Aim: Sleep bruxism (SB) has been present for over a century. There are many treatment modalities in the literature. The objective of this systematic review of randomized controlled clinical therapeutic trials of SB in adults diagnosed by clinical and/or electromyogram and/or polysomnography of SB is to elucidate the most effective of treatment modalities via documentation of the levels of evidence. Materials and Method: This review conducted electronically on PubMed included only English Full text human clinical trials with or without randomization. Twenty-one articles were included in this review. The therapeutic modalities of SB were classified into behavioral therapy, appliance therapy, local pharmacotherapy, and systemic pharmacotherapy. Each article was further allotted a level of evidence. Results: This review suggests that Oral appliances expressed the most positive outcome on SB episodes per hour of sleep. Conclusion: There is still not sufficient evidence to support behavioral and pharmaco-therapeutic approach

Aim: The aim of this study was to determine the relationship between Carotid atheromatous plaque in carotid artery with periodontal health and disease clinically and ultrasonographically and secondarily whether these relations are dependent on the level of serum high-density lipoprotein (HDL) cholesterol. Materials and Methods : The cross-sectional study was carried out on 60 subjects. Of which 30 subjects with chronic periodontitis and 30 subjects with healthy periodontium were recruited and they underwent ultrasound scanning of common carotid arteries to determine carotid plaque thickness. Clinical parameters measured were probing pocket depth, clinical attachment loss, plaque index, gingival index and biochemical parameters included total cholesterol, triglycerides, and HDL levels. Results : Periodontal disease is positively associated with carotid atherosclerosis. Plaque thickness and prevalence of carotid atheromatous plaque were significantly higher in the test group as compared to the control group. In the test group the mean carotid atheromatous plaque thickness was found to be 2.18 mm whereas in the control group it was found to be 0.14 mm. In test group, there was a positive and highly significant correlation of probing depth (PD) with triglycerides and total cholesterol levels and carotid atheromatous plaque thickness but a negative correlation between PD and HDL, triglycerides and total serum cholesterol levels in healthy subjects. HDL was significantly less in test group when compared with a control group with a P = 0.004. Conclusion: An inter-relationship between periodontal disease and the presence of atheromatous plaque exists. The prevalence of both periodontitis and atherosclerosis is very high. Periodontitis should be diagnosed and treated at its earliest and hence that clinician and public health practitioner can control the epidemic of cardiovascular diseases and reduce mortality.

Aim: The aim of this study was to compare the fluoride release and recharge characteristics of a zinc reinforced glass ionomer cement (GIC) (ChemFil Rock ™, Dentsply, York PA, USA) to that of two traditional high strength GICs (Fuji IX ™, GC Corp, Japan and Ketac-Fil™, 3M-ESPE, Germany). Materials and Methods: A total of 60 specimens (20 in each group) were used in this study. The materials were prepared according to the manufacturers' instructions and placed in plastic molds 9 mm in diameter and 2 mm high. The 20 specimens in each group were further subdivided into two subgroups of 10 each. Subgroup A (control) involved no fluoride treatment. Subgroup B involved application of a 1450 ppm dentifrice for 2 min twice daily for 30 days with a soft toothbrush. The specimens were then suspended in airtight plastic bottles containing 20 ml deionized water. A fluoride electrode was used to measure fluoride release and recharge from the discs on the 1 ^st , 2 ^nd , 7 ^th , 15 ^th , and 30 ^th day. Results: The results of the study showed that the zinc reinforced glass ionomer had a significantly higher fluoride release and recharge when compared to conventional high strength glass ionomers. Conclusions: The results of this study suggest that zinc reinforced glass ionomers have better fluoride recharge and release characteristics than conventional high strength glass ionomer.

