With the advances in the field of imaging sciences, new methods have been developed in dental radiology. These include digital radiography, density analyzing methods, cone beam computed tomography (CBCT), magnetic resonance imaging, ultrasound, and nuclear imaging techniques, which provide high-resolution detailed images of oral structures. The current review aims to critically elaborate the use of CBCT in endodontics.

This review assessed the most up-to-date literature on the accuracy of detecting vertical root fractures (VRFs] using the currently available diagnostic imaging methods. In addition, an overview of the biological and clinical aspects of VRFs will also be discussed. A systematic review of the literature was initiated in December of 2015 and then updated in May of 2016. The electronic databases searched included PubMed, Emabse, Ovid, and Google Scholar. An assessment of the methodological quality was performed using a modified version of the quality assessment of diagnostic accuracy studies tool. Twenty-two studies were included in this systematic review after applying specific inclusion and exclusion criteria. Of those, 12 favored using cone beam computed tomography (CBCT) for detecting VRF as compared to periapical radiographs, whereas 5 reported no differences between the two methods. The remaining 5 studies confirmed the advantages associated with using CBCT when diagnosing VRF and described the parameters and limitations associated with this method, but they were not comparative studies. In conclusion, overwhelming evidence suggests that the use of CBCT is a preferred method for detecting VRFs. Nevertheless, additional well controlled and high quality studies are needed to produce solid evidence and guidelines to support the routine use of CBCT in the diagnosis of VRFs as a standard of care.

Objective: Dental caries is frequently observed in children, particularly among those residing in developing countries. The most adapted strategies against this pathology remains prevention based on information, education, and communication (IEC), as well as on early diagnosis and treatment. We carried out a study that aimed to analyze the development of dental caries in a cohort of school children followed during their primary education. The objective was to assess the evolution of the dental status of a cohort of students during their elementary curriculum. Materials and Methods: A cohort of school children was followed during 6 years from the first grade to the sixth grade. Monitoring of these school children focused every year on IEC based on learning methods of brushing messages, dietary advice, systematic visits, fluoride use, and primary dental care. During the school year, the students were periodically subjected to education and communication briefings (IEC). Primary care consisted of extracting and descaling rhizalyzed teeth in the same period. The data from this review were collected using the World Health Organization questionnaire, and statistical analysis was performed with the software Epi-info version 6.04 d. Results: The mean age of the 171 school children was 6 years in the first grade and 11 years in the sixth grade. In the first grade, the decayed permanent teeth prevalence was 31.6% and the In permanent teeth: Decayed, missing or filled teeth (DMF/T) was 0.47. The decayed primary teeth prevalence was 75% and the in primary teeth: decayed or filled teeth (df/t) 2.23. In the sixth year, the prevalence of decayed permanent teeth was 51% and DMF/T 0.36 whereas the decayed primary teeth prevalence was 12% and the df/t was 0.19. The prevalence of decayed permanent teeth increased from 31.6 to 51% whereas the mean DMF/T was not statistically different between school children of the first and sixth grade class. Conclusion: The promotion of oral health by IEC messages and monitoring of children constitute an effective preventive method for children's oral care.

Aim and Objectives: Fissure caries is most common in children due to deep pit and fissures. Pit and fissure areas on the occlusal surface of the teeth make them susceptible to dental caries, which need to be prevented or restored. Fissures sealant reduces the risk of occlusal caries. The present study was done to evaluate microleakage and shear bond strength of various fissure sealants. Materials and Methods: Thirty-six extracted molars were randomly allocated equally (n = 12) into three groups with three different sealants to evaluate shear bond strength and microleakage at sealant space. The shear bond strengths was evaluated with one-way analysis of variance and microleakage by Kruskal-Wallis nonparametric test using the Statistical Package for the Social Sciences version 18.0 (Chicago: SPSS Inc, 2009). Results: Tetric flow (16.8 MPa) recorded the highest shear bond strength and the difference was statistically significant with enamel loc (12.8 MPa). There was no statistically significant difference in relation to microleakage (P > 0.05) in the tested groups. Conclusions: Tetric flow recorded the highest shear bond strength and the difference was statistically significant with enamel loc. However, there was no statistically significant difference among the groups regarding microleakage.

