Impact of class II and class III skeletal malocclusion on pharyngeal airway dimensions: A systematic literature review and meta-analysis.

Background: This study is a pioneer systematic review and meta-analysis aimed at comparing the influence of Class II and Class III skeletal malocclusions on pharyngeal airway dimensions. It stands as the inaugural comprehensive assessment to collate and analyze the disparate findings from previously published articles on this topic. The objective of this study was to identify published articles that compare the effects of class II and class III skeletal malocclusion on the pharyngeal airway dimensions. Methods: An all-inclusive search for existing published studies was done to identify peer-reviewed scholarly articles that compared the influence of class II and class III skeletal malocclusion on pharyngeal airway dimensions. The search was done via five electronic databases: Cochrane Library, EMBASE, Scopus, Web of Science, and PubMed. Screening of the articles was done and the eligible studies were critically assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results: The initial search yielded 476 potential articles of which, nine were finally included in this study for a total of 866 patients. Three studies were of cross-sectional design and six were of retrospective study design. Following a critical analysis and review of the studies, class III skeletal malocclusion had significantly larger volume and area measurements compared to class II skeletal malocclusion. Conclusion: Research in the field of literature has established that variations in skeletal classifications have a discernible effect on the size of the pharyngeal airways. With the advancement of skeletal malocclusions to a class III, there is an observed increase in both the volume and cross-sectional area of the airways.

Minor physical anomalies including palatal rugae pattern and palatal dimensions in children with sickle cell disease: A cross-sectional analytical study.

Background: Sickle cell disease (SCD) is the most common hereditary hemoglobinopathy, which delays growth leading to an altered skeleton and craniofacial pattern. Palatal rugae patterning has been considered the regulator of the development of the palate. The purpose of the research work was to study the morphology of the palate, rugae pattern, and its dimensions in SCD children and compare them with healthy normal children, and to evaluate its role as minor physical anomalies (MPAs). Methods: A cross-sectional case-control study was designed as per STROBE guidelines. The sample comprised 50 children diagnosed with sickle cell disease (Group SCD) and 50 normal healthy children as control (Group C) belonging to the same age group (10-18 years). Dental impressions were made, followed by the pouring of dental casts. The length of the palatal rugae was measured and categorized into primary (>5 mm), secondary (3 mm-5 mm), and fragmentary rugae (<3 mm). The shape of each primary palatal rugae was identified and categorized as curved, wavy, straight, circular and non-specific. Linear and angular measurements of the palatal rugae patterns and palatal dimensions (width, height, area) were measured and recorded. Results: The total number of palatal rugae and fragmentary rugae was lesser in Group SCD than in Group C (p < 0.05). The depth of the palate was significantly increased, whereas the area of the palate significantly decreased in Group SCD. Conclusions: The children with SCD showed distinctive palatal rugae patterns and dimensions when compared with normal healthy children that can be attributed as potential MPAs for sickle cell disease. Children with SCD had an under-developed palatal rugae pattern with a deep, narrow and small palate when compared to healthy children.The dimensions of the palatal rugae pattern in SCD showed reduced distance between the incisive papilla and the first and last rugae, indicating a further decrease in the anteroposterior dimensions of the palate. These findings may aid in the early diagnosis and prevention of malocclusion in children with SCD by appropriate interceptive orthodontic treatment.

Efficiency and accuracy of artificial intelligence in the radiographic detection of periodontal bone loss: A systematic review.

