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ABSTRACT Objective: To evaluate the antibacterial effect and the solubility of experimental root canal filling pastes containing the phytoconstituents terpineol and cinnamaldehyde. Material and Methods: Minimum Inhibitory Concentration (MIC) of each phytoconstituent was determined against Enterococcus faecalis. Five groups of antibiotic pastes based on zinc oxide were obtained by mixing: only terpineol, only cinnamaldehyde, terpineol and cinnamaldehyde combined, chlorhexidine (antibiotic control), and CTZ paste (control paste). Antibacterial activity was analyzed through direct contact test within 24 and 72 hours. Solubility was evaluated by spectrophotometry within 48 and 144 hours. Antibacterial activity data were analyzed descriptively, and solubility data was analyzed using ANOVA and Tukey tests (p<0.05). Results: The MIC obtained for terpineol and cinnamaldehyde were, respectively, 2000 µg/mL and 500 µg/mL. After 24h, only the terpineol paste did not inhibit E. faecalis growth. After 72h, all groups inhibited E. faecalis growth. After 48h, the highest solubility was verified in the terpineol paste (p<0.05), and no differences were detected among other groups (p>0.05). After and 144h, highest solubility was observed in the terpineol paste (p<0.05), followed by the CTZ paste (p<0.05). No differences were detected for cinnamaldehyde, terpineol+cinnamaldehyde and chlorhexidine pastes (p>0.05). Conclusion: Pastes containing cinnamaldehyde or terpineol+cinnamaldehyde showed antibacterial activity against E. faecalis similar to CTZ paste, with lower solubility.

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ABSTRACT Objective: To evaluate the postoperative pain and clinical and radiographic success of pulpotomized primary molars using two materials, Ferric Sulfate (FS) and Calcium-Enriched Mixture (CEM) cement, over a period of 3 and 6 months. Material and Methods: This randomized clinical trial was conducted on a total of 38 teeth selected from 19 patients aged 3-9 years. FS 15.5% and CEM cement were used as pulpotomy agents. Permanent restorations were Stainless Steel Crowns (SSCs) in both groups. Patients were recalled for follow-up at 3 and 6 months intervals for clinical and radiographic assessment. Postoperative pain was recorded by using Visual Analogue Scale up to ten days following the treatment. The data were statistically analyzed using chi-square test and repeated measures ANOVA. Results: At 6 months, a 100% clinical success rate was observed in the FS and CEM cement groups. The radiographic success rate in the FS group was 94.7%, whereas 100% in the CEM cement group at 6 months. No statistically significant difference was found between the two groups (p>0.05). There was no significant difference in postoperative pain between the teeth that received either FS or CEM cement as pulpotomy agents following the procedure (p>0.05). Conclusion: There were favorable outcomes of FS and CEM cement in pulpotomy of primary molar teeth.

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ABSTRACT Objective: To analyze the ability of saliva in controlling the growth and the biofilm formation of Streptococcus mutans (S. mutans) as well as the effect of histatin-5 anti-biofilm relate to pH and saliva viscosity. Material and Methods: The S. mutans biofilm assayed by crystal violet 1% and its growth measured by spectrophotometer. The saliva viscosity was analyzed by viscometer, and pH of saliva was measured by pH meter. Results: Based on the optical density values, growth of S. mutans in saliva ranged <300 CFU/mL (0.1 nm) at concentrations of 25%, 12.5% and 6.25% for 24 hours. Whereas at the 48 h and 72 h period of incubation shown an increase in growth of S. mutans ranged 300-600 CFU/mL (0.2-0.36 nm). The inhibitory biofilm formation of S. mutans in saliva was significantly higher at concentrations of 12.5% and 6.25% at 24 h incubation times on a moderate scale, whereas the histatin-5 was effective to inhibit S. mutans biofilm on the 50 and 25 ppm. The saliva possessed a higher inhibitory of biofilm S. mutans than histatin-5 and good level viscosity (0.91-0.92 cP). Conclusion: The saliva was able to control the growth of S. mutans, and histatin-5 can inhibit the biofilm formation S. mutans. Furthermore, the saliva was also able to respond to the pH change with good viscosity of saliva.

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ABSTRACT Objective: To determine the association of socio-demographic and clinic-pathological risk factors with oral cancer in Kelantan, Malaysia. Material and Methods: A 19-year cross-sectional survey was performed in Hospital Universiti Sains Malaysia (HUSM), Malaysia. Medical record of 301 oral cancer patients was retrieved from the Medical Records office. Results: The majority of the oral cancer cases were male (62.8%), non-smokers (57.5%), non-alcohol consumers (83.4%), non-betel quid chewers (96.7%), and belonged to Malay ethnicity (68.8%). At the time of diagnosis, most of the patients were at stage II (38.9%). Approximately one-third (30.6%) of the total OC patients experienced loco-regional/distant metastasis, whereas no metastasis was detected in around two-thirds of cases (69.4%). A combination of surgery and radiotherapy was the most commonly employed treatment modality (27.2%). At the time of this study, the survival status of most of the patients was alive (69.1%). The most frequently encountered oral cancer in the Kelantanese population was oral squamous cell carcinoma (70.1%), with the tongue being the most frequently involved oral cavity site (35.5%). Conclusion: More than three-fourths of the cases were alive at follow-up, which included the cases that did not undergo any form of treatment.

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ABSTRACT Objective: To evaluate the satisfaction of adolescents undergoing dental treatment between 2016 and 2018 at the Dental School of the Federal University of Minas Gerais (FAO UFMG). Material and Methods: A descriptive cross-sectional study using the Oral Health Services Satisfaction Assessment Questionnaire (QASSaB). The structured questionnaire has eleven questions divided among the dimensions: dentist / patient relationship, relationship with other professionals, effectiveness, accessibility/availability, technical-scientific quality, cleanliness and physical environment, acceptability, effectiveness/resolution, each with five response options. Descriptive data analysis was performed using absolute and relative frequencies. Results: A total of 145 adolescents participated in this study, 60 males and 85 females; 74.85% of adolescents rated dental treatment received as excellent, 76.7% reported having no symptoms after treatment, 46.2% considered it easy/very easy to get treatment, 65.6% reported that waiting time was short/very short, 90% considered dental equipment modern/very modern, 98% regarded the cleanliness of the waiting room and bathrooms as being excellent, 83.4% reported that they always received an explanation about the treatment, and 51.57% were totally satisfied with the appearance of the treated teeth and their chewing capacity. Conclusion: It was possible to observe that the adolescents, users of FAO UFMG, were satisfied with the service in the studied dimensions: human relations, effectiveness, accessibility/availability, technical-scientific quality, physical environment/cleanliness, acceptability and resolvability/effectiveness.

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ABSTRACT Objective: To evaluate the remineralizing potential of a hydrocolloid-based, controlled fluoride-releasing system added to dentifrice formulas. Material and Methods: Sixty-five human enamel blocks were prepared and the surface microhardness (SH0) values were determined. The artificial caries lesions were induced and the demineralization surface microhardness (SH1) was evaluated. The blocks were randomly allocated into five groups (n = 13): (1) 100-TGF (100% NaF with Tara gum added); (2) 50-TGF (50% free NaF + 50% NaF with Tara gum added); (3) 100% TG (100% Tara gum without fluoride); (4) 100% NaF (positive control); and (5) placebo (without Tara gum and NaF). The blocks were submitted to 7 days pH cycling and treated with dentifrice slurries twice a day. Finally, surface hardness (SH2) was assessed and the percentage of surface hardness recovery (%SMHR) was calculated. Analysis of variance (ANOVA) followed by Bonferroni test was used for statistical analysis. Results: A positive %SMHR was found in the 100% NaF (5.07) and 50-TGF (0.64) groups, while the 100-TGF (-1.38), 100% TG (-3.88) and placebo (-0.52) did not undergo remineralization. Statistically significant differences were observed between 100% NaF and all the groups except for 50-TGF (p<0.05). Conclusion: The presence of hydrocolloid (Tara gum) promoted minimal remineralization when associated with NaF. In the applied model, Tara gum may have compromised remineralization, preventing free fluoride from acting effectively in the carious lesion.

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ABSTRACT Objective: To evaluate the effect of virtual reality (VR) on dental anxiety, pain, and behaviour at different time points among children undergoing dental treatment under local anaesthesia. Material and Methods: This randomised, two‐armed, within-subject, cross-over, placebo-controlled trial included 76 children. Eligible participants were treated in two dental visits using the following methods: with protective glasses only, without distraction (attention placebo-controlled - APC); and with the treatment condition (i.e., VR). Primary outcomes were dental anxiety and pain; secondary outcome was dental visit behaviour. Heart rate scores were recorded as an objective measure to evaluate dental anxiety and pain. Subjective measurements for each variable were also performed. Results: Significant reduction in dental pain and anxiety was observed in the VR group, according to the heart rate scores; however, no statistical differences were observed according to the self-reported measures. Decreased dental anxiety and pain were associated with the first visit sequence with VR. Dental pain and anxiety scores were lower during local anaesthesia in the VR group than in the APC group. Conclusion: Virtual reality significantly reduced pain and anxiety during local anaesthesia in children undergoing dental treatment; therefore, it may be recommended during dental treatment in school-age children.

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ABSTRACT Objective: To assess the knowledge of undergraduate health care students, about avulsion of permanent teeth. Material and Methods: It is a cross-sectional study. The sample consisted of Brazilian undergraduate students of the nursing, medicine, and dentistry degree programs. A structured questionnaire developed by the researchers, containing 18 objective questions about avulsion of permanent teeth was used as the data collection. Data analysis included Pearson's Chi-square and Fisher's Exact. Results: A total of 82.7% dental students, 22.9% nursing students, and 23% medical students had previously received some information about dental trauma. Students in the second half of the dentistry program had a higher percentage of correct answers in all questions (p<0.05). Being in the first or second half of the nursing program had no relation to the percentage of correct answers by students for any questions (p>0.05). Students in the first half of the medical program had a higher percentage of correct answers for six of these questions (p<0.05). Dentistry students had the highest percentage of correct answers in all the questions (p<0.001). Conclusion: Although students from the dentistry degree program report having information on avulsion of permanent teeth, their practical experience was considered low. Upon comparing students from the dentistry, nursing, and medical degree programs regarding their learning about avulsion of permanent teeth, dentistry students had greater knowledge on the subject.

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ABSTRACT Objective: To assess the current level of oral health knowledge and identify information sources among adolescents in Bhubaneswar, India. Material and Methods: A cross-sectional examination was conducted among 1330 adolescents aged 13 to 15 years enrolled in 24 randomly selected government and private schools in Bhubaneswar. A specially designed self-administered questionnaire was used to collect the responses. Chi-square test with a level of significance set at 5% was used for statistical analysis. Results: Parents (55%) followed by media (18%) were the major sources of oral health information among the study population, which was statistically not significant in relation to gender and school type. Many subjects (95.3%) perceived sweets could cause tooth decay; however, this was statistically significant only among school type (p<0.05). Around (45%) knew about fluoride and only 36% properly identified fluoride's action as preventing cavities. This was statistically significant among both gender and school type (p<0.05). Seventy-five percent of students effectively distinguished gum disease symptoms, which was significant only with gender (p<0.05). Around 55% identified that oral habits have an influence on oral health, which showed significance among gender (p<0.05). Conclusion: Children oral health knowledge was not satisfactory, highlighting the need to utilize parents, schoolteachers and media to provide oral health education. It’s essential for designing and implementing a person-centered care model in dentistry.

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ABSTRACT Objective: To analyze children's and parents' oral health-related quality of life (OHRQoL) and children's dental fears before and after the dental rehabilitation under general anesthesia (DRGA). Material and Methods: 104 parents and their 3 to 13-year-old children (5.90 ± 2.42) who received DRGA were surveyed before and after DRGA. The children were divided into two groups: Group 1 - healthy children (n=43) and Group 2 - children with medical problems (n=61). After recording their socio-demographic information, parents completed a self-administered questionnaire named Early Childhood Oral Health Impact Scale (ECOHIS), which includes two main parts - Child Impact Section (CIS) and Family Impact Section (FIS). On the other hand, the children received a dentist-administered questionnaire named Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and Frankle Behavior Scale (FBS). For statistical analyses, Wilcoxon Signed-Rank, Mann Whitney-U, Kruskal-Wallis, and Spearman's Correlation tests were used. Results: A statistically significant decrease in all CIS, FIS, ECOHIS and CFSS-DS scores was observed after DRGA (p<0.01). This decline was greater in healthy children than in children with systemic problems (p<0.01). Conclusion: Children's and parents' OHRQoL showed better results after DRGA. The decreases in dental anxiety in children were observed after DRGA.

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ABSTRACT Objective: To evaluate the amount of residual monomers released after polymerization by the compomers in different colors and viscosities over time. Material and Methods: The compomer samples of different colors and viscosities (flowable compomers; blue-pink and packable compomers; A2-blue-pink-gold) were prepared in molds with an inner diameter of 5 mm and a height of 2 mm. In polymerization of samples, a LED unit was used. The amount of monomers released from the samples kept in 75% ethanol/water solution was measured by a high-performance liquid chromatography (HPLC) instrument in the 10th minute, in the 1st hour, and in the 1st, 7th, and 14th days. For statistical analyses, the paired sample t-test, independent sample t-test, and one-way ANOVA with Tukey's post hoc test were used. Results: The amount of residual monomers released from all materials increased over time. At the end of the 14th day, the most released monomer from all compomer samples was BisGMA. The total amounts of released monomers from the packable compomers were Gold>A2>blue>pink. The amount of residual monomers released from flowable compomers was higher in blue than in pink. Conclusion: The color and the viscosity are the factors affecting the residual monomer release in compomers.

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ABSTRACT Objective: To determine the awareness and sources of information on first aid management of avulsed permanent teeth in a group of South-western Nigerian mothers. Material and Methods: An 18-item interviewer-administered questionnaire was used to survey 385 mothers attending the antenatal and immunization clinics on their perception towards dental avulsion, its management, sources, and preferred mode of receiving information on first aid. The effect of all significant factors was inferred at p<0.05. Results: Mothers who had previous information on the first aid management of dental avulsion had significantly higher knowledge (p=0.000). Majority (80.8%) of the mothers did not know that an avulsed permanent tooth could be replanted, though mothers whose children had not experienced dental trauma had significantly higher knowledge (p=0.003). The knowledge of first aid management of avulsed permanent tooth was low, regardless of age, education and employment status of the respondents. Conclusion: There was low knowledge among mothers regarding the first aid measures in the management of avulsed permanent teeth. Their main preference for receiving information was through social media and television. There is a need to increase oral health educational campaigns targeted towards mothers.

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ABSTRACT Objective: To determine the relationship of transmission of COVID-19 virus knowledge with dental care during a pandemic. Material and Methods: Online questionnaire using Google forms distributed through social media (WhatsApp groups, Facebook, line groups) using a combination of convenience and snowball sampling. The level of knowledge about coronavirus transmission was measured using a questionnaire consisting of 5 statement items. This questionnaire uses the Guttman scale with 3 response and anxiety categories for dental care as measured using a modified questionnaire from the Dental Fear Survey. This questionnaire consisted of 9 question items using a Likert scale. Results: 285 respondents came from WhatsApp media users (89.9%) with an average age of 29.91 years. Respondents who experienced "dental health problems" during the pandemic were 44.7%. The knowledge of respondents about the transmission of the COVID-19 virus in dental care was 79.9% and the knowledge of the fear of caring during the pandemic period was 31.85% afraid. Statistical analysis showed a significant relationship between knowledge about transmission of the COVID-19 virus and fear of dental care (rs=0.388, p<0.001). Conclusion: The results obtained have a significant relationship between knowledge about transmission and fear for dental care during the COVID-19 pandemic in South Sulawesi Province.

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ABSTRACT Objective: To determine the level of clinical contamination in the clinic and laboratory of the prosthodontics department of Kerman Dental School. Material and Methods: Clinical surfaces of the dental units, the laboratory, and the professors' lounge of the prosthodontics department were randomly sampled. The sampled surfaces included the dental units' console, light switch, light handle, headrest, and air-water spray syringe in the clinic, plastering tables, buttons of the vibrator, polishing, and trimmer machines, acryl tables, handles of pressure pot and press machine, handpiece holders, work desks, and drawer handles in the laboratory, and desks, computer mouse and keyboard, telephone sets, and doorknob in the professor's lounge. The samples were examined for the type and growth of microorganisms. The data were entered into SPSS, where they were analyzed using the chi-square test at the 0.05 significance level. Results: Of all the samples taken, 89.9% showed microbial contamination. The most common type of contamination was fungus (34.8%) and the least common types were Enterococcus faecalis and Staphylococcus epidermidis (1.1%). The second and third most common types of bacteria in the samples were Staphylococcus aureus (18%) and Pseudomonas aeruginosa (12.4%), respectively. There was no significant difference between the frequencies of microbial contamination in the clinic, the laboratory, and the professors' lounge. Conclusion: Given the strong chance of cross-infection in the examined department and laboratory, it is necessary to enforce protocols for proper disinfection of surfaces before, between and after treatments.

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ABSTRACT Objective: To evaluate the regeneration of mandibular cartilage defect after implantation of human umbilical cord mesenchymal stem cells (hUCMSC) over platelet rich fibrin (PRF) as scaffold. Material and Methods: 20 male Wistar rats were randomly divided into four experimental groups consisting of: a control group featuring untreated mandibular defects (C), experimental groups whose mandibular defects were implanted with hUCMSC (E1), mandibular defects implanted with PRF (E2), mandibular defects implanted with hUCMSC and PRF scaffold (E3). The subjects were sacrificed after six weeks of observation for immunohistochemical examination in order to evaluate the expression of Ki67, Sox9, FGF 18, type 2 collagen, and aggrecan, in addition to histology examination to evaluate chondrocyte number and cartilage thickness. Data was analyzed with univariate analysis (ANOVA). Results: The implantation of hUCMSC and PRF scaffold proved capable of regenerating mandibular cartilage defect through the expression of FGF 18, Sox9, Ki67, chondrosis counts, type 2 collagen, aggrecan, and cartilage thickness. The regeneration were significantly higher in group E3. Conclusion: Human umbilical cord mesenchymal stem cells in platelet rich fibrin scaffold proved capable of regenerating mandibular cartilage defect.

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ABSTRACT Objective: To evaluate the level of inflammatory factors of erythrocyte sedimentation rate and reactive protein C in benign and malignant thyroid nodules. Material and Methods: In this case-control study, patients who were referred because of an enlarged thyroid gland were selected, patients who had undergone surgery for the thyroid nodule were included in the study. Erythrocyte sedimentation rate and reactive protein C were measured before surgery in patients who were candidates for thyroid surgery. The histopathological records of patients were retrospectively reviewed. Relevant cases had a cytological evaluation of thyroid nodules by fine-needle aspiration cytology (FNAC). The mean of ESR / CRP in both groups was compared using an independent t-test (p>0.05). Results: In malignant tumor type, in all patients, with Pill (PTC), analyzes in the malignant group showed a significant difference between the mean ESR / CRP in both groups with and without thyroid history. Sub-analyzes in the malignant group were significantly different between the mean ESR / CRP in both groups with and without thyroid histories (p=0.009) (40.16 ± 28.81). The association between ESR and CRP, ESR / CRP and tumor size, ESR / CRP and age in each group as well as in the whole patients were evaluated using Pearson correlation test, which showed a positive association between ESR age and ESR (p=0.024, r=0.375). In the malignant group, a negative correlation was found between the age and the CRP rate (p=0.027, r=-0.441), and in the total patients between the age and the rate (ES=0.043, r=-0.256). Conclusion: Factors such as ESR and CRP, which are considered acute phase reactors and their levels increase in acute inflammatory conditions, may not have a significant increase in chronic inflammatory conditions and malignancies.

