Diagnosis and Dental Management of a Patient With Forbes Albright Syndrome: A Report of a Rare Case.

Forbes Albright syndrome is a hyperprolactinemia syndrome linked to a pituitary tumor associated with galactorrhea and amenorrhea. Cabergoline, an ergot derivative, is its drug of choice. Here, we report the oral manifestations and management of a case of a 32-year-old female, diagnosed and treated with the same. The patient had an alarming increase in the incidence and progression of dental caries. Her diagnosis and management have been highlighted. This can have overbearing effects on the psychology and function of the individual, thus making early diagnosis and precise management important.

Effect of Herbal Intracanal Medicaments on Microhardness of Root Dentin: An In Vitro Study.

INTRODUCTION: The use of intracanal medicaments (ICM) is crucial to reduce the microbial load in root canals. However, its application may negatively affect the physical properties of root dentine. Thus, this in vitro study was performed to investigate the effects of different herbal ICM on the microhardness of root dentin. MATERIALS AND METHODS: A total of 100 mid-root discs were randomly divided into five groups (n = 20) and treated with Aloe vera, Aloe vera + chitosan, curcumin, curcumin + chitosan, and control for 14 days. A Vickers hardness indentation machine (Laizhou Laihua Testing Instrument Factory, Yantai, China) with a load of 200 g and a dwell time of 15 seconds was used for microhardness testing before and after treatment. The results were analyzed using Statistical Product and Service Solutions (SPSS, version 26.0; IBM SPSS Statistics for Windows, Armonk, NY). Intragroup comparisons were executed using paired t-tests, while intergroup comparisons employed ANOVA, followed by post-hoc Tukey's tests. RESULTS: The Aloe vera + chitosan and curcumin + chitosan groups showed a statistically significant reduction in dentin microhardness (p < 0.05). The decrease in dentin microhardness of the Aloe vera and curcumin groups was non-significant (p > 0.05) and similar to that of the control. CONCLUSION: Aloe vera or curcumin alone as ICM did not affect the root dentin microhardness. The addition of 0.2% chitosan to either Aloe vera or curcumin negatively affected the root dentin microhardness.

Minimally Invasive Esthetic Reinforcement of a Fractured Anterior Tooth Using Dentapreg PINPost: A Case Report.

The reason to use post is to retain the core that holds the definitive prosthesis. The maxillary central incisor always poses a challenge during reconstruction using the post and core system. Dentapreg PINPost, a pre-cured flexible post made of fiber-reinforced composite (FRC), has many advantages over metallic posts and fiber posts. The purpose of this case report is to present an innovative technique to place both FRC posts and FRC sheets as a single assembly into the canal which gives a monoblock effect. This technique is feasible and may eradicate some of the problems associated with the failure of the post and core.

Regenerative Therapy for the Permanent Immature Teeth: A Long Term Study. An Original Research.

Introduction: Endodontics faces several clinical difficulties while treating young necrotic permanent teeth. The use of regenerative endodontic procedures (REPs) enables apical closure, improved canal wall thickness, and root growth. The objective of this study was to assess the effects of these regenerative procedures on immature necrotic permanent teeth. Methods: This prospective clinical study was conducted at the tertiary care hospital for the study period of 2 years. This study includes 30 necrotic permanent immature teeth that were studied in 30 subjects of both genders. A standard REP protocol was used to treat every tooth. A follow-up visit was scheduled for each patient at timely intervals. Various study parameters as well as the demographics were assessed at each visit. To examine various parameters, a calibrated endodontist also performed a radiographic evaluation. Results: Our findings point to excellent rates of survival, clinical success, and apical pathological resolution for 29 teeth. After 2 years, there were significant variations in the root thickness area and the average root length. The apical diameter significantly decreased during the research period, with 30.8% of the instances exhibiting full apical closure. Apical diameter, root length, and thickness changed more frequently in teeth with the level of the immaturity of the root, although the variations were not significant. Conclusions: REP treatment for teeth preceded symptom relief. Increased root thickness, root length, and apical closure were seen at 30 months, even if the clinically meaningful change was not attained in all patients.