Aims: To identify the relation between need, demand, and effective demand for dental services in Andhra Pradesh, India. Materials and Methods: This is a cross-sectional study performed among populations residing in the rural and urban areas of Krishna district, Andhra Pradesh, India. Data were collected from 3102 individuals who were selected through multiphase random sampling. Data regarding self-perceived dental need, dental service utilization, and barriers for utilization were collected through s pretested questionnaire followed by type-III clinical examination to assess the normative need of the individuals. Chi-square test was used to compare independent and dependent variables, and further comparison was done with multivariate logistic regression analysis for significant variables. Results: Less than half (40%) of the participants perceived a need for dental care. Among the people who perceived need for care, only 21.4% utilized dental care and 78.6% of them had unmet dental needs. The two main reasons for not seeking dental care was lack of money, i.e., unaffordable dental treatment (48%) and having the perception that they do not have any dental problem (19.4%). Conclusions: There is an enormous difference between normative need, demand, and actual utilization rates in dental care, and hindrances for effective demand need to be addressed to improve dental care delivery system.

Aim: Pathologic tooth migration (PTM) has been defined as tooth displacement that occurs when the balance among the factors that maintain physiologic tooth position is disturbed by periodontal disease. The aim of this cross-sectional epidemiological study was to determine the prevalence of pathologic tooth migration among patients with periodontitis. Materials and Methods: Recorded documents of 370 patients (72.4% females, 27.6% males) within the age range of 17 to 70 years (mean 37.77 ± 11.46) were studied. Statistical analysis was carried out using t-test and Chi-square test. Results: Pathologic migration prevalence was 11.4% (35/314 patients), however, there was no pathologic migration in patients with mild chronic periodontitis. The Chi-square test showed that there was no statistically significant difference between males and females. Conclusions: The results of this study confirm that pathologic tooth migration is relatively common among periodontal patients and its prevalence is increased by the severity of periodontal disease.

Objectives: The premature loss of primary teeth is a potential risk factor for poor arch length development. Adequate arch length is important to the progression of the permanent teeth. Poor arch length can lead to crowding, ectopic eruption, or impaction of these teeth. This study is designed to assess the prevalence of premature loss of primary teeth in the 5-10-year-old age group. Materials and Methods: The study group included 185 children, that is, 91 boys and 94 girls. The dental examination was conducted by an experienced examiner under sufficient artificial light. Data including patient age and missing teeth were collected. Descriptive statistics were applied for data analysis, and from the results, Chi-square tests were used at a level of significance of 5% (P < 0.05). Results: We observed a 40.54% prevalence of premature loss of primary teeth with no statistically significant difference between genders. The lower left primary second molar was the most commonly absent tooth in the dental arch (13.5%). Conclusion: The status of premature loss of primary teeth was high in the study group. Implementation of efficient educational and preventive programs to promote oral health would help children maintain a healthy primary dentition and eventually prevent the disturbances in the future development of normal occlusion. Early detection and management of the space problems associated with the early loss of primary teeth would help in reducing malocclusion problems.

Aim: The purpose of this study is to achieve an effective method to remove root canal filling material from the root canal system. The study, thus, aims to evaluate the efficacy of the cleaning ability of two different rotary Ni-Ti systems; ProTaper Retreatment files and RaCe System compared to hand instrumentation with Hedstrom files for the removal of gutta-percha during retreatment. Materials and Methods: Thirty mandibular premolars with one single straight canal were decoronated and instrumented with ProTaper files and filled with thermoplastic gutta-percha. After 30 days, the samples were divided into three groups and gutta-percha was removed with the test instruments. The postoperative radiographs were evaluated with known criteria by dividing the root into cervical third, middle third, and apical third. The results were tabulated and Statistical Package for Social Sciences Software (IBM Corporation) was used for analysis. Results: The mean deviation of the results were first calculated and then t-test and analysis of variance test (two-tailed P value) were evaluated for establishing significant differences. The rotary instruments were effective in removing the gutta-percha from the canals. Therefore, significant difference was observed between the efficacies of the two rotary systems used. The rotary instruments showed effective gutta-percha removal in the cervical and middle one third. (P > 0.05). However, apical debridement was effective with Hedstrom files. Conclusion: The study concluded the use of both rotary and hand instrumentation for effective removal of gutta-percha for retreatment.