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ABSTRACT Objctive: To assess the soft tissue characteristics of Bangladeshi adults to formulate soft tissue 3D CT standards using Holdaway’s (HA) and lip morphology (LM) analyses. Another aim of this study was to assess the gender dimorphism of Bangladeshi population. Material and Methods: One hundred and seventeen (Eighty-five men and Thirty-two women) Bangladeshi adults have obtained their computed tomography (CT) scan at the Radiology Department for normal diagnosis. Craniofacial deformities were undetected in all cases. The CT images were prepared by a 3D imaging programming software (Mimics 11.02 Materialise). Parameters from the identified landmark points were measured in 3D through this software. Results: Upper lip thickness (ULT) (vermillion UL-A point) measurement was significant in HA and in LM analyses, upper lip protrusion (ULP) (Ls to Sn-SPog) measurement has demonstrated significant difference among both genders, where p-value was less than 0.05. Mean measurements of Bangladeshi adults were relatively comparable except the face convexity (FC) when compared with the HA cephalometric soft tissue values. Conclusion: By using HA and LM analyses, 3D CT soft tissue standards were established for Bangladeshi adults. Measurements for all parameters have remained equivalent with the HA standard data apart from the FC measurement. This consequently may demonstrate that the Bangladeshi population retains a convex shape with a slight protrusive lip or retruded chin.

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ABSTRACT Objective: To investigate the influence of parental depression and substance use in the oral health care of children with disabilities. Material and Methods: A cross-sectional study was conducted involving 151 children with disabilities and their parents/caregivers. To detect the presence of depression and alcohol or tobacco use, the parents/caregivers answered three questionnaires: two versions of the Patient Health Questionnaire (PHQ), AUDIT (Alcohol Use Disorders Identification Test), and the Fagerstrom Test for Nicotine Dependence (FTND). Then, the children with disabilities underwent oral examination to evaluate biofilm control, gingival condition and the dental carie index (decayed, missing, and filled teeth - dmft ̸ DMFT). Results: There was a statistically significant association between tobacco use and dental caries in deciduous teeth (p=0.046). The children of smokers had six times greater need for dental treatment than that of non-smokers (OR= 6.36; CI= 1.3-30.5). There was no statistically significant association between the oral health of the children with disabilities and parental alcohol consumption and depression (p>0.05). Children with medical condition had a higher need for dental treatment than children with intellectual disability (p=0.003). Conclusion: Parental smoking habits increase dental caries in the deciduous teeth of children with disabilities, but parental depression and alcohol use do not influence the oral health of children with disabilities. Children with medical condition have more treatment needs than children with intellectual disability.

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ABSTRACT Objective: To use qualitative research methods to evaluate the experiences of patients with chronic oral diseases. Material and Methods: Purposive sampling was used to recruit patients from the Oral Medicine Unit of Kerman University Dental School. An experienced independent facilitator convened the focus groups and conducted individual interviews in a non-clinical setting. Focus groups were mixed regarding their gender, age, chronic oral mucosal condition, time since diagnosis, and severity. A total of 39 patients participated in the study, including patients with oral lichen planus, pemphigus, recurrent aphthous stomatitis and leukoplakia. Results: Analysis of the interviews revealed that patient views could be divided into the following themes: biopsychosocial issues, treatment limitations and side effects, unpredictability of the conditions and the potential for malignant transformation. Chronic oral mucosal conditions affected patients' daily lives in various areas, from physical health and functioning to concerns about their future. Conclusion: The oral medicine practitioner's role in treating patients with chronic oral mucosal diseases extended beyond active management and symptomatic relief to the management of all aspects of these conditions that affected their daily lives.

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ABSTRACT Objective: To evaluate the pulp tissue of rat molars after pulpotomies with mineral trioxide aggregate (MTA), BiodentineTM (BDT) and calcium hydroxide (CH) mixed with sterile saline solution (24 hours, 72 hours, 7 days and 15 days), through correlating MPO activity with active neutrophils and MMP8 activity with tissue remodeling. Material and Methods: Thirty-eight Wistar rats were randomly distributed into groups (control, I (MTA gray), II (BDT), and III (CH)) and subdivided according to the study period of 24 hours, 72 hours, 7 days or 15 days after pulpotomy. MMP8 activity was assessed through fluorescence technique, and MPO activity was determined using the MPO assay. Results: A gradual decrease of MPO and MM8 activity occurred in the group MTA over the experimental periods (p<0.05). Groups BDT and CH exhibited an increase in the activity at 7 and 15 days (p<0.05). Conclusion: MTA demonstrated a decrease in the values of MPO e MMP8. BDT and CH showed high neutrophilic and collagenase activity over the experimental periods.

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ABSTRACT Objective: To determine the effect of sprue design on the marginal accuracy of the casting. Material and Methods: It was an experimental in-vitro study. There are forty-four crowns of single sprue group with a forty-four double sprue group that was compared in 6 different locations of the margin. The sections were inspected under a microscope at 50X magnification and took a micrograph. The radius from an actual casting edge to a possibly excellent margin was then documented as marginal discrepancy (d), in µm. The marginal discrepancy was documented for each of the six sections per casting. Thus 264 sections were measured for each group. Data were analysed using (ANOVA) for analysis of variance. For bivariate analyses, Chi-square and Student t test were used. The significance level was set at < 0.05. Results: The marginal discrepancy was greater in the single sprue group of cast crown (43.1 ± 4.74 µm) and in double sprue group of cast crown was less (25.7 ± 4.25 µm). This difference is statistically significant (p<0.05). The correlation between single sprue group of casting with a double sprue group of casting by student’s t-test where determination height was 95%. Conclusion: Double sprue design produces a higher accurate margin than single sprue design in the nickel-chromium alloy cast crown.

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ABSTRACT Objective: To evaluate the effects of commonly used smokeless tobacco forms on oral health at habitual placement sites of smokeless tobacco compared to non-placement sites among the North Indian population. Material and Methods: This cross-sectional study was conducted among 542 individuals using smokeless tobacco recruited from the outpatient wing of the Dental College. Subjects completed a questionnaire and received an oral examination. Periodontal pocket depth, gingival index, plaque index, gingival recession, and oral mucosal changes were assessed. Kendal’s Tau test, paired t-test, and chi-square test were carried out to compare different variables among placement and non-placement sites. Results: Most of the subjects were male, reporting an average of 11.26 years of SLT use. Clinical inflammation of gingiva was significantly greater (p=0.01) at placement-sites (1.64 ± 0.53) of SLT in comparison to non-placement-sites (1.40 ± 0.41). The difference in the GR and PPD at placement and non-placement-sites was also statistically significant with p=0.002 and p=0.001, respectively. Clinically, the majority of subjects had mucosal changes at the placement sites, and a statistically significant association (p=0.034) was observed between the duration of the use of smokeless tobacco and the mucosal changes. Conclusion: Smokeless tobacco use predisposes to increased risk of periodontal diseases and oral mucosal changes at the placement sites in an individual due to the local irritant effect.

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ABSTRACT Objective: To investigate the difference of chemical bonds between urethane dimethacrylate (UDMA) bonding agents with ethanol solvent and acetone solvent on dentin collagen. Material and Methods: This experimental comparison study used three groups: G1 (Control): UDMA and collagen; G2: UDMA, collagen and ethanol; and G3: UDMA, collagen and acetone. The groups were then pelleted and analysed with FTIR, then the peak value of carbonyl absorption band from each study group was calculated. The result of FTIR analysis and the peak of carbonyl absorption band (P) was calculated using the formula: P = (BC / AB) X 100; AB. BC is measured in centimeters. The study of chemical bond differences between ethanol-solvent UDMA agents compared with acetone-solvent on dentin collagen resulted in a graph of peak of carbonyl absorption bands of UDMA and dentin collagen groups. To determine the chemical bonds of UDMA from the top of the carbonyl ester absorption bands with wavenumber absorption in range 1700-1750 cm-1, the decreasing peak of the carbonyl absorption bands is assumed as more chemical bonds that formed. Data were analysed using Anova one way and Tukey HSD test. Results: There were significant differences between the three study groups (p<0.05). Conclusion: UDMA bonding agents' chemical bonds with acetone solvent are much higher than the chemical bonds between UDMA bonding agents with ethanol solvent on dentin collagen.

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ABSTRACT Objective: To evaluate the prevalence of temporomandibular disorders (TMD) in students and to evaluate if any relationship existed between the stress levels, salivary cortisol levels, and TMD. Material and Methods: A total of 348 students, 187 female, and 161 male students, participated in this cross-sectional study. Students were evaluated based on the Research Diagnostic Criteria for TMD. The stress levels were evaluated using the Perceived Stress Scale. The students were divided into the control and TMD groups. Salivary cortisol levels in the salivary samples were analyzed. Results: The prevalence rate of TMDs was 30.7% in the study population. Of the female students, 61% had TMD compared with 46% of male students. Muscle disorders were the most predominant disorder in 14.2% of the students with TMD. The TMD group showed significantly higher salivary cortisol and stress levels than the control group. The TMD group also showed a moderate positive correlation between cortisol and stress levels (p=0.01). Conclusion: The study showed a strong association between salivary cortisol levels, stress, and temporomandibular disorders. Salivary cortisol could be used as a prognostic biomarker for stress while assessing the severity of TMJ problems in stressed individuals.

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ABSTRACT Objective: To evaluate the intra-examiner and inter-examiner reliability of linear and curvilinear measurements for the complete assessment of implant sites and jaw pathologies using Cone-Beam Computed Tomography (CBCT). Material and Methods: Fifty cone-beam computed tomographic images of patients were retrieved from the archives of Dentomaxillofacial Radiology. CBCT images taken for implant planning and evaluation of intrabony jaw pathologies (benign cyst/tumor) were included. Two expert oral and maxillofacial radiologists analyzed the images independently and made the measurements. The images for implant planning were analyzed for width, the height of the edentulous site, and the qualitative analysis of bone in the region. Jaw pathologies were assessed for linear dimensions and curvilinear measurements. Results: The inter-observer measurement error for implant site analysis ranged from 0.12 to 0.42 mm with almost perfect agreement (ICC: 0.94 to 1). The inter-observer measurement error for jaw pathology was 0.09 to 0.25 mm (ICC: 0.98-1). Curvilinear measurements showed perfect agreement between the observers. The intraobserver reliability for the various parameters used for the assessment of the implant site and jaw pathologies indicated almost perfect agreement. Conclusion: Reliability between the radiologists is high for various measurements on CBCT images taken for implant planning and jaw pathologies.

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ABSTRACT Objective: To assess the prevalence of dental caries and fluorosis among 7-12-year-old school children in Muradnagar, India. An additional objective was to determine the relationship between dental caries and fluorosis in the studied population. Material and Methods: A total of 1500 school children aged between 7 to 12 years, and both genders were randomly selected for the present study. The selected participants were divided into three groups based upon age, viz 7-8 year (group I), 9-10 year (group II) and 11-12 year (group III). Sterile mouth mirrors and explorers were used for the detection of caries. The water samples were collected to assess the fluoride concentration. The data collected were tabulated and statistically analysed using Chi-square, ANOVA, Spearman’s correlation and t-test wherever applicable. Results: Out of 1500 participants, 54.1% were females and 45.9% were males. The prevalence of dental caries and fluorosis was 89.3% and 93.7%, respectively. The prevalence of caries increased with age (p<0.05) and females showed a higher prevalence in both the dentitions. Most dental fluorosis was ‘very mild’ (40.1%). Prevalence of dental fluorosis increased with age and males showed more fluorosis than females. A negative relationship was found between dental caries and fluorosis (p<0.05). Conclusion: Dental caries and fluorosis are the public health problems in Muradnagar; therefore, preventive programs should be organized to increase awareness among the general people.

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ABSTRACT Objective: To compare prevalence of dental caries, oral hygiene status and associated risk factors of children in suburban and rural communities in the Southwest region of Nigeria. Material and Methods: Secondary data was extracted from cross-sectional researches conducted in two study locations involving 8 to 12 year olds. Data retrieved included age, gender, family structure, socioeconomic status, oral hygiene and dental caries. Caries assessment was done using WHO Oral Health Survey methods. Oral hygiene data was collected using Simplified Oral Hygiene Index (OHI-S) by Greene and Vermillion. Statistical significance was established at p<0.05. Results: The prevalence of dental caries in Group A and Group B study participants were 13.4% and 22.2% respectively. Children from rural community had significant higher caries prevalence (p=0.00) and poorer oral hygiene (P=0.00) compare with their counterparts in the suburban community. There was a significant association between oral hygiene, age and dental caries in suburban participants (p=0.02) while among the rural participants there was significant association between gender and dental caries (p=0.04). Children with poor oral hygiene have increased odds of having dental caries compared to children with good oral hygiene in the two study communities. Conclusion: Dental caries was more prevalent among the rural dwellers than the sub-urban dwellers. There is a need to make oral health care services/products available, accessible and affordable for the rural community.

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ABSTRACT Objective: To evaluate the potential effect of poly-vitamins and probiotics use among preschool children permanently living within iodine deficiency territory on caries prevention. Material and Methods: 80 children aged 2-3 years old were randomly distributed among the study group (21 male and 19 females) and control group (20 males and 20 females). Oral fluid samples were formed from each study subject during primary examination and after 1 year of monitoring, which further were analyzed by parameters associated with mineralization potential of oral fluid. Both groups were provided with oral hygiene educational training, while the study group was also prescribed with poly-vitamin-mineral drug complex and probiotics. Results: After 1 year of monitoring, no significant changes considering caries prevalence (p>0.05) or intensity (p>0.05) values were registered among study and control groups. Difference of free calcium level, phosphate ion level and alkaline phosphatase activity was statistically approved (p<0.05) while comparing between study and control group after 12 months of monitoring. Conclusion: Caries preventive approach consisted of oral hygiene educational training and course of properly prescribed poly-vitamins and probiotics intake demonstrates positive results related to the changes within mineralization potential of oral fluid among preschool children with long-term residence over geographically associated iodine-deficient territory.

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ABSTRACT Objective: To describe the sociodemographic profile of elderly people with temporomandibular disorder and depression in Parkinson's disease cases. Material and Methods: It is a cross-sectional cohort cut study, which used secondary data from 124 elderly people with Parkinson’s disease (PD). To diagnose temporomandibular disorder (TMD), the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire was used, and the variables studied were: age, sex, race, education, marital status, family income, stage of the disease, and depression. The statistical analysis performed was descriptive and used absolute numbers and a frequency count. Results: After the application of the eligibility criteria, the patient records of 81 elderly people with Parkinson’s disease were selected; 15 presented associated TMD and depression. The average age was 69 years old; 66.67% were male; 46.67% had more than 9 years of schooling; 60% were married or had a partner; 53.33% received between 1 and 2 minimum wages; 33.33% stated they were brown; 80% were in the moderate stage of the disease; 46.66% were in group II according to the RDC/TMD, presenting disk displacement; and 53.33% presented severe depression. Conclusion: It was verified that the elderly people with Parkinson’s and associated TMD and depression were male, married or with a partner, on a low income, with nine or more years of schooling, and were in the moderate stage of the disease.

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ABSTRACT Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value <0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted.

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ABSTRACT Objective: To investigate the types of dental emergencies that occurred during the lockdown period in Italy (12th March-4th May) and to investigate future therapeutic preferences related to the use of different types of appliances. Material and Methods: A questionnaire dedicated to assessing dental emergencies during the lockdown period and surveying the resumption of orthodontic practice was submitted to clinicians in digital form. The first part of the questionnaire, focused on the orthodontic emergencies that were encountered in relation to the different types of orthodontic appliances and how these were resolved. The second part of the questionnaire was devoted to the resumption of clinical practice; in particular, it was designed to assess whether and what percentage of clinicians are willing to change the duration of appointments in relation to the different types of appliance used, asking them whether their approach to orthodontic treatment would change in the coming months as compared to the pre-COVID-19 era. Results: Results show that in most cases (82%), the percentage of patients who experienced a dental emergency was less than 5% and that far fewer emergencies were attributable to removable (5.7%) than to fixed appliances (94.3%). Looking ahead, clinicians expressed a greater preference for using removable (60.8%) rather than fixed appliances (39.2%). Conclusion: During the lockdown, there relatively few orthodontic emergencies, many of which were handled by telephone consultation. However, a far lower percentage of emergencies were generated by removable (e.g., clear aligners) as opposed to fixed appliances (e.g., multibracket equipment), likely influencing the decision of the majority of clinicians to opt for removable appliances in the wake of the COVID-19 pandemic.

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ABSTRACT Objective: To evaluate the dentists' knowledge about biosafety considering the SARS-CoV-2 and the risks of increasing the COVID-19 outbreak by dental practices during the pandemic in Brazil. Material and Methods: A cross-sectional study was performed by internet-based snowball sampling technique. A questionnaire with questions about different content was applied, and then analyzed the following two parameters: participants' Brazilian region and professional's specialty. Results: A total of 413 e-questionnaires from all Brazilian regions were considered valid. There were no significant differences among biosafety measures adopted by participants from different Brazilian regions (p≥0.05), except for those from North region, which have applied less previous oral antisepsis, temperature screening, and specific anamnesis tracking COVID-19 symptoms (p<0.05). The unique use of N95 mask was positively associated with North region (p<0.05). Expert participants of Groups 2 (oral surgery and correlate areas) and 4 (orthodontics, oral radiology and facial jaw orthopedics) were more updated than other ones (p<0.05). Conclusion: The biosafety protocols applied by participants were not adequate for the epidemiologic status of COVID-19 in each region of Brazil, from 13th May to 17th June 2020. Specialties linked to microbiology area or structured social networks have better applied preventive measures for COVID-19.

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ABSTRACT Objective: To investigate the possible relationship between early admission to the school of children in early childhood and oral health conditions (OH) and nutritional status (NS). Material and Methods: Cross-sectional study conducted with 140 children aged 3-4 years, selected for convenience, in 4 public schools in the city of São Paulo, Brazil, during 2016, divided into children with early (IE) and late (IL) admission at school. Comparisons between groups were performed for the presence of overweight / obesity (OW / OB), caries lesions (CL), malocclusion (MO) and dental biofilm (DB), in addition to socioeconomic and dietary data. Multiple regression analysis was applied to determine the association between age of admission at school and OH and NS. Results: Children with IE had CL = 28.1%; DB = 46.9%; MO = 54.7% and OW / OB = 25.9%. Children with IE had IL = 29.8%; DB = 35.1%; MO = 61.4% and OW / OB = 30.8%. No significant association was found between age of admission at school and CL: 1.40 (0.53-3.73) 0.490; DB: 0.51 (0.22-1.16) 0.112; MO: 1.77 (0.77-4.05) 0.173 and OW / OB: 1.27 (0.55-2.92) 0.568, [OR (95% CI) p]. Conclusion: The age of admission at school of children in early childhood did not show a significant association with OH and NS.

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ABSTRACT Objective: To evaluate the effects of unilateral loss of the lower first permanent molar (L6) on the position and development of the lower third molar (L8). Material and Methods: Fifty-four panoramic radiographs of subjects with unilateral loss of L6 were examined. The L8 on the side of the L6 loss was compared with the L8 in the hemiarch without L6 loss (contralateral). The effect of L6 loss on the positioning of L8 was examined in all the samples (n=54), whereas the effect on the development of the third molar was examined in 38 patients with L8 with incomplete root formation. The Signs statistical test was used to evaluate the comparison between loss and contralateral hemiarches. Results: In 20 (37%) of 54 subjects, the L8 was better positioned in the hemiarch with loss of the lower first molar (p<0.001) compared with the control side. In the remaining 34 subjects, no difference was found. When only the L8 considered as impacted on the control side was examined (n=30), the cases with better positioning on the side with L6 loss increased to 66.6% (p<0.001). Conclusion: The loss of lower first molars improves the position of the lower third molar during its active eruption, mainly when the lower third molar is impacted. However, L6 loss does not affect the root development of lower third molars.

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ABSTRACT Objective: To determine the initial mechanical stabilization of conventional glass ionomer cements (GICs) indicated for the atraumatic restorative treatment (ART) in different storage periods. Material and Methods: Specimens were divided according to the GIC (n=12): IZ - Ion-Z, KM - Ketac Molar Easymix, RS - Riva Self Cure, and GL - Gold Label 9. They were prepared and stored in distilled water. Superficial microhardness (SMH) was evaluated (KHN) in three phases: (A) after 1, (B) 3, and (C) 7 days of storage. Data were submitted to 2-way ANOVA and Tukey tests (α = 5%). Results: The average KHN values for phases A, B, and C were, respectively, 33.05 ± 9.74; 33.21 ± 10.31 and 52.07 ± 11.75 (IZ); 50.35 ± 11.39; 66.05 ± 10.48 and 67.77 ± 13.80 (KM); 89.63 ± 15.59; 71.31 ± 23.86 and 57.70 ± 16.89 (RS); 42.18 ± 9.03; 68.54 ± 6.83 and 57.95 ± 8.24 (GL). Significant differences were observed: GIC, time, and interaction of both (p<0.05). KHN values differed between the groups, except in the GIC parameter for KM and GL. The time parameter values of phase A were lower than those of B and C, except for IZ and RS. Conclusion: The initial mechanical stabilization differed between the types of GIC tested and the storage time, and after the final period, all had similar SMH.

