Background: The nature of collagen in the oral potentially malignant disorder of oral submucous fibrosis (OSF) has always been a subject of interest to researchers studying the condition. The type, constitution, and morphology of the collagen has been studied to understand the pathogenesis of the disorder. Aim: The present review attempts to collate literature to assess the changes reported on the nature of collagen in OSF. Materials and Methods: A systematic analysis of literature based on the PRISMA protocol was carried out on studies that analyzed the nature of collagen in OSF. A total of 30 articles were found acceptable for analysis. The reported literature was categorized into histological, immuno-histochemistry (IHC), electron microscopic (EM)/scanning electron microscopic (SEM), biochemical, culture, and genetic studies. Results: Light microscopic studies revealed increased collagen with compaction and condensation as the disease advanced. Polarising microscopy revealed presence of greenish yellow (type I) thick fibers replacing the yellowish orange (type III) thin fibers in the submucosa. Fibrosis originated in the submucosa and subsequently involved the lamina propria as the disease advanced. EM/SEM investigations revealed frayed ends, degeneration of collagen cores. Increased expression of collagen antibodies and total collagen content were observed in IHC and biochemical studies, respectively. Cultured fibroblasts from OSF tend to produce more collagen in comparison to normal fibroblasts indicating a phenotypic change. Increased expression and upregulation of collagen genes were consistent in OSF cases. Conclusion: The collagen deposition in OSF is biochemically normal but quantitatively more. Fibroblast phenotypic change, upregulation of collagen genes, and selective remodeling due to decreased degradation seem to contribute to the increased fibrosis in the disorder.

Background and Aim: The aim of the study was to compare the physical (processing shrinkage) and mechanical properties (bending deflection, flexure strength, and flexure modulus) of pressure-molded (Lucitone 199 and ProBase Hot) and injection-molded (SR-Ivocap) denture base materials in different conditions. Materials and Methods: Two denture base materials for pressure molding, Lucitone 199 and ProBase Hot, and one for injection molding (SR-Ivocap) were tested. Polymerization shrinkage (PS) was determined by measuring the linear distances between the reference points on the wax patterns (65 mm × 55 mm × 6 mm) and the corresponding cured acrylic plates and calculating the difference. Rectangular specimens (50 mm × 10 mm × 2.5 mm) were machined from these acrylic plates and used to measure bending deflection (BD) at various load levels, flexure strength (FS), and modulus of elasticity using a three-point bend test on an Instron Universal Testing Machine. A minimum of seven specimens were tested for each variable category. For each material, the percentage of specimens that failed within the load range of 9-10 kg was noted. Statistical analysis involved calculation of mean and standard deviations followed by group comparison of properties of different materials by using analysis of variance (ANOVA) and Tukey's multiple range tests. Level of significance was set at P < 0.05. Result: There was no significant difference between the PS values. ProBase Hot exhibited significantly less BD and greater FS values than the other two materials (P < 0.05). Within the load range of 9-10 kg., 5% of the lucitone specimens, 25% of the SR-Ivocap specimens, and all of the ProBase Hot specimens fractured. Conclusion: The three tested denture base acrylics did not show any significant differences in processing shrinkage. However, ProBase Hot showed significantly lower bending deflection values than Lucitone 199 and SR-Ivocap. Compared to Lucitone 199 and SR-Ivocap, ProBase Hot is a tougher and a stiffer material. Hence, it is more likely to fracture readily if subjected to extreme loading conditions due to the accidental fall of the denture on a hard surface or if the denture wearer inadvertently bites on a particularly hard particle.

Background: With the advent of new interim crown materials, it has become imperative to evaluate its strength in order to select the appropriate interim crown and partial fixed dental prosthesis material. Aim: The purpose of this in vitro study was to compare marginal adaptation, wear resistance, and fracture resistance of a computer-aided design/computer-aided manufacturing (CAD/CAM) versus a dual polymerized interim fixed dental prosthesis (FDP). Materials and Methods: Twenty models were randomly allocated into two equal groups (I and II). Group (I) received 10 CAD/CAM fabricated interim FDP (CAD-Temp) and Group (II) received 10 directly fabricated interim FDP using a dual polymerized material (TempSpan). All specimens were stored before testing. Marginal adaptation was tested using stereomicroscope and image analyzing software to measure the amount of marginal gap. For wear resistance test, all specimens were subjected to mechanical tooth brushing. Stereomicroscope and image analyzing software were used to measure the difference in height before and after tooth brushing. Specimens were subjected to cyclic loading; specimens intact from defects were then loaded to fracture. Data were analyzed using Student's T- test, Mann Whitney test and Fisher exact test (α = 0.05). Results: CAD-Temp (15.026 ± 4.340 μm) showed significantly higher marginal adaptation than TempSpan (145.418 ± 25.365μm)(P < 0.001). The wear resistance of CAD-Temp (7.3322 ± 0.99853 μm) was significantly higher than TempSpan (22.3165 ± 2.35459 μm) (P < 0.001). The fracture resistance of CAD-Temp (605.1 ± 31.718N) was also significantly higher than that of TempSpan (225.76 ± 32.469N) (P < 0.001). Conclusions: CAD/CAM fabricated interim restorations have better marginal adaptation, wear resistance and fracture resistance than dual polymerized interim restorations hence, might withstand longer duration in the oral cavity.

