Dental Research and Oral Health is an open access peer-reviewed scientific journal dedicated to Dentists, Dental educators, Oral and dental policy-makers and Hard-tissue scientists for dissemination of new knowledge and information about the latest research inventions relevant to dentistry and to the oral cavity and associated structures in oral health and disease.
Diagnostic Dilemmas and Management Strategies in Conjoined Primary Teeth: A Case Series on Fusion and Gemination
Introduction: Conjoined primary teeth (fusion and gemination) are developmental anomalies that pose diagnostic ambiguity with direct implications for treatment planning. Their co-occurrence in the same primary dentition and the limitations of any single diagnostic modality have rarely been described in a single case series. Case Presentations: Three paediatric patients (aged 5 to 8 years) with conjoined primary anterior teeth were evaluated. A three-step diagnostic approach was applied including Intraoral periapical radiography, Mader's two-tooth rule, and developmental groove analysis. Case 1 (teeth 51, 52): non-vital fused teeth, treated with pulpectomy. Case 2 (teeth 72, 73): asymptomatic fusion with delayed exfoliation causing eruption obstruction, managed by extraction. Case 3 (teeth 71, 72): diagnostic dilemma between fusion and gemination with intact pulp, treated with glass ionomer cement restoration and scheduled for follow-up. Conclusion: No single diagnostic modality reliably differentiates fusion from gemination in all cases. A three-step validation protocol enhances diagnostic accuracy. Treatment should be guided by pulpal status and eruption dynamics rather than anomaly classification alone. Paediatric dentists must maintain clinical vigilance for conjoined teeth across all primary dentition presentations.
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Influence of Age on Anchorage Loss During Initial Orthodontic Alignment in Extraction Cases
Background: Anchorage control is a critical factor in orthodontic treatment, particularly in extraction cases where unwanted tooth movement can compromise treatment outcomes. Biological factors, including age, may influence the extent of anchorage loss during orthodontic tooth movement. Objective: To evaluate the influence of age on anchorage loss during the initial leveling and alignment phase in orthodontic patients undergoing extraction therapy. Materials and Methods: A cross-sectional analytical study was conducted on 20 orthodontic patients aged 13–30 years undergoing fixed appliance therapy with premolar extraction. Patients were divided into two age groups: ≤20 years and >20 years. Anchorage loss was assessed before treatment and after completion of initial leveling and alignment using both lateral cephalometric radiographs and study model analysis. Measurements were made using standardized reference points, and the differences between pre- and post-treatment values were calculated. Statistical analysis was performed to compare anchorage loss between the two age groups. Results: Anchorage loss was observed in all patients following initial alignment. The younger age group (≤20 years) demonstrated significantly greater anchorage loss compared to the older group (>20 years) in both cephalometric (2.66 ± 1.44 mm vs 1.65 ± 0.89 mm) and model analyses (1.77 ± 1.31 mm vs 1.06 ± 0.51 mm) (p ≤ 0.05). Conclusion: Age significantly influences anchorage loss during early orthodontic treatment, with younger patients showing greater susceptibility. Careful anchorage planning is essential, particularly in adolescent patients, to achieve optimal treatment outcomes.
Analysis state of Tensions and Strains in the structure of the active part material of a Dental Bur and its Failure
The paper aims to assess the wear and damage/failure of a dental bur, addressing the concept of its durability and reliability. A series of elements that underlie the occurrence of the wear and failure phenomenon are highlighted, considering the operating life of dental burs and the conditions imposed by the environment. The paper synthesizes the issues of degradation mechanisms and the effects they have on the active part of dental burs, on dental materials used in dental laboratories. Some theoretical aspects, state of tensions and strains, respectively, functional parameters in the work process were identified, and one of the ways of evaluating the wear and failure of the active part of a dental bur.
Differences in Sports Test Scores Depending on Occlusal Stability of Elite- Level Junior Badminton Players
The purpose of this study was to clarify the differences in sports test scores according to occlusal stability in elite-level junior badminton players. The participants were 10- to 17-year-old Japanese national badminton players (56 males and 54 females) who had been invited to the Nippon Badminton Association junior representative selection meeting. Based on the eruption status of the molars, they were divided into two groups: under 12 years old and over 14 years old, and further divided into two groups: stable and unstable occlusal groups based on their occlusal state. Sports tests (sit-ups, side-steps, double jumps, triple jump, fivestep jump, and sprint) were conducted, and these scores were compared by gender and occlusal stability using two-way ANOVA. No differences in sports test scores according to occlusal stability were observed in players aged 12 years and under. In players aged 14 years and over, the scores for side-steps, double jumps, and five-step jump were significantly higher in the occlusal stable group for both sexes (P<0.01, P<0.05). The results of this study revealed that the sports test scores of elite-level junior badminton players are influenced by occlusal stability. It was clarified that among athletes whose molars had fully erupted, those with good occlusal stability had higher scores in side steps, double jump, and five-step jump. This suggests that to utilize occlusion for trunk stabilization and cutting movements, it may be necessary to have a stable left–right balance of occlusion supported by the molars.
Paediatric Traumatic Brain Injury: The Evolving Role of Blood and Salivary Biomarkers
Traumatic brain injury is an important priority in intensive care, particularly in paediatrics. Many brain biomarkers, particularly serum glial fibrillary acidic protein, S100 calcium-binding protein B and ubiquitin C-terminal hydrolase L1, have been proposed to improve sensitivity and specificity of diagnosis and management. This is particularly important for identifying clinically significant mild traumatic brain injury in paediatric patients, as it could potentially reduce unnecessary hospitalisations and neuroimaging scans. This manuscript focuses on recent clinical guidelines and research on clinical chemistry tests for various biological fluids, particularly saliva. The text discusses biomarkers in adults and children, highlighting their application in blood and saliva, focused on studies published between January 2021 and June 2025. Firstly, we report on the characteristics of brain biomarkers and the relevance of serum biomarkers of mild traumatic brain injury in paediatric population, as well as the its epidemiology in paediatric and adult populations. Then, we focuses on six important areas: a) Diagnostic guidelines and the rationale for biomarkers: a) Neuroanatomical and functional vulnerabilities in paediatric traumatic brain injury; b) Molecular mechanisms of injury and inflammation in paediatric traumatic brain injury; c) Saliva as an emerging matrix for traumatic brain injury biomarkers; e) Analytical, biological and clinical challenges in biomarker use; f) Experimental biomarkers: exosomes and non coding RNAs. Research and their potential clinical applications is promising. However, many challenges remain in controlling for biological variability and potential pre- and analytical confounding factors in order to obtain reference values and cut-offs, particularly for salivary biomarkers, and to implement them in paediatric clinical practice.