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ABSTRACT Objective: To identify etiologic microbiota associated periodontal diseases among diabetes patients and the factors related to the most commonly identified bacteria species. Material and Methods: Periodontal plaque samples from 11 diabetic participants and 13 non-diabetic controls were collected to assess their aerobic and anaerobic bacterial growth. Different distinct colonies were identified by microscopic and 16srDNA sequencing. Pearson's chi-square tests were conducted to examine any association between categorical variables. Results: The diabetic subjects revealed a more intense plaque formation with a mean plaque index of 2.4 compared to 1.8 in non-diabetics. A total of 86 bacteria were isolated from 24 plaque samples, 44 were aerobic, and 42 were anaerobic. Only aerobic isolates, 22 from diabetic patients and 22 from non-diabetic patients, were evaluated in these analyses. Bacillus spp. (B. cereus mainly) and Klebsiella spp. (K. pneumoniae, K. aerogenes, K. oxytoca) were detected markedly higher in non-diabetic individuals than in diabetic subjects (p=0.026 and p=0.021, respectively). Some bacteria were only identified in the dental plaque of diabetic individuals, namely, Bacillus mojavensis, Enterobacter cloacae, Proteus mirabilis, Staphylococcus epidermidis, Staphylococcus hominis, Staphylococcus pasteuri, Streptococcus mutans, and Streptococcus pasteurianus. The presence of acid reflux and jaundice were significantly associated with the most common bacterial isolate, namely Bacillus spp., with the p-values of 0.007 and 0.001, respectively. Conclusion: Type-2 diabetes mellitus is associated with a higher amount of dental plaques. Periodontal plaque samples from diabetic and non-diabetic subjects possess differential microbial communities. Diabetic plaques contain more versatile microbes predominated by gram-positive streptococci and staphylococci.

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ABSTRACT Objective: To assess the influence of oral and maxillofacial trauma on the development of Post-Traumatic Stress Disorder (PTSD) and to determine the efficiency of the Impact of Event Scale-Revised (IES-R) as a diagnostic tool for detecting PTSD in patients with Oral and Maxillofacial injuries. Material and Methods: PTSD was assessed one month postoperatively by the diagnostic instrument, IES-R, to arrive at a provisional diagnosis. A structured clinician-administered PTSD Scale then assessed the patients for the Diagnostic and Statistical Manual of Mental Disorders-5th edition (CAPS-5) to establish a final diagnosis. The assessment of the severity of PTSD was done based on various types of oral and maxillofacial injuries. Results: The IES-R scale provisionally diagnosed 54 subjects with PTSD, out of which 42 were diagnosed to have PTSD by the CAPS-5 scale. Subjects with injuries involving the ‘orbital complex,’ those presenting with a perceptible scar in the maxillofacial region and with multiple avulsed/ luxated anterior teeth, showed a higher affinity to develop PTSD, and this was statistically significant. Conclusion: Higher levels of PTSD in patients with injuries to the maxillofacial region warrants correct diagnosis and detection, and hence the maxillofacial surgeon plays a vital role in this regard. The IES-R is a useful diagnostic tool to detect PTSD early.

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ABSTRACT Objective: To determine the satisfaction with the dentist-patient interaction and factors associated with patient satisfaction among patients attending the outpatient dental clinic Hospital Universiti Sains Malaysia (HUSM). Material and Methods: This cross-sectional study involved 229 patients who attended outpatient dental clinic Hospital USM that located in the East Coast region of Malaysia. A self-administered Skala Kepuasan Interaksi Perubatan - 11 (SKIP-11) questionnaire was used to assess the satisfaction towards dentist-patient interaction. Systematic random sampling was applied in this study. The data were analyzed using simple logistic regression analysis to determine the factors associated with patient satisfaction with dentist-patient interaction. Results: The mean age of patients was 32.6 ± 13.9 years, 71.6% of them study up to tertiary level, 31.5% came to for dental check up and 23.6% of them had tooth decay. More than half (64.6%) of the patients were satisfactory with dentist-patient interaction. The satisfaction percentage in the distress relief domain was 60.7%, 56.8% in the rapport domain, and 53.7% in the interaction outcome domain. Satisfaction with dentist-patient interaction was significantly associated with the dentists’ characteristics such as age (OR = 0.583, 95%CI 0.44-0.76, p=0.001), gender (OR = 0.386, 95% CI 0.22-0.69, p=0.001) and years of service (OR = 0.294, 95% CI 0.15-0.57, p=0.001). Conclusion: The result showed that slightly more than half of the patients who attended the outpatient dental clinic HUSM were satisfied with the dentist-patient interaction, which was found to be influenced by the characteristics of the dentists. Efforts to improve patient-dentist interaction are recommended to ensure delivery of good quality oral health care.

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ABSTRACT Objective: To assess the usefulness of online teaching for undergraduate students during this Corona pandemic, to point the drawbacks of online teaching, and to learn the areas of improvement in online teaching for the future. Material and Methods: A descriptive cross-sectional study on 130 students was done in Bhubaneswar, Odisha, India. The questionnaire consisted of two parts, personal details and specific information. The first part of the questionnaire consisted of questions related to age, gender, etc. The second part had questions pertaining to online teaching. Pearson’s Chi-square test was applied and the level of significance was set at 5%. Results: Most of the students (83.3%) were in the view that classroom lectures are the best mean of imparting knowledge, which was significant (p<0.001). A significant number of students (88.1%) agreed that online teaching is the best method of teaching apart from classroom teaching. Almost all the students (93%) agreed significantly that online teaching is the best way to learn in this present pandemic scenario. Most students (59.6%) agreed that connectivity/network issue is a major drawback in online teaching, which is again significant (p<0.001). Conclusion: Here in these testing times, the role of online teaching becomes important for medical/dental students, both undergraduates and postgraduates, to keep up with their studies.

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ABSTRACT Objective: To compare the effect of Maleic acid and Irritrol (combination of Chlorhexidine & Ethylenediaminetetraacetic acid) irrigation on the sealing ability of Biodentine when used as root-end filling material. Material and Methods: Thirty single-rooted human premolars were subjected to standardized root canal instrumentation and were irrigated with 2.5% Sodium Hypochlorite (NaOCl) after each instrument change. Apical root resections were done by removing 3 mm of the apex at a 90° angle to the long axis of the root with a diamond bur. The root end cavity preparation was done using ultrasonic tips at a low power setting under water coolant. They were randomly divided into 3 groups (n=10). Group 1 was irrigated with 7% Maleic acid, Group 2 was irrigated with Irritrol, and Group 3 was irrigated with 0.9% Saline (Control). Then, the root end cavities of all the samples were restored with Biodentine and were subjected to leakage analysis using a glucose filtration test. The mean values for each group were calculated and the obtained data was statistically analysed using ANOVA with post-hoc Tukey’s test, ANOVA with post-hoc Games-Howell test and repeated measures ANOVA with post-hoc Bonferroni test. Results: The specimens irrigated with Irritrol showed least microleakage as compared to 7% Maleic acid and 0.9% Saline. Conclusion: A regimen involving irrigation of the root-end cavity with Irritrol followed by root-end filling with Biodentine can improve the apical seal.

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ABSTRACT Objective: To describe the gonial angle characteristics in class III skeletal malocclusion in Javanese ethnic. Material and Methods: Pretreatment lateral cephalometric radiographs of 43 Javanese ethnic patients were measured: upper (Go1) and lower gonial angle (Go2), anterior (AFH) and posterior face height ratio (PFH), maxilla-mandibular length difference, mandibular plane angle (FMA), Y axis, ramus position, ANB angle, posterior cranial base/ramus height and mandibular body length/anterior cranial base. The relation between Go1, Go2 and other variables were analysed using correlation and regression analysis. Results: The total gonial angle is within normal range, but Go1 is below normal and Go2 is above normal. There is no difference between male and female gonial angle measurements (p=0.939 and p=0.861, respectively). Ramus position is positively correlated to Go1 (p=0.003), while AFH (p=0.000), maxilla-mandibular length difference (p=0.000), FMA (p=0.000), Y axis (p=0.000), and posterior cranial base/ramus height (p=0.018) are positively correlated to Go2. PFH is negatively correlated to Go2 (p=0.018). Conclusion: The upper gonial angle is influenced by the position of mandibular ramus, while the lower gonial angle is affected by the posterior and anterior lower facial height and mandibular size and rotation. Javanese with class III malocclusion tends to have hypodivergent facial type, with more posteriorly located mandibular ramus and excess mandibular length.

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ABSTRACT Objective: To investigate the tissue response and the biomineralization ability of CER prepared with epoxy resin or water compared to Mineral Trioxide Aggregate (MTA). Material and Methods: Polyethylene tubes containing materials or empty tubes for control were inserted into the subcutaneous tissues of 30 rats. After 7, 15, 30, 60, and 90 days, the rats were killed and the tubes were removed for analysis using hematoxylin-eosin staining, von Kossa staining, and under polarized light. Inflammation was graded through a score system; the thickness of the fibrous capsule was classified as thin or thick; the biomineralization ability was recorded as present or absent. The results were statistically analyzed using the Kruskal-Wallis test (p<0.05). Results: Histologic analysis performed after 7 and 15 days for CER prepared with epoxy resin or water and for MTA showed moderate inflammation and a thick fibrous capsule (p>0.05). After 30, 60, and 90 days, mild inflammation, and a thin fibrous capsule were observed in all groups (p>0.05). Conclusion: All materials had structures positive for von Kossa and birefringent to polarized light. CER epoxy resin showed biocompatibility and biomineralization similar to CER water and MTA.

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ABSTRACT Objective: To assess the impact of wearing palatal expanders on the oral health-related quality of life (OHRQoL) of children aged 8 to 10 years. Material and Methods: The sample consisted of 35 children aged 8 to 10 years treated at the orthodontics and pediatric dentistry outpatient clinics affiliated with the Dental School. Children were divided in two groups: 17 were submitted to palatal expansion treatment (Group 1), while 18 just received coronal polishing and topical fluoride application (Group 2). The Brazilian version of the Child Perceptions Questionnaire (CPQ8-10) was used to assess children’s OHRQoL. The questionnaire was administered before the expander was placed, at the end of its activation, and before its removal. Intervals between the interviews were similar in the two groups. Descriptive statistics and ANOVA were used for data analyses. Results: The overall CPQ8-10 score was not significantly different between the groups. The results show statistically significant differences between the two groups only for the functional limitations domain after activation of the appliance (p=0.001). Conclusion: Palatal expanders may negatively affect children's functions only during the initial wearing period.

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ABSTRACT Objective: To describe dental findings of kidney and liver, pre and post-transplant patients of an oral health care service from a Brazilian Southeast state. Material and Methods: A descriptive cross-sectional study was developed with a sample of patients attending the oral health care program for transplantation of Universidade Federal de Minas Gerais. Participants were divided into two groups according to the kind of transplantation-kidney or liver. Characteristics of the sample, sex (male/female), age (18-44; 45-54; 55-80), living region (Belo Horizonte, or outside), phase of transplantation (pre-Tx or post-Tx), and self-report of diabetes mellitus and hypertension were presented by frequencies. Dental caries experienced was measured by Decayed, Missing and Filled-Teeth (DMF-T) index. Results: 185 patients, kidney (46; 24.9%), and liver (139; 75.1%) were included. Mean DMFT was 18.3 (20.0). DMFT scores of males (18.7; 20.0), females (17.2; 18.0), pre-transplanted (18.3; 20.0), and post-transplanted (18.1; 20.0) were similar. The liver transplantation group (19.3; 20.0) showed higher caries experience comparing to kidney´s (15.2; 17.0). Conclusion: Dental caries experience was high in kidney and liver patients under transplantation therapy. This highlights the demand for treatment need in this population.

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ABSTRACT Objective: To evaluate the effect of pain and swelling related to third molars on patients' quality of life prior to third molar surgery. Material and Methods: The effects on quality of life with reference to oral health of 246 healthy patients seeking treatment of third molars were analyzed using the 14-item Oral Health Impact Profile (OHIP) questionnaire before surgery. The patients' sociodemographic characteristics, medical and dental history, reasons for third molar removal were recorded. Adverse effects of pain and swelling on oral health-related quality of life were recorded. Results: The mean age of the patients included in the study was 23.15 years, with maximum male patients and the mean OHIP-14 score of 8.01 ± 7.51. About 36.97% of patients reported that their chief complaint was pain/swelling due to third molar infection, and 27.9% of subjects reported one or more of the 14 OHIP items. The odds of reporting for age with ≥25 years was approximately 2 times greater than age with ≤25 years (OR=1.56, 95% CI: 1.01-2.57) and tooth loss due to traumatic history (OR=3.14, 95% CI: 2.12-6.54). Conclusion: Adverse influences on quality of life were seen in a significant number of patients seeking third molar removal. The probabilities increased by 3-fold for patients who had experienced pain or swelling than asymptomatic individuals.

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ABSTRACT Objective: To assess the attitudes, experiences, training levels, and interest in future education regarding the use of hypnosis by dentists working in Dental Clinic of Monastir, Tunisia. Material and Methods: A cross-sectional study was conducted among 330 dentists working in Dental Clinic of Monastir in November 2019. Students, internship, residents, and professors were randomly selected. This was a survey with a structured questionnaire mailed to all dentists. The questionnaire was pre-fabricated, simple, and close-ended. Data were analyzed using SPSS 24.0 statistical software. Results: A total of 202 dentists respond to this survey. 54% of the participants were interns with a female predominance (66.5%). Findings revealed that beliefs toward hypnosis in the sample were generally positive. Using a visual analogue scale, dentists reported having moderate acknowledge in hypnosis (3.4). 60% of the participants in our study consider that hypnosis is useful in dentistry and, more particularly, in pediatric dentistry. 78.2% of respondents want to follow training courses in hypnosis. Conclusion: Our survey highlights the weak knowledge of participants in hypnosis and reveals certain misconceptions about this procedure. More efforts are required to better educate dentists about hypnosis's benefits in their practice.

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ABSTRACT Objective: To evaluate dental age assessment reliability through Tooth Coronal Index (TCI) method. Material and Methods: The cone-beam computed tomography (CBCT) scans of 160 individuals aged between 20-70 years were analyzed in the present study. The height of the crown, i.e., coronal height, and the height of the coronal pulp cavity, i.e., coronal pulp cavity height, of mandibular second premolars and first molars were calculated and then TCI was measured. The actual age of a subject was compared with TCI of tooth and the acquired data were subjected to Pearson’s correlation and unpaired t-tests. Results: Negative correlation was observed between the real age and TCI of mandibular first molar (r = -0.094, p=0.382) and second premolar (r = -0.176, p=0.0961. Statistically significant difference was observed between actual age and TCI for mandibular second premolar and first molar (p<0.001). Conclusion: Tooth coronal index has the potential to estimate age of an individual on CBCT scans. It is simple, cost-effective than histological methods and can be applied to both living and unknown dead.

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ABSTRACT Objective: To compare Transforming growth factor-β1 (TGF-β1) expression in various L-PRF concentrations on the hDPSC differentiation process. Material and Methods: hDPSC cell cultures were subjected to serum starvation by reducing FBS levels in the hDPSC culture media. Lysate PRF was obtained from the PRF gel, which was then incubated at 4°C for 24 h. The supernatant was dried, transferred to a 2-ml Eppendorf tube, and stored at −20°C. The evaluation of TGF-β1 expression in 1%, 5%, 10%, and 25% L-PRF samples and 10% FBS (control) during the process of hDPSC differentiation was quantified using an ELISA reader on day 7. The expression of TGF-β1 was subjected to a one-way ANOVA test, followed by Bonferroni’s post hoc test with significant values (p<0.05). Results: Significant differences were noted in TGF-β1 expression between 1%, 5%, 10%, and 25% L-PRF and the control group (10% FBS). The highest TGF-β1 expression occurred with 25% L-PRF (0.645 ± 0.048), followed by 10% L-PRF (0.461 ± 0.035), 10% FBS (0.374 ± 0.013), 5% L-PRF (0.275 ± 0.045), and the lowest expression was with 1% L-PRF (0.160 ± 0.045). Conclusion: The best result of TGF-B1 expression in hDPSC differentiation was in the 25% L-PRF group.

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ABSTRACT Objective: To evaluate the possible association of a polymorphism in the gene encoding methylenetetrahydrofolate dehydrogenase 1 (MTHFD1), 1958G>A, with the susceptibility to orofacial cleft in an Indonesian population. Material and Methods: A total of 200 stored secondary biological samples from 30 cases of orofacial cleft and 170 unaffected controls were analyzed to determine the polymorphism status at base 1958. The analysis was conducted using the PCR-restriction fragment length polymorphism technique after digestion with the Msp1 restriction enzyme. The samples were then subjected to agarose gel electrophoresis to investigate the presence or absence of the following fragments: genotype GG, 196, 86 and 40 base pairs (bp); genotype AA, 282 and 28 bp and genotype AG, 282, 196, 86, 40 and 28 bp. The test groups were compared using the Chi-square test. Results: The wild-type allele containing 1958G, as well as the genotype GG, were significantly more common in the control group than in the orofacial cleft group. Conclusion: The MTHFD1 1958G>A polymorphism was significantly associated with orofacial cleft susceptibility in the tested Indonesian population.

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ABSTRACT Objective: To investigate whether a low body mass index (BMI) has a significant relationship with mandibular bone porosity progression by conducting a mandibular inferior cortex (MIC) classification in elderly Japanese people. Material and Methods: A total of 266 study subjects, aged 70 at baseline, were recruited for this study, conducted from 1998 to 2007. The subjects were divided into two groups according to changes in the MIC on serial panoramic radiographs during this nine-year study period: a no change group (MIC-NC) and a change group (MIC-C). All subjects in the MIC-C showed changes trending toward greater fragility. We evaluated the BMI at baseline. Logistic regression analysis was performed to assess the relationship between the MIC condition during the nine-year period (0: MIC-NC, 1: MIC-C) and BMI (kg/m2) adjusted for gender, current health status (CHS), and smoking habit (SH) at baseline. Results: The mean and standard deviations of the BMI at baseline in the MIC-NC and MIC-C were 22.8 ± 2.1 and 21.8 ± 2.5 kg/m2 for males and 23.1 ± 2.9 and 21.9 ± 2.4 kg/m2 for females. There was a significant relationship between the MIC condition and the BMI in both males (p=0.04) and females (p=0.01). The logistic regression analysis revealed a significant association between the MIC condition over the nine-year period and the BMI (OR=0.84, p=0.003), which was adjusted depending on the gender (OR=5.18, p=0.000), CHS (OR=0.53, p=0.015), and SH (OR=4.15, p=0.002) at baseline. Conclusion: A low BMI carries a risk of developing mandibular bone porosity by measuring the MIC condition in panoramic radiographs.

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ABSTRACT Objective: To evaluate genotoxicity of zinc oxide, P. A. calcium hydroxide, mineral trioxide aggregate and an iodoform paste using comet assay on human lymphocytes. Material and Methods: Two positive controls were used: methyl-methanesulfonate for the P.A. calcium hydroxide and mineral trioxide aggregate; and doxorubicin for the iodoform paste and zinc oxide. There were also two negative controls: distilled water for the P.A. calcium hydroxide and mineral trioxide aggregate; and DMSO for the iodoform paste and zinc oxide. Comets were identified using fluorescence microscopy and 100 of them were counted on each of the three slides analyzed per drug test. A damage index was established, taking into consideration the score pattern that had previously been determined from the size and intensity of the comet tail. Analysis of variance, followed by Tukey’s test, was used to compare the means of the DNA damage indices. Results: The DNA damage index observed for mineral trioxide aggregate (7.08 to 8.58) and P.A. calcium hydroxide (6.50 to 8.33), which were similar to negative control index. On the other hand, damage index for zinc oxide (104.7 to 218.50) and iodoform paste (115.7 to 210.7) were similar to positive control index. Conclusion: Iodoform paste and zinc oxide showed genotoxicity at all concentrations used.