Background and Aim: The aim was to determine the prevalence of zygomatic air cell defect (ZACD) among children of Indian origin and also to determine the dominant form of ZACD. Materials and Methods: One thousand six hundred and eighty-eight routine panoramic radiographs of subjects between 7 and 18 years, processed between January 2006 and January 2009 were screened, recorded and analyzed for ZACD. Results: Of the 1688 panoramic radiographs examined, 768 were of males and 920 of females. The radiographs were divided into two groups, Group I comprising of subjects in the age 7-12 years and other Group II in the age range 13-18 years. ZACD was found in 50 subjects, accounting for prevalence of 2.96%. Other occurrences found were unilateral 38 cases, bilateral 12, unilocular 20 and multilocular 42 respectively. Conclusion: This study described the prevalence and characteristics of ZACD among selected Indian children. It is essential to know and determine this variant of normal anatomy and differentiate it from pathologies.

Introduction : The role of bacteria in pulpal and periradicular lesions is well established. However, the association of bacterial species with signs and symptoms of endodontic infection is not well elucidated. The purpose of this study was to investigate the types of bacterial species in infected root canals (using MicroSeq 500 16S ribosomal ribonucleic acid, rRNA) and the association of bacterial species with clinical signs and symptoms of different pulpal and periapical infections. Materials and Methods: Microbial samples were obtained from 92 adult patients (one tooth with single root canal for each patient). Clinical data including signs and symptoms were collected. Polymerase chain reaction (PCR) (MicroSeq 500 16S rRNA) was used to detect bacteria in the infected root canals. Results: A total of 179 bacterial species were identified. Actinomyces viscosus and Streptococcus sanguis were associated with the presence of pain. While Staphylococcus haemolyticus and Veillonella spp. were associated with pain of palpation, the pain to percussion was associated with Actinomyces spp., Actinomyces naeslundii, and Actinomyces viscosus. Also, Streptococcus mitis, Bacteroides spp., and Veillonella spp. were associated with periapical swelling. The presence of sinus tract was found to be significantly associated with Neisseria spp. and Staphylococcus haemolyticus. The wet canal was significantly associated with the presence of Propionibacterium acnes and Bacteroides spp. Conclusions: There are significant associations between the presence of some bacterial species with clinical signs and symptoms of infected root canals.

Background and Aim: There is limited data on dentin hypersensitivity (DH) among young adults in Africa. The objective of this study was to determine the prevalence and trigger factors associated with DH among young adults in a university community in Nigeria. Materials and Methods: The study population consisted of 360 young adults, 188 males and 172 females, aged 18-33 years. All individuals answered questions regarding demography, self-reported dentin sensitivity, trigger factors, action taken, and impact of DH on quality of life. Statistical analysis used descriptive statistics and the Chi-square test. Results: The prevalence of DH was 228 (63.3%) among the surveyed population and was significantly higher in females as compared to males (P = 0.03). All the participants who reported DH were right-handed. Among the participants with DH, majority 139 (61.0%) have not taken any action. The major precipitant for the DH was a cold drink 78 (34.2%). Of the 228 who experienced DH, 92 (40.3%) indicated eating as the precipitant, 76 (33.3%) indicated tooth brushing and 22 (9.6%) indicated talking as the precipitant. Approximately, 30% of the participants expressed unhappiness due to tooth sensitivity. Individuals with functional and psychological disturbance were significantly more likely to visit a dentist. Conclusion: The prevalence of DH found in this study was higher than previously reported, suggesting an increase in the levels of sensitivity within the general population. All the participants were right-handed and left side of the mouth was the most commonly affected.

Background and Aim: Oral tori are bony growth present in the oral cavity and are not considered as pathological lesions. Smaller tori do not cause any problems, but larger sized tori can result in significant problems. The aim of this study was to determine the prevalence of torus palatinus (TP) and torus mandibularis (TM) in the Indian population. Study Design: A total of 3087 patients were examined between August, 2010 and October, 2012 for the presence of TP and TM by inspection and palpation. The data were collected and analyzed using SPSS 12.0 (SPSS Inc., Chicago, USA). Results: A total of 36 patients (1.3%) presented with TP, while 214 patients (6.9%) presented with TM. Tori were more frequent in males and this difference was statistically significant (P < 0.05). TP was more common in 31-40 years age group (13 patients, 36.1%), whereas TM was more in the 41-50 years age group (81 patients, 37.9%). The most commonly observed type of TP was flat shaped, whereas bilateral solitary types were the most common TM. Conclusion: The results of this study showed a significantly higher prevalence of tori in males. No difference in the prevalence of TP and TM was noted regarding the age groups. Although, not pathologically significant, these bony overgrowths very often need surgical removal, especially when prosthesis are indicated.