Purpose: Artificial intelligence (AI) is poised to play a major role in medical diagnostics. Periodontal disease is one of the most common oral diseases. The early diagnosis of periodontal disease is essential for effective treatment and a favorable prognosis. This study aimed to assess the effectiveness of AI in diagnosing periodontal bone loss through radiographic analysis. Materials and Methods: A literature search involving 5 databases (PubMed, ScienceDirect, Scopus, Health and Medical Collection, Dentistry and Oral Sciences) was carried out. A specific combination of keywords was used to obtain the articles. The PRISMA guidelines were used to filter eligible articles. The study design, sample size, type of AI software, and the results of each eligible study were analyzed. The CASP diagnostic study checklist was used to evaluate the evidence strength score. Results: Seven articles were eligible for review according to the PRISMA guidelines. Out of the 7 eligible studies, 4 had strong CASP evidence strength scores (7-8/9). The remaining studies had intermediate CASP evidence strength scores (3.5-6.5/9). The highest area under the curve among the reported studies was 94%, the highest F1 score was 91%, and the highest specificity and sensitivity were 98.1% and 94%, respectively. Conclusion: AI-based detection of periodontal bone loss using radiographs is an efficient method. However, more clinical studies need to be conducted before this method is introduced into routine dental practice.

Impact of fully guided implant planning software training on the knowledge acquisition and satisfaction of dental undergraduate students.

BACKGROUND: A majority of dental school students do not undergo hands-on clinical training in implantology in the undergraduate curriculum. Training is usually restricted to pre-implant evaluation and post-implant prostheses. Virtual implant planning software (VIPS) provides an alternative opportunity for undergraduate students to experience implant planning much before gaining hands-on experience. However, not many studies have the contribution of VIPS to the knowledge acquisition of students. We conducted a preliminary study to evaluate the knowledge acquisition of the students when exposed to a hands-on session of VIPS. We also evaluated students' satisfaction levels, when exposed to hands-on training in fully guided implant planning software. METHODS: A two-part theory lecture on fully guided implant planning was delivered to 90, 5th (final)-year dental undergraduate students by the oral radiology faculty. The students were then randomly divided into three groups. Group A was exposed to didactic lectures only. Group B was shown a video for fully guided implant planning in addition to the didactic lecture. Group C was shown a video for fully guided implant planning in addition to a didactic lecture and then performed a hands-on session of virtual implant planning under faculty guidance. Students from all groups were given an MCQ-based test. After the completion of the test students from group A and B also received VIPS hands-on training. Students from all three groups answered and a feedback questionnaire regarding their satisfaction levels with VIPS. RESULTS: The overall test score of students in Group C was higher than their colleagues in both Groups A and B and the differences were statistically significant (p = 0.01). More than 85% of the students were satisfied with the teaching approach. CONCLUSIONS: The utilization of VIPS in the training of dental undergraduate students improves their performance confirming better knowledge acquisition and content mastery.

Acceptability of fully guided virtual implant planning software among dental undergraduate students.

BACKGROUND: Fully guided implant surgery as a technique is gaining popularity. It has been observed that use of surgical guides improves precision and predictability for dental implant placement. However, like any other newer technology, the acceptance of fully guided dental implant technology among users is based upon its perceived usability. This study aimed at evaluating the perception about using Virtual Implant Planning Software (VIPS) among undergraduate dental students at the university of Sharjah. METHODS: Ninety-Six dental surgery students from the University of Sharjah were included in the study. One week after the Virtual Implant Planning Software (Planmeca Romexis version 6.2 procedure, students were asked to complete a Combined technology acceptance model and the theory of planned behaviour (C-TAM TPB) questionnaire. Sixty-six students responded to the questionnaire. RESULTS: Cronbach's alpha surpassed 0.7 for perceived usefulness, perceived ease of use, perceived behavioral control, and subjective norm. Attitude and behavioural intention reported Cronbach's alpha values less than 0.7. Spearman's correlation coefficient was significant for all the constructs. Perceived ease of use explained 49%, 33%, and 42% of the variance of perceived usefulness (R2 = 0.49), attitude (R2 = 0.33), and perceived behavioral control (R2 = 0.42) respectively. Perceived usefulness explained 25%, 18%, and 23% of the variance of attitude (R2 = 0.25), behavioral intention (R2 = 0.18), and perceived behavioral control (R2 = 0.23) respectively. Attitude accounted for 25%, 33%, and 29% of the variance of behavioral intention (R2 = 0.25), perceived behavioral control (R = 0.33), and subjective norm (R = 0.29) respectively. CONCLUSION: The fully guided VIPS was acceptable by dental students specifically because of its usability. This makes VIPS a very effective tool for teaching implantology for dental students. VIPS also allows students to perform multiple repetitions of the implant planning procedure which enhances understanding and content retention.