Aims and Objectives: This study aimed to assess how competent the recent dental graduates perceive themselves to be in Dental Public Health. Materials and Methods: A 21-item structured, close-ended questionnaire study was carried out at the KLEVK Institute of Dental Sciences, Belgaum, India. Students assessed their competencies using a three-point ordinal scale. One hundred and thirty-three students were asked to rate their proficiency on a 21-item matrix of the dental public health program. The responses were grouped using the Likert-type scale. Frequencies descriptive data were generated, and statistical analysis of examined variables was carried out using the Chi-square test. Mann-Whitney test was conducted to identify the correlation between variables. Results: The overall mean score was 22.61 ΁ 10.94, highlighting confidence of the graduates in managing the oral health problems at the community level. Females showed higher competencies in functions related "to develop activities to motivate the community development," "to motivate health and oral health through health education," and "to motivate health and oral health through the creation of healthy settings." While males reported greater competency for the function "to adjust the dental practice to situations of restrictions that limits it." Conclusion: Recent dental graduates at the Institute perceived themselves competent in managing oral and dental health problems at the public level. Additional countrywide evidence regarding teaching and learning of public health dentistry is essential to compare the current experiences of dental graduates and ultimately enhance patient care.

Aims and Objectives: To study the genotoxic effects of tobacco on the exfoliated buccal epithelial cells in patients with oral precancerous lesions (OPLs) and Patients with tobacco habit but without oral precancerous lesion( habit controls) by using micronucleus assay as well as the quantification and detection of the biomarkers in these premalignant lesions which will be helpful in finding those patients who are at higher risk for malignant transformation. Materials and Methods: Forty samples were collected from the right and left side of buccal epithelial cells obtained from 20 individuals, i.e., 10 patients with habit control and 10 patients with OPLs. Statistical analysis was performed by the Statistical Package for the Social Sciences version 21.0 Unpaired t-test was performed to determine the micronucleated cell (MNC) and micronuclei (MN) frequencies in individuals; significance was set at P > 0.05. Results: There was an increase in both the MNC and MN frequency from habit controls to OPLs, indicating that the number of cells with chromosomal damage and extent of chromosomal damage in each cell was high in OPLs. Conclusion: The MN count can be used as a noninvasive tool for early detection, educating patients, screening a large population, and to check the risk for malignancy, which in turn may help in treatment planning.

Aims and Objectives: Parents play an important role in the dental behavior of a child patient. This study aimed to assess the effect of parental presence on the behavior of the child and objectively measure the behavior using pulse oximetry. Materials and Methods: The study was registered with the clinical trials registry of the National Institutes of Health (NCT02619981). The children were divided into three groups, those who had no accompanying parent, those accompanied by their fathers, and those accompanied by their mothers. The Venham anxiety and behavior scores were used for subjective measurements whereas the objective measurement of fear was done by measuring the heart rate using a portable pulse oximeter at six critical clinical situations. Statistical analysis was carried out using the Statistical Package for the Social Sciences version 21 (IBM corp. Armonk, NY, USA). Results: One hundred and twenty two children aged between 6 years and 8 years completed the study. Most of the children accompanied by fathers were males while most of the children accompanied by their mother were females. It was seen that females showed a higher mean heart rate than males at all steps. Children who had their parents outside the operatory exhibited lower anxiety and behavior scores than those whose parents were present; however, they showed a significantly higher pulse rate at all procedures. Boys had higher anxiety and behavior scores than girls, however, these differences were not statistically significant. Conclusion: The results of this study suggest that the presence of the parent in the operatory reduces the physiological manifestations of anxiety in children in their first restorative dental visit.