Background and Aim: This study was conducted to assess the periodontal knowledge, orientations of Saudi medical interns and the medical curriculum. Study Population and Methodology: Questionnaires were distributed to 221 medical interns chosen randomly from two major educational institutions in Saudi Arabia. Questions were developed from literature reviews. The questionnaire had five true/false knowledge items, and eight Likert-scale questions. Data were analyzed by computerized SPSS (version 20). Level of significance was set at P < 0.05. Results: Of the 221 respondents, 66% were male and 34% were female. Most of the participants were 24 years old (48%). About 40% of the interns answered all five true/false general knowledge questions correctly, nearly half of the respondents (49.8%) reported they never asked patients if they were diagnosed with periodontal disease, 93.2% reported not receiving any training about periodontal disease in medical school, 23.5% reported they would feel absolutely uncomfortable performing a simple periodontal examination, about one-third of interns (29.4%) agreed that patients expect physicians to discuss/screen for periodontal disease, 43.9% felt that discussing/evaluating the periodontal status of their patients was peripheral to their role as physicians, nearly half of interns (48.4%) reported never screening patients for periodontal disease, and 33% stated they never referred patients to dentists. Conclusion: Medical interns were not prepared nor trained to screen patients for periodontal disease. They had limited knowledge about the association between periodontal health and general health. Oral health training as part of the medical curriculum is strongly recommended.

Background: The restorative materials used in dentistry are required to have long-term durability in the oral cavity. Effect of various fluids in the oral environment can affect the hardness of these restorations. This study was carried out to evaluate the effect of different mouth rinses on the hardness of Silorane and Nano-hybrid resin composites. Materials and Methods: Thirty specimens were prepared from each type of composite and stored in artificial saliva for 24 h at 37°C. They were then divided into six experimental groups based on the test solution and were immersed and stored for 24 h at 37°C. Thereafter, the specimens were washed, dried and the hardness was measured for each specimen by Vickers microhardness tester. Results: Nano-hybrid resin composite showed higher Vickers hardness number (VHN) than Silorane composite in any test solution. There was only a mildly significant difference in the mean VHN of Silorane composite immersed in alcohol-containing mouthwash compared with artificial saliva. However, there was a significant difference in the mean VHN of Nano-hybrid composite when immersed in different mouthwashes. Conclusion: The microhardness values of Silorane-based and Nano-hybrid resin composites were decreased after immersion in the mouthwashes. The hardness of Nano-hybrid composite immersed in artificial saliva showed the highest VHN and was significantly affected when immersed in other test solutions. Silorane-based composite is more resistant to alcohol-containing mouthwash than Nano-hybrid composite.

It is uncommon for children or young adults to have rotated central incisors. The restorative options are to carry out an orthodontic treatment or root canal treatment followed by crown placement for their correction. Often overlooked and misunderstood, another treatment option in the intra-alveolar auto-transplantation where the tooth is rotated within the same socket to an appropriate position. This article highlights the overview of intra-alveolar auto-transplantation along with a case of rotated central incisor. A 12-year-old complaining of rotated tooth and wanted it to be corrected. On clinical examination, there was rotation of maxillary left central incisor with no history of any gingival and periodontal involvement. After obtaining the consent from the patient and his parent, intra-alveolar auto-transplantation procedure was carried out. After a four-year follow-up, the concerned tooth, had retained its vitality and showed no signs of relapse.

The aim of this short communication is to describe the True Triangle (TT) technique for the repair of unilateral cleft lip (CL). A total of 309 patients were operated using the TT technique. The final cleft lip repair results showed positive outcomes. Conclusion: This technique may overcome some of the drawbacks of the previously described surgical techniques used for CL repair.

Congenital epulis (CE) also known as granular cell tumor of new born was first described by Neumann in the year 1871. Most frequent location includes maxillary alveolar ridge with a female preponderance up to 8 times more than males. These tumors are usually small and can be solitary or multiple, pedunculated or protuberant mucosa covered nodules presenting at birth. Multiple theories have been proposed for their origin. Though, it may cause panic at birth they are indolent and regress spontaneously. Rare cases require surgical intervention in the neonatal period when symptomatic, causing difficulties in respiration or deglutition. We describe a case of CE in a 2-day-old female neonate, who presented with pink protuberant mass in the anterior alveolar ridge of maxilla. The mass was symptomatic and surgery was indicated. The mass was excised and the benign nature was confirmed by histopathology.

Sebaceous glands in the oral mucosa are said to be a normal variation, but the presence of the sebaceous gland in the jaw is extremely rare. Sebaceous gland differentiation in dentigerous cysts and in keratocystic odontogenic tumor (earlier odontogenic keratocysts) has been reported, but it has never been reported in any radicular cyst. We presented a case of a radicular cyst in an 18-year-old male with sebaceous gland differentiation.