental and control sites. To accelerate the tooth movement, MOPs were performed distal to the canine root in the extraction space under local anesthesia with a miniscrew. Thereafter, the maxillary canine retraction was initiated using a NiTi closed coil spring. The CBCT images were taken and evaluated at the following time intervals: 1 week before MOPs(T0);1 week after MOPs(T1);3 weeks after MOPs(T2). RESULTS: A statistically significant reduction in bone density was observed at the center of resistance of canine on the experimental site (after MOPs) at 1 week and 3 weeks (T0-T1 = 0.000,0.115; T1-T2 = 0.0025,0.0117), whereas a statistically non-significant difference was found 1 week before and 3 weeks later in the control group. CONCLUSION: Accelerated orthodontics by MOPscan result in a substantial reduction in bone density during canine retraction, leading to an increase in the tooth movement rate, hence lowering the overall orthodontic treatment time.

Delaying Intraoral Radiographs during the COVID-19 Pandemic: A Conundrum.

BACKGROUND: The COVID-19 pandemic has made dentists very assiduous about cross-infection during dental treatment, thereby delaying dental radiographs for treatment. However, patients needing dental emergency treatment in the ongoing pandemic require relevant intra/extraoral dental radiography for adequate diagnosis and treatment planning. METHODS: This article is aimed at adding to the hot debate: Is delay for intraoral radiographs justified or a possible proxy? As a narrative review, it provides an insight into the reasons for delaying intra-oral dental radiographs during in the pandemic and options of the nontraditional radiographic techniques available until the pandemic subsides. Discussion and Conclusion. Cross-contamination concerns through respiratory droplets grow while using intraoral film holders that stimulate gag reflex, coughing, saliva secretion, and if proper disinfection protocols are not applied. Since the patients' acquiring emergency dental treatment cannot be neglected, the return-to-work guidelines by the health regulatory bodies urge to prioritize extraoral radiographic imaging techniques to curb the infection, offering the best diagnostic efficacy. The dental professionals can consider cone-beam computed tomography (CBCT) scans and sectional dental panoramic radiographs (SDPRs), followed by a risk assessment for COVID-19, a safer modality in reducing cross-contamination and assuring an innocuous environment for both patient and coworkers.

Three-Dimensional Evaluation of Condyle-Glenoid Fossa Complex Following Treatment with Herbst Appliance.

The purpose of the present retrospective observational study was to compare the effects of treatment with Herbst appliance and fixed therapy with elastics on the condyle and glenoid fossa complex. Thirty patients aged between twelve and sixteen years with skeletal Class II malocclusion who met the inclusion criteria were included in the study: fifteen patients treated with Herbst appliance (Group 1), and fifteen patients treated with orthodontic camouflage using MBT prescription (MBTTM Versatile+ Appliance System) (Group 2). For Group 2, patients had CBCT scans taken before treatment either after Herbst appliance removal or at the end of treatment. CBCT scans were evaluated for changes in condyle-glenoid fossa complex using the In Vivo Dental 5.1 software. Statistical significance was set at p ≤ 0.05. On inter-group comparison, the Herbst group showed statistically significant increases in the condylar height of 1.35 mm (p ≤ 0.001) on the right and 1.21 mm (p ≤ 0.01) on the left side, and a condylar volume of 111.03 mm3 (p ≤ 0.01) on the right and 127.80 mm3 (p ≤ 0.001) on the left side. The Herbst group showed anterior remodelling on the postero-superior aspect of glenoid fossa. Herbst appliance treatment induced growth at the condylar head and anterior remodelling of glenoid fossa, thereby improving the maxilla-mandibular relationship in growing skeletal Class II patients.

Marginal bone loss around axial and straight implants supported with prefabricated SFI-Bar with mandibular overdentures.