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ABSTRACT Objective: To describe the dental practice patterns related to caries prevention in children aged 6-18 years and associated factors. Material and Methods: Dentists (n=162) from Araraquara, Brazil, completed two paper questionnaires: (1) one about characteristics of their practice and their patient population; and (2) a translated version of the “Assessment of Caries Diagnosis and Caries Treatment” Questionnaire from the National Dental Practice-Based Research Network. Regression analyses were used for data analysis (p<0.05). Results: Dentists reported using in-office fluoride (IOF) and dental sealants (DS) in 74.2% and 45.1% of their pediatric patients, respectively. Regression analysis showed that female dentists (p=0.035 for DS; p=0.044 for IOF; p=0.011 for non-prescription fluoride rinse), those with advanced degrees (p=0.032 for prescription of fluoride), those who graduated from a private dental school (p=0.018 for chlorhexidine rinse), those who provided caries prevention regimens (p<0.001 for DS; p=0.004 for IOF; p=0.013 for non-prescription fluoride rinse), those with a greater percentage of patients interested in a caries prevention regimen (p=0.007 for non-prescription fluoride rinse), those working in a private practice model (p=0.047 for prescription of fluoride) were more likely to recommend some type of preventive methods to their pediatric patients. Conclusion: Dentists reported recommending IOF to most of their pediatric patients. Certain dentists’, practices’, and patients’ characteristics were associated to some caries prevention regimens recommended by dentists.

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ABSTRACT Objective: To investigate the antimicrobial activity of colloidal selenium nanoparticles in chitosan solution (Cts-Se-NPs) against Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans. Material and Methods: Cts-Se-NPs solution was prepared using a simple chemical reduction method. The MIC and MBC against S. mutans, L. acidophilus, and C. albicans were determined using the broth dilution assay. Results: The Cts-Se-NPs had remarkable antimicrobial activity against S. mutans, L. acidophilus, and C. albicans. The MIC values of the Cts-Se-NPs were lowest for S. mutans (0.068 mg/ml) compared to L. acidophilus (0.137 mg/ml), and C. albicans (0.274 mg/ml). The MBC values of the Cts-Se-NPs against the microorganisms after one, two, six, and 24 hours indicated that the concentration of 0.274 mg/ml of Cts-Se-NPs completely killed S. mutans, L. acidophilus, and C. albicans after one, two, and six hours, respectively. At the concentration of 0.137 mg/ml, S. mutans and L. acidophilus were killed after six and 24 hours, respectively. Conclusion: These findings encourage the potential use of Cts-Se-NPs in dentistry, while further clinical research is required in this area.

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ABSTRACT Objective: To evaluate the efficacy of pre-cooling and the use of higher gauged needles in reducing pain during local anesthetic infiltration. Material and Methods: We conducted a split-mouth randomized controlled trial among 70 patients who require bilateral maxillary local anesthetic (LA) injections for dental treatment. After applying the topical anesthetic, each participant received four local anesthetic injections, two on buccal and two palatal sides. At each visit, the participants received one buccal and one palatal infiltration based on the randomization. On the buccal aspect, participants received LA with a 26G needle injection on one side (control) and a 31G needle (test) on the contralateral side. On the Palatal aspect, participants either received LA with a 31G needle on one side (control). In contrast, the opposite side was preceded by topical ice application (iced cotton swab) before LA with a 31G needle (test). Both the visits were spaced with a gap of 7-10 days based on the participants' feasibility. Participants were asked to rate the pain on a visual analog scale independently for buccal and palatal LA injections. Results: On the Buccal aspect, the mean pain scores were 2.74 ± 1.26 and 2.11 ± 1.26 for control and test groups, respectively (p=0.002). On the Palatal aspect, the mean pain scores were 4.14 ± 1.49 and 4.3 ± 1.80 for control and test groups, respectively (p=0.295). Conclusion: Significant lower pain scores were reported with higher gauge needles (31G) when compared to traditional (26G) needles on the buccal aspect. No significant difference was seen with pre-cooling the injection site on the palatal aspect when used with higher gauged needles (31G).

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ABSTRACT Objective: To determine the frequency of oral potentially malignant disorders and Oral Squamous Cell Carcinoma (OSCC) and evaluate the consistency between their clinical and pathological features. Material and Methods: This retrospective study was conducted on records with a diagnosis of oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, lichen planus, and OSCC in the Pathology Department of Kerman dental school from September 1997 to September 2017. Data were analyzed in SPSS 21 at the significance level of ≤5%. Results: There were 378 cases of oral potentially malignant disorders and 70 cases of OSCC with a mean age of 46.82 ± 15.24 years. Buccal mucosa was the most frequent site, and lichen planus the most common lesion. Females were significantly older than males in leukoplakia and carcinoma in situ lesions. Clinical diagnosis and histopathology were consistent in 69.03% of cases. Conclusion: Clinical and histopathological diagnoses were consistent in 69.03% of records. The highest degree of clinical compliance with histopathology was observed in OSCC. Dentists should pay attention to oral potentially malignant disorders for early diagnosis to prevent their transformation to malignancy.

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ABSTRACT Objective: To evaluate the emotional and social experiences of parents or caregivers of children with cleft lip and/or palate (CL/P) in a city in the Northeastern of Brazil. Material and Methods: A quantitative and cross-sectional study was conducted among parents or caregivers of children with CL/P by interviews based on a questionnaire. Interviews were conducted during the First Smile Project in Sobral, Ceará, Brazil. All participants (n=41) agreed to participate in the interview and signed an informed consent. The data was analyzed in SPSS software version 22.0. Results: The majority of participants were female (87.2%), with a mean age of 37 years, with a low level of education and low family income. The great majority (90.2%) of the parents were not prenatally diagnosed to have CL/P babies. Of those interviewed, 56.1% mentioned that the first diagnosis of cleft lip and palate was not presented by the professionals in a clarifying way to the family. Fear (36.6%) and sadness (19.5%) were the main feelings experienced when the child was diagnosed with fissure. Feeding (48.8%) was pointed out as the main concern in caring for a child with CL/P. Conclusion: The parents and caregivers interviewed faced important emotional and social problems that must be addressed by the professional team that assists the child with CL/P.

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ABSTRACT Objective: To determine the children's primary dental treatment needs reported by the parents and pediatric dentists. Material and Methods: 125 children (36 girls and 89 boys) and their parents participated in this study. The children’s decayed-missing-filled teeth/teeth surfaces scores were recorded. A questionnaire about their children’s primary dental treatment needs was conducted with the parents. Shapiro-Wilk test was used to test the normality of the data. Kruskal-Wallis test was used to compare the clinical findings according to the categorical variables. The Chi-Square test was used to compare the categorical data. Also, multiple linear regression analysis was performed to determine the effect of some variables on children’s dmft/DMFT scores. The significance level was accepted as p<0.05. Results: The average age of the children who participated in the study was 7.59 ± 2.36 years. The main reason for applying to the paedodontics clinic was dental caries (38.4%), followed by dental pain (33.6%). As for the primary dental treatment needs, 28% of the parents said they needed dental filling, while 19.2% said they needed orthodontic treatment. According to the pediatric dentists, while the treatment rate of dental caries was 47.2% as the primary treatment need, it was only 4.8% for the orthodontic treatments. Conclusion: Turkish children who were admitted to paedodontics clinics were too old and dental caries and dental pain were the most common reasons for these visits to the clinics. The children's needs for primary treatment varied according to parents and pediatric dentists. There is a need for more comprehensive studies about the subject.

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Abstract Objective: To analyze differences in vertical mandibular and trunk symmetry in orthodontic patients. Material and Methods: This was a cross-sectional study of 129 growing orthodontic patients who sought orthodontic treatment at the Dental Hospital Universitas Sumatera Utara, Indonesia. Mandibular symmetry index was observed with pre-treatment panoramic radiography based on Kjellberg's technique and trunk symmetry was evaluated based on questionnaires and visual observation. Vertical mandibular asymmetry was decided if the index of asymmetry was lower than 93.7%. The bivariate analysis used the chi-squared and Fisher's exact tests, with a significance level of 5%. Results: There was a significant association between vertical mandibular and trunk symmetry (p<0.05). The prevalence odds ratio for the association with vertical mandibular asymmetry was 3.007 (95% CI = 1.016-8.905) for trunk asymmetry. Conclusion: The necessity to consider trunk symmetry could be included in orthodontics treatment of any malocclusion with vertical mandibular asymmetry that might require a multidisciplinary approach in the future.

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ABSTRACT Objective: To compare the survival of occlusal and occlusal-proximal restorations performed with resin-modified glass-ionomer cement (RMGIC) in deciduous molars using rubber dam and cotton rolls isolation. Material and Methods: Ninety-two patients were included and 200 deciduous molars with cavitated occlusal or occlusoproximal dentin caries lesions were randomized into two groups: cotton rolls (n = 100) and rubber dam (n = 100) and RMGIC restorations were placed. At baseline and in the follow-up visit, presence, severity and activity of caries lesions were registered. Two independent, blinded examiners evaluated the treated teeth clinically using the USPHS criteria and radiographically after 9 months. Descriptive analysis, survival curve (log-rank test) and Cox regression were performed to assess risk factors related to failure. Results: Out of the 179 teeth (92 cotton rolls group and 87 rubber dam group) evaluated at 9-month follow-up period. No lesion progression was observed radiographically. The overall treatment success rate was 85.47% (83.47% for cotton rolls and 87.35 rubber dam group). No significant difference between isolation methods was observed in the log-rank test (p = 0.16). Cox regression showed no risk factors related to failure. Conclusion: No difference was found in the survival of occlusal and occlusal-proximal restorations performed with RMGIC in deciduous molars using a rubber dam and cotton rolls isolation after a 9-month follow-up period.

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ABSTRACT Objective: To evaluate and compare lipid profile level in oral submucous fibrosis (OSMF), oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) patients. Material and Methods: Thirty histopathologically diagnosed subjects each of OL, OSMF, OSCC were recruited along with 30 healthy controls. 5ml of venous blood is collected and estimated using standard diagnostic kits. Results: The mean of Total cholesterol level in controls was 219.03 mg%, in OSCC, OL and OSMF was 142.89 ± 10.21mg%, 155.44 ± 17.63 mg% and 180.60 ± 13.25 mg%, respectively. The mean low-density lipid level in controls was 137.24 mg and in OSCC, OL and OSMF groups were 109.28 ± 2.16 mg%, 126.63 ± 0.85 mg% and 119.15 ± 0.93 mg%, respectively. The mean of high-density lipid level in controls, OSCC, OL and OSMF was 42.87 ± 0.42 mg%, 36.50 ± 2.31 mg%, 21.13 ± 0.77 mg% and 28.37 ± 1.11mg%, respectively. The mean of very low density lipids level in controls, OSCC, OL and OSMF was 30.12 ± 1.51 mg%, 17.24 ± 0.80 mg%, 22.25 ± 0.93 mg% and 25.89 ± 0.43 mg%, respectively. The mean triglyceride level in controls, OSCC, OL and OSMF was 118.80 ± 9.47 mg%, 91.2 ± 3.03 mg%, 105.05 ± 2.96 mg% and 106.19 ± 3.09 mg%, respectively. Conclusion: Lipid profile levels could be early indicators of precancer and cancer.

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ABSTRACT Objective: To evaluate the knowledge and attitude of the students of Kerman dental school (Iran) about ethics in dental research. Material and Methods: This cross-section study was conducted on 307 dental students selected through the census sampling method. Data were collected by a researcher-made questionnaire consisting of 12 items about knowledge and 17 items about attitude toward research ethics. Data analyzed in SPSS software using t-test and linear regression test. P-values of less than 0.05 were considered statistically significant. Results: Of the respondents, 33.9% were male and 66.1% were female, and 44% had good knowledge and 20.8% had a positive attitude about research ethics. A significant correlation was found between knowledge and attitude. A significant correlation was also observed between knowledge and participation in research workshops. Knowledge and attitude showed no significant correlation with gender or year of admission. Conclusion: Participants had appropriate knowledge and attitude about research ethics. There is some room for improvement in research ethics education concerning experimental works and retrospective studies on biologic samples. Holding research workshops with an introduction to ethical codes of research is recommended.

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ABSTRACT Objective: To test the modified Demirjian's method of dental age estimation on the South Indian population and correlate it with the patient's chronological age. Material and Methods: This retrospective radiographic study was performed on digital panoramic radiographs taken during a one-year duration. Radiographs of patients in the age range from 8 to 18 years were included in the study. The radiographs were examined and according to the stage of the crown and root status of the left side mandibular teeth. The stage of calcification was observed for eight teeth in the mandibular arch and was recorded in a specially designed proforma. Each rated tooth with stage was converted into a score using a conversion table specified for girls and boys. Results: 224 digital panoramic radiographs were retrieved from the radiologic database. Out of total study sample, 49.5% (n=111) were boys and 50.5% (n=113). The mean chronological and estimated dental age using dental maturity scores resulted in an overestimation of 3 years and eight months. Also, it was noted that there was a strong positive association between chronological (real) and dental age. Conclusion: It was observed that there was a strong correlation between chronological and dental age. A new formula for determining the chronological age from the estimated dental age was derived. Further studies on a larger population may prove the reliability of this age estimation method.

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ABSTRACT Objective: To compare the agreement of clinical and radiographic diagnosis with the histopathological diagnosis in fibro-osseous lesions of the jaws. Material and Methods: An analytical and exploratory study was made based on systematic collected data, carried out in the laboratory of surgical pathology of a public Dental School. There were evaluated cases of fibrous dysplasia (FD), cemento-osseous dysplasia (COD) and ossifyng fibroma (OF), diagnosed by clinical, radiographic (panoramic and periapical radiography), and histopathological analysis, in a period of 12 years (from March 2001 to June 2013). Descriptive and inferential statistics (Fisher's exact test) were obtained. Results: Ninety-six cases of FOLs were evaluated. The radiographic aspects of the FOLs studied did not differ significantly (p=0.09). Radiolucent lesions were the least frequent, corresponding to approximately 13.5% of radiographic findings. Mixed lesions and radiopaques were more present, how they were COD and FD, respectively. The more aggressive variation of OF (Juvenile Ossifying Fibroma - JOF) was less frequent among the pathologies evaluated. In approximately 61.46% of the cases clinical and radiographic diagnosis were confirmed by histopathological diagnosis of FOLs. The highest agreement and the highest disagreement were observed in COD cases (40.7% and 62.2%, respectively). Conclusion: FOLs of the maxillaries represent a group of lesions in which the establishment of the clinical and radiographic diagnosis supported by the histopathological confirmation is critical and challenging.

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ABSTRACT Objective: To assess the relationship of ɑ and ß angles of maxillary impacted canines with maxillary lateral incisor root resorption. Material and Methods: For this, 40 patients (between 11 and 45 years) with impacted maxillary canines presenting to a private orthodontic clinic were evaluated.20% of the cases were male and 80% were female. The ɑ and ß angles were measured on panoramic radiographs to determine the angulation of impacted canine. CBCT scans had been taken by ProMax 3D CBCT system were used to examine lateral root reorption. The relationship between the size of ɑ and ß angles of impacted maxillary canines and root resorption in the adjacent maxillary lateral incisor was analyzed using SPSS version 22. Results: The mean size of ɑ and ß angles had no significant correlation with the presence/absence, location, or severity of root resorption in the adjacent lateral incisor or the buccolingual position of impacted canine. The ɑ and ß angles in impacted maxillary canines cannot be used to determine the incidence or severity of root resorption in the adjacent lateral incisor. Conclusion: No significant association between ɑ and ß angles and incidence or severity of root resorption in the adjacent lateral incisor was found.

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ABSTRACT Objective: To evaluate in vitro the flexural strength of two newer composite resin materials. Material and Methods: Twenty-four samples were equally divided into two groups: G1 - Brilliant EverGlow and G2: Brilliant NG. The rectangular blocks of 25 mm in length, 2 mm in width and thickness were prepared from two composite materials. Blocks were created by applying composites to a customized split mold and formed between two parallel glass plates. Before light-curing, blocks were covered with Mylar strips and rinsed for 10 seconds in water. Subsequently, they were stored in distilled water for 24 hours at 37ºC and 100% humidity before testing. Each sample was placed within a suitable framework of aluminum. The length of gap between the support was 21 mm and the speed of crosshead at 1 mm/minute. The data were subjected to an independent t-test. The level of significance was set at p <0.05. Results: A less flexural strength was observed in G1 (77.43 Mpa) compared to G2 (118.70 Mpa) (p<0.001). Conclusion: Universal nanohybrid composite resin material was found to have greater flexural strength than universal submicron hybrid composite material.

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ABSTRACT Objective: To determine the prevalence of malocclusion and associated factors in children and the level of knowledge of mothers participating in the child care group of a basic health unit. Material and Methods: This is a cross-sectional study conducted in children between 18 and 72 months of a childcare group in Pelotas. Children whose parents or legal guardians signed the informed consent term participated in the study. Data were collected through a questionnaire previously tested and applied to the mothers, and a clinical examination of children's occlusion were performed by examiners after training and calibration. Statistical analysis was descriptive and analytic. In the bivariate analyses, it was used the Pearson, Fisher or Linear Trend Qui-Square tests and, in the multivariate analysis, the Poisson regression. Prevalence ratios and 95% confidence intervals were obtained, and a p-value <0.05 was used. Results: Forty-seven children were included and 41.3% presented malocclusion. The prevalence of malocclusion was associated with a higher number of children in the family (p<0.005) and breastfeeding for more than 12 months (p<0.05). The highest prevalence of open bite was associated with the use of a pacifier and working mothers (p<0.05). Conclusion: Most mothers reported having knowledge about the time and use of pacifiers in childhood. In this group, the prevalence of malocclusion in children was high and associated with behavioral and social factors.

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ABSTRACT Objective: To determine the prevalence of third molar agenesis and associated characteristics. Material and Methods: A total of 2374 panoramic radiographs were retrieved from the radiological archives and evaluated in a computer monitor under optimum viewing conditions. The basic demographic data (age and sex) and the primary findings regarding the presence or absence of third molars in the maxillary and mandibular arches were recorded systematically in a specially designed proforma. Categorical variables were compared using the Chi-square test. Results: A total of 2000 panoramic radiographs were included in the study, of which 1004 were females (50.2%), and 996 were of males (49.8%). The incidence of third molar agenesis was 486 patients (24.3%). Maxillary third molar showed a higher prevalence of agenesis (28.8%) than mandibular third molars (16.4%). A total of 1514 patients (75.7%) had third molars in all four quadrants, and the remaining 486 patients (24.3%) had agenesis of third molar tooth in at least one of the quadrants. Single tooth agenesis was observed in 219 (11%) patients, two teeth agenesis in 172 (8.6%) patients, three teeth agenesis in 39 (2%) patients, and four teeth agenesis in 56 (2.8%) patients. Conclusion: The present study exhibited a maximum number of single tooth agenesis. It was also observed that maxillary third molar agenesis is more than the mandibular third molar and the right side is more than the left side. Agenesis of the third molar is more prevalent in males as compared to females.

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ABSTRACT Objective: To assess the clinical competence of undergraduate dental students in pediatric dentistry at Qassim University dental school. Material and Methods: A retrospective audit of students' clinical competency sheets of fourth and fifth-year students (n= 102) over two years was performed. Mean competency scores for each clinical procedure aswell as overall scores of the students were compared according to their academic level and gender. Also, the percentage of competent students was compared according to the academic level. Chi-square and t-tests were used to analyze the data (p<0.05). Results: Compared to fifth-year students, fourth-year students were significantly more competent in pediatric dentistry (100% scored >50% overall compared to 86.9 % of fifth-year students). They had significantly higher mean overall scores (84.63 ± 9.15 compared to 67.68 ± 13.83) as well as individual scores in performing an examination, diagnosis, and treatment planning of a child patient, restorations, and stainless steel crowns than fifth-year students. In addition, females had significantly higher mean scores in the aforementioned procedures and in placing esthetic crowns (p<0.05). Conclusion: Fourth-year dental students at Qassim University were more competent clinically than fifth-year students in pediatric dentistry. Also, in most of the shared procedures, females were more competent than males. A deficiency in the competence of fifth-year students was noted in pulp therapy, stainless steel and esthetic crowns procedures, and these are currently being addressed.