Efficiency of Near-Infrared Technology in the Clinical Detection of Carious Lesions: A Systematic Review.

The field of dentistry has seen various technological advances regarding caries detection, some lesions still prove to be difficult to detect. A reasonably new detection method, near-infrared (NIR), has shown good results in caries detection. This systematic review aims to compare NIR with conventional methods in terms of caries detection. Online databases (PubMed, Scopus, ScienceDirect, EBSCO, and ProQuest) were used for the literature search. The search was performed from January 2015 till December-2020. A total of 770 articles were selected, of that 17 articles qualified for the final analysis as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles were assessed according to a modified Critical Appraisal Skills Programme checklist, and then synthesis of the review started. The inclusion criteria were clinical trials done in vivo on teeth with active caries of vital or nonvital teeth. This review excluded nonpeer reviewed articles, case reports, case series, opinions, abstracts, non-English written articles, studies of subjects with arrested caries, or teeth with developmental defects of tooth structure and teeth having environmental defects of tooth structure, as well as in-vitro studies. The review compared near-infrared technology with radiography, visual inspection, and laser fluorescence in terms of caries detection, sensitivity, specificity, and accuracy. The sensitivity of NIR ranged from 99.1 to 29.1%. Studies showed that NIR exhibited higher sensitivity for occlusal enamel and dentin caries. The specificity of NIR ranged from 94.1 to 20.0%. In enamel and dentinal occlusal caries, NIR demonstrated lower specificity than that of radiograph. The specificity of NIR in early proximal caries was low. Accuracy was determined in 5 out of 17 studies where the values ranged from 97.1 to 29.1%. The accuracy of NIR was the highest for dentinal occlusal caries. NIR shows promising evidence as an adjunct in caries examination due to its high sensitivity and specificity; however, more studies are required to determine its full potential in different situations.

The feasibility of needleless jet injection versus conventional needle local anesthesia during dental procedures: a systematic review.

This systematic review evaluates current evidence regarding the feasibility of using needleless jet injection instead of a conventional local anesthetic needle. EBSCO, ProQuest, PubMed, and Scopus databases were used to identify relevant literature published in English from 2005 to 2020. Ten studies were selected. Five of them were randomized clinical trials, 3 case-control studies, and 2 equivalence trials. Using the Critical Appraisal Skills Program checklist, 6 studies scored between 67% and 100%, and 4 studies scored between 34% and 66%. According to Jadad's scale, 2 studies were considered strong, and 8 studies were considered moderate in quality. The results of the 10 studies showed differences in patient preference for needleless jet injection. Needleless injection technique has been found to be particularly useful in uncooperative patients with anxiety and needle phobia. Needleless jet injection is not technique sensitive. However, with needleless jet anesthesia, most treatments require additional anesthesia. Conventional needle anesthesia is less costly, has a longer duration of action, and has better pain control during dental extraction. Needleless jet anesthesia has been shown to be moderately accepted by patients with a fear of needles, has a faster onset of action, and is an efficient alternative to conventional infiltration anesthesia technique.

Rhinocerebral mucormycosis: a systematic review of case reports and case series from a global perspective.

OBJECTIVE: Rhinocerebral mucormycosis (RCM) is the most common variant and the presenting features in the head and neck region are seldom pathognomonic. The aim of this systematic review was to obtain a thorough insight into the predisposing factors, clinical features, disease course, management protocol, outcome, and prognosis. STUDY DESIGN: An electronic search was carried out using MEDLINE by PubMed, Scopus, Google Scholar, Web of Science, and EMBASE databases. Articles in which the clinical findings on the extra- and intraoral features of RCM were included for systematic review. Descriptive statistics was applied to obtain the results. RESULTS: A total of 124 case studies (90 case reports, 34 case series) which yielded 219 patients. Diabetes mellitus (57.40%) was the most common comorbid condition. Neurologic manifestations were noted in 23.3% of the individuals. Maxillary/hard palate involvement was a common occurrence (59.2%). Intra-oral necrotic lesions with eschar were noted in 75/219 patients. Amphotericin B was the commonly used drug for the management, and surgical debridement was performed in majority of the cases. The mortality rate was 18.4%. CONCLUSIONS: The clinical manifestations often mimic odontogenic symptoms, hence a sound knowledge about the pathogenesis and course of the disease will aid in the prompt diagnosis and management.