To assess the role of prefabricated SFI-Bar in peri-implant bone loss around immediately axially loaded and straight implants. This study comprised of 40 complete denture wearer patients who received two axially parallel implants connected by SFI-Bars in group I and two 15° mesially tilted implants connected by SFI-Bars in group II. Peri- implant bone loss (PiBL) was measured at 1 year, 2 years and 3 years. The mean PiBL at 1 year in group I was 0.21 mm and I group II was 0.22, at 2 years in group I was 0.26 mm and in group II was 0.23 mm and at 3 years, in group I was 0.29 mm and in group II was 0.34 mm. The difference was significant at 3 years (P< 0.05). The mean mesial PIBL at 1 year in group I was 0.18 mm, in group II was 0.20 mm, at 2 years in group I was 0.19 mm and in group II was 0.07 mm and at 3 years, in group I was 0.25 mm and in group II was 0.29 mm. The difference found to be significant in each time duration in both groups (P< 0.05).The mean distal PIBL at 1 year in group I was 0.23 mm, in group II was 0.22 mm, at 2 years in group I was 0.33 mm and in group II was 0.39 mm and at 3 years, in group I was 0.34 mm and in group II was 0.39 mm. The difference found to be significant at 2 and 3 years in both groups (P< 0.05). Authors found that mandibular overdentures retained with Prefabricated SFI-Bar with axial and straight inserted implants may be useful in patients with reduced bone height.

Evaluating the efficacy of desensitizing dentifrices on dentinal hypersensitivity management: A scanning electron microscopic analysis.

INTRODUCTION: Dentin hypersensitivity (DH) adversely affects quality of life by impairing the ability to eat and drink certain foods, therefore, should be addressed promptly with a contingency plan that includes initial treatment with a noninvasive prophylactic home care approach, followed by in-office treatment if desired result is not achieved. AIM: The purpose of this study was to evaluate the effectiveness of four different pastes containing 5% NovaMin (Sensodyne Repair and Protect®), Propolis (Phytoshield Propolis®), 5% potassium nitrate (Sensodyne®), and 8% arginine (Colgate Sensitive Pro Relief®) based toothpastes in the treatment of DH. MATERIALS AND METHODS: One hundred dentin slices were cut from the crown section of molars. Etching with 37% orthophosphoric acid was done to open the tubules. Scanning electron microscope (SEM) study was done to ensure that the tubules are opened. The dentin specimens were divided into four groups: Group 1 -5% NovaMin, Group 2 - Propolis, Group 3 - 5% potassium nitrate, and Group 4 - 8% arginine. Samples were brushed for 2 min twice daily with a soft toothbrush for 15 days and were stored in distilled water. The samples were rinsed under running water to remove the toothpaste. The SEM was performed to check the obliteration of tubules. RESULTS: 5% NovaMin group showed more completely occluded dentinal tubules when compared to other groups. The differences among all the groups were statistically significant (P ≤ 0.05). CONCLUSION: In the present study, all materials, NovaMin, Propolis, potassium nitrate, and arginine, were effective in occluding dentinal tubules but NovaMin appeared most proficient in occluding tubules, followed by arginine, potassium nitrate, and Propolis. Topical NovaMin is an upcoming agent demonstrating desensitization and remineralization properties.

Effect of Craniofacial Morphology on Pharyngeal Airway Volume Measured Using Cone-Beam Computed Tomography (CBCT)-A Retrospective Pilot Study.

BACKGROUND: The present study aimed to determine the correlation between pharyngeal airway volume and craniofacial morphology through cone-beam computed tomography (CBCT). Additionally, the study analyzed the influence of gender on pharyngeal airway volume. (2) Methods: 80 CBCT scans of 40 male and 40 female patients (mean age: 15.38 + 1.10 years) fulfilling the eligibility criteria were included. CBCT scans were evaluated for pharyngeal airway volume using the In Vivo Dental 5.1 software. Additionally, CBCT-derived lateral cephalograms were used to assess various craniofacial morphology parameters. To examine the influences of gender on airway volume, T-test was carried out. Correlation between airway volume and craniofacial parameters were measured using Pearson correlation followed by regression analysis. The value of p < 0.05 was considered statistically significant. RESULTS: The mean airway volume was significantly greater in males than in females. A statistically significant negative correlation was found between maxillary plane inclination and pharyngeal airway volume. In contrast, a positive correlation was observed between mandibular length and lower molar inclination with oropharyngeal and total pharyngeal airway volume. Females showed a statistically significant positive correlation between the pharyngeal airway volume and sagittal position of maxilla and mandible; they also showed a negative correlation between oropharyngeal airway volume and the mandibular plane angle. CONCLUSIONS: Overall, the pharyngeal airway space differs significantly between males and females. Craniofacial morphology does have a significant effect on the pharyngeal airway, especially on the oropharyngeal airway volume.

Cone beam computed tomographic evaluation of pharyngeal airway in North Indian children with different skeletal patterns.