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ABSTRACT Objective: To compare and assess the primary and secondary closure techniques following extraction of impacted third molars for post-operative complications. Material and Methods: In total, 30 patients ranging between 18-30 years of age and of either sex who had bilaterally impacted mandibular third molars were randomly selected. Split mouth study method was used so that the participants served as their own control. Group 1 consisted of primary closure of left mandibular impacted third molars and Group 2 consisted of secondary closure of right mandibular impacted third molars. Basement evaluations were recorded for each patient along with subjective and objective evaluations for postoperative 7 days. Data analysis was carried out by SPSS 17.0 software using Mann-Whitney U test, Wilcoxon matched-pairs test and t-test. A p-value ≤ 0.05 was assigned as statistically significant. Results: When compared to group 1, group 2 revealed statistically less pain and swelling following the secondary closure of wound from day 1 to 7. There was a significant improvement in mouth opening in Group 2 at day 1 (p=0.0005) and at day 7 (p=0.00001). Conclusion: Secondary wound closure after disimpaction of mandibular third molar results in better postoperative recovery than primary closure.

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Abstract Objective: To measure the level of immunoglobulin G (IgG) in the gingival crevicular fluid (GCF). Material and Methods: A total of 158 patients aged >45 years were examined for periodontitis and interviewed regarding their menopausal status. The non-menopause group entailed female patients with periodontitis without menopause (n=23). The menopause group included females who stopped menstruating since >1 year, had a pocket depth of 4-5 mm, and did not have other systemic conditions (n=40). Samples were selected based on periodontal and menopausal status. In total, 63 samples of GCF were collected from the participants and tested using an enzyme-linked immunosorbent assay kit for IgG. Results: The median level of IgG in the menopause group was 39.50 (g/mL, whereas that of the non-menopause group was 41.08 (g/mL. There was a positive correlation between the plaque index and IgG level in both groups. In contrast, there was a negative correlation between age and IgG level. However, there was no correlation between plaque index and age regarding the IgG level in both groups (p>0.05). Conclusion: The IgG levels in the menopause group were lower than those in the non-menopause group. As such, menopausal females should take great care of their overall health, including the periodontium.

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ABSTRACT Objective: To evaluate the influence of oral health clinical and non-clinical indicators on adolescents’ academic performance. Material and Methods: A longitudinal design was performed with a random sample of 1,134 12-year-old Brazilian adolescents. In 2012, the adolescents were clinically assessed by calibrated dentists and investigated about demographics, socioeconomic factors, dental service use, toothache, and verbal bullying related to oral condition via structured questionnaires. The contextual variable was obtained from the city’s official database. After two years, 771 adolescents were reassessed. The outcome adolescent’s academic performance (good or poor) was collected through official school’s register. Multilevel logistic regression analyses were performed to assess associated factors for adolescents’ academic performance. Results: Adolescents with toothache (OR 1.74; CI 95%: 1.05-2.89), who have been a victim of bullying (OR 2.23; CI 95%: 1.21-4.09), and were male (OR 1.92; CI 95%: 1.19-3.09) had a lower academic performance. On the other hand, adolescents whose mothers had higher educational levels (OR 1.79; CI 95%: 1.08-2.97) and belonged to higher-income households (OR 1.95; CI 95%: 1.18-3.23) had higher academic performance when compared to their peers. Conclusion: Adverse oral conditions, as well as subjective and socioeconomic factors, impacted on adolescents’ academic performance.

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ABSTRACT Objective: To analyze caries experience depending on periodontitis affection concomitant or not with cardiovascular risks or mental health issues with the hypothesis that worse accumulated caries experience is not necessarily the result of the presence of concomitant overall health issues. Material and Methods: All subjects of this cross-sectional study were participants of the Dental Registry and DNA Repository project. Variables age, ethnicity, sex, caries experience, periodontitis and mental disease statuses and blood pressure assessment, dental clinical data (DMFT, DMFS and periodontitis) were evaluated and collected from the clinical records. We used chi-square, Fisher's exact, or Student's t-tests to determine differences in frequencies of sex, age, ethnicity, and dental clinical data depending on caries experience, periodontitis, mental health status, and cardiovascular risks. The established alpha was 5%. Results: Of the total 1,437 subjects included in this study, 407 were individuals with high blood pressure and 1,030 were individuals without high blood pressure. Also, 558 were individuals with mental disease and 879 were individuals without mental disease. High blood pressure patients were mostly men (47.17%) and women were the majority when analyzing patients with mental illness (60.04%). Most of the patients in the different groups were white, with a mean age ranging from 15.4 to 88 years. Conclusion: We concluded that caries experience concomitant or not with periodontitis affection does not associate with high blood pressure and mental disease.

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ABSTRACT Objective: To compare salivary and serum biochemical levels in patients with chronic renal failure undergoing hemodialysis. Material and Methods: The sample was composed of 57 patients treated in Hemodialysis Reference Centers, from a state of Northeastern Brazilian, with age ≥21 years old with at least 3 months of hemodialysis treatment time. Serum data were obtained from records. Unstimulated and stimulated saliva were collected. Flow rate (mL/min) was measured. Spectrophotometry was performed for the measurement of salivary levels of calcium (570 nm), urea (340 nm), and creatinine (510 nm). Statistical analysis used Mann Whitney and Kruskal-Wallis tests (p<0.05). Results: Unstimulated and stimulated salivary flow rates were 0.43 mL/min and 1.69 mL/min, respectively. There was significant difference (p<0.001) of levels of calcium (5.41 mg/dL and 9.70 mg/dL), urea (118.03 mg/dL and 183.22 mg/dL) and creatinine (0.59 mg/dL and 9.20 mg/dL) between saliva and serum, respectively. Concerning the time of hemodialysis, salivary and serum calcium not exhibited significant association; however, serum urea (p=0.012) and serum creatinine (p=0.025) showed significant association to the time of hemodialysis. Conclusion: Salivary biochemical levels of urea, creatinine and calcium can indicate the presence of a possible chronic renal failure and the saliva demonstrated to be a potential auxiliary biofluid for clinical monitoring renal alterations.

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ABSTRACT Objective: To investigate the antibacterial, mechanical, physical properties and water sorption of flowable dental composites containing 3,4-dihydropyrimidin-2(1H)-ones. Material and Methods: 3,4-dihydropyrimidin-2(1H)-ones was synthesized and the antibacterial activity of flowable dental composites containing 0-5 wt% 3,4-dihydropyrimidin-2(1H)-ones and also of their mechanical and physical properties on flowable dental composites were investigated. Flexural strength was measured by a three-point bending test. Compressive strength (CS), Water sorption (WS) and depth of cure (DOC) were investigated. The data were analyzed by One-way ANOVA test. The level of significance was determined as p<0.01. Results: The direct contact test demonstrates that by increasing the 3,4-dihydropyrimidin-2(1H)-ones content, the bacterial growth is significantly diminished (p<0.001). The average flexural strength results show that with increasing 3,4-dihydropyrimidin-2(1H)-ones until 3% in the composite, no significant difference was observed in flexural strength (p>0.001) and the mean of compressive strength results show no significant difference between 0-4% groups (p>0.001). The mean of water sorption and depth of cure results shows no significant difference between groups (p>0.001). Conclusion: Incorporation of 3,4-dihydropyrimidin-2(1H)-ones into flowable resin composites in 3% wt can reduce the activity of Streptococcus mutans.

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ABSTRACT Objective: To evaluate the association of oral health indicators and social variables on the frequency of visit to the dentist by persons with intellectual disability (ID). Material and Methods: The study comprised a sample consisting of 149 participants with ID, aged from 11 to 29 years, from non-governmental institutions. Semi-structured interviews were held to collect sociodemographic and psychosocial information with their parents/guardians, followed by oral health evaluations in accordance with World Health Organization criteria. Crude analyses and multiple analysis were conducted to test whether oral health indicators and social data were predictors of the visit to dental care services. Results: In the multiple logistic regression model, individuals with lower DMF-t (OR=3.13; 95% CI=1.40-6.97) and those with less crowded housing (OR=2.33; 95% CI=1.06-5.12) presented less frequency of visits to oral health services. Conclusion: DMFT and crowded housing are associated to the frequency of persons with intellectual disability to dental care as well as this outcome measure affects the oral health of persons with ID. Therefore, identifying limiting factors to dental care of persons with intellectual disability is needed so that this group can receive adequate attention.

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ABSTRACT Objective: To identify proteins associated with the formation of Streptococcus gordonii and Fusobacterium nucleatum biofilms. Material and Methods: Biofilms composed of two bacterial species, S. gordonii and F. nucleatum, were cultured for 1, 4, 7, and 10 days. The presence of both species was confirmed via amplification of the srtA and radD genes using real-time PCR. The concentrations of proteins associated with the biofilms and individual species were quantified using Western blotting. Results: The protein profiles of S. gordonii and F. nucleatum from individual cultures determined using one-dimensional electrophoresis revealed proteins found in S. gordonii and in F. nucleatum. Ct and reciprocal Ct values were determined for the exposed S. gordonii and F. nucleatum biofilms. Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) protein was detected in biofilms and F. nucleatum, whereas HSP40 protein was present only in biofilms after 7 and 10 days of formation. Conclusion: HSP40 was detected only in the formed biofilms; thus, HSP40 is an essential proteins for adhesion.

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ABSTRACT Objective: To investigate the influence de two instruments for evaluation of cariogenic foods consumption by schoolchildren. Material and Methods: The convenience sample comprised of 30 active-caries children (7-10 years old) attended in a public dental clinic and their mothers, who have not received dietary orientation before study. A trained evaluator administered the Previous Day Food Questionnaire (PDFQ) to children and other examiner applied the 24-hour dietary recall with mothers. Internal consistency between PDFQ and 24-hour dietary recall regarding frequency of sugar intake was calculated using intraclass correlation coefficient. Bivariate analyses (Mann-Whitney test) were performed to investigate the factors associated with frequency of sugar intake when using both instruments (α=0.05). Results: A moderate correlation (ICC = 0.51; 95%CI: -0.04-0.77; p=0.03) was found between instruments. Mean frequency of sugar intake reported by mothers and children was 3.5 (± 1.8) and 3.7 (± 1.5) times a day, respectively. When using the PDFQ, the frequency of cariogenic foods consumption varied depending on frequency of toothbrushing, i.e., children that had higher frequency of sugar intake brushed their teeth at least two times a day (p=0.016). Conclusion: Previous Day Food Questionnaire applied with schoolchildren could substitute the mothers' reports of cariogenic foods consumption when dietary interventions for controlling dental caries are necessary. If doubts remain regarding the children's response, mothers should be consulted.

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ABSTRACT Objective: To assess the 6-month efficacy of natural tooth color change in in-office bleaching treatment in terms of time by using a spectrophotometer. Material and Methods: A total of 20 participants were chairside treated with 40% hydrogen peroxide (HP), three applications each 20 minutes, in one appointment. Instrumental color measurement was performed on six anterior maxillary teeth before bleaching (baseline-t0), immediately after in-office bleaching and rehydration of the teeth (t1), 3 months (t2), and 6 months after bleaching treatment (t3). The spectrophotometer measured the tooth shades based on the CIE L*a*b* color notation system and Bleach index during the period of observation. CIE L*a*b* (ΔEab) color differences were calculated. Results: The color change at t1 was ΔEab = 3.2, at t2 was ΔEab = 1.8, at t3 was ΔEab = 1.2 and overall color change of in-office method was ΔEab = 3.6 (p<0.05). A significant effect for the mean CIEL*a*b* values was detected as within time b* values decreased significantly (p<0.05). Bleach index values significantly decreased during the time of observation, too (p<0.05). Conclusion: The in-office bleaching treatment using 40% hydrogen peroxide was effective, and the results showed a statistically significant decrease in color change during the period of 6-month observation.

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ABSTRACT Objective: To evaluate Indian dental students' perception of seeking international dental higher education during COVID-19. Material and Methods: We conducted an online survey among the dental students. A self-administered questionnaire was prepared, which had information on country choice, reasons for the decision to study abroad, measures to be taken by the foreign universities because of COVID-19, the application's status, current plan, and opinions on exploring other possibilities. Results: Four hundred students constituted the final sample, out of which the majority were females (69.3%). Most of the students were not sure about their status in the application process (63%). The current plan to study abroad remained uncertain for almost half of the students (50.2%). Concerning the status of the application process, a significantly higher number of female students were "not sure" and are still "searching colleges" (p<0.001). Similarly, a higher number of females were "uncertain" or "postponed" or "canceled" when compared to the males concerning the current plan to study abroad (p=0.001). Also, a significantly higher proportion of female students cited the study budget as the main deterrent for pursuing a career abroad and opined that "flexible study options" will help them get admissions post-COVID-19 (p=0.001 and 0.035). Conclusion: A substantial impact was perceived by Indian dental students concerning higher education abroad, more among females.

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ABSTRACT Objective: To analyze periodontal comparison between Systemic Lupus Erythematosus (SLE) subject and healthy control. Material and Methods: This descriptive cross-sectional study included 122 subjects, 61 SLE patients and 61 healthy subjects who visited the Rheumatology Department, Dr. Saiful Anwar General Hospital, Malang, during 2017-2018. Clinical examination of SLE was using Mexican SLE Disease Activity Index and oral cavity conditions were assessed using the periodontal index, gingival index, calculus index, bleeding on probing, clinical attachment loss and mobility teeth. Results: The age of SLE patients ranged from 18-55 years old with the mean age of 29.50 ± 9.57 years old. Periodontitis was higher in SLE patients (88.5%) than healthy subjects (22.95%). In addition, periodontitis occurrence in SLE (2.66 ± 1.02) was significantly different (p<0.001) compared to healthy subjects (0.51 ± 0.81). Conclusion: This study found higher rates of periodontitis, gingivitis, bleeding on probing, clinical attachment loss, and mobility tooth among SLE patients compared to healthy subjects. Periodontitis was also found to be higher along with more severe SLE group.

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ABSTRACT Objective: To establish the validity of COVID-19 Peritraumatic Distress Index (CPDI) questionnaire and assess the stress with its associated factors during COVID-19 among dental professionals in Bhubaneswar, India. Material and Methods: An online survey through Google Forms was steered among 234 dentists. CPDI questionnaire was used for data collection post its validation assessment. Content validity was judged satisfactory by two psychiatrists, and excellent internal consistency was found (Cronbach’s alpha = 0.92). For statistical analysis, chi-square and binomial logistic regression tests were used with a significance level of p=0.05. Results: 70 (29.9%) were males and 164 (70.1%) were females with a mean age of 30.58 ± 6.70 years. Around 50% had an MDS degree and were attached to an institution and nearly 80% were having experience of less than 10 years. The mean CPDI score was found to be 29.09 ± 15.47. A statistically significant association was observed between CPDI scores with age (p<0.003), gender (p<0.03), practice (p<0.06) and education (p<0.006). Binomial logistic regression revealed that odds of stress were 2 times higher among males than females (OR=2.01, p<0.04), which was statistically significant. Conclusion: Acceptable validation scores confirmed CPDI as an effective instrument for detecting stress. Importance of early interventions to combat the issue of stress among dental professionals as it is allied with negative consequences on health and furthermore affects daily activities is highlighted.

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ABSTRACT Objective: To evaluate and systematize tongue color-related manifestations among patients with PCR-confirmed COVID-19 infection. Material and Methods: This retrospective study included analysis of tongue images obtained from patients with PCR-confirmed COVID-19 infection. Evaluation of coronavirus disease severity (mild, moderate, severe, critical) was provided, considering clinical symptomatology and results of laboratorial and instrumental diagnostic methods. Each picture was analyzed considering the parameters of color of the tongue and color of the tongue plaque by two dental specialists. Cochran-Armitage test for trend was used to evaluate associations between the tongue color and tongue plaque color, and coronavirus disease severity. Results: The most prevalent tongue colors were pale pink, red and dark red (burgundy color). A total of 64.29% of patients with mild disease demonstrated pale pink color of the tongue. Patients with moderate coronavirus disease were characterized with the adverse trend: 62.35% of them presented with red-colored tongue, while in 37.64% of cases, the tongue was pale pink. Severe COVID-19 patients, almost in 90% of the cases, had either red or burgundy color of the tongue. Conclusion: SARS-COV-2 infection is not manifested by tongue-targeted or tongue-specific signs and features; however, coronavirus disease itself provokes changes within the tongue color and tongue plaque color similar to those registered during other internal pathologies.

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ABSTRACT Objective: This cross-sectional study aimed to assess clinical dental status in military firefighters of Rio de Janeiro State and compare data with Brazilian National and Regional oral health surveys. Material and Methods: A sample of 926 military firefighters was examined using the visible biofilm index, the DMFT index and the Community Periodontal Index (CPI). Clinical exams were performed by 15 trained dentists. The Kruskal-Wallis test and Mann-Whitney test with Bonferroni correction were used. Results: Higher biofilm accumulation was associated with increased age. The mean DMFT index for the whole sample of this study was 12.74 (±7.03), and the ‘filled’ component was the most prevalent (69.9%), whereas the ‘decayed’ and ‘missing’ components were, respectively, 8.4% and 21.7%. There was a higher prevalence of periodontal diseases with increasing age, ranging from 57.1% in firefighters of 34 years or less to 70.5% in the ones between 35 and 44 years old and 75.4% in participants at age 45 years or older. Clinical dental status of the military firefighters who belonged to the age group 35-44 was better than the one observed for the Brazilian population at the same age range. However, pathological conditions that can be solved with health promotion strategies associated with dental procedures of low complexity still persist. Conclusion: These results suggest that the availability of dental health care services itself does not represent the most effective approach to the oral health problems found in the studied population.

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ABSTRACT Objective: To compare the detection rate of root canal orifices of maxillary first molar by various techniques in the Indian population. Material and Methods: A total of 50 maxillary 1st molar cases were selected and sequentially divided into four groups: Group I: Naked eye; Group II: Surgical loupe; Group III: Surgical operating microscope; and Group IV: Fluorescein sodium dye. After access opening, the number of root canal orifices was detected in all cases with these methods. Results: By naked eye and surgical loupe, a total of 171 root canal orifices were detected, by a surgical operating microscope, 176, and by fluorescein sodium dye, 177 root canal orifices were detected. The detection rate of root canal orifices is as follows: Group I (96.61%) = Group II (96.61%) < Group III (99.44%) < Group IV (100%) and detection rate of MB-2 canal orifices Group I (40%) = Group II (40%) < Group III (50%) < Group IV (52%). No significant difference in the number of canal orifices detected could be seen for any of the comparisons. No significant difference was observed between the naked eye and surgical loupe techniques. Although the surgical operating microscope detected more root canal orifices, it did not have a significantly higher detection than the other two techniques. Conclusion: No significant difference was seen among various methods. However, the use of a surgical operating microscope and fluorescein sodium dye increased the detection rate of root canal orifices.

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Abstract Objective: To compare the estimates obtained, considering or not the weighting data. Material and Methods: Secondary data from the Oral Health Survey of the State of São Paulo (SBSP2015) was used for calculation of mean estimates, standard errors of the mean and confidence intervals (CI) for the DMFT index and components (decayed, lost and filled), in the age group of 35-44 years. Multiple logistic regression models were estimated, considering or not the weighting from the sampling plan (p<0.05). Results: It was observed that the estimates of the DMFT index and the carious component did not vary much when the design was considered or not (1.1% and 2.0%, respectively). However, the data referring to the lost and filled component showed greater differences between the values of the means. The averages fluctuated up and down by up to 6.7% for weighted versus unweighted analyses. The standard error was underestimated in the unweighted analysis and the confidence interval showed variations. Differences between the regression models obtained by the weighted and unweighted analysis of the data were detected. Conclusion: Although weighted and unweighted models presented differences of less than 10% in estimates of the mean, confidence intervals, as well as statistical inferences, were different. Thus, weighting should be applied in the population base data analysis collected by sampling with complex designs.

