Rate and anchorage loss during en-masse retraction between friction and frictionless mechanics: A randomized clinical trial.

OBJECTIVE: To compare rate and anchorage loss during en-masse retraction of anterior maxillary teeth between friction mechanics (FM) and frictionless mechanics (FLM). SETTING AND SAMPLE POPULATION: Thirty-eight patients requiring en-masse retraction of protruded anterior maxillary teeth were randomly allocated into FM and FLM groups. METHODS: En-masse retraction with sliding mechanics (FM) using an elastomeric chain was compared with continuous mushroom loop archwire mechanics (FLM). Study models and lateral cephalograms were taken before (T1) and immediately after retraction (T2). The primary outcome was the rate of en-masse retraction. Anchorage loss was the secondary outcome. Intergroup comparison was performed using an independent t test (P < .05). RESULTS: Baseline characteristics were similar between groups. Thirty-six patients completed the trial. Two patients were lost to follow-up in the FLM group. The rate of en-masse retraction did not differ significantly (P = .625) between FM (0.7 mm/mo) and FLM (0.8 mm/mo) groups. The intragroup comparison showed significant anchorage loss in FM (2.28 mm) and FLM (1.13 mm) groups; however, the intergroup comparison showed no statistically significant difference (P = .093). Maxillary first molar showed a statistically significant change in angulation between the two mechanic groups (P < .001). Vertical movement of the maxillary incisor and first molar showed no significant difference between FM and FLM groups (P = .143, P = .546, respectively). CONCLUSIONS: The rate of en-masse retraction and anchorage loss was comparable between the FM and FLM groups. Significant anchorage loss was seen with both mechanics. The result suggests that both the mechanic group require external reinforcement to prevent anchorage loss.

Study of MicroRNA (miR-221-3p, miR-133a-3p, and miR-9-5p) Expressions in Oral Submucous Fibrosis and Squamous Cell Carcinoma.

Oral squamous cell carcinoma (OSCC) is one of the common types of cancer. Its progression follows a transition from oral potentially malignant disorders (OPMDs) such as oral submucous fibrosis (OSMF). Epigenetic modifiers, especially microRNAs (miRNAs), have an appreciable role in the regulation of various carcinogenic pathways which are being used as biomarkers. miRNAs may also be helpful in the differentiation of oral submucous fibrosis from oral squamous cell carcinoma. Three miRNAs, miR-221-3p, miR133a-3p, and miR-9-5p, were found differentially expressed in many cancers in the literature search supported by our preliminary database search-based screening. The literature and our functional enrichment analysis in an earlier study have reported these miRNAs to regulate carcinogenesis at various steps. In the present study, the expression of these miRNAs was examined in 34 histopathologically confirmed OSCC, 30 OSMF, and 29 control (healthy volunteers) human samples. There was a significant downregulation of miRNA-133a-3p in OSCC compared to OSMF and controls, whereas there was up-regulation in oral submucous fibrosis compared to controls. There was no significant difference in the expression of miR-221-3p between OSCC and OSMF, but an upregulation in OSCC compared to controls. miR-9-5p was also found upregulated in both OSCC and OSMF. Further, miR-133a-3p expression was negatively correlated with age, smoking, drinking status, and AJCC staging, whereas miR-9-5p expression was only positively associated with tobacco/ areca nut chewing. The ROC plots, logistic regression model generated, and the correlation between the expression of miR-9-5p and miR-133a-3p in blood and tissue suggests that these could be used as risk stratification biomarkers.

Estimation of Sex From Dental Arch Dimensions: An Odontometric Analysis.

ABSTRACT: Sex estimation is one of the "big three" of human identification and is a vital aspect of the process of generating biological profile of unknown deceased. Anthropometric and odontometric methods that utilize measurement of distances between certain landmarks are commonly employed to differentiate between the 2 sexes. Teeth are the most robust and well-preserved parts of the human body, and studies have shown that the sex of an unknown individual can be estimated using their measurements. The present study was carried out to analyze the sex differences based on the dental arch dimensions of both the jaws in an Indian population. A proper understanding of dental arch dimensions not only help forensic odontologists in human identification, but also help dental practitioners in teeth restoration, and to quantify selection of anterior teeth in bonding of dentures. The dental arch dimensions of the canines, premolars, and the molars of both the jaws were recorded in dental casts of 307 participants. Comparison of the dental arch dimensions of males and females was done and logistic regression models were generated to estimate sex. Receiver Operating Characteristic analysis was done to find out the potential to estimate sex for all the dental arch dimensions in both the sexes. It was observed that maxillary intermolar II distance gave the best results in estimating the sex. The sexing accuracy is seen to increase as we go distally from canines to molars in each jaw; minimum for intercanine distance and maximum for distance between the 2nd molars. The sexing accuracy from dental arch dimensions was found to be between 72.7% and 86.5%. The models derived for estimation of sex from dental arch dimensions can be used in cases of skeletal remains.