Aim: To evaluate the efficacy of platelet rich fibrin (PRF) with or without bone graft [demineralized bone matrix (DBM) graft] in the treatment of intrabony defects based on clinical and radiographic parameters. Materials and Methods: Thirty six intrabony defects in 36 patients were randomly divided into three different groups and were treated with group A (PRF with DBM) or group B (PRF alone) or group C [open flap debridement (OFD)]. Clinical parameters such as plaque index (PI), gingival index (GI), probing depth (PD), relative attachment level (RAL), and gingival recession (GR) were assessed at baseline and 9 months postoperatively; radiographic parameters such as linear bone growth (LBG) and percentage in bone fill (%BF) were calculated by using the image analysis software. Comparisons of groups were analyzed using Kruskal-Wallis analysis of variance test. Pair-wise comparison of groups was done by Mann-Whitney U test. Results: Mean PD reduction and RAL gain were greater in group A (4.25 ± 1.48, 3.92 ± 0.90) and group B (3.82 ± 0.75, 3.27 ± 0.65) than control (3.00 ± 1.21, 2.25 ± 0.62). Furthermore, statistically significant improvement in LBG and %BF was found in group A (3.47 ± 0.53, 61.53 ± 4.54) compared to group B (2.55 ± 0.61, 49.60 ± 14.08) and group C (1.21 ± 0.80, 24.69 ± 15.59). Conclusions: The study demonstrated that PRF improves clinical and radiological parameters compared to OFD alone in intrabony defects. Addition of DBM enhances the effects of PRF in RAL gain and radiographic defect fill.

Aim: The aim of the present study was to evaluate the efficiency of different endodontic irrigants in the removal of smear layer through scanning electron microscopic image analysis. Materials and Methods: The present in vitro study was carried out on 45 single-rooted extracted human mandibular premolar teeth with single canal and complete root formation. Teeth were randomly assigned to three groups with 15 teeth in each group. Group I samples were irrigated with 17% ethylenediaminetetraacetic (EDTA) irrigation, Group II with 7% maleic acid irrigation, and Group III with 2% chlorhexidine irrigation. Scanning electron microscope evaluation was done for the assessment of smear layer removal in the coronal, middle, and apical thirds. Comparison of the smear layer removal between the three different groups was done by Kruskal-Wallis test, followed by Mann-Whitney U test for comparing individual groups. A P value less than 0.05 was considered to be statistically significant. Results: Statistically significant difference was seen between the two test groups (17% EDTA vs. 7% maleic acid and 17% EDTA vs. 2% chlorhexidine) in smear layer removal at coronal, middle, and apical thirds of the root canal. The most efficient smear layer removal was seen in Group I with 17% EDTA irrigation compared with other groups (P < 0.05) and the least by 2% chlorhexidine. Conclusion: The present study shows that 17% EDTA efficiently removes the smear layer from root canal walls.

Aims and Objectives: Satisfactory composite restoration depends upon its smooth finish, quality of polishing agents, type of composite material used, and its composition. The present study evaluated the effect of different polishing systems on the surface roughness of composite resin. Materials and Methods: Forty discs of composite were prepared and equally subjected to different finishing and polishing procedures; (i) unpolished control group, (ii) sof-lex discs, (iii) diamond tips, and (iv) Astrobrush groups. Later, the surface roughness for the entire specimen was evaluated using Profilomotor. Data were tabulated and statistically analyzed using analysis of variance and Tukey's test at significance level of 0.001. Results: Composite surface roughness after polishing was statistically significant between the groups. Sof-lex group produced lesser surface roughness compared to control, Astrobrush, and diamond group. Conclusion: The present study indicated that diamond tips can be used to remove rough surface whereas sof-lex can be used for final finish and polish of the composite restoration.

Osteosarcoma is a very uncommon tumor of the maxillofacial region. Due to the occurrence of the tumor at a young age and its aggressive nature, radical surgery forms the only modality of treatment. A combination of radiotherapy and postoperative chemotherapy has been used for the management of this tumor. A case report of osteosarcoma of the posterior maxilla in an adolescent with a 1-year disease-free follow-up is presented in this report.