Copyright (c) 2025 Dental Research and Oral Health
The Deleterious Systemic Effects of Common Oral Care Products: A Narrative Review
Introduction: Oral care products are essential for maintaining hygiene, but growing evidence suggests that certain ingredients in them may have systemic health effects. Methodology: We conducted a narrative review of studies published in PubMed and Google Scholar from 2000 to 2024 on the systemic effects of common ingredients in toothpaste and mouthwash, their mechanisms of action, and their potential risks to human health, emphasising the need for greater consumer awareness and regulation. Results: Key ingredients, including triclosan, fluoride, alcohol, SLS, parabens, artificial sweeteners, and titanium dioxide, have been linked with endocrine disruption, neurotoxicity, carcinogenicity, and other adverse outcomes. Conclusion: Widespread use of these products raises concern. There is an urgent need for regulatory oversight and increased public awareness regarding ingredient safety in oral care products.
Comparative Effects of Cigarette Smoke and E-Cigarette Vapor on Oral Squamous Cell Carcinoma: Unraveling Distinct Molecular Pathways
Oral squamous cell carcinoma (OSCC) poses a significant global health burden, driven by cigarette smoking and complicated by the rising popularity of e-cigarettes. This study compares the effects of cigarette smoke extract (CSE) and e-cigarette vapor extract (EVE) on OSCC progression using Ca9-22 gingival OSCC cells. CSE significantly increased cell invasion by upregulating the receptor for advanced glycation end-products (RAGE), nuclear factor kappa B (NF-κB), and matrix metalloproteinases (MMP-9, MMP-13), facilitating extracellular matrix degradation and metastasis. Conversely, the effects of EVE varied by flavor and nicotine content. Red Hot EVE (cinnamaldehyde-based) enhanced invasion and NF-κB levels with nicotine while reducing MMP-9 expression, suggesting alternative invasion pathways via MMP-13. Green Apple EVE had a less pronounced impact, indicating flavor-specific bioactivity. These findings reveal distinct mechanisms: CSE drives RAGE-NF-κB-MMP-mediated invasion, whereas EVE elicits variable, flavor-dependent responses, potentially involving nicotinic acetylcholine receptors. Targeted therapies, such as RAGE or NF-κB inhibitors, could mitigate tobacco-related OSCC progression. With e-cigarette use surging among youth, stricter regulations on flavored products and robust public health campaigns are urgently needed. Future research should investigate chronic exposures and diverse OSCC models to refine clinical and regulatory approaches, addressing the evolving landscape of tobacco-related oral cancers.
Effect of Thermocycling on Microhardness of Three CAD/CAM Provisional Materials
Purpose: This study aimed to evaluate and compare the surface Microhardness of three CAD/CAM provisional restorative materials before and after Thermocycling. Materials and Methods: In this in-vitro study, ten rectangular specimens (12 × 13 × 1.5 mm) were prepared from each of the following CAD/CAM provisional materials: Structur CAD (VOCO GmbH, Germany), Telio CAD (Ivoclar Vivadent, Liechtenstein), and Vita CAD Temp Monocolor (Vita Zahnfabrik, Germany). Surface Microhardness was measured using the Vickers test (20 g load for 10 seconds). All specimens underwent 5,000 thermal cycles between 5°C and 55°C to simulate six months of clinical service. Post-cycling Microhardness was measured, and results were statistically analyzed using Repeated Measures ANOVA. Results: Before Thermocycling, Telio CAD exhibited significantly higher Microhardness compared to Structur CAD and Vita CAD Temp (p < 0.05). After Thermocycling, differences among the three groups were not statistically significant (p > 0.05). Telio CAD and Structur CAD showed a significant decrease in surface Microhardness post-Thermocycling, while Vita CAD Temp did not show a statistically significant change. Conclusion: Thermocycling affected the surface Microhardness of CAD/ CAM provisional materials differently. While initial hardness varied among the materials, all showed comparable performance after simulated clinical aging. For temporary restorations lasting up to 6 months, none of the tested materials demonstrated a clinically superior advantage in terms of surface microhardness.
Predictors of Dental Care Services Before and After the onset of the Covid-19 Pandemic among undergraduates at a U.S. University
Objective: To analyze predictors of dental service use over 2 years among students aged 18-24 at a large public university. Methods: Participants were 349 first-year students from the 2019 cohort of the Mason Health Starts Here longitudinal study. We examined measures of enabling or impeding factors, such as health resources, family characteristics, psychological functioning, health behaviors, and self-rated health to predict receipt of dental services in 2019 and 2021. Results: Approximately 75% of students received dental exams in the year before entering college (pre-pandemic) and 74% reported dental exams two years later, after the onset of the COVID-19 pandemic. There was a trend for females to receive more dental services than males after the onset of the pandemic, not before. We found significant relationships between receiving dental exams and eye exams, physical exams, possessing health insurance, self-rated health, and anxiety. Receiving eye exams, health insurance, and self-rated health explained significant unique variance in receiving dental exams at time 1 (T1). T1 dental exams correlated significantly with completing dental exams two years later. Receiving dental exams, financial support from parents, and a sense of hope explained significant unique variance in self-rated health at T1. Conclusions: Health behaviors of completing multiple types of medical exams, resources such as health insurance, and psychological characteristics such as self-rated health and anxiety were related to completing dental exams. Increased access to health insurance and habitual use of medical services were found to help enable and motivate increased use of preventive dental services.