BACKGROUND: In growing patients with skeletal discrepancies, early assessment of functional factors can be vital for the restoration of normal craniofacial growth. AIM: To compare airway volumes in patients with mandibular retrognathism with the normal anteroposterior skeletal relationship, thereby assessing the association between cephalometric variables and airway morphology. METHODS: Cone-beam computed tomography volume scans, and lateral cephalograms, 3-dimensional airway volume and cross-sectional areas of 120 healthy children (54 boys and 66 girls mean age 15.19 ± 1.28) which were done for orthodontic assessment were evaluated. The subjects were divided into 2 groups based on the angle formed between point A, Nasion and point B (ANB) values and cephalometric variables (such as anterior and posterior facial height, gonial angle etc.) airway volumes, and cross-sectional measurements were compared using independent t tests. Pearson's correlation coefficient test was used to detect any relationship of different parts of the airway and between airway volume and 2-dimensional cephalometric variables. RESULTS: Means and standard deviations for cephalometric, cross-sectional, and volumetric variables were compared. ANB, mandibular body length and facial convexity were statistically highly significant (P < 0.01) whereas condylion to point A, nasal airway and total airway volume (P < 0.05) were statistically significant. The nasal airway volume and the superior pharyngeal airway volume had a positive correlation (P < 0.01), nasal airway was correlated to middle (P < 0.05) and total airway superior had a relation with middle (P < 0.05), inferior and total airway (P < 0.05), middle was related to all other airways; inferior was also related to all the airways except nasal. Lateral cephalometric values were positively correlated with the airway volume with Frankfurt Mandibular Plane Angle and facial convexity showed significant correlations with total airway volume (P < 0.05). Additionally, ANB angle was significantly correlated with total airway volume and superior airway (P < 0.05). CONCLUSION: The mean total airway volume in patients with retrognathic mandible was significantly smaller than that of patients with a normal mandible.

Reliability and Reproducibility of Landmark Identification in Unilateral Cleft Lip and Palate Patients: Digital Lateral Vis-A-Vis CBCT-Derived 3D Cephalograms.

BACKGROUND: The aim of the retrospective observational study was to compare the precision of landmark identification and its reproducibility using cone beam computed tomography-derived 3D cephalograms and digital lateral cephalograms in unilateral cleft lip and palate patients. METHODS: Cephalograms of thirty-one (31) North Indian children (18 boys and 13 girls) with a unilateral cleft lip and palate, who were recommended for orthodontic treatment, were selected. After a thorough analysis of peer-reviewed articles, 20 difficult-to-trace landmarks were selected, and their reliability and reproducibility were studied. These were subjected to landmark identification to evaluate interobserver variability; the coordinates for each point were traced separately by three different orthodontists (OBA, OBB, OBC). Statistical analysis was performed using descriptive and inferential statistics with paired t-tests to compare the differences measured by the two methods. Real-scale data are presented in mean ± SD. A p-value less than 0.05 was considered as significant at a 95% confidence level. RESULTS: When comparing, the plotting of points posterior nasal spine (PNS) (p < 0.05), anterior nasal spine (ANS) (p < 0.01), upper 1 root tip (p < 0.05), lower 1 root tip (p < 0.05), malare (p < 0.05), pyriforme (p < 0.05), porion (p < 0.01), and basion (p < 0.05) was statistically significant. CONCLUSION: In patients with a cleft lip and palate, the interobserver identification of cephalometric landmarks was significantly more precise and reproducible with cone beam computed tomography -derived cephalograms vis-a-vis digital lateral cephalograms.

Intra- and Interobserver Reliability of Bone Volume Estimation Using OsiriX Software in Patients with Cleft Lip and Palate Using Cone Beam Computed Tomography.