Streptococcus mutans (S. mutans) is an important bacterium involved in the first steps of dental biofilm formation with subsequent initiation of several oral diseases. Aim: To evaluate the influence of Myrrh plant extract on S. mutans and its biofilm formation. Material and Methods: The antibacterial activity of the Myrrh prepared plant extract was tested against S. mutans using disc diffusion method. The ability of the Myrrh plant extract to inhibit biofilm formation of S. mutans was also determined. Results: showed the ability of the tested Myrrh oil plant extract to cease the bacterial growth. The recorded clear zone is 11 mm with extract concentration 42.5%. Myrrh extract was able to inhibit the S. mutans biofilm formation in 78.5% inhibition percentage on fibroblast cellular viability. Conclusion: Myrrh plant extract has promising antibacterial effect as well as on biofilm inhibition of S. mutans. The significant antimicrobial effect of the Myrrh plant extract indicates about its promise in controlling S. mutans biofilm, which has suspected role in the etiology of dental caries and periodontal diseases.

Aim: The purpose of the study was to establish a relation between the crest of alveolar ridge and functionally obtained neutral zone and to determine the effect of duration of edentulism on the location of neutral zone in relation to the crest of residual alveolar ridge. Materials and Methods: The study included three groups, Group I: 15 human subjects edentulous for 0 months to 2 years, Group 2: 15 human subjects edentulous for 2 years to 5 years and Group 3: 15 human subjects edentulous for more than 5 years. Neutral zone recording was performed for each human subjects and the bucco-lingual relationship of the crest of the mandibular alveolar ridge and position of neutral zone was examined. The results were analyzed by Kruskal-Wallis h-test and Chi-square independent test. Results: The results suggested that the location of neutral zone varies from individual to individual depending on their musculature and there is significant relation to the duration of edentulism. As the duration of edentulism increases, there is more lingual positioning of neutral zone at the molar region of both side of the arch. At premolar region, there is no change in position of neutral zone, it remains constant since resorption of the alveolar ridge is directly under the buttress. In anterior region, there is more labial positioning of neutral zone as duration of edentulism increases. Conclusion: This technique proved itself to be an easy and inexpensive way to determine the relationship between the crest of alveolar ridge and neutral zone. Incorporating this technique into the practice would be a great aid, which could be exploited by the clinicians for functional and psychological comfort of the patients.

Aim: To examine and compare cytomorphometric changes in the keratinocytes obtained from buccal mucosa of oral submucous fibrosis (OSF) cases in different clinical stages with healthy subjects and oral squamous cell carcinoma (OSCC) cases. Materials and Methods: Buccal mucosal smears of OSF cases [n = 30], OSCC cases [n = 30] and age-sex matched healthy controls [n = 30] were stained with Papanicolou stain and observed under light microscope (40x objective magnification) and 100 cells in each case were analysed cytomorphometrically using an image analyser. The average nuclear area (NA), cell area (CA), ratio of nuclear area/cell area, nuclear diameter (ND), cell diameter (CD) and ratio of nuclear diameter/cell diameter was obtained for each case. One-way ANOVA and Tukey-HSD procedure (P < 0.05) were used to analyze all the parametric variables. Results: The comparison of mean values of the NA, CA, NA:CA, ND, CD, ND:CD shows statistically significant difference among the healthy, OSF and OSCC groups [P < 0.05]. OSF group showed significant increase in nuclear dimensions and N/C ratio and significant decrease in cell dimensions compared to healthy group (P < 0.05). Among the parameters analysed ND:CD and NA:CA showed a highly statistically significant difference between the OSF and healthy group (P < 0.001). Conclusions: There are significant alterations in the cell and nuclear dimensions of the buccal mucosal cells in OSF patients. These alterations could be attributed to usage of various tobacco and areca nut preparations and due to the mucosal changes (atrophic epithelium, high epithelial turnover) in the OSF. Atrophic epithelium, in OSF is envisaged to predispose malignant transformation with persistent exposure oral carcinogens. As the mean values of CA, NA:CA in stage IV OSF are close to OSCC cases, it strengthens the view that advancement of fibrosis increases the risk of development of epithelial dysplasia.