Clear Aligners vs. Fixed Appliances in the Management of Mild to Moderate Malocclusion: A Review of Treatment Efficacy, Stability, and Patient- Centered Outcomes
Aim: To evaluate and compare clear vs fixed orthodontic appliances in the management of mild to moderate malocclusions with respect to the treatment efficacy, stability and patient centred outcomes. Methods: Peer reviewed published articles between 2010 and 2025 were structurally searched across PubMed, Scopus and Google Scholar. The search strategy included cohort studies, clinical trials, systematic reviews and meta-analyses directly comparing fixed aligners and fixed appliances. Furthermore, utilising relevant keywords. Studies were assessed for quality, relevance, and outcome reporting on treatment effectiveness, duration, periodontal health, and patient experience. Results: Favourable outcomes were reported with clear aligners, which included shorter treatment time, improved periodontal health, and higher reported patient satisfaction in terms of comfort and aesthetics. However, fixed appliances were occasionally superior in achieving occlusal control, management of torque, and precision of tooth movement. Some studies found no significant difference between the two appliances across various parameters, highlighting variability based on type of malocclusion, complexity of treatment, and patient adherence. Conclusion: Clear aligners offer a promising alternative to traditional fixed appliances, especially for adults seeking discreet and comfortable treatment. While clear aligners are associated with improved oral hygiene and reduction in discomfort, fixed appliances may provide superior control in specific cases. The evidence remains moderate, and high-quality clinical trials are needed to further clarify comparative effectiveness and inform personalized orthodontic treatment planning.
An SEM-based study of dentinal defects caused by four advanced rotary file systems
Introduction: The research examined and compared dentinal microcracks after biomechanical preparation using Protaper Next, Hyflex EDM, Waveone Gold, and Jizai rotary file systems in middle, apical, and coronal root canal levels. Material and Methods: 100 human-extracted permanent mandibular premolars have been divided into one control group and four experimental groups of 20 teeth each. The roots have been sectioned at 3, 6,9 millimeters from apex and studied under scanning electron microscope. A Fisher's Exact Test and Chi-Square have been utilised to record and analyse dentinal defects. Results: No microcracks were found in control group. All studied groups exhibited comparable distribution of dentinal microcracks in coronal, middle and apical section. Dental defects in middle third were more common in ProTaper Next than in the control group. Conclusions: In the study, all tested rotary systems resulted in some degree of dentinal microcracks. The middle third of the root canal was the most affected region, showing a statistically significant increase in defect formation.
Prevalence of Malocclusions and Oral habits in a preschool Albanian children population: A cross-sectional study
Aim: Malocclusions represent a significant concern in pediatric dentistry, affecting craniofacial growth, masticatory function, and overall wellbeing. Understanding their prevalence and associated risk factors is crucial for implementing effective public health interventions. This study aimed to assess the prevalence of malocclusions and oral habits among preschool children in Albania and examine their interrelationship. Materials and Methods: A cross-sectional study was conducted on a sample of 1213 preschool children aged 3 to 6 years from eight districts in Albania. Clinical orthodontic examinations and parental questionnaires were employed to assess malocclusion types and oral habits. Data were analyzed using SPSS version 27.0, and statistical significance was determined using Chi-square tests. Results: Malocclusions were observed in 52% of the studied population, with vertical anomalies, particularly increased overbite being the most prevalent. Non-nutritive sucking habits. especially pacifier use (47.8%), were commonly reported. While no significant gender differences in malocclusion prevalence were noted, variations across different age groups were evident. A significant correlation was established between oral breathing and anterior open bite. Conclusions: The findings highlight the necessity of early orthodontic evaluation and targeted public health strategies to mitigate malocclusion development. Preventive measures addressing deleterious oral habits should be integrated into pediatric dental care to support optimal craniofacial development.
Infection Control Knowledge and Practices among Dentists in the Outpatient Department of a Dental College Hospital
Background: Dental surgeons are vulnerable to infection caused by various microorganisms. The outpatient department is the most important place, as here come many infected patients, so there is a chance that the infection will spread very easily. Taking precautions to control infection in this department plays an important role to prevent spreading infections. Methods: A cross-sectional study was conducted from January to December 2020 to evaluate the infection prevention and control in Dhaka Dental College and Hospital. A convenient sampling technique was used, and data was collected from 209 dental surgeons. The sample was calculated using the Cochran formula for sample for calculation in a smaller population. All the questions of knowledge had been modified and developed from the Infection Prevention and Control National Guideline and the Centre for Disease Control and Prevention Guideline in Dental Settings. All the questions regarding practice had been modified and developed from the World Health Organization Infection Control Guideline and 5 pillars of infection control practice. Results: Most respondents (52.2%) were in the 20–24-year age group, with an average age of 24.77 years (±1.250). Among the respondents, 51.4% of female dental surgeons had good knowledge in comparison to males, which was 48%. Among male respondents, only 51.0% had fair knowledge in comparison to female respondents, which was 48.6%. An association between the level of education and level of knowledge was statistically significant (X2 =10.168, p=0.006). Among the respondents 25.7% of post graduate had good knowledge. On the other hand, 54.6% graduate had good knowledge. Among 209 respondents, only 48.3% respondents were good ≥80% in infection control practices and significantly associate between knowledge level and practices level, p<0.05. Participants with good knowledge of infection control also demonstrated good practice scores. However, only 16.2% respondents scoring fair according to knowledge level but according to practice level each of them was poor about infection control practice. Among respondents practices score was significantly higher in female and in graduate than male and post-graduate. Conclusion: Study findings indicate that awareness and practice of current infection management among dental surgeons in this hospital was good and most likely right. Simple specific prevention measures can minimize the occurrence and prevalence of any infections.