The objective of the current study was to evaluate intra- and interobserver bone volume measurements and effect of orientation on the reliability of bone volume evaluation in as-acquired vis-à-vis oriented cone beam computed tomography scans using Osirix software and possible correlation between gender, age, and bone volume required. For this, 31 cone beam computed tomography (CBCT) scans of 14 girls and 17 boys (aged 9-13) with unilateral cleft lip and/or palate who met the inclusion criteria were analyzed. Efficacy and reliability of third party software Osirix for bone volume calculation was assessed using as acquired and oriented volumes by three specialists (a radiologist, an orthodontist, and an oral maxillofacial surgeon). The dataset and readings were anonymized to prevent any bias. Two-way mixed model analysis on as-acquired and oriented observations exhibited intra-class coefficient (ICC) values ≥ 0.90. Wilcoxon signed rank test (p = 0.10) and Kruskal-Wallis ANOVA (p = 0.46) indicated that although a clinical difference in volume assessment was seen between as-acquired and oriented observations (inter-observer and intra-observer), it was statistically insignificant. Spearman's bi-variate correlation analysis revealed a significant relation between the type (side) of cleft and bone volume required to fill the defect (p < 0.05). Although there was clinical difference in bone volume measurement by the three observers, it was insignificant statistically. Clefts on the left side in the patients had significantly more bone required than the right side, whereas age and gender had no relation with bone needed to fill the defect. OsiriX software provided good reliability in measurements of bone volume.

Comprehensive management of malocclusion in maxillary fibrous dysplasia: A case report.

BACKGROUND: Fibrous dysplasia (FD) is a developmental hamartomatous bone disease characterized by a blend of fibrous and osseous entities. Though rarely malignant, the tumor can vary from being small and asymptomatic, to a fairly large sized lesion, progressing gradually, compromising occlusion and facial esthetics. Treatment approach depends on the stage of skeletal maturity. It primarily involves surgical management for stabilizing the disease process. Post-surgical comprehensive dental treatment is necessary for restoring form and function of the jaws and teeth. This article describes comprehensive orthodontic management of severe malocclusion in a surgically operated case of FD maxilla. CASE SUMMARY: A 19-year female presented with a chief complaint of excessive gingival display when smiling. Dental history included swelling of gums around the upper right front teeth, diagnosed at the age of 15 as FD of the right anterior maxillary segment and treated with surgical recontouring of the dysplastic bone. The clinical and radiological examinations showed adequate post-surgical healing. The surgically treated dysplastic area presented with right canting of the maxillary anterior occlusal plane. The maxillary teeth were torqued palatally, with the root of the right maxillary canine exposed clinically. We discuss sequential management of the associated malocclusion with comprehensive fixed orthodontics, along with special precautions taken to prevent reactivation of the quiescent and healed lesion. CONCLUSION: The adequate healing of fibro-dysplastic bone post-surgery must be allowed before initiating orthodontic tooth movement in the dysplastic bone. Periodic follow-ups are needed to monitor stability of occlusion and any relapse of the lesion.

Dentistry during and after COVID-19 Pandemic: Pediatric Considerations.

This article is a rumination on the outbreak of the dreaded coronavirus disease-2019 (COVID-19) pandemic which has engulfed both the developed and the developing countries, thereby causing widespread global public health concerns and threats to human lives. Although countries have made varied efforts, the pestilence is escalating due to the high infectivity. It is highly likely that dental professionals in upcoming days will come across COVID-19 patients and SARS-CoV-2 carriers, and hence must ensure a tactful handling of such patients to prevent its nosocomial spread. Despite the avalanche of information that has exploded in relation to this rapidly spreading disease, there is a lack of consolidated information to guide dentists regarding clinical management including precautions to take materials to use and postprocedure care, during and after the COVID-19 pandemic. Available sources of information have been analyzed, while relying on peer-reviewed reports followed by information available from the most respected authoritative sources, such as WHO, Centers for Disease Control and Prevention (CDC), and ADA. This review aims to provide a comprehensive summary from the available literature on COVID-19, its insinuation in dentistry, recommendations that have been published, and the actual in-practice implications, so a plan can be formulated and adapted to the circumstances of each dental practice during the pandemic and the times to follow. HOW TO CITE THIS ARTICLE: Kochhar AS, Bhasin R, Kochhar GK, et al . Dentistry during and after COVID-19 Pandemic: Pediatric Considerations. Int J Clin Pediatr Dent 2020;13(4):399-406.

Appropriate orthodontic appliances during the COVID-19 pandemic: A scoping review.