The prevalence of traumatic dental injuries in primary teeth: A systematic review and meta-analysis.

BACKGROUND/AIMS: The varied prevalence of traumatic dental injuries (TDI) in primary teeth around the globe raises a serious knowledge gap in the available literature. The aim of this study was to evaluate the prevalence of TDI in primary teeth and also to evaluate the different factors associated with TDI in primary teeth. MATERIALS AND METHODS: Comprehensive searches were performed in PubMed, Embase, Google Scholar, and The Cochrane Central Register of Controlled Trials with predefined search criteria. The primary outcome was the prevalence of TDI in primary teeth, and the secondary outcomes were the factors associated with TDI in primary teeth. Qualitative analysis was done using the Newcastle-Ottawa scale adapted for cross-sectional studies. The random-effect model was used for meta-analysis, and meta-regression analysis was done to evaluate the heterogeneity between the included studies. Meta-analysis was done using the "meta" package of "R" language. The overall quality of evidence was assessed using GRADEpro GDT software. RESULTS: A total of 24 cross-sectional studies met the inclusion criteria representing 4876 TDIs in 22 839 children aged between 0 and 6 years old. The overall prevalence of TDI in primary teeth was 24.2% (95% CI: 18.24-31.43, P = 0, I2  = 99%). Falls contributed the highest number of TDI - 59.3% (95% CI: 41.05-76.40, P < .01, I2  = 98%) - in primary teeth. The most common type of tooth fracture in primary teeth was an enamel fracture (61.9%), and prevalence of TDI in children with incompetent lip closure was 49.4%. CONCLUSION: The prevalence of TDI in cross-sectional studies of primary teeth was 24.2% with very low quality of evidence. Falls contributed the highest number of TDI in primary teeth, accounting for 59.3%. Children with incompetent lip closure have the highest prevalence (49.4%) of TDI in primary teeth.

Clinical differences of hand and rotary instrumentations during biomechanical preparation in primary teeth-A systematic review and meta-analysis.

BACKGROUND: The hand and rotary instruments are used for cleaning and shaping of root canals during biomechanical preparation in primary teeth. AIM: To determine clinical differences of hand versus rotary root canal instrumentation in primary teeth. DESIGN: Comprehensive searches were made in four electronic databases [MEDLINE (via PubMed), EMBASE, Google Scholar, and The Cochrane Central Register of Controlled Trials] till March 2020, and prospective studies that met the inclusion criteria were included. The primary outcome was instrumentation time, whereas the secondary outcomes were quality of obturation, obturation time, and clinical and radiographic success. From 604 screened studies, eleven studies qualified for meta-analysis. The random-effect model and generic inverse variance approach were used for meta-analysis. RESULTS: There was significant decrease in instrumentation time [MD-5.00 minutes (95% CI: 3.05-6.94), P < .00001, moderate evidence quality] and obturation time [MD-0.43 minutes (95% CI: 0.15-0.71), P = .003, low evidence quality] with rotary instrumentation. Optimal quality of obturation was achieved in significantly more number of teeth [risk ratio (RR) = 0.71(95% CI: 0.53-0.95),P = .02, moderate to high evidence quality] with rotary instrumentation. Similar clinical and radiographic success was observed in hand and rotary instrumentation techniques. CONCLUSION: Significant reduction in instrumentation time of five minutes was observed using rotary instrumentation with moderate quality evidence.

BCG vaccination impact on mortality and recovery rates in COVID-19: A meta-analysis.