Complete Rehabilitation of a Patient with Multiple Post Core as Foundation Restorations for Mutilated Dentition – A Case Report
Tooth wear can occur through erosion, abfraction, abrasion, or attrition. Excessive wear off the teeth can cause esthetic deformity, occlusal disharmony, pulpal damage, and impaired function. Anterior guidance is lost when anterior teeth are severely lost. Such severe tooth wear and abnormalities frequently affect a patient's speech, mastication, and appearance, which in turn affects the patient’s lifestyle. Rehabilitation of the compromised dentition is therefore required. Full mouth rehabilitation enhances a patient's health and function by integrating the science of restorative dentistry with aesthetics. This clinical case report discussedthe simplified systematic full mouth rehabilitation approach and management of an attrited dentition which helped the patient to adapt well to new restoration.
Intervention Effect of Occlusion on the Straight Jump in Trampoline Gymnastics: Effect on T-score and H-score
The purpose of the present study was to clarify the effect of an occlusal intervention involving a mouthguard on the T-score and H-score of straight jumps in trampoline competitions. The participants were 15 male trampoline gymnasts (17.6±2.5 years). Custom-made mouthguards were fabricated using a 2.0-mm-thick ethylene-vinyl acetate thermoplastic elastomer, and that were fitted to the participating trampoline gymnasts and adjusted so that all teeth made equal contact when the mouth was lightly closed. The gymnasts were instructed to wear the mouthguards about half the time during their six practice sessions per week. The trial comprised 10 consecutive straight jumps. Flight time (T-score) and landing position (H-score) were recorded using the HDTS all-in-one measurement system. Measurements were taken at three time points: before the mouthguard intervention, immediately after intervention, and 2 months after the intervention. Comparisons of T-score or H-score by measurement time point were analyzed using one-way analysis of variance with repeated measures or Friedman test, respectively. The T-score was observed between the before intervention and 2-month time points (P<0.01). The H-scores increased with the mouthguard intervention, with significant differences observed of the before intervention time point with the immediately after intervention (P<0.05) and 2-month (P<0.01) time points. The results of the present study suggest that an occlusal intervention involving a mouthguard affects flight time and landing position in straight jumps in trampoline competitions. The effects on the H-score were evident immediately after intervention, and the T-score was improved 2 months after the intervention.
Comparision of Biomechanical Effects of Infrazygomatic Crest Bone Screws and Modified C-Palatal Plate Appliance for Total Maxillary Arch Distalization in Treatment of Class II Malocclusion: A Finite Element Study
Class II malocclusions may be corrected by combinations of restriction or redirection of maxillary growth, distal movement of maxillary dentition, Experimental studies have shown that forces for Class II correction produced by extraoral traction and intermaxillary elastics cause posterior repositioning of the maxillary dental complex, as well as of the maxilla itself [1]. Besides exploiting the periodontal anchorage potential (teeth), additional anchorage aids are often needed to achieve maximal anchorage. The aids conventionally used for intraoral anchorage to enhance periodontal anchorage quality are trans palatal and lingual bars, Nance holding arch and intermaxillary elastics [2]. The anchorage in edgewise treatment is the most important factor that affects the treatment plan and result. Until now, various techniques to reinforce anchorage have been devised and used in orthodontic practice. Recently, several kinds of implant anchors providing absolute anchorage have attracted the attention of orthodontists. Among them, titanium screws, which were originally used for intermaxillary or bone ?xation, have the following advantages: minimal anatomic limitation for placement, lower medical cost, simpler placement surgery, and less discomfort after implantation when compared with dental implants for abutment. Therefore, titanium screws of various sizes have gradually come to be used for orthodontic absolute anchorage. However, there have been few human studies in which the success rates for various kinds of implant anchors were examined [3]. Anchorage is a critical component of en-masse retraction. Clinicians pay considerable attention to Newton’s third law- the law of action and reaction. They know that every action they take will have an equal and opposite reaction. Many approaches to treatment mechanics have been developed to ef?ciently retract anterior teeth [4]. In tooth-borne anchorage cases, complicated mechanics or supplementary appliances are needed to control anchorage. Extraoral appliances can provide stable anchorage but depend totally on patient cooperation. Lack of cooperation can result in anchorage loss and unsatisfactory treatment results; these have led to greater use of intraosseous anchorage [5]. It has become more practical to use implants for anchorage in orthodontic patients, Orthodontic screws expand the horizons of orthodontic treatment because they allow treatment to proceed successfully with virtually no anchorage loss and minimal patient cooperation. However, they are typically used as auxiliaries to the posterior anchor teeth during en-masse retraction with sliding mechanics. The mechanics of force application can be simple or complicated, according to the anchorage control. For anterior retraction, if the mini-implants are designed to accommodate arch wires, the number of teeth requiring bands or brackets can be reduced, moderating the risk of damage to the periodontium or enamel surfaces. Distalization of the maxillary dentition has been recognized as an important treatment approach for the correction of Class II malocclusions and it has been traditionally performed using headgear. However, known disadvantages of headgear appliances include poor aesthetics and dependence on patient compliance. In an attempt to overcome the limitations of headgear, several noncompliance devices such as distal jet and pendulum appliances were introduced. However, they often resulted in undesirable side effects such as extrusion and protrusion of the maxillary anterior teeth and extrusion, distal tipping, and distal rotation of the maxillary first molars [6]. The advent of temporary anchorage devices (TADs) has allowed better control over unwanted reciprocal movement of the anchor units, although miniscrew insertion in the interradicular region is associated with serious limitations, including a short range of action, coupled with the risk of root injury. Miniplates have been advocated as an alternative to avoid contact with adjacent roots in the area of insertion; however, their placement and removal require more invasive surgical procedures.6Orthodontics in its century of existence have had a lot of landmarks in its evolution, but very few can match the clinical impact made by micro-implants and the recently introduced infra-zygomatic crest (IZC) and buccal shelf (BS) orthodontic bone screws. Orthodontics in its century of existence have had a lot of landmarks in its evolution, but very few can match the clinical impact made by micro-implants and the recently introduced infra-zygomatic crest (IZC) and buccal shelf (BS) orthodontic bone screws. Many studies have been reported on the application and clinical ef?ciency of total arch distalization mechanics; however, studies about biomechanical effects such as stress and displacements on the teeth and the surrounding tissues are limited. finite element analysis (FEA), a common method in engineering, became a valuable option for evaluation of biomechanical factors in orthodontics [7,8]. The purpose of this study was to (1) Evaluate three-dimensional stress distribution and initial displacement of maxillary dentition under total arch distalization mechanics for correction of Angle’s Class II malocclusion using IZC bone screws and C-Palatal plate appliance in Pre-adjusted Edgewise Appliance (PEA) setup and finite element models and to (2) To compare biomechanical effects of the IZC bone screws and MCPP for total maxillary arch distalization.