Local Anesthesia Onset and Pain Perception in Hemophilic and Thalassemic Conditions.

The study aims to evaluate and compare the onset of local anesthesia (LA) and pain perception during endodontic treatment in hemophilic and thalassemic patients. Methods: The study included 90 patients with symptomatic irreversible pulpitis of the mandibular molars. Three groups (n = 30 in each group) were included. Group 1: hemophilic patients; group 2: thalassemic patients; and group 3: individuals without any systemic diseases. Onset of LA and visual analogue scale (VAS) scores was recorded immediately after the administration of local anesthesia, during the pulp exposure procedure, and during canal instrumentation, and were compared between the three groups. Frequency distribution, ANOVA, and linear regression analysis (p < 0.05) were applied. Results: The mean onset time was 46 ± 34 s in the hemophilic group, 42 ± 23 s in the thalassemic group, and 38 ± 12 s in controls, but the differences were statistically insignificant. After LA administration (LA-VAS), all three groups experienced a statistically significant reduction in pain (p = 0.048). On pulp exposure (PE-VAS) (p = 0.82) and during canal instrumentation (CI-VAS) (p = 0.55), there was no statistically significant difference in pain perception between the groups. The coefficients indicate a positive correlation between the VAS and onset time, indicating a positive reduction in the VAS following the administration of LA. Conclusions: Hemophilic patients exhibited a clinically longer average onset time for LA. However, the difference among the three groups with regard to the overall pain perception after LA administration, during and after pulp exposure, and during canal instrumentation was statistically insignificant.

Comparative Evaluation of Efficacy of Bioactive Glass, Tricalcium Phosphate, and Ozone Remineralizing Agents on Artificial Carious Lesion.

Objectives: Evaluation of efficacy of bioactive glass (BAG), tricalcium phosphate, and ozone remineralizing agents on artificial carious lesion. Materials and Methods: Freshly extracted 48 human premolar teeth were included for this in vitro study. Remineralization of demineralized teeth was done with respective remineralizing agents (Group A - calcium sodium phosphosilicate [BAG], Group B - tricalcium phosphate [Clinpro Tooth Crème], Group C - ozone remineralizing agents, and control group: Group D - deionized water) three times a day for 12 days for 4 min. The degree of demineralization and remineralization was evaluated with Vickers hardness number. Results: There was a decrease in microhardness from baseline to demineralization in all the groups. The difference in microhardness values from demineralization to remineralization in all the three test groups was found to be statistically highly significant. Conclusion: BAG and Tricalcium phosphate had higher remineralizing capacity, which can be used clinically to treat early carious lesions.

Oral Health-Related Quality of Life in Children and Adolescents with a Traumatic Injury of Permanent Teeth and the Impact on Their Families: A Systematic Review.

The aim of this systematic review was to evaluate the impact of a traumatic dental injury (TDI) of permanent teeth in children and adolescents on their oral health-related quality of life (OHRQoL) as well as on their families. A bibliographic search in the biomedical databases (PubMed, Cochrane Library, MEDLINE) was limited to studies published between January 2000 and February 2021. The study selection criteria were cross-sectional, case control, or prospective clinical studies, which analyzed TDI before and after the treatment of permanent teeth in healthy children and adolescent, assessed their OHRQoL, and were written in English. The search found 25 eligible articles that were included in the study. The quality assessment of the studies was performed using the quality assessment checklist for survey studies in psychology (Q-SSP). The results indicated that a TDI of permanent teeth strongly influences the OHRQoL of children and adolescents, and the timely-performed dental management of a TDI allows for preventing further biological and socio-psychological impacts. Sociodemographic status, economic status, parent's education, gender, age group, and type of schooling were determinants of the TDI impact on OHRQoL.

Assessment of Different File Systems for Working Time Based on Glide Path, Operating Kinetics, and the Fracture Resistance.