COVID-19 is a pandemic caused by SARS-CoV-2 virus which is a very worrisome public health emergency. In this study, we compared the mortality rate and recovery rate in countries with and without BCG vaccination policy. The data of mortality of COVID-19 was extracted from worldometer (https://www.worldometers.info/coronavirus/) on 26th July 2020. The data of countries where BCG vaccination is being done for all individuals is taken from BCG world atlas (http://www.bcgatlas.org/index.php), updated in 2017. BCG vaccination policy recommended countries are intervention group versus countries without BCG vaccination policies which are regarded as control group. Pooled analysis of countries with and without BCG vaccination policy revealed mortality rate of 1.31% (95%CI - 1.31% to 1.32%; I2 = 100%, p<0.01) and 3.25% (95%CI - 3.23% to 3.26%; I2 = 100%, p<0.01), respectively. The recovery rates in two country groups were found to be 72.60% (95%CI - 72.57% to 72.63%) and 55.94% (95%CI - 55.90% to 55.98%), respectively. 52 individuals need to be BCG vaccinated to prevent one death (NNT = 52). In BCG vaccination program countries, there is statistically and clinically significant less mortality (p<0.001) as compared to countries without BCG policy. Our findings corroborate the hypothesis that BCG vaccination may provide protection from COVID-19. High quality evidence from randomised controlled trials are required to establish causality between BCG vaccination and protection from severe COVID-19.

Comparative assessment of conventional and light-curable fluoride varnish in the prevention of enamel demineralization during fixed appliance therapy: a split-mouth randomized controlled trial.

Objective: To evaluate the effects of single application of a conventional versus light-curable fluoride varnish (LCFV) on prevention of enamel demineralization during fixed orthodontic treatment over a 4 month period. Design: The research was designed as a split-mouth, randomized control trial (RCT). Methods: Twenty-two patients requiring fixed orthodontic treatment with premolar extractions were included in the RCT. In each patient, two diagonal quadrants (i.e. upper right and lower left, or vice versa) were randomly assigned to receive conventional fluoride varnish or LCFV. After allocation of one intervention, the other diagonal quadrants received the second intervention. At specific time intervals, premolars were extracted and sectioned, and the demineralized lesion was assessed in each group. Main outcome measures: The primary outcome was demineralized enamel lesion depth (DELD) at the end of 45, 90, and 120 days. Randomization: A simple complete randomization list using random allocation rule (restricted randomization) was computer generated to ensure homogeneity of application of conventional or LCFV to each contralateral quadrant in a split-mouth design. Allocation concealment was not employed. Blinding: Blinding was done only for outcome assessor because of clinical limitations. Results: Twenty-two patients with 88 teeth were enrolled in the trial. After excluding the drop-outs, primary analysis was performed on 66 teeth distributed among two interventional groups. Mean difference between DELD among two groups was 36.6 µm [95 per cent confidence interval (CI) 34.61-38.55] and 58.5 µm [95 per cent confidence interval (CI) 55.65-61.43] at 90 and 120 days, respectively. Cluster level analysis performed by Paired t-test showed that DELD was significantly higher (P < 0.001) in the conventional fluoride varnish group at the end of 90 and 120 days as compared to LCFV group. No adverse effect was observed in any patient. Limitations: Being a histologic study, the role of fluoride varnish could be assessed only for 4 months. Conclusion: The result of this study indicate that single application of LCFV (Clinpro™ XT) can prevent enamel demineralization for longer duration (for up to 4 months) of time as compared to conventional fluoride varnish (Duraphat™, 45 days) during fixed appliance therapy. Registration: The trial was registered retrospectively in the Clinical Trial Registry-India, number CTRI/2016/09/007232.

Minimal clinically important difference in maxillofacial trauma patients: a prospective cohort study.

The present study estimated the minimal clinically important difference (MCID) for pain on a visual analogue scale - numerical rating scale (VAS-NRS) and mean bite force (MBF) in patients treated for maxillofacial trauma (MFT). This cohort study included 120 MFT patients treated according to AO principles. Preoperative and four-week postoperative pain on the VAS-NRS, and MBF were measured to calculate MCIDs as indicators of functional rehabilitation. The patient's perspective of the treatment was assessed using a four-item anchor question. The MCID was determined by two anchor-based approaches, namely, the change difference (CD) method and receiver operating characteristic (ROC) curve method. According to the CD method, the MCID for pain was 2.4 and the MBF was 147.9 N. Based on the ROC curve, the MCID for pain was 2.5 (sensitivity 91.7%, specificity 47.2%) and MBF was 159.1 N (sensitivity 71.4%, specificity 61.1%). This study demonstrated a high sensitivity (>70%) for MCID, which implies that pain reduction of 2.4-2.5 points on the VAS-NRS and a gain in MBF of 147.9-159.1N are clinically relevant for patients treated for MFT.