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Abstract Objective: To evaluate the knowledge of patients treated in a public University concerning dental avulsion and its emergency first-aid management. Material and Methods: Three hundred patients were invited to answer a questionnaire about demographic characteristics, attitude and knowledge of first-aid management of dental avulsion. Chi-square test was used to assess the association between knowledge about dental replantation and education level. Results: Female gender (66.7%) aged from 31 to 40 years (31.3%) with high school education (50.3%) predominated among all the participants. It was not found a difference between education level and management of avulsed permanent teeth (p=0.076), and 66% of the respondents were not able to do the replantation. In relation to the management of avulsed tooth, 42.7% of the respondents would brush the tooth and if the replantation was not possible, most of them would choose inappropriate media for storage. The association between the storage medium and educational level showed to be statistically significant (p=0.043). Conclusion: It was possible to notice the lack of knowledge about this subject, and it could result in the worst prognosis. In avulsion cases, the subsequent root resorptions may lead to the loss of the child's tooth. It is important to implement educational campaigns to spread knowledge and improve success rates of permanent avulsed teeth

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Abstract Objective: To analyze the role of an individual’s perception of their partner’s oral health in heterosexual couples. Material and Methods: The exploratory study with a qualitative and quantitative approach and data were collected in households in 2015. The quantitative data were analyzed using simple and multivariate binary logistic regression (p<0.05), and the qualitative using Thematic Content Analysis. Results: Of 143 participants, 113 (79.0%) were in a relationship and made up the final sample of the present study. Both women and men reported a small percentage of discomfort in relation to their partners’ oral health (23.1% vs. 14.8%; p=0.199), and only a few had received complaints about their own oral health (20.7% vs. 10.7%; p=0.179). However, almost half of the sample had been told by their partner to see the dentist (47.6% vs. 31.0%; p=0.156), and of these, most were men (48.3% vs. 25.0%; p=0.022). The men that were more likely to be told by their partners to see the dentist (OR=5.82; 95% CI: 1.71-19.80) were upper-class (OR=3.35; 95% CI: 1.05-10.67), workers (OR=7.45; 95% CI: 1.62-34.20) who were dissatisfied with their oral health (OR=3.45; 95% CI: 1.13-10.51). The participants’ reasons for complaining of their partners’ oral health or for telling them to see the dentist were related to physiopathological clinical aspects and healthcare habits. Conclusion: The women told their male partners to seek dental services more often, and future studies should explore whether women are predictors of care and the validity of this information as an indicator of the oral health condition of their male partners.

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Abstract Objective: To evaluate the effect of the COVID-19 pandemic on senior undergraduate dental students' psychological health by measuring depression, anxiety, and stress levels. Material and Methods: 259 fifth-year dental students participated in this study, including 156 females (60.2%) and 103 males (39.8%), aged 20–25. An online-based questionnaire was created, including a few questions about learning, post-graduation challenges, and fear of the virus exposure. Students were asked to define their acute anxiety state by visual facial anxiety scale (VFAS) and depression, anxiety, and stress levels by The Depression, Anxiety and Stress Scale (DASS-42). All data were analyzed statistically. Results: Participants stated online learning platforms were insufficient for clinical competence (91.5%), the COVID-19 pandemic changed post-graduation career perspectives (29.3%), and they feared exposure to COVID-19 while performing their profession (82.6%). Acute anxiety levels of the students were recorded as 95.4% mild to highest. Mild to extremely severe depression, anxiety, and stress scores of the participants were 82.1%, 79.6%, and 72.9%, respectively. Higher mean values for all depression, anxiety, and stress parameters were obtained in females than males (p<0.05). Conclusion: Data showed that the psychological health of senior undergraduate dental students had been affected adversely due to the COVID-19 pandemic.

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Abstract Objective: To evaluate the reliability of infrared (IR) thermal camera connected to smartphones, already used in medicine for diagnostic purposes, as an easy tool for access screening to pediatric dentistry services. Material and Methods: After the preventive telephone triage, thirty orthodontic patients (7-13 years) underwent temperature measurement in the office with two no-contact IR devices: forehead digital thermometer and thermal-camera connected to a smartphone (reference areas: forehead, inner canthi, ears). Measurements were compared and differences were statistically investigated with T student’s test (p<0.01). Results: Forehead digital thermometer temperatures were superimposable to those recorded in ear areas and inner canthi with the thermal camera connected to a smartphone. Differences were not statistically significant even in comparison between the sexes. Forehead temperature values detected with a thermal camera are lower than those detected with a digital forehead thermometer. Conclusion: Thermal camera on a smartphone could be reliable in measuring body temperature. Mobile thermographic values of ears and inner canthi areas can be used as an alternative to forehead digital thermometer measurements. Further applications in pediatric dentistry of thermography on smartphones should be examined.

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Abstract Objective: To determine the level of biofilm formation of S. mutans after being exposed to 5% sucrose, 8% lactose, or 1% xylitol. Material and Methods: This research was a laboratory-based experimental study with post-test only control group design. S. mutans was grown in test tubes containing tryptose soy broth (TSB) medium supplemented with 1% glucose. They were incubated at 37° C for 24 hours to grow the biofilms. The culture was then exposed to 5% sucrose, 8% lactose or 1% xylitol, incubated for 24 hours at 37° C, and examined using ELISA at a wavelength of 625 nm. The statistical analysis was performed using a one-way analysis of variance followed by the least significant difference test (a=0.05). Results: There were some differences in the biofilm formation of S. mutans after exposure to 5% sucrose, 8% lactose, or 1% xylitol (p<0.05). An LSD test indicated significant differences among the biofilm formations after exposure to 5% sucrose and 8% lactose and between 5% sucrose and 1% xylitol. In comparison, there were no significant differences (p>0.05) between 8% lactose and 1% xylitol. Conclusion: Sucrose, lactose and xylitol can form biofilms and the formation of lactose biofilms is the same as xylitol.

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Abstract Objective: To analyze the distribution of childhood cancer in Brazil and the time between the diagnosis and the start of treatment, according to hospital-based cancer registries (2010-2016). Material and Methods: This was an observational descriptive study using secondary data (36,187 records) from hospital databases of the National Cancer Institute (INCA) and the Onco-center Foundation of São Paulo (FOSP). Epidemiological data were obtained, and compliance with Federal Law 12,732/12 was verified, which establishes a maximum period of 60 days to start cancer therapy after the diagnosis. Absolute and percent frequencies, central tendency and dispersion measures, and the coefficient of prevalence of childhood cancer were calculated. Results: The mean age of the pediatric patients was 9.3 years (± 6.2); 54.1% (n=19,586) of them were males; 32.0% (n=11,440) were aged 0 to 4 years; and 43.4% (n=11,338) had a self-reported mixed-race skin color. The Southeast region of Brazil accounted for 40.2% (n=14,564) of the cases, of which 63.0% (n=9,178) corresponded to solid neoplasms, as opposed to the North region, where hematological neoplasms prevailed (53.9%, n=1,535). Most registered patients aged 0 to 19 years were treated in 60 days or less (77%, n=27,929). However, for 24.0% (n = 2,207) of adolescents (15 to 19 years) this time was more than 60 days after the diagnosis. Conclusion: The characteristics related to childhood cancer varied across the Brazilian geographic regions, and most patients were properly treated within the time enforced by law.

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ABSTRACT Objective: To investigate the relationship between mental health and spiritual well-being among general and post-graduate dental students. Material and Methods: This is a cross-sectional, descriptive-analytical study conducted on 268 general and post-graduate dental students. Data collection tools included the Mental Health Questionnaire (GHQ-28: General Health Questionnaire) and the Spiritual Health Questionnaire. The data were analyzed by the SPSS version 25 using Independent Samples t-test, One-way ANOVA, Pearson correlation coefficient, Multiple linear regression with a significant level at 0.05. Results: The total score of the Spiritual Health Questionnaire was 71.48 ± 0.507 and the Mental Health Questionnaire was 40.31±0.65. There was a significant difference in the spiritual health status between the general and post-graduate students (p=0.009). Overall, there was a significant positive relationship between the students' spiritual health and mental health (p=0.045), although a significant relationship was evident between mental health and age of the students (p=0.019). Conclusion: The spiritual health was high in the dental students and Kerman University of medical sciences residents. Also, there was a positive significant relationship between spiritual and mental health.

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ABSTRACT Objective: To assess the effect of metal artifact reduction (MAR) algorithm of two cone-beam computed tomography (CBCT) software programs on the accuracy of peri-implant bone width measurements. Material and Methods: This in vitro study evaluated 35 bovine rib bone blocks measuring 8 x 8 x 11 mm. Titanium implants were inserted in bone blocks and placed in a wax model of mandible. CBCT scans were obtained with ProMax 3D and Cranex 3D CBCT systems with and without the MAR algorithm. The width of buccal and lingual bone plates surrounding the implant was measured on CBCT scans by two observers. The Cronbach’s alpha was calculated to assess inter-observer agreement. The area under the curve (AUC), sensitivity and specificity values were calculated and compared. Results: The two observers had an excellent agreement. The accuracy of Cranex 3D was higher than that of ProMax 3D (p<0.05). Both CBCT systems showed higher accuracy when the MAR algorithm was not used (p<0.05). Both CBCT systems showed higher accuracy for measuring the width of the lingual plate than buccal plate (p<0.05). Conclusion: The application of MAR algorithm did not notably increase the measurement accuracy in any CBCT system. Cranex 3D showed generally higher measurement accuracy than ProMax 3D.

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ABSTRACT Objective: To evaluate the quality of life of mothers of Brazilian children with congenital Zika virus syndrome (CZS) and associated factors. Material and Methods: This cross-sectional study assessed the quality of life (QoL) of 65 mothers of children diagnosed with CZS using the WHOQOL-bref questionnaire. Information related to mothers and children's characteristics and aspects of QoL (physical, psychological, social and environment domains) was collected. Data were presented using descriptive and inferential statistics. Associations between independent variables and quality of life outcome were carried out through bivariate analyses, adopting a 5% significance level. Results: The “physical” domain showed the highest score (65.98 ± 17.62), while the “environment” domain showed the lowest score (48.55 ± 14.75). The quality of life for the physical domain was associated with maternal schooling and child's sex, while the psychological domain was associated with family income and child's sucking difficulty. Conclusion: Socioeconomic characteristics and comorbidities were associated with mothers' QoL. Knowledge of QoL determinants and their impact on different dimensions of life can serve as a guide for interventions aimed at improving the QoL of this population.

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ABSTRACT Objective: To assess the association between environmental factors during pregnancy and early childhood with the presence and severity of Molar Incisor Hipomineralization (MIH). Material and Methods: This cross-sectional study was conducted with 120 patients between 7 and 14 years of age. MIH was evaluated according to EAPD criteria. Data collected included the child’s medical history and the mother’s health. Chi-square and logistic regression were performed to determine any statistical evidence of the environmental factors, with the significance level set at 5%. Results: The participants were divided into groups with MIH (n=60) and without MIH (n=60), with average ages of 9.9 (±1.9) and 9.7 (±1.7) years, respectively. There was a statistically significant difference between intercurrences during pregnancy (OR=3.55; IC95%=1.35-10.57) and medication taken by the child (OR=3.01; IC95%=1.74-8.42) and the presence of MIH. In addition, other variables were also associated with the MIH (p≤0.05). However, there was no association with variables and degree of MIH severity (p>0.05). Conclusion: The use of medications in childhood and complications during pregnancy can be association to the presence of MIH. However, these factors do not interaction to MIH severity.

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ABSTRACT Objective: To characterize adolescent health care in a Family Health Unit in Olinda, Brazil. Material and Methods: The study carried out a census in a primary health unit, and results were obtained through the analysis of medical records from individuals aged 10-19 years. Data analysis was initially performed by descriptive statistics followed by association analysis using the Chi-square test or Fisher's exact test (p≤0.05). Results: Of all registered adolescents (n=895), 54% were female. However, only 36.9% (n=330) had a care record from 10 to 19 years. Regarding the frequency with which adolescents used the health service, 89.1% performed no more than three visits throughout the entire adolescence period. Almost all care provided to adolescents had curative nature (82.7%) in relation to the preventive nature (17.3%). Conclusion: The results pointed out that adolescents seek the Family Health Unit predominantly in search of curative care and that the number of consultations is reduced and far from recommendations from the Paced and Integrated Programming Guideline of the Ministry of Health, which establishes a minimum of one medical consultation and two nursing consultations per year for adolescents and young people in general.

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ABSTRACT Objective: To compare the influence of different clinical operative motions (pecking motion vs. MIMERACI) on apical debris extrusion using WaveOne Gold and EdgeOne Fire reciprocating files in the mesiobuccal canal of extracted molars. Material and Methods: Sixty mandibular molar teeth with curvature less than 20° were divided into 4 groups (n=15 each): G1A: WOG pecking Group; G1B: WOG MIMERACI Group; G2A: EOF pecking Group; and G2B: EOF MIMERACI Group. The produced debris was collected in the preweighed Eppendorf tubes and following the shaping procedures; they dried in the incubator for 5 days at 70º C. The tubes were weighed again, and the final extruded debris was measured by subtracting the pre-instrumentation from post-instrumentation weight of tubes. The canal preparation time was calculated with a digital chronometer. The obtained data were analyzed using two-way ANOVA at a 0.05 level of significance. Results: MIMERACI method significantly decreased the amount of debris pushed out in both instruments (p<0.05). Neither instruments nor clinical motions created a statistical difference regarding the required time (p>0.05). Conclusion: All tested instruments pushed debris out apically at some level, but MIMERACI operative technique was associated with significantly less apical debris extrusion.

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ABSTRACT Objective: To evaluate output of endodontic in oral public healthcare by analyzing differences in instrumentation techniques, quantitative and qualitatively. Material and Methods: Endodontic services were differentiated by instrumentation techniques: hand techniques with stainless steel instruments (SS) or rotary using NiTi rotary instruments. Secondary data on the productivity of 2011 were obtained from the information system. Student’s t and Mann-Whitney tests were used. Qualitative data were based on semi-structured interviews, direct observation and field diary. Results: Service I employed SS hand techniques, service II used both techniques, while NiTi rotary system was used in service III. Statistically significant differences were observed in total endodontic productivity, with I presenting more productive results than II (p=0.001) and III (p=0.009); III presenting more productive results than II (p<0.001). Comparisons of endodontic treatment types revealed that I performed more multiradicular tooth treatments than did II and III (p=0.005), and III performed more treatments on biradicular teeth than did I and II (p=0.002). Qualitative analyses were divided into themes: “perceptions of the service” and “perceptions of the employed instrument”. Conclusion: Professional experience and high productivity per hour can be a differential; the use of rotary instrumentation can be useful in solving unmet demands. Perception of endodontists showed that chosen endodontic technique influenced job satisfaction and lack of integrality of the treatment is a problem in secondary care.

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ABSTRACT Objective: To assess the anti-microbial activity of sage oil and hempseed oil against Streptococcus mutans and Candida albicans. Material and Methods: The sage oil and hempseed oil in pure extract form were collected from an authorized government organization. The anti-microbial activity from the oils was assessed by Kirby-Bauer disc diffusion method. Standard antibiotics Vancomycin and Fluconazole were taken as a positive control for Streptococcus mutans and Candida albicans, respectively. The mean zone of inhibition (ZOI) was measured at 24 hours, 48 hours and 72 hours by HI-MEDIAs antibiotic zone scale. One-way Analysis of variance with Tukey’s Post Hoc was applied for statistical analysis. Results: The mean zone of inhibition of sage oil and hempseed oil at 24 hours, 48 hours and 72 hours against Streptococcus mutans was (7.0 ± 4.24, 9.1 ± 3.71 and 8.4 ± 3.02) and (0.0, 3.2 ± 0.75, 1.9 ± 1.24) respectively. The zone of inhibition against Candida albicans 24 hours, 48 hours and 72 hours for sage oil (2.80 ± 1.151, 6.70 ± 1.30 and 6.30 ± 1.44), hempseed oil (0.0, 3.80 ± 0.75, 3.10 ± 0.41). Sage oil presented potential anti-microbial activity against Streptococcus mutans and Candida albicans. Comparing the anti-microbial efficacy, standard antibiotic (Vancomycin/Fluconazole) was more effective than test oils. Conclusion: Test oils showed anti-bacterial and anti-fungal activity against Streptococcus mutans and Candida albicans. Among these, sage oil showed efficacy at 24 hours, while hempseed oil did not show any effect at this time point. Further studies are needed to affirm the same and test their efficacy in different forms and concentrations.

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ABSTRACT Objective: To investigate the complications of crown fractures that might occur in different follow-up periods. Material and Methods: Individuals within the 6-13 age range with crown fracture and consulted to University Hospital were included in the study. Patients were randomly divided into three groups by block randomization method and evaluated clinical and radiographically for complications at the 6, 8 weeks, and 6, 12, 24 months. The crown of the tooth was divided into 9 equal squares and 6 classes of fracture types were created. Complications and their frequencies were evaluated based on the post-traumatic substance losses in these illustrated fracture types. Results: The incidence of complications was 28.9% at 6 months, 51.3% at 1year, and 63.9% at 2years. Class4 fractures had the highest probability of complications (32.4%) and the development of pulp necrosis (40.3%). It was detected that the complications such as pulp necrosis (21.6%) can be frequently observed in the 2nd year or later periods of crown fractures. Conclusion: In addition to current regular checks, periodic follow-up of crown fracture should be extended to reflect current findings. Dentists, patients, and their parents must be made conscious of the importance of the treatment and follow-ups of crown fracture.

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ABSTRACT Objective: To analyse the mortality rate and autopsy rate of oral cancer (malignant neoplasms of lip, oral cavity and pharynx) over a ten-year period. The percentage change of autopsy rate of oral cancer will be evaluated. Material and Methods: The study sample was divided into two age sub-categories: 1) patients who died of oral cancer and were autopsied in a period 2010-2014 and 2) patients who died of oral cancer and were autopsied in a period 2015-2019. Data from oral cancer death patients (n=6,313) and autopsy patients caused oral cancer (n=251) between 2010-2019 were obtained from the Statistical Office of the Slovak Republic. The percentage change of autopsy rate was evaluated by Chi-squared test. Statistical significance was set at p-value <0.05. Results: The highest autopsy rate of malignant neoplasms of lip, oral cavity and pharynx was found in 2017 (4.1%). It was observed growing trendy of autopsy rate of malignant neoplasms of lip, oral cavity and pharynx in the period 2010-2019 (R2=0.059). It was found decrease of percentage change of autopsy rate in malignant neoplasm of pyriform sinus (-75.3%). A significant increase of percentage change of autopsy rate was found in malignant neoplasm of tonsil (216.1%; p=0.021). Conclusion: This study provides one of the larger epidemiology overviews of oral cancer autopsies presented so far in Slovakia.

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ABSTRACT Objective: To evaluate the droplets and aerosols, posing potential risks of infection transmission of COVID-19 disease in dentistry. Material and Methods: PubMed, Embase, ISI, Scopus, Medicine have been used to search for articles between September 2019 to December 2020. Data extracted from the studies were included, study, study design, sample size, Sample collection time, Hallway Air Samples (copies/L of air), Personal Air Samples (copies/L of air). Effect size with 95% confidence interval (CI), fixed effect model, Inverse-variance methods were calculated. The Meta-analysis was evaluated with Stata/MP v.16 statistical software (The fastest version of Stata). Results: According to the purpose of the study, 64 articles were found; studies that did not meet the inclusion criteria were excluded from the study; the full text of 11 studies was reviewed. Finally, two studies were selected. The effect size of airborne COVID-19 concentrations of the hallway and personal air samples was 64% copies/L of air (ES, 0.64 95% CI=-1.45-2.73) and 100% copies/L air (ES, 1.00 95% CI=-1.77-3.76), respectively. Conclusion: Evidence of aerosol transmission of COVID-19 in observational studies of patients with COVID-19 was 64% copies/L of air and 100% copies/L of air in the hallway and personal air samples, respectively.