Analysis of the Volumetric Asymmetry of the Mandibular Condyles Using CBCT.

OBJECTIVES: The aim of this study was to analyse volumetric asymmetries between the right and left condyles in relation to age, gender, and dental status. MATERIALS AND METHODS: A retrospective analysis of 150 cone beam computed tomography (CBCT) scans was conducted. A single investigator performed the volumetric analysis of the CBCT scans using Vesalius 3D software. The volumetric data were analysed in relation to the gender, age, and dental status. RESULTS: The mean right condylar volume was significantly higher (P < .01) than the left condylar volume. Right and left condylar volumes were significantly higher (P < .01) in male study participants when compared to female study participants. There was no significant difference (P = .47) in the volumetric asymmetry between the male and female study participants. The volumetric asymmetry was significantly higher (P < .01) in the older age groups when compared to the younger age groups. The volumetric asymmetry was significantly higher (P < .01) in the partially and completely edentulous patients when compared to the dentate study participants. The condylar volume on the side having a partially edentulous area was significantly lower than the condylar volume of the contralateral dentate side (P < .001). CONCLUSIONS: The volumetric asymmetry between the right and left condyle significantly increases with age and edentulousness. The result of the study encourages the clinicians to perform volumetric evaluation of the condyles in cases of radiographically evident condylar asymmetries to obtain a more accurate diagnosis.

Comparison of clinical outcomes of non-surgical adjunctive use of the 980-nm diode laser to conventional periodontal flap procedure-a randomised controlled split-mouth clinical trial.

Lasers have been found to be effective as an adjunctive in periodontal therapy. The objective of the study was to compare the outcomes of non-surgical adjunctive use of 980-nm diode laser to that of conventional flap surgery in terms of clinical outcome measures and radiographic osseous defect depths. This study was designed as a double-blinded split-mouth randomised controlled clinical trial. A total of fifteen patients (30 quadrants) with generalised periodontitis stage III grade B were randomly assigned test group (diode laser) and control group (conventional flap surgery). Both test and control groups had 15 quadrants each. At 3 months, the probing pocket depth (PPD) was 3.46 ± 0.19 mm (test) and 4.20 ± 0.20 mm (control), with a statistically significant difference between the groups (p = 0.01). Similarly, at 6 months re-evaluation, PPD was 1.46 ± 0.12 mm (test) and 2.33 ± 0.13 mm (control) with a highly significant statistical difference (p = 0.001). Plaque index showed a difference between both test and control groups at baseline, 3 months and 6 months (p = 0.001) while gingival index, modified sulcular bleeding index and radiographic osseous defect depth showed a difference at 3 months and 6 months (p = 0.001). Within the study's limitations, 980-nm diode laser can result in significant improvements in the clinical and radiographic parameters and is very well tolerated by the subjects.

The Effectiveness of Artificial Intelligence in Detection of Oral Cancer.