Efficacy of Oral Magnesium on Bone Regeneration and Implant Stability in Immediate Dental Implants: A Randomized Controlled Trial.

PURPOSE: The successful osseointegration around immediate implants requires high quality and quantity of osteogenesis around them. The role of magnesium as a boneenhancing mineral, and as an adjunctive analgesic has been well documented in orthopedic literature. However, there is a paucity of literature in its role in successful osseointegration around immediate implants. This randomized controlled trial sought to assess the promising impact of magnesium on osseointegration by examining various aspects of implant stability, correlating them with serum bone markers, and establishing a foundation for future research on its potential as a potent analgesic. MATERIALS AND METHODS: Immediate implant placement was done after the extraction of the indicated mandibular molar tooth, and all the patients were segregated into 2 groups (Placebo- Lactose, and Magnesium citrate). Bone regenerate in the peri-implant area was assessed radiographically immediate post-operatively, on the 6th week and 12 weeks. Implant stability was measured immediate post-operatively, at the 4th week and 12th week. Serum parameters were procured pre-operatively and post-operatively for serum calcium, serum alkaline phosphatase (ALP), and serum parathyroid hormone at the 8th week, and serum vitamin D3 levels preoperatively. RESULTS: 54 immediate implants placed showed the demographics and baseline serum, clinical, and radiographic parameters were comparable in both groups. Analysis of Implant Stability Quotient at 12th week showed statistically significant difference in intervention group both on intergroup and intragroup analysis. Radiodensity measurement showed a statistically significant difference in both intragroup and intergroup analysis in the intervention group at the 6th and 12th week. In bone gap analysis, the difference in mean change in the horizontal bone gap (HG) at 6 weeks was non-significant while the difference in HG at the 12th week was significant in the intervention group. On intragroup analysis, mean change HG at 6 weeks and 12 weeks both were significant only in intervention group. Intergroup analysis of vertical bone gap (VG) 12 and VG 12-0 (mean difference in the vertical bone gap from 12th week-day 0) showed a statistically significant difference in the intervention group. On intragroup analysis, VG 12 was significantly better in the intervention group. On serum analysis, ALP post-operatively was found to be significantly raised (P=0.013) in intervention group. Numerical rating Scale (NRS) analysis showed a significant decrease in post-op day 5 and 7, (P=0.017) and (P=0.002) respectively. CONCLUSION: The oral magnesium citrate supplementation after immediate implant placement helps in enhancing the stability of the immediate implants, along with improved radiodensity around them which was found to be statistically significant. It also helps in reducing the horizontal, and vertical gap around the implant and has significant analgesic potential.

Mucormycosis: An Epidemic Complicating the COVID-19 Pandemic.

COVID-19 is a relatively new disease whose complete pathogenesis and complications have not been elucidated. Apart from the morbidity and mortality caused by the virus itself, it is noted that patients affected with this virus have a higher susceptibility to bacterial and fungal co-infections. Mucormycosis is a rare and life-threatening fungal infection generally associated with uncontrolled diabetes mellitus and immunosuppression. It tends to rapid disease progression and poor prognosis if not diagnosed and managed promptly. There has been a sudden increase in the number of mucormycosis cases in patients with moderate to severe COVID-19 infection in the past few months. Herein, we present a series of 10 mucormycosis cases diagnosed over one week.

Comparison of Teriparatide and Combination of Cissus Quadrangularis and Dalbergia Sissoo on Bone Healing Against the Control Group in Maxillofacial Fractures: A Randomized Open-label Control Trial.

Study Design: Randomized Control Trial. Objective: A randomized control trial was planned to aim to assess whether subcutaneous Injection of Teriparatide and Tablet Reunion (combination of Cissus Quadrangularis and Dalbergia sissoo) improves maxillofacial fracture healing as compared to the control group. Methods: 24 patients of mandibular fracture with or without concomitant maxillofacial fractures were randomly divided into 3 equal groups (Group 1- Control, Group 2- Tablet Reunion, and Group 3- Injection Teriparatide) and the treatment duration was 4 weeks. Pain, fracture site mobility, bite force, serum markers, and radiographic healing were assessed preoperatively and postoperatively at regular intervals till 12 weeks. Results: Group 2 showed early pain relief, although it was insignificant. Group 3 showed the highest anterior bite force at all the time points. Change in mean posterior bite force (PBF) showed a statistically significant increase at 8th week and 12th week in intergroup comparison; however, at 12th week, Group 3 was significantly better than Group 1 and reported the highest posterior bite force compared to other groups. Serum calcium and PTH level showed no significant difference, whereas Serum ALP showed a statistically significant increase in Group 3. The radiographic assessment showed no significant difference among the 3 groups. Conclusions: Both the intervention group drugs showed a promising effect on accelerating the fracture healing and improving bite force restoration with the osteoanabolic action; however, early radiographic healing and increased serum osteogenic markers in Group 3 indicate its possible optimistic role in maxillofacial fracture healing.