AIM: This study was done to assess the time to achieve the working distance based on the size of the glide path, operating kinetics, and the fracture resistance of different file systems. MATERIALS AND METHOD: One hundred and eighty mandibular premolars were divided into two groups of 90 each. Group I was subjected to continuous 360° rotary motion and group II to adaptive motion. Twisted File (TF) and Endostar E3 file methods were practiced in groups. The time (seconds) to achieving desired working length was recorded. Failures were classified as torsional failure or flexural failure. RESULTS: The time taken by glide path size 15 in group I was 5.90 ± 4.06 seconds and in group II was 6.12 ± 4.16 seconds. The time taken by glide path size 20 in group I was 5.86 ± 3.12 seconds and in group II was 4.22 ± 2.10 seconds, with 25 size the time taken in group I was 5.32 ± 2.48 seconds and in group II was 3.16 ± 3.14 seconds. The time taken by group I was less as compared to group II, and the difference was significant (p < 0.05). There was a significant difference in time taken with different number files in both groups (p < 0.05). The mean time taken reaching the working length for continuous rotation was less as compared to TF adaptive motion; however, the difference was nonsignificant (p > 0.05). CONCLUSION: We recorded higher instrument separation and deformation with the TF method and adaptive gesture. The TF system showed additional time to achieve the working distance as compared to the Endostar E3 system. CLINICAL SIGNIFICANCE: The TF system showed higher instrument separation and deformation, and it requires additional time to achieve the working distance compared to the Endostar E3 system. Hence, the Endostar E3 system is effective in achieving required clinical results.

Perinerural, lymphovascular and depths of invasion in extrapolating nodal metastasis in oral cancer.

OBJECTIVE: The role of tumour thickness (TT), depth of invasion (DOI) from two different reference points (TT2 and TT3), perineural invasion (PNI) and lymphovascular invasion (LVI) were evaluated to predict lymph node metastasis (LNM) in oral squamous cell carcinoma (OSCC). Reference points for measuring the DOI were suggested. MATERIAL AND METHODS: Paraffin-embedded tissues of excisional biopsy cases diagnosed as OSCC were sectioned and stained in haematoxylin and eosin to study variables like TT1, TT2, TT3, PNI and LVI. Out of total 150 cases collected for the study, 136, 123 and 149 cases were qualified for analysis of TT1, TT2 and TT3 respectively. The association with LNM was studied using chi square test of independence. A binary logistic regression model (BLC) was developed to indicate high-risk cases. RESULTS: Receiver operating curve analysis suggested an optimum cut-off value. A significant correlation of TT1 (> 8.64, RR = 1.642, p = 0.018) and TT2 (> 7.64, RR = 2.041, p = 0.016), PNI (p = 0.028) and LVI (p = 0.000) were found with LNM. A mathematical model was suggested as Z = - 1.866 + 0.101TT2 + 2.106VI + e, where Z = log [(p/(1 - p)] p = probability of the case experiencing the event of interest. CONCLUSION: With the suggestion of a standardised reference point to measure DOI for the first time, this study has shown an association of TT1, TT2, PNI and LVI with LNM in Indian Population. The mathematical model can help in identifying high-risk cases in OSCC. CLINICAL RELEVANCE: Such studies would offer avenues for the pre-surgery assessment of depth of invasion and tumour thickness before performing neck dissection, thereby decreasing morbidity.

Knowledge, attitude and practice of dental professionals towards substance use.