AIM: The early detection of oral cancer (OC) at the earliest stage significantly increases survival rates. Recently, there has been an increasing interest in the use of artificial intelligence (AI) technologies in diagnostic medicine. This study aimed to critically analyse the available evidence concerning the utility of AI in the diagnosis of OC. Special consideration was given to the diagnostic accuracy of AI and its ability to identify the early stages of OC. MATERIALS AND METHODS: From the date of inception to December 2021, 4 databases (PubMed, Scopus, EBSCO, and OVID) were searched. Three independent authors selected studies on the basis of strict inclusion criteria. The risk of bias and applicability were assessed using the prediction model risk of bias assessment tool. Of the 606 initial records, 17 studies with a total of 7245 patients and 69,425 images were included. Ten statistical methods were used to assess AI performance in the included studies. Six studies used supervised machine learning, whilst 11 used deep learning. The results of deep learning ranged with an accuracy of 81% to 99.7%, sensitivity 79% to 98.75%, specificity 82% to 100%, and area under the curve (AUC) 79% to 99.5%. RESULTS: Results obtained from supervised machine learning demonstrated an accuracy ranging from 43.5% to 100%, sensitivity of 94% to 100%, specificity 16% to 100%, and AUC of 93%. CONCLUSIONS: There is no clear consensus regarding the best AI method for OC detection. AI is a valuable diagnostic tool that represents a large evolutionary leap in the detection of OC in its early stages. Based on the evidence, deep learning, such as a deep convolutional neural network, is more accurate in the early detection of OC compared to supervised machine learning.

A study on the association between the inferior nasal turbinate volume and the maxillary sinus mucosal lining using cone beam tomography.

Objectives: The volume of the inferior turbinates (IT) and the lining of the maxillary sinuses are important parameters when assessing sino-nasal diseases. However, no radiographic studies have investigated the correlation between these parameters. The present study was conducted to analyze the association between IT volumes and thickness of maxillary sinus mucosal lining. Materials and methods: A retrospective evaluation of the cone-beam computed tomography (CBCT) scans of 100 adult subjects was carried out by two radiologists. The scans were assigned to two groups (Group 1 & 2) based on the radiographic evidence of maxillary sinus lining in the CBCT scans. Group 1 consisted of 50 CBCT scans of subjects with no evidence of maxillary sinus mucosal lining, whereas Group 2 consisted of 50 subjects with evidence of maxillary sinus mucosal lining. The scans in the Group 2 were further sub-classified into five categories, based on the thickness of the maxillary sinus mucosal lining. Vesalius 3D software was used to evaluate the total volume of inferior nasal turbinates by the two radiologists and a mean volume was obtained for each study subject. Results: The intraclass correlation coefficient (ICC) between the volumetric estimations performed by the two radiologist was 0.87. Analysis of the results revealed that there was no significant gender-based difference (Group 1, P = 0.67 and Group 2, P = 0.95) in the total turbinate volume in either of the study groups. The total turbinate volume did not show any significant correlation (Group 1, r = 0.24 and Group 2, r = 0.12) with the age. There was a significant increase (P = 0.001) in the total turbinate volume of the subjects in Group 2 compared to Group 1. Regression analysis revealed that the thickness of sinus lining correlated significantly (P = 0.001) with the total turbinate volume. Conclusion: An increase in the total turbinate volume has been associated with an increase in the thickness of the maxillary sinus mucosal lining. The data from this study will be useful for post-operative follow-up of inferior turbinates and maxillary sinus lining after the turbinate volume reduction procedures.

The effect of concha bullosa and nasal septal deviation on palatal dimensions: a cone beam computed tomography study.

INTRODUCTION: Nasal septal deviation (NSD) and concha bullosa (CB) are associated with airway obstruction in mouth breathers. Mouth breathing is associated with alterations in maxillary growth and palatal architecture. The aim of our study was to determine the effect of the presence of CB and NSD on the dimensions of the hard palate using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A retrospective study was conducted using CBCT scans of 200 study subjects. The study subjects were divided into four groups based on the presence of CB and NSD. Septal deviation angle (SDA), palatal interalveolar length (PIL), palatal depth (PD) and maxillopalatal arch angle (MPAA) were measured in the study groups. RESULTS: The presence of NSD and CB was associated with significant (p < 0.001) differences in the palatal dimensions of the study subjects. The PIL and MPA (p < 0.001) were significantly reduced (p < 0.001), whereas the PD was significantly increased (p < 0.001) in study subjects with NSD and CB. There was no significant change in the palatal dimensions between the unilateral and bilateral types of CB. Among the palatal dimensions, the PIL had the most significant association (R2 = 0.53) with SDA and CB. There was a significant correlation between the palatal dimensions and SDA when CB was present along with NSD. CONCLUSION: Based on the results of this study, it can be concluded that the presence of NSD and CB have a significant effect on the palatal dimensions and, therefore, they may be associated with skeletal malocclusion.