INTRODUCTION: The esoteric Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection or COVID-19 has been an unusual plummet in dental/orthodontic practice. Based on current recommendations for various amendments in an orthodontic practice, this scoping review aims to identify orthodontic appliances that are most appropriate to us during this on-going pandemic. METHODS: Electronic databases (PubMed, Scopus, Web of Science, Science Direct, and Google Scholar) were searched up until August 11, 2020. Full-text articles in English with keywords "COVID-19 and Orthodontics" and related search terms were included. RESULTS: Out of 17 retracted articles, only 4 articles were found to be brief the choice for orthodontic appliances in pandemic times speculating clear aligner therapy (CAT) to be a pragmatic solution. The remaining articles were also thoroughly studied and the new norms set by the pandemic were determined. Criteria for orthodontic appliance selection included careful patient screening and collection of records, minimal physical visits, efficient use of technology, virtual consultations but the use of PPE for physical appointments; and lesser AGPs with a lesser risk of airborne transmission. CONCLUSIONS: Subject to regional demands, CAT can be considered as the relatively safer modality-predictable and effective apposite to fixed orthodontic appliances in these unprecedented times.

Frontal and Axial Evaluation of Craniofacial Morphology in Repaired Unilateral Cleft Lip and Palate Patients Utilizing Cone Beam Computed Tomography; An Observational Study.

The current study was conducted to assess the extent of maxillary arch collapse on the cleft vis-a-vis non-cleft sides in the same individual presenting withunilateral cleft lip and palate (UCLP), using cone-beam computed tomography (CBCT). Thirty-one children (eighteen boys andthirteen girls) with surgically repaired UCLP, who met the inclusion criteria, were selected. Following the acquisition of CBCT scans, fourteen bilateral landmarks were selected. The distance of the bilateral landmark was calculated from the midsagittal plane on the cleft and non-cleft sides for both frontal and axial views. Tracings were done;the data obtained was subjected to statistical analysis;and intra-observer variability was checked with intraclass correlation coefficient (ICC) and two-way ANOVA. Subsequently, the measurements were subjected to paired t-tests at the 95% level of significance with Bonferroni correction. A significant reduction of pyriforme and an alveolar crest above the maxillary 1st molar were discerned in frontal analysis on the cleft side. In the axial view, the zygomatic arch, malar, porion and alveolar crest at the molar region were non-significant, but the alveolar crest at the premolar region (p < 0.004)) was significantly decreased. In the frontal analysis, pyriforme and the alveolar crest above the maxillary 1st molar, and, in the axial view, premolar widths, showed significant reduction when comparing the cleft vis-a-vis non-cleft sides.

Evaluation of Hydroxyapatite Granules, CERAMENT™, and Platelet-rich Fibrin in the Management of Endodontic Apical Surgery.

AIM: The present study compared hydroxyapatite granules, CERAMENT™, and platelet-rich fibrin (PRF) in the management of endodontic apical surgery cases. MATERIALS AND METHODS: The present study was conducted on 126 patients requiring apical surgery of both genders. Patients were treated with hydroxyapatite granules, CERAMENT™, and PRF and were recalled regularly for assessment of pain, mobility, presence or absence of sinus, and healing site. RESULTS: The mean days taken for the disappearance of pain in group I was 51.2 days, in group II was 52.3 days, and in group III was 44.7 days. The difference was significant (p < 0.05). There was a less number of draining sinuses in II and III groups. This was statistically significant (p < 0.05). Significantly less area remained after surgical intervention in groups II and III compared to group I recorded at follow-up period. The difference was significant (p < 0.05). CONCLUSION: Authors found PRF superior in terms of reducing pain, mobility, and sinus and improving the healing site as compared to hydroxyapatite and CERAMENT™. CLINICAL SIGNIFICANCE: Platelet-rich fibrin is considered more superior in terms of reducing pain, mobility, and sinus and improving the healing site, and it can be advised in clinical practice for endodontic management.

COVID-19 Pandemic and Dental Practice.

SARS-CoV-2, a virus causing severe acute respiratory syndrome, has inundated the whole world, generating global health concerns. There is a wildfire-like effect, despite the extensive range of efforts exercised by the affected countries to restrain the expanse of this pandemic, owing to its community spread pattern. Dental specialists in the upcoming days will likely come across patients with presumed or confirmed COVID-19 and will have to ensure stringent infection prevention and control to prevent its nosocomial spread. This paper strives to provide a brief overview of the etiology, incubation, symptoms, and transmission paradigms of this novel infection and how to minimize the spread in a dental healthcare setting. This review presents evidence-based patient management practice and protocols from the available literature to help formulate a contingency plan with recommendations, for the dental practices prior to patients' visit, during in-office dental treatment, and post-treatment, during the pandemic and after.