INTRODUCTION: The dentist must be aware of this drug use in their individual patients to: (1) avoid possible contraindications during dental treatment, (2) be aware of the many oral and craniofacial manifestations of such drug use, (3) be able to provide necessary dental treatment to combat the dental/oral ravages of drug use, and (4) be able to refer such patients, if so desired by the patient. AIMS AND OBJECTIVES: The aim of the study is (1) To determine the knowledge of abusive drugs among dentists and (2) To determine the attitude and role of dentists in identifying patients with abusive drugs. SUBJECTS AND METHODS: A modified 27-item questionnaire was formulated and distributed among the study. The participants were to return the filled questionnaire to the investigators within a week. A total of 203 validated entries were collected. Data were entered into Microsoft Excel 2007 and analyzed in SPSS V20. Associations between categorical variables were determined using Chi-square or Fisher's exact test. P < 0.05 was considered statistically significant. RESULTS: Irrespective of the educational qualification drugs are perceived harmful with definite oral manifestations, and dentists should be concerned with identifying individuals with drugs. It is believed that trying drugs once could lead to possible addiction and that dental practitioners should have their skills developed to handle cases and referred to deaddiction centers with modification of treatment plans. CONCLUSIONS: Educating dental graduates and postgraduates about the oral implications of drugs intake and making it a part of the dental curriculum may help us dealing with the global issues of drugs. Even making dental students a part in counseling and part of the behavioral therapies advocated in treating drug addicts.

A Retrospective Analysis of Pulp Stones in Patients following Orthodontic Treatment.

AIM: The present study aimed to find prevalence of pulp stones in known South Indian orthodontic patients and to find correlation between pulp stones and patients who underwent orthodontic treatment as well as to reveal any differences due to gender, tooth type, and dental arches. MATERIALS AND METHODS: The present retrospective study was carried out among 200 patients who underwent nonextraction orthodontic treatment. Maxillary and mandibular first and second premolar and molar teeth were selected for the purpose of the study using panoramic radiographs. A total of 3200 teeth of 200 patients were studied for the presence of pulp stones. Statistical analysis of the obtained data was carried out using Statistical Package for Social the Sciences (SPSS) version 22.0. Chi-square test was applied to find the significant value and p < 0.05 was considered as a significant value. RESULTS: In all, 11.5% of cases reported pulp stones before the commencement of the orthodontic treatment and 15.5% cases after completion of orthodontic treatment. Overall, 4% increase in cases were found which was statistically significant (p < 0.05); 5.1% of total number of teeth were evaluated in both arches before orthodontic treatment and 6.3% of teeth after orthodontic treatment revealed the presence of pulp stones. Maxillary first molar was found to be teeth with maximum number of pulp stones before and after orthodontic treatment. CONCLUSION: The present study reported the prevalence of pulp stones to be increased by 4% in the pre- and posttreat-ment radiographs, which was statistically significant. The study found the presence of pulp stones more in maxillary first molar and it was found to be teeth with maximum number of pulp stones before and after orthodontic treatment. However, further researches with larger samples are advisable. CLINICAL SIGNIFICANCE: Dentists performing endodontic treatment among patients who have undergone orthodontic treatment should be aware about the increased chances of presence of pulp stones and thus to avoid hindrances encountered during extirpating the pulp, they should thoroughly study the radiographs beforehand.

Prevalence of Tooth Shade and its Correlation with Skin Colour - A Cross-sectional Study.

INTRODUCTION: Aesthetics has become an important issue in modern society. Tooth shade is one of the factors in determining aesthetics. Studies have revealed that tooth shade is influenced by age, gender, eye colour, skin colour and other factors. AIM: The present study was aimed to assess the prevalence of tooth shade and its correlation with skin colour. MATERIALS AND METHODS: A total of 300 subjects aged 18-20 years were evaluated for tooth shade using Vitapan - 3D shade guide. Anterior teeth were checked under natural light and facial skin colour by Lakme liquid foundation make up as a shade guide. Data was analysed using chi square test and spearman's correlation. RESULTS: Out of 300 students, 114 (38.00%) had A2 tooth shade; the least prevalent tooth shade among Chitradurga population was C1 (4.00%). There was a positive correlation between tooth shade and skin colour which was found to be statistically significant (p <0.05). CONCLUSION: The most prevalent tooth shade among Chitradurga population was A2 and least was C1. There was a significant correlation between tooth shade and skin colour with lighter skin tone subjects having lighter tooth shade hence skin colour can be used as a guide for shade selection.