Serum ceruloplasmin as cancer marker in oral pre-cancers and cancers.

BACKGROUND AND AIM: Oxidative stress leads to a compensatory increase in levels of serum ceruloplasmin in patients with such imbalances. Greater than normal serum ceruloplasmin levels are noticed in numerous cancers including the leukemias and Hodgkin's lymphoma. The purpose of the present study was to estimate and evaluate the efficacy of serum ceruloplasmin levels as a potential biomarker in the early detection of oral potentially malignant epithelial lesions (PMELs) including leukoplakia, oral submucous fibrosis (OSMF), and oral squamous cell carcinoma (OSCC) patients. MATERIALS AND METHODS: The present observational study was conducted over a period of 2 years wherein 100 subjects aged between 18 to 60 years were divided into four groups with Group A consisting of 25 healthy controls, Group B and C with 25 patients each, clinically diagnosed with oral leukoplakia and OSMF and Group D with 25 patients clinically diagnosed and histopathologically proven OSCC. The patients were subjected to incisional biopsy after routine hematological investigation while the same sera samples were used for analysis of serum ceruloplasmin levels. STATISTICAL ANALYSIS USED: Comparison of serum ceruloplasmin levels between the groups was performed using one way analysis of variance (one way ANOVA) test while P < 0.05 was considered statistically significant. RESULTS: The mean serum ceruloplasmin levels were found to be 43.19 ± 1.90mg/dl in subjects of group A, 47.68 ± 1.51mg/dl in group B, 47.74 ± 1.45mg/dl in group C and 47.73 ± 0.74mg/dl in group D. Using one-way ANOVA, statistically significant variations were found in the values of mean serum ceruloplasmin levels in subjects of the four groups (F-value = 59.58, P = 0.0001). CONCLUSIONS: The observations of the present study revealed that serum ceruloplasmin levels were found to be raised in all 3 study groups including oral leukoplakia, OSMF and OSCC as compared to the controls while the results were found to be statistically significant.

Analysis of inferior nasal turbinate width and concha bullosa in subjects with nasal septum deviation: a cone beam tomography study.

BACKGROUND: In individuals with nasal septal deviation (NSD), compensatory hypertrophy of the nasal turbinates occurs as a protective mechanism of the nasal passage from dry and cold air. NSD associated nasal turbinate hypertrophy is usually recurrent, requiring repetitive imaging. Therefore, a multiplanar imaging modality with a low radiation dose is best suited for long-term follow-up of this condition. This study aimed to evaluate the association of width of inferior turbinates and presence of concha bullosa with the degree of NSD using Cone beam computed tomography (CT). METHODS: The CBCT scans of 100 patients with NSD were selected as per convenience sampling and were evaluated by two maxillofacial radiologists. The width of the non-hypertrophied inferior turbinate (NHT) on the convex side of the NSD, and hypertrophic inferior turbinates (HT) on the concave side of the NSD were measured at three locations. The septal deviation angle (SDA) and the presence of concha bullosa (CB) were determined. RESULTS: A significant difference was observed in the anterior, middle, posterior, and mean widths between HT and NHT (p < 0.001). There was a significant difference in the widths of the HT and NHT among different types of NSD. A strong positive correlation (r = 0.71, p < 0.001) was found between SDA and the mean width of the HT. Age (P = 0.71) and gender (P = 0.65) had no significant difference among different types of NSD. Regression analysis revealed that the presence of CB (p = 0.01) and middle width of the HT (p < 0.001) are significant predictors of SDA and type of NSD. CONCLUSION: The results of the present study reveal that the middle width of the HT and the presence of CB influence the degree of NSD. The present study results recommend the use of CBCT as a substitutive low radiation dose imaging modality for evaluation of NSD, CB, and associated inferior turbinate hypertrophy.