The Clinical Efficacy of EMLA as a Topical Anesthetic Agent Instead of Palatal Injection During Maxillary Dental Extractions: A Randomized Controlled Trial.

Background: Even after the invention of the modern injection techniques, palatal injection still remains a painful experience for patients, and this pain is attributed to the presence of rich nerve complement and displacement of tightly adherent palatal mucosa during anesthesia. Aim: To check the clinical efficacy of EMLA as a topical anesthetic agent instead of palatal injection during maxillary dental extractions. Methodology: The trial includes a total of 102 participants, in whom maxillary molar extractions were indicated, were randomly divided into the experimental group (eutectic mixture of local anesthesia (EMLA) topical application was used along with buccal injection) and control group (palatal injection along with buccal injection). Pain perception during extraction was recorded using the visual analog scale (VAS). Results: Mean VAS score for 'injection' in control group patients was 5.2 ± 2.08 in contrast to no pain in experimental group. In experimental group, mean VAS score on 'probing' was 0.92 ± 1.50. VAS score on 'extraction' in EMLA group was little higher though the difference was not statistically significant. The overall experience using Liekert's scale was higher in experimental group (4.0 ± 0.76) as compared to (3.3 ± 0.82) in control group leading to higher overall satisfaction among patients who underwent extraction in the experimental group. Conclusion: EMLA application produced a satisfactory level of anesthesia in the palatal tissue when compared with the palatal injection.

An in-vitro analysis to evaluate the disinfection effectiveness of Cold Atmospheric Pressure (CAP) plasma jet in Enterococcus faecalis infected root canals.

Cold Atmospheric Pressure (CAP) plasma has shown successful antibacterial efficacy in different medical applications which have prompted researchers to explore its possible use in endodontics. The aim of the present study was to comparatively evaluate the disinfection effectiveness of CAP Plasma jet with 5.25% sodium hypochlorite (NaOCl) and Qmix in Enterococcus Faecalis infected root canals at different time intervals (2, 5, and 10 min). 210 single-rooted mandibular premolars were chemomechanically prepared and infected with E. faecalis. The test samples were exposed to CAP Plasma jet, 5.25% NaOCl, and Qmix for 2, 5, and 10 min. The residual bacteria from the root canals if any were collected and evaluated for colony-forming units (CFUs) growth. ANOVA and Tukey's tests were used to evaluate the significant difference between treatment groups. 5.25% NaOCl showed significantly more antibacterial effectiveness (<0.001) when compared with all other test groups except Qmix at 2 and 10 min of exposure time. A minimum contact time of 5 min with 5.25% NaOCl is recommended to get zero bacterial growth in E. faecalis infected root canals. QMix requires a minimum contact time of 10 min to achieve optimal CFUs reduction and CAP plasma jet requires a minimum contact time of 5 min to achieve substantial CFUs reduction.

Safety and Efficacy of Resveratrol in Healing of Maxillofacial Fractures: A Randomized Controlled Study.

Objectives: To assess the efficacy of resveratrol in improving functional outcomes following open reduction and internal fixation of maxillofacial fractures. Study Design: A single-center, randomized, parallel group, prospective, double-blind clinical trial was conducted on 40 patients between the age 20 and 60 years, requiring open reduction and internal fixation of maxillofacial fractures. The selected patients were randomly divided into two groups, Group 1 (placebo) and Group 2 (resveratrol) where tablets resveratrol 500 mg were given twice daily for 1 month following open reduction and internal fixation of fractured segments. Bite force was calculated pre-operatively and on the 1st, 4th, 8th and 12th week postoperatively. Serum markers osteocalcin and alkaline phosphate were calculated pre-operatively and at 4th and 12th week postoperatively. Results: Bite force (690.55 ± 262.00) in the resveratrol group was higher than the placebo group (553.27 ± 300.08) at 12th week postoperatively. However, the difference was non-significant statistically (p = 0.132). Resveratrol group (116.80 ± 55.25) showed better maintenance of serum ALP level as compared to placebo group (107.90 ± 42.99) at 12th week postoperatively, but again it lacked statistical significance (p = 0.573). Resveratrol group after initial reduction at 4th week showed serum osteocalcin levels nearly equal to the preoperative values at 12th week, while the placebo group showed a decline both at 4th and 12th week postoperatively. However, these results were not statistically significant (p = 0.065). Conclusion: There was no statistically significant difference in bite force, serum ALP level and serum osteocalcin levels between placebo group and resveratrol group. Though not statistically significant but early increased level of serum osteogenic markers, better restoration of bite force in group 2 (tab. Resveratrol) indicates toward its possible optimistic role in maxillofacial fracture healing. More studies with larger sample sizes are needed in order to confirm the efficacy of this drug in maxillofacial fracture.