Aim: To evaluate the bond strength of two splinting materials (orthodontic wire and ribbond) to the tooth structure using cyanoacrylate (CA) ester, self-adhering flowable composite (Vertise flow) and conventional flowable composite as adhesives. Materials and Methods: A total of 120 human central incisors free of any carious lesions were selected for the study. To obtain the specimens, 120 human central incisors were embedded in the blocks of rapid polymerizing self-cure acrylic resin with two teeth each. The specimens were divided into six groups with ten specimens each. Group I-Orthodontic wire bonded with CA, Group II-Orthodontic wire bonded with flowable composite Group III-Orthodontic wire bonded with Vertise flow, Group IV-Ribbond bonded with CA, Group V-Ribbond bonded with flowable composite and Group VI-Ribbond bonded with Vertise flow. The adhesive force in newtons to debond the splinting material was measured in tension using universal testing machine. The force at which the splint system failed was noted. The data obtained were statistically analyzed using one-way ANOVA and significant differences were subjected to Tukey's post-hoc test at a confidence interval of 0.05. Results: Bond strength with the orthodontic wire groups was significantly less compared with Ribbond groups p < 0.05. Among the adhesives, CA demonstrated lower bond strength value as compared to Vertise flow and flowable composite p < 0.05. Conclusion: Orthodontic wire groups demonstrated significantly lower bond strength compared to ribbond groups. Among the adhesives CAs showed significantly lower bond strength compared to Vertise flow and conventional flowable composite.

Aim: To determine the impact of a school-based oral hygiene instructions program on the gingival health of children in randomly selected middle schools in Riyadh, Saudi Arabia. Materials and Methods: Nine hundred and fourteen children were selected from nine schools that were randomly determined from Riyadh City public schools. After obtaining the parents' consent, the criteria-guided enrolment of study participants yielded 457 children in the control group and 457 students in the experimental group. The intervention design was 90 days experimental period with an intermediate follow-up visit at 45 days. A calibrated examiner (HW) measured the plaque index (PI) and the gingival index (GI). The indices were measured at day 1, day 45 and day 90 in both the control and the experimental groups. Results were analyzed with Wilcoxon sign rank test for each index, site, and by sessions for each group to determine if the scores had increased, decreased, or remained the same between intervals. Results: Plaque and gingival scores in the control group showed a steady improvement throughout the experimental period when compared with the baseline scores. Scores in the experimental group were significantly improved at each session between baseline and session 2 (45 days) and session 3 (90days) respectively. Conclusions: The continued reduction of GI and PI scores at the end of the intervention observed in this pilot study suggest that a school-based oral hygiene measures program can significantly improve oral health among school children in Saudi Arabia.

Proliferative verrucous leukoplakia (PVL) is a rare form of oral leukoplakia, which was first described in 1985 by Hansen et al. Since then, various published case series have presented PVL as a disease with aggressive biological behavior due to its high probability of recurrence and a high rate of malignant transformation, usually higher than 70%. PVL is a long-term progressive condition, and tends to become multifocal with a progressive deterioration of the lesions, making it more and more difficult to control. According to reported literature tobacco use does not seem to have a significant influence on the appearance or progression of PVL as these lesions may occur both in smokers and nonsmokers. At present, the etiology of PVL remains unclear as well as its management and diagnosis, which is still retrospective, late and poorly defined, lacking consensus criteria. Here we present a case of PVL and intend to discuss the key features related to etiology, diagnosis, management and prognosis of proliferative verrucous leukoplakia.

Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the major salivary glands, accounting for 15.5% of all cases, benign and malignant. The aim of this article is to report a case of MEC in a 73-years-old male patient who presented with a painless firm fluctuant swelling in left preauricular area. The lesion was thoroughly examined preoperatively, and investigations were carried out. Fine-needle aspiration cytology was done for the lesion and report suggested tumor of the parotid gland. Superficial parotidectomy procedure was done, taking care not to injure the lower division of the facial nerve. Post recovery was uneventful with no defect of facial nerve functions. The histologic picture confirmed that the tumor was MEC of parotid gland. Through the literature reviews of MEC the discussions on prevalence, origin, diagnosis, histological finding, investigation and the modes of treatment are made.