Cone-beam computed tomography characterization of the intraosseous vascular canal in the lateral wall of the maxillary antrum.

OBJECTIVES: : The purpose of the study was to assess the occurrence, location, and dimensions of the intraosseous vascular canal in the lateral wall of the maxillary antrum using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: In this retrospective study, we examined 400 CBCT scans from our archive of patients who had earlier reported to a dental teaching hospital in the United Arab Emirates. The prevalence, location, and dimensions of the lateral antral intraosseous canal (LAIC) in the maxillary antrum were evaluated by 2 examiners using standardised methods. A third examiner was consulted in cases of disagreement. RESULTS: The prevalence of LAIC was 62.3% (249 maxillary antra) among the study population. The mean distance between the most inferior point of the alveolar bone and the inferior border of the LAIC in the posterior maxillary region was 19.83±3.12 mm. There was a significant difference (P=0.05) between the maxillary molar and premolar regions in mean distance from the most inferior point of the alveolar bone and the inferior border of the LAIC. There was no statistically significant difference in mean distance between the most inferior point of the alveolar bone and the inferior border of the LAIC between dentulous and edentulous areas (P=0.1). The G3-intrasinusal type canal less than 1mm in diameter was the most common type of LAIC. CONCLUSION: This study established the approximate location of the LAIC in a United Arab Emirates cohort, which will assist the oral surgeon in selecting the appropriate site for sinus lift procedures with reduced risk of surgical hemorrhage.

Application of a Cone-Beam Computed Tomography-Based Index for Evaluating Surgical Sites Prior to Sinus Lift Procedures-A Pilot Study.

OBJECTIVES: Radiography-based indices can help surgeons perform detailed examinations of the surgical site and predict the surgical difficulty of cases. We aimed to develop and validate a novel CBCT-based index that can predict the surgical difficulty of sinus-augmentation procedures. MATERIALS AND METHODS: In the first stage, five experienced dental specialists performed a review of the literature and closed group discussions and designed the novel index. In the next stage, the index was validated. CBCT scans of 30 patients scheduled for sinus-augmentation procedures were evaluated and assigned presurgical CBCT evaluation scores (PSCESs) by five examiners. Subsequently, one oral surgeon performed sinus augmentation using the lateral antrostomy technique and assigned surgical difficulty scores (SDSs) to each of the 30 cases along with 2 observers. The PSCESs and SDSs were statistically analysed to determine the interrater reliability and validity of the index. RESULTS: The interrater agreement of the PSCES among the five presurgical evaluators was 0.85. The PSCES of the five evaluators had highly significant correlation (P < 0.001, r = 0.68 to 0.76) with the SDS. Regression analysis revealed that for every unit increase in the PSCES, there is 0.46 to 0.57 increase in the SDS value. CONCLUSION: The results of this pilot study revealed that a novel CBCT-based index can be used as a reliable tool for predicting the surgical difficulty of sinus-augmentation procedures. However, the novel index needs to be tested on a larger sample of patients and evaluators for a more concrete validity and reliability.

Comparison of Time-kill Assay to Evaluate the Antimicrobial Efficacy of Garlic (Allium sativum) and Guava (Psidium guajava) Extracts on Periodontal Pathogens.