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ABSTRACT Objective: To evaluate the association of MMP-9 promoter gene polymorphism in generalized chronic periodontitis patients of an Indian population. Material and Methods: Eighty patients were selected and divided into case and control groups (n=40). Patients included were aged 15-60 years of both genders and diagnosed with chronic periodontitis. Peripheral venous blood samples were obtained, and genomic DNA was isolated by a 'salting out' method. Three possible genotypes were distinguished by three distinct banding patterns, depending on the presence or absence of the Sph I restriction site: CC as allele 1, TT as allele 2, and CT, respectively. Statistical analysis was carried out by applying the Chi-squared test and One-way ANOVA. Results: There was a significant difference in MMP-9 genotypes between Chronic periodontitis patients and healthy controls. Odds ratios for CT genotype and combination of CT and TT genotypes were 3.125 (95% confidence interval, p=0.028) and 3.667 (95% confidence interval, p=0.006) relative to subjects with CC genotype, respectively. Conclusion: The present study revealed an association of MMP-9 (-1562 C/T) gene polymorphism with generalised chronic periodontitis.

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ABSTRACT Objective: To analyze whether children and their parents prefer a particular professional coat worn by the dentist and whether these preferences are influenced by their gender or level of anxiety. Material and Methods: Standardized images of male and female models dressed with different coats were shown to 400 pairs of 5-12 year-old children and respective parents and they were asked to point their preference. Information about child's dental experience was collected and children's anxiety level was obtained using the Children’s Fear Survey Schedule-Dental Subscale. Results: Both children (55.5%) and parents (76.5%) preferred a female professional over a male one. Children preferred the dentist wearing a white coat, while adults preferred the dentist wearing a colored coat (p<0.05). There was a tendency for the child to choose a dentist with the same gender as theirs, so boys chose more male dentists and girls more female dentists (p<0.05), but there was no difference between the choice of the dentist’s coat between boys and girls (p=0.53). Conclusion: Children have strong preferences in relation to the appearance of their dentists. Children and parents preferred female dentists, but there was a tendency to choose the dentist with the respondent’s gender. Contrary to popular belief, children preferred their dentists wearing the conventional white coat, different from their parents who preferred dentists wearing a colored coat.

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ABSTRACT Objective: To determine the knowledge and clinical experience of dentists regarding MIH in Kerman/Iran. Material and Methods: In this cross-sectional study, a census sampling method was used, and all dentists registered in Kerman medical council were asked to participate in the study. A validated and reliable researcher administered questionnaire was used to determine participants' demographic characteristics, knowledge, and clinical experience. The association between knowledge score and demographic variables was determined using an independent t-test and ANOVA. The level of significance was set as 0.05. Results: Overall, 400 specialized and general dentists in Kerman completed the questionnaire. The mean knowledge score of dentists was 6.6±1.9 of 11. Female dentists’ knowledge was higher than male dentists (p<0.05). General dentists had a higher level of knowledge regarding MIH compared to specialists (p<0.05). Overall, 79.5 % had been faced with MIH during their practice years. After confronting MIH teeth, 48.8% of dentists referred patients to specialists for treatment. Providing aesthetics was considered the most difficult part of treatment (43.2%). Resin composite was the most favorable dental material for treating MIH (60.9%). Conclusion: Although most dentists in Kerman had encountered MIH defects during their clinical practice, they did not have enough knowledge of the defect and required education on all aspects of MIH diagnosis and management. Younger dental practitioners, general dentists and females presented higher knowledge of MIH.

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ABSTRACT Objective: To analyze the perception of mothers of children with Cerebral Palsy (CP) on the diagnosis moment and the child’s health. Material and Methods: Research with a qualitative approach, carried out with 19 mothers of children with CP, in a public higher education institution, in the state of Minas Gerais, Brazil. For data collection, the interview was used and for data interpretation, content analysis. Results: Mothers reported that the diagnosis of a child with CP resulted in major changes in the family’s daily life, increasing their responsibility and demands. After the diagnosis, mothers revealed oscillating feelings, with progressively replaced by her motherly ability to take care, reestablishing the psychic balance. The health associated with the absence of disease and curative practices was frequently observed. Mothers reported a great concern with oral hygiene habits and frequent visits to the dentist. Conclusion: The diagnosis of a child with CP led to changes in the family's priorities and routine. After the moment of anguish, uncertainty and fear, the mothers accepted the reality. The biomedical principle significantly influenced the mother´s perception of health, being health perceived as the absence of disease and curative practices. In relation to oral health, practices widely spread and recommended by the media and health services, such as correct tooth brushing, showed an orientation of patients to maintain oral health.

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ABSTRACT Objective: Use cone-beam computed tomography (CBCT) images to evaluate the dentin thickness of the pulp chamber floor in primary molars. Material and Methods: Cross-sectional study, conducted with CBCT images of teeth of children. Primary molars with preserved pulp chamber floor were included. The dentin thickness of the pulp chamber floor in the primary molars was measured linearly in CBCT cross-sections. Data were descriptively analyzed and the Mann-Whitney test was applied (p<0.05). Results: 27 CBCT exams and 123 primary molars of children aged 4 to 13 years were analyzed; the majority was female (52.0%). In maxillary molars, the median dentin thickness was 1.50 (0.6-2.2) mm in the first and 1.65 (0.6-2.3) mm in the second (p=0.049) molars. In mandibular molars, the median was 1.20 (0.3-1.7) mm in the first and 1.60 (1.0-2.2) mm in the second (p<0.001) molars. Children aged 4 to 8 years showed less dentin thickness (p<0.001). Conclusion: The median dentin thickness of the pulp chamber floor in primary molars was 1.50 mm, ranging from 0.3 to 2.3 mm. Less dentin thickness was associated with younger children, teeth in the mandibular arch, and first molars.

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ABSTRACT Objective: To assess the association between dental caries experience, severe dental caries experience and socioeconomic determinants on oral health-related quality of life among children and their families. Material and Methods: This is a cross-sectional study whose sample was composed of children aged 4-12 years, who sought dental care in a dentistry school clinic, and their parents/caregivers. Dental caries experience and severe dental caries experience were assessed according to the DMF-T/dmf-t indexes. Parents/caregivers answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ), the Family Impact Scale (FIS) and a questionnaire on socioeconomic and demographic conditions. Data analysis included the chi-square test and Poisson regression (PR). Results: The sample was composed of 105 children and their parents/caregivers. Severe dental caries experience in children was determinant for negative perception of children's OHRQoL by parents/caregivers (PR = 1.22; CI = 1.05-1.41). Negative impact on OHRQoL perceived by family members was determined by severe dental caries experience in children (PR = 1.22; CI = 1.05-1.42) and family income <5 minimum wage (PR = 1.32; CI = 1.08-1.61). Conclusion: Severe dental caries experience was associated with a negative impact on OHRQoL perceived by children and their families. Low family income was associated with a negative impact on the OHRQoL perceived by children and their families.

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ABSTRACT Objective: To evaluate the systemic factors associated with Molar-Incisor Hypomineralization (MIH) etiology. Material and Methods: A total of 731 8-year-old schoolchildren enrolled in the public school system in Curitiba, Brazil, was randomly selected. The MIH diagnosis was performed by calibrated examiners (Kappa >0.80) according to the European Academy of Pediatric Dentistry criteria (2003). The systemic factors were collected through a semi-structured questionnaire and applied to the children’s mothers, addressing the medical history from pregnancy to the first three years of children’s life. Associations were analyzed by Poisson regression analysis with robust variance (p<0.05). Results: The systemic factors in the prenatal and perinatal periods were not associated with MIH (p>0.05). The children who used medications during the first years of life had a significantly higher prevalence of MIH (PRc = 2.18 CI = 95% 1.06-4.48; p=0.033). Conclusion: The use of medications during the first three years of children’s life is associated with a higher prevalence of MIH.

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ABSTRACT Objective: To evaluate the knowledge and attitude in relation to basic life support (BLS) and cardiopulmonary resuscitation (CPR) skills among the dental undergraduates and interns in Sakaka, Saudi Arabia. Material and Methods: This cross-sectional study was undertaken between October 2019 and December 2019 in Sakaka, Saudi Arabia. One hundred and eighty randomly selected dental students aged over 18 years participated in the study. Their knowledge and attitude towards BLS were gathered through a questionnaire. Results: A total of 158 (out of 180) UG students and interns participated in this study, making the responses of 87.8%. The mean age of the participants was 24.6 years. The samples comprised 86 (54.4%) males and 72 (45.6%) females. The assessments showed that overall the participants had average knowledge towards BLS and CPR, with males responding significantly better than the females (p˂0.05). Furthermore, as students climb the academic ladder, their knowledge regarding BLS and CPR tends to rise. Also, their attitude was positive, and they were willing to receive CPR training. Conclusion: Attitude toward acquiring knowledge about CPR was very positive. However, their knowledge about the topic was average. Students should understand the importance of such skills and efficiently involve in these life-saving procedures.

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ABSTRACT Objective: To evaluate the breastfeeding practice of mothers of children assisted in the educational and preventive dentistry program to create actions to promote, protect and support breastfeeding. Material and Methods: This is a cross-sectional study with a quantitative approach carried out in a dental clinic for babies. A questionnaire was applied to the mothers containing 10 multiple choice questions about breastfeeding practices and attitudes. Data were stored in a Microsoft Excel database for descriptive statistical analysis. Results: 614 mothers answered the questionnaire. It was found that 96.4% of mothers considered breastfeeding the best way to feed a baby and the child's health benefits stood out as the main reason (98.7%) for breastfeeding. According to 82.9% of mothers, the ideal time to breastfeed the baby is up to 2 years of age; 81.8% breastfed or intended to breastfeed their children up to this age, finding it perfectly natural to breastfeed in public (72.1%). The greatest fear of mothers was not being able to breastfeed their child long enough (61.4%), feeling guilty about it (77%). On the other hand, breastfeeding in public was considered a fantastic attitude (56.8%). Conclusion: Mothers in this sample have information about the recommendations of the health agencies regarding breastfeeding; however, there was a large weaning index among them.

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ABSTRACT Objective: To test possible associations between Oral Health Literacy (OHL) level and socioeconomic covariates among users of Centers for Dental Specialties (CEOs). Material and Methods: The Health Literacy in Dentistry (HeLD-14) instrument was applied to 130 adult users of CEOs located in 13 municipalities in the state of São Paulo - Brazil, as well as socioeconomic issues. The researcher applied instruments in a specific room after randomly selecting individuals in the waiting room and invitation acceptance. Each item was ranked on a 5-point scale, ranging from 0 to 4, in which high scores indicate minimal difficulties in performing functions (high OHL) and low scores indicate very limited abilities to perform functions (low OHL). Statistical analysis using the Levene test was used to verify the possibility of using the one-way ANOVA test, and in case results show positive values (p>0.05), the Kruskal Wallis test was used. Results: The average age of participants was 45 years, with more than half being female (68.7%) with 9-11 years of schooling (48.4%). When considering the total value of HeLD-14 questions, OHL was associated with covariates schooling, marital status and family income. Conclusion: OHL levels were associated with socioeconomic variables, contributing to evidence in this field of specialized care.

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ABSTRACT Objective: To propose a classification of patients by occlusal condition and its apparent validation. Material and Methods: This cross-sectional analytical study was divided into two phases. In the first, a trained examiner divided the patients into four groups according to the proposed classification of this design: Type 1 patient - completely dentate individuals; Type 2 - partially edentulous individuals with occlusal stability; Type 3 - partially edentulous individuals with no occlusal stability; Type 4 - completely edentulous individuals. In this phase, 122 patients were analyzed with an instrument developed for this experiment. Results: All patients in the sample of this research were classified in some division of the proposed instrument. In the second phase, the apparent validation of the classification was conducted by three judges, who obtained an excellent agreement with the allocation of patients in one of the types according to the indication of the first examiner (Kappa = 85%). Conclusion: It is evident that the classification presents reliability, ease of visualization, good conditions for interprofessional communication, and it can be used in dental clinical practice to assist in the study and integrated planning of clinical cases.

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ABSTRACT Objective: To analyze the difference in the on-line searches for terms related to hand hygiene during the COVID-19 pandemic in developed and middle-income countries. Material and Methods: The cross-sectional study analyzed the digital data through the Google Trends website to obtain the variation of the relative search volume (RSV) through the terms "alcohol gel" and "handwashing." According to socio-economic development, the countries were divided into two groups: countries from different continents and hemispheres, with more than 15 million inhabitants, with more than 50% of the population with access to the Internet network and over 1,000 confirmed cases of infected with COVID-19. The paired t-test was applied to compare the means. The significance value adopted was p<0.010. Results: The searches related to the term "hand washing" were more significant when compared to the term "alcohol gel," and the term "alcohol gel" presented a higher average volume of research in developed countries (p<0.010). The developed countries had a higher average relative volume of research than middle-income countries (p<0.010). Developed countries sought more for the term "alcohol gel," and the term "hand washing" showed no difference in the volume of research about the country's socio-economic aspect. Conclusion: Developed countries have a higher volume of search for hand hygiene terms. The middle-income countries must create proposals for raising awareness outside the on-line environment so that this information reaches the entire population during the pandemic.

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ABSTRACT Objective: To analyze the profile of the dental teleconsulting in the Pediatric Dentistry field of Telehealth Brazil Networks Program, in Minas Gerais centers, Brazil. Material and Methods: Asynchronous dental teleconsulting was evaluated in the Pediatric Dentistry specialty, extracted from secondary databases of the telehealth centers: the Clinical Hospital of the Universidade Federal de Minas Gerais and UFMG Medical School, from July 2015 to July 2017. The variables collected were: type of issues and area and sub-area of Pediatric Dentistry. The results were descriptively analyzed using the SPSS v.22,0 program by frequencies. Results: Most of the issues in the Pediatric Dentistry specialty were about clinical conduct (81.4%). There was a predominance of issues regarding prevention (16.6%), surgery (15.3%), tooth eruption (15.1%), endodontics (12.1%), harmful oral habits (9.7%), patient cooperation (8.7%), primary teeth trauma (7.2%) and dentistry (6.7%). Regarding sub-areas, most issues were related to child oral hygiene (68.5%), tooth extraction (92%), tooth eruption chronology (65.6%), pulp diagnosis (49.0%), bruxism (64%), patient management (74.3%), post-trauma treatment (79.3%), and restoration (88.9%). Conclusion: Pediatric Dentistry teleconsulting suggested a difficulty of the professionals in the pediatric patient approach. Continuing education programs and training courses for professionals working in primary health care are crucial for the comprehensive care of pediatric patients.

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ABSTRACT Objective: To study the influence of the first thousand days of life on establishing determinant behaviors for dental caries in childhood. Material and Methods: Longitudinal retrospective study involving 664 children born in 2009 living in a southern Brazilian municipality was carried out. Data was collected through interviews with mothers and through child’s health card. Dependent variables were 1) tooth brushing onset after two years of age; 2) absent tooth brushing or once a day; 3) tooth brushing without adult supervision; 4) not having gone to the dentist until the age of 6; and 5) seek for dental services due to toothache at 6 years of age, over the last 30 days. Bivariate and multivariate analyses were performed using Poisson Regression to estimate relative risks (RR) and respective confidence intervals at the 95% accuracy level. Results: Mothers with lower schooling at child’s birth presented a higher risk of “child’s tooth brushing onset only after two years of age”, “brushing the teeth once a day only or not brushing” and with “child not having gone to the dentist until the age of 6”. Mothers who did not have a job when the child was born were associated with “not having gone to the dentist until the age 6”. Children with gastroesophageal reflux who underwent hospitalization for more than 2 days under age 2 were associated with “seeking dental services because of pain at 6 years of age over the last 30 days”. Conclusion: Higher risks of some determinant behaviors related to dental caries were associated with variables of the period of the first thousand days of life.

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ABSTRACT Objective: To evaluate the effectiveness of oil pulling in the management of oral submucous fibrosis (OSMF). Material and Methods: A total of 62 patients clinically and histopathologically diagnosed as OSMF were incorporated in the present study. The subjects are randomly divided equally into two groups, Group A (oil pulling group) and Group B (placebo group). Subjects in Group A were asked to perform OP with sesame oil on an empty stomach in the morning for 3 months and Group B was given placebo capsules for 3 months. Assessment of various clinical parameters was done regularly, and data were analyzed using the Chi-square test. Results: Eighty-two percent had a habit of betel nut chewing, while 18% of the patients had tobacco chewing habits, which were among the main causative factors for OSMF. Clinical improvements in mouth opening, tongue protrusion, difficulty in speech and deglutition, and burning sensation were significant in the Group A. None of the patients reported any discomfort or side effects. The symptoms were not severe in nature and resolved in few days without stopping the therapy. Conclusion: Oil pulling can bring about significant clinical improvements in the symptoms like a mouth opening and tongue protrusion.

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ABSTRACT Objective: To evaluate the influence of tooth loss and the use of removable dentures on chewing function and nutritional status of institutionalized elders. Material and Methods: Cross-sectional study with 155 elders from seven long-stay institutions in João Pessoa, Brazil. The participants were classified according to the presence of reminiscent teeth and use of dentures in four levels: toothless, without denture (1); toothless with a complete denture (2); partial toothless without denture (3) and partial toothless with a partial denture (4). Nutritional status was assessed using the Mini-Nutritional Assessment (MNA) instrument and the Body Mass Index (BMI). Swallowing threshold was used for the assessment of masticatory function, using a portion of roasted peanuts (3.7 g). Comparisons among groups were performed using Kruskal-Wallis test with Bonferroni adjustment, considering p<0.05. Results: MNA (p=0.702) and BMI (p=0.884) were not modified in relation to the presence of teeth and denture use. Toothless individuals without dentures had a lower swallowing threshold (p<0.001), whilst partial toothless with dentures had better masticatory function (p>0.05). Conclusion: The presence of reminiscent teeth and the use of dentures do not influence the nutritional status of the elders but interfere with the masticatory function. Prosthetic rehabilitation is desirable for complete toothless individuals.

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ABSTRACT Objective: To characterize the access to primary dental care and the work process of Oral Health Teams (OHTs), nationwide and by geographic region, based on data from the 3rd phase of the PMAQ-AB (the Program for Improving Access and Quality of Primary Care). Material and Methods: This was a cross-sectional study using data from the external assessments of the PMAQ-AB regarding the variables access to dental care and the work process of OHTs. The data were analyzed descriptively. Results: A significant number of healthcare users (41.2%) reported an average waiting time of 10 days to schedule dental appointments at the primary care facility (PCF). In the Northeast region, a greater number of users (48.4%) had access to dental care, with a waiting time of 7 days, whereas a smaller number of users in the Southeast region could schedule an appointment with the dentist (33.9%) and experienced a longer waiting time (17 days). Most OHTs worked in Primary Care Teams (PCTs) (85.1%), received support from Specialized Dental Care Centers (70.9%), worked with scheduled appointments and/or spontaneous demands (98.0%), listened to the users’ complaints during user embracement sessions (99.0%), and scheduled the first appointment at the dental office (51.9%). Conclusion: In Brazil, 41.2% of the healthcare users had access to dental care and experienced a waiting time ranging from 7 to 17 days, depending on the geographic region. While the OHTs developed primary oral care actions, further initiatives to ensure the expansion of access to dental care are needed.

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Abstract Objective: To determine differences in how orthodontic patients perceive the aesthetics relating to the use of Essix and Hawley retainers. Material and Methods: Photographs of a female patient using an Essix retainer and a Hawley retainer, respectively, were assessed by 70 orthodontic patients aged between 21 and 55 years. All participants were provided with the same images of the two retainer types being worn and were asked to grade the aesthetics of each retainer using a visual analog scale. The significance of differences in orthodontic patient perceptions of aesthetics in the use of Essix and Hawley Retainers in the young adult and adult age groups were tested using the Mann-Whitney test with assumed significance p<0.01. Results: There were differences in participants’ perceptions between the two retainers that were statistically significant, with responses varying between young adults aged 21 to 35 years and adults aged 36 to 55 years. According to the VAS, the two retainers’ average scores in the total population are 82 for Essix Retainer and 60 for Hawley Retainer in both groups. Conclusion: The Essix retainer as a retention appliance is considered more aesthetically pleasing than the Hawley retainer among both young and middle-aged adults.