Efficacy of Enhanced Recovery after Surgery (ERAS) protocol in maxillofacial trauma: A randomized controlled trial.

INTRODUCTION: Enhanced Recovery after surgery (ERAS) guidelines have been formulated in the literature for various different specialties but none is present for maxillofacial trauma patients. Hence, we have formulated ERAS protocol for maxillofacial trauma (ERAS-MT) patients and compared with the patients receiving the standard traditional care for post trauma outcomes. METHODOLOGY: A randomized controlled trial included 74 patients divided into two groups: Group 1 (ERAS group:37 patients) and Group II (Control group:37 patients). ERAS group were intervened according to the formulated ERAS protocol based on the previous literature and the control group received the standard of care. The both groups were compared for various post trauma outcomes. RESULTS: Baseline demographic data was non-significant between both the groups. There was significant decrease in pre-operative IV fluid use and total number of IV analgesics used till 72 h as well as in the immediate post operative period in the ERAS group(p = 0.001). ERAS group started oral feeds within 6 h and they were significantly compliant for oral carbohydrates in the pre-operative phase(p = 0.001). PONV episodes, swelling and infections were insignificantly less in the ERAS group(p > 0.05), however a significant difference was seen throat pain and decreased anxiety as well as Oral Hygiene Index(p = 0.001). At two weeks, a significant difference was seen in overall patient's satisfaction and cost analysis in the ERAS group (p = 0.001). CONCLUSION: Our study suggested that ERAS protocol was associated with shorter hospital stay, early recovery with better overall satisfaction of the patients, lesser post-operative complications and significantly decreased cost analysis.

Treatment Outcome Comparison Between two 3-Dimensional Plates (Y-Shaped Plate Versus Trapezoidal Condylar Plate) in Management of Mandible Condylar Fracture: A Randomized Control Trial.

Aim: To compare the treatment outcomes (clinical, functional and radiographical) using the two different 3-Dimensional plates in open reduction internal fixation of mandibular condylar fracture (MCF). Assessment of ease of fixation and fixation time were also performed. Methodology: 20 MCF patients were divided equally into two groups (Group A: Trapezoidal Condylar Plate and Group B: Y-shaped plate) and the treatment outcomes were compared. Intraoperatively time required for fixation was also compared. The patients were followed up at different timelines till 3 months. Result: Baseline parameters had statistically insignificant distribution in both groups implying effective randomization and balanced confounding factors. Intraoperatively, adequate anatomical reduction was achieved in both groups with statistically insignificant difference in time required for fixation. Postoperatively, no statistically significant difference was found in radiographic and functional parameters. None of the patients in either group reported with facial nerve injury, condylar resorption, Temporomandibular Disorders. However, 02 patients in Group A and 01 patient in Group B presented with infection, parotid fistula, and hardware failure respectively with statistically insignificant difference. Conclusion: This study concluded that the treatment outcomes were satisfactory with the use of both 3-D plate, but further studies with larger sample size and longer follow up are required.

Gap areas in mitigation of oral cancer: A cross-sectional study evaluating awareness and knowledge of risk factors in oral cancer in a tertiary hospital.