Feeding practices and Jaw Development: A Comprehensive Literature Review of Their Interconnected Dynamics
Objective: Nutritive sucking plays a crucial role in infant growth and craniofacial development. This review examines the impact of breastfeeding, bottle-feeding, and non-nutritive sucking on jaw development and the risk of malocclusion, with a focus on early feeding practices, weaning and food consistency. Methods: A comprehensive search was conducted across several databases, including PubMed/Medline, Scopus and Web of Knowledge. Studies involving human subjects published in English were selected. The review included observational studies, cross-sectional studies and clinical trials. Keywords used in the search included "nutritive sucking," "jaw development" and "malocclusion." Results: The findings showed that breastfeeding promotes optimal jaw development and reduces malocclusion risks by engaging oral muscles. Bottle-feeding, including a more passive sucking action, does not provide the same benefits and is associated with misalignments like crossbite and open bite. Non-nutritive sucking habits, such as pacifier use and thumbsucking, further contribute to malocclusion. The consistency of foods during weaning also plays a role, with harder foods encouraging jaw muscle development, while soft foods may hinder proper growth. Conclusions: Breastfeeding supports healthy craniofacial development and lowers the risk of malocclusions. Bottle-feeding and non-nutritive sucking behaviours are linked to jaw misalignments. Early feeding practices, weaning and food texture are critical factors in jaw health and should be considered in craniofacial development strategies.
Feasibility of Transnasal dental Implant Placement Determined by PLACATE Guidelines
Introduction: Transnasal dental implant treatment is a relatively new manner of addressing severely atrophic maxillae. These implants involve anatomic features which are not common to traditional implant dentistry such as inferior conchae, prelacrimal bone, and nasolacrimal ducts. To date, there is no systematic manner for presurgical anatomic evaluation of transnasal dental implant feasibility. This paper remedies this deficiency with the PLACATE guidelines. Methods: A sequential review of 300 CBCT scans of patients referred for advanced full arch implant treatment was performed to determine feasibility for transnasal dental implant placement according to PLACATE guidelines. The following parameters were measured: 1) Simmen classification; 2) Prelacrimal bone width; 3) Subnasal bone height; 4) Distance from subnasal bone to prelacrimal bone engagement point. Additionally, the following anatomic data pertinent to transnasal dental implants was collected: 1) Diameter of nasolacrimal canals; 2) Distance from nasal aperture to nasolacrimal canal; 3) Angle of nasolacrimal canal relative to maxilla; 4) Patency of nasolacrimal canals. Results: A total of 300 CBCT scans were evaluated for 117 men and 183 women with an average age of 62.1 years (range 31-87). Using PLACATE Guidelines, 30.54% of scans were found to be appropriate for transnasal dental implant treatment. The most common reason for patient disqualification from transnasal dental implant treatment was insufficient prelacrimal bone width. Conclusion: Using PLACATE guidelines as a systematic method for evaluating full arch patients for transnasal dental implant feasibility, patient safety may be improved by treating only those patients who anatomically qualify.
To evaluate the antibacterial efficacy of triclosan coated resorbable suture, chlorhexidine coated resorbable suture and non-coated resorbable sutures in alveoloplasty
Background and objectives: Sutures at the surgical site can act as a reservoir for microbes, leading to surgical site infection. This mainly occurs in braided sutures due to wicking action. The study was designed to assess the antibacterial efficacy of resorbable triclosan-coated suture and chlorhexidine-coated suture along with its effect on healing after alveoloplasty procedure in comparison to non-coated sutures. Patients and methods: 45 patients who went for alveoloplasty procedures have been selected by considering inclusion and exclusion criteria. 3 different wound closing suture material are used each in 15 of them and divided into 3 groups (triclosan coated suture, chlorhexidine coated suture, non-coated suture). Wound healing is evaluated by Early wound healing score index and post-operative pain by Mccaffery and Beebe et al scale at interval of 8th, 15th and 30th day post-operatively. Result: There has been no statistical difference found in wound healing evaluation and post-operative pain assessment between all 3 groups at 8th, 15th and 30th day post- operative. Aerobic bacteria count at the end of 8th day post-operative was found greater in non-coated suture group then in Triclosan coated suture group and least in Chlorhexidine coated suture group with mean score of 731.60, 436.00 and 171.33 respectively and Anaerobic bacteria counts at the end of 8th day post-operative was also found greater in non-coated suture group then in Triclosan coated suture group and least in Chlorhexidine coated suture group with mean score of 563.53, 353.40 and 53.87 respectively. Conclusion: Triclosan and chlorhexidine are known antibacterial agents. Local drug delivery in the form of coated sutures can be an effective method to inhibit biofilm formation and decrease the bacterial load at the surgical site as shown in our study, it can be concluded that chlorhexidine coated vicryl suture will be a greater choice of wound closing material.