BACKGROUND: The role of Gram-negative anaerobic periodontal pathogens in periodontal diseases has led to the loss of tooth-supporting structures. These diseases can be prevented by the inhibition of bacterial biofilm on the tooth surfaces. Many treatment modalities have been tried to prevent periodontal diseases. With the rise in resistance to synthetic antimicrobials, there is a requirement to develop natural antimicrobials for the control of periodontitis. AIM: The aim of the study was to evaluate and compare the efficacy of garlic (Allium sativum) and guava (Psidium guajava) extracts on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans using time-kill assay. MATERIALS AND METHODS: Aqueous garlic extract (AGaE), ethanolic garlic extract (EGaE), aqueous guava extract (AGuE), and ethanolic guava extract (EGuE) were prepared. Time-kill assays were performed on P. gingivalis and A. actinomycetemcomitans. The aqueous and ethanolic extracts of guava and garlic were compared to assess the maximum bactericidal potency. RESULTS: The comparison of time-kill assay of AGaE and AGuE on P. gingivalis showed a statistically significant difference at 2 h (t = 5.29, P < 0.01), 4 h (t = -4.867, P < 0.01), and 6 h (t = -3.647, P < 0.001). The comparison of time-kill assay of EGaE and EGuE on A. actinomycetemcomitans showed a statistically significant difference at 2 h (t = 4.54, P < 0.01) and highly significant difference at 4 h (t = 6.57, P < 0.001). CONCLUSIONS: The, judicious use of these phytomedicinal products could be cost-effective and also the adverse effects caused due to the long-term usage of synthetic antimicrobials can be avoided.

Focus on periodontal engineering by 3D printing technology ­ a systematic review / Enfoque en la ingeniería periodontal mediante la tecnología de impresión 3D: una revisión sistemática

Three-dimensional (3D) bioprinting of cells is an emerging area of research but has not been explored yet in the context of periodontal tissue engineering. Objetive: This study reports on the optimization of the 3D bioprinting scaffolds and tissues used that could be applied clinically to seniors for the regenerative purpose to meet individual patient treatment needs. Material and Methods: We methodically explored the printability of various tissues (dentin pulp stem/progenitor cells, periodontal ligament stem/progenitor cells, alveolar bone stem/progenitor cells, advanced platelet-rich fibrin and injected platelet-rich fibrin) and scaffolds using 3D printers pertaining only to periodontal defects. The influence of different printing parameters with the help of scaffold to promote periodontal regeneration and to replace the lost structure has been evaluated. Results: This systematic evaluation enabled the selection of the most suited printing conditions for achieving high printing resolution, dimensional stability, and cell viability for 3D bioprinting of periodontal ligament cells. Conclusion: The optimized bioprinting system is the first step towards the reproducible manufacturing of cell laden, space maintaining scaffolds for the treatment of periodontal lesions.

La bioimpresión tridimensional (3D) de células es un área emergente de investigación, pero aún no se ha explorado en el contexto de la ingeniería de tejidos periodontales. Objetivo: Este estudio informa sobre la optimización de los tejidos y andamios de bioimpresión 3D utilizados que podrían aplicarse a personas mayores en el entorno clínico con fines regenerativos para satisfacer las necesidades de tratamiento de cada paciente. Material y Métodos: Exploramos metódicamente la capacidad de impresión de varios tejidos (células madre / progenitoras de la pulpa de dentina, células madre / progenitoras del ligamento periodontal, células madre / progenitoras de hueso alveolar, fibrina rica en plaquetas avanzada y fibrina rica en plaquetas inyectada) y andamios utilizando impresoras 3D que pertenecen solo a defectos periodontales. Se ha evaluado la influencia de diferentes parámetros de impresión con la ayuda de andamios para promover la regeneración periodontal y reemplazar la estructura perdida. Resultados: Esta evaluación sistemática permitió la selección de las condiciones de impresión más adecuadas para lograr una alta resolución de impresión, estabilidad dimensional y viabilidad celular para la bioimpresión 3D de células del ligamento periodontal. Conclusión: El sistema de bioimpresión optimizado es el primer paso hacia la fabricación reproducible de andamios de mantenimiento de espacio cargados de células para el tratamiento de lesiones periodontales

Sodium hypochlorite accidents in dentistry. A systematic review of published case reports.

The aim of this paper was to analyze the literature published in the research related to sodium hypochlorite induced injury. An internet search using search engines (Google, Researchgate and PubMed) was carried out. The keywords used for search were sodium hypochlorite, injury, cellulitis, apical extrusion, ulcer, endodontics. Full text articles of the articles were collected from the year 2007 to 2017. The data available from the clinical trials the journal articles were analyzed and presented in both tabular and descriptive patterns.