Purpose and Objectives: One of the main causes of the increasing oral cancer (OC) burden in India is a lack of awareness and a significant gap in knowledge about risk factors and symptomology of OC. Materials and Methods: A questionnaire-based cross-sectional study was to evaluate the knowledge and awareness about OC among 500 random patients presenting for care at a tertiary hospital in western Rajasthan which serves a wide area of western, northern, and central Rajasthan. Results: A total of 446 participants, among which 83.6% were males enrolled in the study. Much to our despair, the results showed 35.23% of the participants (P = 0.007) started their habit at age <15 years. Nearly 60.3% of the participants were well aware of the harmful temporary or permanent effects of the tobacco. Around 40.85% of the participants taking tobacco products were ignorant about their changes in the tissues (site of tobacco placement). TV and Radio (50.5%) were the main source of information of the ill effects of tobacco and form a major contribution in public awareness. More than 90% of the participants had read the warnings on the tobacco packets. No doubt participants have knowledge about the ill effects of tobacco still there was a lack in behavioral modifications for tobacco cessation, leading to nonsuccess in quitting, with actual nonunderstanding about the ill effects of tobacco and overall lack of belief in the tobacco control measures. Conclusion: Our findings have found a gap in the awareness efforts of OC for the general population and will make public health professionals, clinicians, policymakers, and government a better judge and motivate them to strengthen existing national tobacco control efforts.

Effects of delayed appointments in fixed orthodontic patients due to lockdown during the COVID-19 pandemic.

Objectives: To determine the frequency of orthodontic emergencies and their impact on the treatment progress caused by delayed appointments due to the lockdown during the COVID-19 pandemic. Materials and methods: Two hundred thirty-eight patients undergoing fixed orthodontic treatment participated in this cross-sectional study. A pre-structured questionnaire was divided into six parts (Part A-C comprised of orthodontic emergencies and Part D-F comprised of various adverse effects and impacts on treatment progress). Two specialist orthodontists performed clinical examinations to complete the questionnaire. The final data were expressed as frequency and percentage. Results: Maximum number of patients reported four months after lockdown. Nearly half of the patients reported debonding of at least one of the brackets. Loosening of molar bands and debonding of second molar tubes were observed in 12.6% and 18.9% of patients, respectively. Ligation method failures were reported in 41.2% of the patients. Patients fitted with transpalatal arch/lingual arch skeletal anchorage showed a failure rate of 26.1% and 10%, respectively. Almost 29% of the patient complained of discomfort due to distal wire impingement. Undesired tooth movements were seen in almost 25% of patients. Alignment, space closure, and settling of occlusion were affected in 47.6%, 17.4%, and 35.7% of patients, respectively. Conclusions: This study helps to determine various types of adverse effects that can occur due to delayed appointments. The study's outcomes suggest that clinicians should be prepared to deal with future pandemics or other causes that might lead to delayed appointments.

Global and promoter specific hypermethylation of tumor suppressor genes P16, SOCS1, and SHP1 in oral squamous cell carcinoma and oral submucous fibrosis.

ABSTRACTS: Aberrant methylation pattern leads to altered gene expression, that is, involved in the transformation of various cancers, including oral squamous cell carcinoma (OSCC). In the present study, an attempt has been made to examine the association of global and promoter-specific methylation of tumor suppressor genes in patients with OSCC and oral submucous fibrosis (OSMF). Promoter-specific methylation of tumor suppressor genes P16, SOCS1, and SHP1 had been studied earlier for their aberrant methylation patterns in other cancers; however, these studies were mainly conducted in-vitro or in animal models, and as such, only a few studies are available on human samples. In the present study evaluation of promoter-specific methylation of genes P16, SOCS1, and SHP1 in 76 patients' blood and tissue samples was done and compared with methylation of 35 healthy control samples using qPCR. Further, these samples were analyzed for global methylation patterns using ELISA. The results have shown a significant decreasing trend of promoter methylation (OSCC > OSMF > Controls); the methylation indices (MI) were significantly higher in OSCC than in the controls. The median MI of three genes for OSCC were P16MI (0.96), SHP1MI (0.79), and SOCS1 (0.80). Similarly, median MIs for OSMF were P16MI (0.18), SHP1 MI (0.19), and SOCS1 MI (0.5) against controls with MI (0) for each of the three genes. The global methylation %mC values were 1.9, 0.5, and 0.1, respectively. The values of MI and %mC were found to correlate with various risk factors such as tobacco, smoking, and alcohol consumption, which are positively involved in OSMF pathogenesis followed by oral cancer progression. Further, the methylation trend in tissue was reflected in blood samples, proving a window for methylation load to be used as a lesser invasive biomarker. The sensitivity and specificity of methylation load were also found reasonable. Therefore, the current study suggests that there may be a role of global and promoter-specific methylation load in the transition of OSMF to OSCC.