Crohn’s Disease and Periodontal Manifestations: A Review of Current Evidence
Objective: Crohn's disease (CD) is a chronic inflammatory bowel condition of unknown cause, with rising prevalence. Oral manifestations, ranging from 0.5% to 80% of cases, are frequently associated with the disease. This review examines the association between CD and periodontal disease, underlying mechanisms, and therapeutic strategies to improve oral and systemic health. Methods: A review was conducted using the keywords ((Crohn’s disease OR inflammatory bowel disease) AND periodontal) across multiple databases. Relevant studies were analyzed to investigate the relationship between CD and periodontal health and identify effective treatments. Results: Evidence suggests a bidirectional relationship between CD and periodontal disease. CD patients exhibit microbial dysbiosis, with significant similarities between oral and intestinal microbiomes. Elevated levels of cytokines like TNF-α, IL-1β, and IL-10 in oral fluids are correlated with poor periodontal outcomes (e.g., pocket depth, attachment loss) and increased CD severity. CD patients are about three times more likely to develop periodontal disease [OR = 3.64 (95% CI: 2.33–5.67)] and nearly eight times more prone to early implant failure [OR = 7.95 (95% CI: 3.47– 18.24)]. These findings emphasize the need for further large-scale studies to elucidate these interactions and refine management. Conclusions: Effective CD management requires a multidisciplinary approach, combining pharmacotherapy, nutrition, psychological support, and regular monitoring. Anti-TNF agents are effective but need careful supervision. Dentists play a critical role in identifying oral manifestations as early indicators of CD. Collaborative care between medical and dental professionals is vital for early diagnosis, timely intervention, and improved patient outcomes.
Innovative Oral Rehabilitation with the Double Crown Marburg Denture System: A Case of Severe Maxillary Wear and Partial Mandibular Edentulism
This case report presents the comprehensive oral rehabilitation of a patient with severely worn maxillary dentition and a partially edentulous mandible using the double crown marburg denture system. The patient exhibited significant maxillary tooth attrition and mandibular tooth loss due to caries and periodontal disease. A detailed clinical evaluation guided a treatment plan focused on restoring function, aesthetics, and comfort. The Double Crown Marburg Denture System was selected for its superior stability and ability to preserve remaining teeth. Initial treatment involved periodontal management and oral hygiene optimization. Abutment teeth were prepared for primary crowns, designed with a telescopic fit for optimal retention. Secondary crowns, incorporated into a removable prosthesis, engaged seamlessly with the primary crowns to enhance stability. Multiple trial fittings ensured precise occlusion and comfort. Post-prosthetic care included occlusal adjustments and patient education. This approach resulted in excellent prosthesis retention, improved function, and enhanced patient satisfaction.
Esthetic Rehabilitation of Early Childhood Caries: A Case report
Aesthetic dentistry plays a significant role not only in adults but also in pediatric patients. However, a pediatric dentist is faced with the dual problem of satisfying the aesthetic expectations of the patient and parents as well as managing the pediatric patient. In the present era, there are numerous restorative techniques that can be applied to different clinical scenarios. However, we have to choose the technique that best suits our patient, not only biologically but also aesthetically, psychologically, functionally, and financially. Following paper presents the clinical sequence of rehabilitation of severely carious maxillary anterior teeth from left to right lateral incisors in a child with early childhood caries. Severely carious anterior teeth were endodontically treated. Incisors were restored with glass fiber posts which is mainly used for pediatric patients in endodontically treated teeth followed by strip crown with composite restoration placement.
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Evaluation of Salivary CA 125 Antigen in Patients with Oral Cancer, Oral Potentially Malignant Disorders and in Comparison, with Healthy Controls - A cross sectional study
Background: Oral squamous cell carcinomas (OSCC) account for more than 90% of all oral malignancies. The primary risk factors of significant concern are smoking and drinking alcohol, and their combined impact is greater than their individual effects. Oral potentially malignant disorders (OPMD) establishes clinical presentations that carry an increased risk to develop into OSCC. Achieving early detection of these conditions requires thorough examinations, where biopsy serves as the primary diagnostic tool for oral cancer. Recently, numerous studies have focused on early diagnosis and prognostic assessment of the disease through the analysis of serum and salivary biomarkers. Cancer Antigen 125 (CA 125) is one such biomarker, also known as Mucin 16, is a human protein encoded by the MUC16 gene. It is part of the mucosal glycoproteins family typically present on the cell surface of normal cells. CA 125 is secreted from cancer cell surfaces and can be detected in saliva or blood, serving as a significant cancer marker that may be increased in individuals with epithelial neoplasms like ovarian, breast, and oral carcinoma. Aim & Objectives • To estimate the salivary levels of CA 125 antigen in Individuals with OPMDs, OSCC and in healthy controls. • To compare the estimated levels of CA125 antigen in Individuals with OPMDs, OSCC with healthy controls. • To compare the estimated levels of CA125 antigen with histopathological stage of differentiation of OSCC. Materials and methods: Totally, 45 cases separated into three categories, Group 1 – OSCC, Group 2 - OPMDs and Group 3 – Healthy controls which included 15 participants in each group. Saliva was collected from the subjects using the simple drooling method to obtain whole saliva. The saliva samples were centrifuged at 3000 rpm for 10 minutes. The concentration of CA 125 antigen was determined by using Quantitative sandwich ELISA (Enzyme linked immunosorbent assay) technique. Results: Our study had highest salivary CA 125 antigen levels in OSCC group (7684.40U/L) and followed by OPMD group (4949.53 U/L) and lowest in healthy control group (3009.2U/L). The intergroup comparison of the concentration values was found to be statistically significant between the groups with the p value <0.001. In the present study in Oral cancer patients, the mean concentration was more in moderately differentiated OSCC and statistically significant differences between the type of differentiations against the concentration (p<0.001) were seen. Summary and Conclusion: Our study shows that there is significant increase in salivary CA-125 antigen levels in OSCC and OPMD group compared to healthy controls. The salivary levels of CA-125 antigen also shows significant increase among type of differentiation of OSCC particularly in moderately differentiated OSCC and OPMDs. Thus, it can be inferred that salivary CA-125 antigen can be a potential diagnostic biomarker for Oral cancer and OPMD and comparing with healthy individuals. Further studies with larger cohorts are necessary to establish the clinical effectiveness of salivary CA 125 antigen in OSCC detection and malignant potential risk of OPMDs.
Ozone Therapy – A Dynamic Treatment Modality in Emerging Periodontics and Peri implantitis
Oral cavity comprised of a variety of microbial population which colonizes to form the dental biofilm, which serves as an etiological factor for the periodontal diseases. It is one of the most prevalent diseases in the population with clinically manifestations periodontal pocket formation, clinical attachment loss, alveolar bone resorption and end result with loss of tooth. Disruption of the oral biofilm is essential for the prevention and management of periodontal disease progression which can be achieved with different treatment modalities. Early prevention can be achieved with Scaling and root planing. Supragingival and subgingival scaling can be effectively reduce the bacterial load. Other treatment options include curettage for removing the pocket lining, incision and drainage in cases of periodontal abscess, Local drug delivery for systemic effect of drug in subgingival areas, Gingivectomy, frenectomy, crown lengthening, flap surgery. Advanced treatment measures for the management of periodontal diseases were gaining popularity. Ozone therapy emerges as a new approach for the treatment of periodontal disease. Ozone is a natural gas with potent oxidative action discovered in 1930s. It has many positive effects in both medicine and dental field such as antioxidative, anti-inflammatory, immunomodulating, anti-hypoxic, biosynthetic, and antimicrobial agent. Ozone therapy also effectively enhances the wound healing ability and improves the circulation. Varies modes of applications are available like aqueous, gaseous, and oil. This review article comprises with the features of ozone therapy, its property and treatment options in periodontal disease, which gives as an insight in to the world of ozone therapy.
Comparative Evaluation of the Marginal and internal adaptation of Metal Copings Fabricated using Conventional Casting, Computer aided Design/ Computer aided Milling and direct Metal Laser Sintering techniques: An invitro study
Aim: To comparatively evaluate the vertical marginal gap and internal fit of metal copings obtained from the four techniques and to determine the technique that will provide the best marginal accuracy and internal fit for better clinical results. Material and Method: Forty metal copings will be fabricated using the custom-made metal master die and divided into four groups of ten samples each according to the different fabrication techniques used. The copings from each group will be luted on the metal die using a light viscosity silicone material. Then heavy viscosity silicone material will then be injected on the internal surface and external surface of the light viscosity silicone and sectioned bucco-lingually and observed under a stereomicroscope. Post Hoc Tukey HSD and One-way ANOVA were applied to analysis data. Results: The mean MG was highest for Group I followed by Group III, Group II and Group IV. The mean internal gap at MAW was highest for Group I followed by Group II, I and III. At AOLA the mean gap was highest for Group III followed by Group I, II and IV. While for the MIS the mean gap was greatest for Group III followed by Group II, IV and I. Conclusion: Within the limitations of the study, it was concluded that Copings made by using stainless steel ring with DMLS technique had the least marginal gap then other techniques.
Periodontal health Status among adults affected with pre-cancerous conditions and lesions in Hyderabad city: A case-control study
Aim: To evaluate the periodontal-status of patients with Pre-Cancerous Condition and Pre-Cancerous lesions and compare it to that of healthy control and to compare and correlate the periodontal status of patients with Pre-cancerous condition & Pre-cancerous lesions& healthy adult patients based on age, gender & deleterious habits. Methods: A case-control study was conducted to assess Periodontal-health Status among adults affected with Precancerous conditions & lesions in Hyderabad-city. Study participants were Adults aged 35 years and above with pre-cancerous conditions & lesions. The control group was also matches with the age & gender with case-group.The Periodontal-status was assessed by Bleeding on Probing (BOP), periodontal pockets, Loss of Attachment (LOA) using World Health Organization (WHO)-Oral Health Assessment-form for adults-2013. Results: A total of 200 adults participated in the study, comprising of 57%males and 44%females among them 100-participants are diagnosed with pre-cancerous lesion and pre-cancerous condition( leukoplakia (35%), erythroplakia (17%), Oral sub mucous fibrosis (24%) and oral lichenplanus (24%) and 100-participants are controls with matched age and gender. High mean scores of gingival bleeding, periodontal pocket & loss of attachment was in cases compared to controls (30.1±6.7, 3.9±1.9&2.5±1.5) and there was statistical significant difference of gingival bleeding and periodontal pocket among cases and controls (p-value =0.000&0.004). There is positive correlation between age, gender, deleterious habits, precancerous-lesion, precancerous-condition and periodontal-status among them statistically significance difference was between age and periodontal pocket (p-value =0.026) and presence of lesion to gingival bleeding (p-value=0.046). Conclusion: This study concludes that overall periodontal status was worse (poor) in precancerous lesions (leukoplakia, erythroplakia) and precancerous condition (oral submucous fibrosis, oral lichenplanus) than control group and tobacco and alcohol consumption was significant risk factor for development of precancerous lesion and condition.
Influence of Hip Joint Range of Motion on Postural Stability in Trampoline Gymnasts
The aim of this study was to examine the effect of hip joint range of motion on dynamic stability, including the effect of occlusion. Participants were 13 male trampoline gymnasts. Spinal curvature was measured for each participant in the standing upright position, standing forward flexed, and standing extended positions using a spinal column shape analyzer, and the software calculated hip joint range of motion. Dynamic stability was evaluated by performing a cross-test with a center-of-gravity sway meter. The rectangular area obtained from the product of the longitudinal and transverse moving distances of the center of foot pressure in the center-of-gravity movement trajectory diagram was used as an index of dynamic stability. Measurements were performed under three conditions: mandibular rest position (RP), occlusion in intercuspal position (OP), and occlusion when wearing a mouthguard (MG). The hip joint range of motion or rectangular area under different occlusal conditions was compared using repeated measures ANOVA. Under each occlusal condition, Pearson’s product–moment correlation coefficient was used to analyze the correlation between two variables. The hip joint range of motion and rectangular area were lowest in the OP, with significant differences observed between OP and RP and between OP and MG (P<0.05). A positive correlation was found between the two under all conditions (P<0.05). This study suggested that greater hip joint range of motion was associated with greater dynamic stability. Furthermore, it suggests that hip joint range of motion may be influenced by the balance of occlusal contacts.
Effect of Habitual intakes on Hardness and Color of Resin Composites
Background: Both surface hardness and color stability are among the most important physical factors that govern the success of different composite restoratives. Aim: This in vitro study aimed to evaluate both surface hardness and color change in different resin composites following their immersion in different media of some habitual intakes. Methods: One hundred disc specimens were constructed in 2 groups out of methacrylate (Tetric N-Ceram Bulk Fill, Ivoclar Vivadent) and siloranebased (Filtek P90, 3M ESPE) composites (n=50 each). Specimens of each group were subjected to an interrupted immersion in 5 different media (subgroups 1-5, n = 10), water (control), natural saliva, alcohol, lime juice and khat extract for 4 weeks. Vickers hardness of all specimens was assessed on a micro-hardness tester under a load of 50g for 10s. The color parameters (L*, a* and b*) of each specimen were measured before and after immersion. The difference in specimens’ color (ΔE) was calculated according to CIE formula. The collected data for all subgroups were statistically analyzed using 1-Way ANOVA and Tukeys' comparisons at α = 0.05 to stand on the significance of differences detected between the tested variables. Results: No difference in hardness value was recorded between composite groups (P > 0.05). In comparison to the control subgroup, no significant differences were noticed in the hardness values of composites in subgroups 2-4 (P > 0.05). A significant reduction in hardness values were recorded for composite specimens stored in khat extract (P < 0.05). All composite specimens showed different degrees of color change with no significant differences between groups (P > 0.05). Specimens in subgroups 1-4 had similar visually perceptible color change (1< ΔE <3.3), while those in Subgroup 5 showed higher clinically unacceptable color change (ΔE >3.3) in comparison to other subgroups (P < 0.05). Conclusion: Silorane-based resin composite present comparable behavior to that of Bulk-fill methacrylate-based composite in different media. All the tested intakes have no adversity on composites’ hardness and color, however Khat extract seems harmful to composites’ surfaces.
Effects of Topoisomerase II alpha Inhibition on Oral Cancer Cell Metabolism and Cancer Stem Cell Function
Background: Topoisomerase IIα (TOP2A), is an enzyme involved in DNA replication, transcription, recombination, and chromatin remodeling and is found in a variety of cancers. However, the role of TOP2A regulation in oral cancer progression is not fully explained. We investigated the effect of TOP2A inhibition on cell survival, metabolism, and cancer stem cell self-renewal function in oral cancer cells. Methods: Oral carcinoma cell line SCC25 was cultured in complete DMEM/F12 media and treated with 5μM of Etoposide (Topoisomerase II inhibitor) for 48h. The critical parameters of cellular metabolism, including extracellular acidification rate (ECAR) and mitochondrial oxidative phosphorylation based on the oxygen consumption rate of cancer cells were assessed using Seahorse assay. Western blotting was performed to assess the proteins that are associated with proliferation (Survivin, IL-6) and cancer stem cell function (Oct4, Sox2) in cell lysates prepared from control and etoposide treated groups. Statistical analysis was performed using One-way ANOVA with Dunnett's multiple comparisons test. Results: The protein expression of TOP2A was significantly (P<0.05) inhibited by etoposide. Additionally, TOP2A inhibition decreased the mitochondrial respiratory parameters including basal respiration, maximal respiration and ATP production. However, TOP2A inhibition has no impact on glycolytic function. Moreover, the proliferative marker survivin and IL-6 showed a significant (P<0.05) decrease after TOP2A inhibition. Conversely, the protein expression of cancer stem cell markers Oct-4 and Sox 2 were not altered. Conclusion: These results indicate that inhibition of TOP2A is more efficacious by decreasing the mitochondrial metabolic reprogramming and thereby downregulating the key anti-apoptotic and pro-survival mediators. Thus, TOP2A represents an ideal therapeutic target and offers a potential treatment strategy for OSCC.
Long term complications and Adverse effects associated with O2Vent Optima Oral Appliance and ExVent accessory in Obstructive Sleep Apnea Patients
Introduction: The ExVent is an accessory to the O2Vent Optima mandibular advancement device (MAD) and provides oral Expiratory Positive Airway Pressure (EPAP). Oral EPAP with the ExVent is designed to augment the OSA therapy provided by the O2Vent Optima. Long term complications and adverse effects associated with this combination therapy are not known, but require further study. Methods: A retrospective survey was conducted of all patients who received O2Vent Optima MAD and ExVent in Canada and Australia since 2018. Data collected following consent included: demographics, duration of use, frequency of use, complications and adverse events. Results: Out of the 480 subjects, 168 (35%) could be contacted and agreed to participate. 31 (18%) had stopped using the appliance. Out of 137 (81%) subjects, 118 (86%) were still using the ExVent Accessory, 92% medium strength (Yellow). 56% used morning aligner and 74% performed regular jaw exercises. After 4 weeks of the device use, excessive salivation was (12%, p<0.05), tooth and jaw pain were reported occasionally (8%, p<0.05), tooth movement was none (0%, p<0.05). Gum or tongue bruises (0%, p<0.05). TMJ pain/stiffness (5%, p<0.05). Change in bite or occlusion leading to discontinuation (0%, p<0.05), temporary chewing difficulties (24%, p<0.05) and dry mouth (0%, p<0.05). Difficulty to insert or remove ExVent valve (0%, p<0.05), difficulty breathing (0%, p<0.05), Malfunctioning or dislodgement of ExVent valve (0%, p<0.05). Participants reportedly valued their device (94%) and benefited with ExVent (100%). Conclusion: Majority of the patients prescribed O2Vent Optima and ExVent accessory were compliant, demonstrated no significant complications and only minor adverse effects with the combination therapy.