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ABSTRACT Objective: To evaluate the prevalence of caries stages and interventions on first permanent molars (FPM) in Brazilian children. Material and Methods: Data from FPM were extracted from dental records of children aged 5-14 years of age that attended the UERJ Pediatric Dentistry Clinic. Data include patient age, sex, biofilm index, presence of carious lesions in all stages, and the treatments. Data was analyzed using the SPSS® 20.0 program. Results: A total of 158 dental records were analyzed, 587 registers were related to the caries stage and 601 related to the interventions; mean age of 8.26 (±1.4 years) and 53.2% were girls. The prevalence of active/inactive white spot(AWS/IWS) varied from 14.3% to 21.6% in right upper and lower left FPM, respectively. Enamel/dentin lesions without pulp involvement were also more prevalent in the lower arch and ranged from 3.4% for the right upper to 11.5% for the lower right FPM. Cavities with pulp involvement or indicated extraction ranged from 0% to 1.4%. Treatment included dental sealants, varying from 17.1 to 24.0% (n=126) and restorations, varying from 1.3 to 11.8% (n=38). The lower right were the most affected teeth. Conclusion: First permanent molars presented a higher prevalence of dental caries in early stages and the most prevalent treatment was related to the initial carious process, fluor therapy and sealants.

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ABSTRACT Objective: To determine in vitro the frequency, shape, type, diameter, and patency of accessory canals in the primary molars pulp chamber floor. Material and Methods: Sixteen healthy primary molars were evaluated by micro-computed tomography and scanning electron microscopy. Descriptive analyses of the frequency, shape (round, oval, or irregular), type (blind, true, or hidden), patency and diameter of the accessory canals were performed. Results: Half of the teeth presented accessory canals, 62.5% of which were located in the upper molars and 37.5% in the lower molars. The most frequent shape was irregular. In three-dimensional analysis, blind accessory canals (12.5%) and with patency (18.7%) of the teeth were observed. The average accessory canal diameter was 51.97 µm (± 26.03 µm). Conclusion: Upper molars showed a higher frequency of accessory canals with larger diameters. The irregular shape was the most frequent. 18.7% of accessory channels showed patency.

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ABSTRACT Objective: To translate, perform a cross-cultural adaptation and reliability analysis of the Survey of Anxiety and Information for Dentists (SAID) for use with Brazilian adolescents. Material and Methods: The SAID was translated into Brazilian Portuguese and back-translated to English. An expert committee compared both versions and examined their equivalence. Then, a face validation was performed with 10 adolescents. The SAID was applied in printed format with 25 questions. Participants answered and commented on the questions with a researcher to confirm the understanding and provide suggestions. The suggestions were implemented, and the expert committee approved the final version of the SAID in Brazilian Portuguese. The psychometric properties were tested with 60 adolescents aged 10 to 19 years. Participants answered the Brazilian version of the SAID before their first dental appointment and two weeks later to determine test-retest reliability. Reliability was analyzed by internal consistency analysis (Cronbach's alpha) and test-retest (ICC). Results: The instrument presented excellent reliability according to internal consistency (Cronbach's alpha = 0.77) and test-retest coefficients (ICC = 0.88; 95% CI: 0.81-0.93). The Kappa coefficients and the degree of agreement of the dichotomous questions indicated good reproducibility of the new version. Conclusion: The SAID translation, cross-cultural adaptation and reliability analysis were completed successfully. Thus, the Brazilian version of the SAID can be a useful survey tool for dental care of adolescent patients.

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ABSTRACT Objective: To evaluate the role of poverty and its related factors on early childhood caries (ECC) experience among deprived children. Material and Methods: This population-based cross-sectional study surveyed 418 children aged one to six years enrolled in Brazilian public preschools from an area of the country known for its high social deprivation. Intraoral examination of children evaluated dental caries experience (dmft). Parents/caregivers answered a questionnaire with sociodemographic indicators. Family income was dichotomized into below or above poverty line. Data analysis used Chi-square test, Mann-Whitney test, and Multivariate Logistic Regression analysis (p<0.05). Results: Predisposing variables for an increased chance of ECC were: age group 3-4 years (OR: 4.89; 95% CI: 2.32-10.31), age group 5-6-years (OR: 5.60; 95% CI: 2.60-12.04), being part of families living below poverty line (OR: 1.88; 95% CI: 1.04-3.38) and having mothers with less than nine years of schooling (OR: 2.86; 95% CI: 2.77-7.14). Children from families living below poverty line presented higher dmft (2.9 +3.8; p=0.001) and untreated dental caries (d component) (2.7 +3.7; p=0.002). Conclusion: ECC in a poor population was influenced by indicators of social deprivation. The poorest of poor children from mothers with less years of schooling were at higher risk.

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ABSTRACT Objective: To establish the cephalometric (Ceph.) norm by Ceph. for orthognathic surgery (COGS) analysis for Saudi population. Material and Methods: 500 adult Saudi samples (250 males and 250 females) with the age range of 18-30 years old were selected for this study. The selections of samples were based on a normal occlusal relationship, no history of facial trauma and no previous orthodontic treatment. Lateral Ceph. radiographs were tracing by CASSOS software and analyzed by SPSS software according to COGS analysis. Results: Significant differences were showed between the Saudi males and females on most of the Ceph. parameters. The Saudi males had a convex facial profile with chin prominent and more bimaxillary protrusion, upper and lower lip protrusion than the Saudi females. Conclusion: This study evaluated the craniofacial morphological difference between the male and the female population in Saudi Arabia by using COGS analysis. The finding of this study will help for better diagnosis of orthodontic and orthognathic surgical treatment planning and identify the morphological facial characteristics of Saudi patients.

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ABSTRACT Objective: To examine the types of traumatic dental injuries of the primary teeth (TDI-p) and the long-term sequelae on permanent dentition (LSP) comparing with a control group (CG). In addition, a questionnaire that measures parents' knowledge and awareness was used. Material and Methods: The trauma group (TG) consisted of permanent teeth following TDI-p exposed teeth, while the CG consisted of permanent teeth following unexposed teeth with TDI-p of the same patients. In total, 141 teeth were evaluated in 27 patients. Data concerning such as teeth, when TDI-p occurred, types of treatments and types of LSP were collected. Chi-square test was used for intergroup comparison for gender, type of trauma, LSP, age of trauma and parameters in the parental information questionnaire. Significance level was p<0.05. Results: A statistically significant difference was found in the analysis between TG and CG (p<0.001). The prevalence of LSP due to TDI-p was 29.6% and the prevalence of sequelae in CG was 7.4%. The most common LSP was enamel hypoplasia (14.8%). Parents were aware of the importance of TDI-p, and they had insufficient knowledge about its management. Conclusion: TDI-p can be considered a high-risk factor in the development of LSP. Also, the lack of knowledge in parents should be supported by software-based application systems to be developed.

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ABSTRACT Objective: Tocompare the effect of tooth brushing on surface roughness of Resin-Modified Glass Ionomer Cement (RMGIC; GC Gold label 2LC Light Cured Universal Restorative) and Glass Hybrid (GH; GC EQUIA SYSTEM- EQUIA Forte™ Fil and EQUIA Forte™ Coat) restorative material at 1- and 3-months interval simulated by tooth brushing. Material and Methods: RMGIC and GH material specimens (20 each) were prepared according to manufacturer instructions in 10mm × 2 mm dimensions using a mylar strip. A specially designed toothbrush simulator was used along with Oral B Pro 2 2000N powered toothbrush and Colgate Total dentifrice (Colgate-Palmolive India limited; Relative dentin abrasivity - RDA:70- Low abrasive) to perform brushing strokes. Specimens were subjected to surface roughness analysis before and after simulated tooth brushing at baseline, 1, and 3 months. Results: The intragroup comparison was done using repeated-measures ANOVA. Intergroup comparisons were done using an independent sample t-test and General Linear Model (ANCOVA). Surface roughness increased from baseline through 3 months in both RMGIC and GH groups. The mean surface roughness in RMGIC group was significantly higher than GH group at baseline 1 and 3-months, respectively (p<0.001, <0.001, and <0.001). Interaction between group and baseline surface roughness was not significant (p=0.466). The estimated marginal means were significantly higher in RMGIC than GH group (p=0.008). Conclusion: The surface roughness of both RMGIC and GH restorative increased from baseline to 1 month and 3 months after the simulated toothbrushing protocol. GH exhibited significantly lower surface roughness than RMGIC at all the tested intervals.

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ABSTRACT Objective: Toanalyze the technical quality of endodontic treatment carried out at the undergraduate dental clinics. Material and Methods: Random radiographic records of 92 patients’ were selected who received endodontic treatment by the undergraduate students from June 2018 to July 2019. The quality of root canal filling was determined in relation to the adequate density, length, and taper. Statistical analysis was performed by using GraphPad (Prism 5), and to determine the association between different variables Chi-square test was used. Results: Adequate technical quality of canal obturation conducted by the undergraduate students was found in less than 65% of the cases. The frequency of adequate root canal taper was significantly greater in maxillary teeth (75%) as compared to mandibular teeth (33%); however, adequacy of acceptable density was found more in maxillary teeth (62%) as compared to mandibular teeth (55%).A statistically significant difference was seen in the quality of root canal fillings between anterior and posterior teeth (p=0.001). Conclusion: The root canal therapy performed by undergraduate students was less than optimum in terms of technical quality. Hence, it is suggested that the endodontic training courses delivered at pre-clinical and clinical levelsfor undergraduate students must be thoroughly revised.

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ABSTRACT Objective: To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on whole salivary flow in patients with xerostomia and healthy adults. Material and Methods: Thirty subjects with a history of xerostomia and subjects withunstimulated salivary flow equal to or less than 0.5 ml in 5 min were included in the study group, and 30 healthy subjects were included in the control group. Low forced spitting unstimulated saliva was collected for five minutes in a test tube fitted with a funnel. Then electrode pads of the TENS unit were applied bilaterally on skin overlying the parotid glands and at optimal intensity, stimulated saliva was collected for 5 minutes with the same method in a separate graduated test tube. The salivary flow rate (per minute) was calculated by dividing the amount of collected saliva (volume in mL) by the duration of collection period (5 minutes) and the salivary flow rates prior and after electrostimulation were compared for both groups. The Student’s t-test (unpaired and paired) was performed for group-wise comparisons. Results: In study group, the mean unstimulated salivary flow rate was 0.07 ± 0.01 mL/min. There was an 85.71% increase in salivary flow (0.13 ± 0.03 mL/min) during the TENS application and the difference was highly significant (p<0.001). In control group, the mean unstimulated salivary flow rate was 0.37 ± 0.07 mL/min. There was a 21.62% increase in salivary flow (0.45 ± 0.07 mL/min) during the TENS application and the difference was highly significant (p<0.001). An increase in mean salivary flow rate both in males and females after TENS application in both groups (p<0.001) was noted. The difference between unstimulated, stimulated and mean difference in salivary flow rate between males and females was notstatistically significant in both groups (p<0.05). Conclusion: TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia.

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ABSTRACT Objective: To assess the occurrence of dental trauma in a group of children with Autistic Spectrum Disorder (ASD) in comparison to children without the disorder. Material and Methods: This is a cross-sectional study conducted at the Department of Children and Adolescents Health in the Department of Health of Juiz de Fora, Brazil. The study included individuals with and without ASD, between three and 16 years old, and their parents/caregivers. Children/adolescents were assessed for dental trauma by clinical examination. All exams were performed by a trained and calibrated examiner (MCT), and intra-examiner reliability was previously established (Kappa=0.93). The Socio-demographic status was reported by parents/caregivers. Data analysis included descriptive statistics and generation of frequency distributions. Fisher’s exact test was used to evaluate the association between groups of children/adolescents with and without ASD about the presence of dental trauma. The significance level was set at p < 0.05. Results: Sixty children of both sexes participated in the study, thirty with a diagnosis of ASD and thirty without. The age ranging from 3 to 13 years, with an average of 7.5 ± 3.2 years. Children with ASD had a higher frequency of dental trauma than children without ASD (p=0.02), and the most frequent type of trauma was enamel fracture (57.10%), followed by enamel/dentin fracture without pulp exposure (42.90%). Conclusion: Children with ASD, when compared to children who did not have ASD, had a higher occurrence of dental trauma.

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ABSTRACT Objective: To analyze the factors associated with the SARS-CoV-2 infection among oral health professionals. Material and Methods: This was a cross-sectional study in the city of São Paulo, São Paulo State, Brazil. Professionals from three different categories were included: dental surgeons (DS), dental assistants (DA), and dental hygienists (DH). A questionnaire was created on a digital platform and sent via institutional email to each subject. The questionnaire contained 32 questions about sociodemographic, work, and behavior factors. The data about SARS-CoV-2 infection was confirmed through RT-PCR exams. Descriptive (absolute and relative frequencies) and inferential analyses (chi-squared or Fisher’s exact test) (p<0.05) were performed. Results: There was a SARS-CoV-2 infection prevalence of 3.8% for DS, 30.0% for DH, and 33.3% for DA. SARS-CoV-2 was associated with a lower income (p=0.027), a lower education level (p=0.011), the category of technical professionals (DA and DH) (p=0.025), and using public transportation to commute to work (p=0.009). Conclusion: Sociodemographic factors like lower income and education levels and work factors like job category and public transportation were associated with COVID-19 among professionals on the oral health teams.

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ABSTRACT Objective: To assess the oral health knowledge, attitude, behaviour, and its association with sociodemographic and habitual factors among South Indian Population. Material and Methods: A total of 288 adults living in a residential community situated in Chennai were selected by systematic random sampling method participated in this cross-sectional study. Data collection was carried out using a validated questionnaire. Results: About 97.9% of the participants in our study had good knowledge, 33.3% had a positive attitude and 48.2% had adequate oral health behaviour. Sociodemographic and habitual factors like diet (p=0.006), education (p=0.009), and employment (p=0.003) were significantly associated with knowledge. On the other hand, diet (p=0.012) was the only factor significantly associated with attitude. Ownership of house (p= 0.030) was significantly associated with behaviour and no factor was associated with all three KAB profiles. Absence of correlation were identified between Knowledge-Attitude (r=0.11, p=0.23), Knowledge-Behaviour (r= -0.037, p= 0.68) and Attitude-Behaviour (r =0.01, p=0.94). Conclusion: It has been found a massive number of participants possessed a high knowledge level towards oral health. On the other hand, less than half of the participants had a positive attitude and adequate behaviour towards oral health. No positive linear correlation was seen among knowledge, attitude, and behaviour towards oral health.

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ABSTRACT Objective To compare the capacity of silver diamine fluoride (30%) and the bioactive giomer light-curing varnish for arresting ICDAS score 5 non-retentive caries lesions. Material and Methods An in vitro analytical study was conducted using 36 healthy primary teeth, in which a cavity was created, divided into 3 groups: control (distilled and deionized water), giomer-based light-curing varnish – Barrier Coat, and Silver Diamine Fluoride 30% – Cariestop (SDF). The samples were analyzed for mineral loss as measured by surface microhardness (SMH).The Knoop microhardness test was performed using the HVS-1000 microhardness tester. The data were compared by two-way analysis of variance – treatment and time (before and after treatment) followed by Tukey’s post-test. The significance level adopted in all analyzes was 5%. Results The specimens treated with giomer showed higher SMH compared to the untreated group but were similar to those of the SDF group. The SDF group, on the other hand, showed no statistically significant difference from the control group (p=0.010). Conclusion The giomer varnish had a remineralizing effect on artificial dentinal caries.

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ABSTRACT Objective To evaluate the effect of the COVID-19 impacts on the activities of researchers in the field of Oral Medicine (OM) and Oral Pathology (OP). To assess the research activities and training of human resources by Brazilian productivity fellows in research (BPFR) in OM and OP in the COVID-19 Era. Material and Methods Thirty-six BPFR in OM and OP areas, funded by National Council for Scientific and Technological Development (CNPq), received a virtual structured questionnaire by e-mail, on the Google Forms (Google®) platform, with questions regarding research activities and training of human resources (supervision of undergraduate and postgraduate students), during the COVID-19 pandemic. From the thirty-six BPFR in OM and OP, twenty-seven (75.0%) answered the questionnaire. Results Most of them were males (n=20; 74.1%) and were distributed in four Brazilian regions and ten states of the federation, including the Federal District. Twenty-four (88.9%) BPFR reported having suspended clinical activities, while sixteen (59.3%) answered that histopathology practices are suspended. Twenty-five (92.6%) BPFR mentioned difficulties in conducting research projects and 55.5% stated having no difficulties in the supervision of undergraduates, master’s and PhD students. Conclusion The current scenario may significantly impact the diagnosis of oral diseases in Brazil. Moreover, a decrease in the scientific production of BPFR in OM and OP in the coming years is also considered.

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ABSTRACT Objective: To evaluate both knowledge and attitude of public elementary school teachers in Alfenas, Minas Gerais, Brazil, towards Traumatic Dental Injuries (TDIs). Material and Methods: Four hundred and seventy-one teachers from 10 schools were invited to participate in the research. Two hundred and twelve were accepted, being randomly selected to answer semi-structured questionnaires. Statistical tests Chi-Square and Fisher’s Exact Test were also used for the other variables at a significance level of 5% (p<0.05). Results: 212 teachers answered; 34% had first-aid training in college or even voluntarily (22.6%), but only 7.1% had taken training about TDIs. Only 7.5% were satisfied with the knowledge about TDIs, and 12.3% felt prepared to face it. About 10.8% had seen any type of TDI; 53.3% would report to the headmaster and 8% to the school dentist in a TDI event. The teachers’ first attitude towards TDIs would be contacting the child’s parents (63.2% and 58.5%, respectively). About 47.2% would handle the tooth properly (by the crown). Nearly 90.1% would carry out a permanent tooth dental reimplant, which would be conducted immediately (71.2%). About 36.3% of the teachers storage the avulsed tooth in a liquid: milk (46.7%) and saline solution (24.7%). The dry media mentioned were paper (18.9%) and gauze or cotton (15.1%). Most of the teachers (96.2%) stated that they would like to receive information on TDI. Conclusion: Elementary school teachers in Alfenas have partial knowledge about traumatic dental injuries.

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ABSTRACT Objective: To evaluate the difference in working conditions as perceived by dentists during the pandemic and their professional satisfaction levels. Material and Methods: An online survey was conducted using the convenience and snowball sampling methods. Two hundred seventy-two respondents across various countries answered information related to socio-demographic data and work satisfaction levels during the SARS-CoV-2 pandemic. Results: 40.1% of dentists reported dissatisfied with their current work, while another 13.6% of dentists fell in the extremely dissatisfied category. 22.8% of dentists were significantly dissatisfied with their current income. Furthermore, 38.4% of the dentists were dissatisfied with physical working conditions, while 33.5% reported dissatisfaction with the freedom of working methods. Conclusion: This study was focused on the connection between various intrinsic and extrinsic factors affecting working conditions, social interactions, and psychological stresses. From the findings of this multicultural study, we can see that dentists across different countries have been affected and have varying levels of dissatisfaction. Therefore, regulatory authorities must plan for support and interventional programs to help dental professionals pass this difficult period.

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ABSTRACT Objective: To explore the prevalence of tobacco use and secondhand smoke (SHS) exposure in dental students and to investigate their perceptions on the role of dentists in tobacco cessation activities. Material and Methods: A questionnaire-based study was conducted in a public university in Al Madinah, Saudi Arabia. The questionnaire investigated demographic factors, tobacco use practices, SHS exposure, and student perceptions of tobacco cessation activities. Descriptive statistics and statistical significance of differences between demographic groups were calculated. Results: A total of 228 students participated with 43.0% (n=98) males and 57.0% (n=130) females. A proportion of 30.7% (n=70) of the participants smoked tobacco, and these constituted 51 males (73%) and 19 females (27%). Only 39 students (15 females and 24 males) indicated their method of tobacco use, which was mainly cigarettes and waterpipes. One in two students was exposed to SHS. Non-smokers had better awareness of the health hazards of SHS (p<0.001), and were more likely to adopt tobacco cessation activities recommended by dentists (p<0.05). Conclusion: A substantial proportion of dental students in a very conservative religious area smoke tobacco and are exposed to SHS. Their perceptions of the harms of SHS and attitudes on cessation need improvement. The influence of culture and religion in shaping health risk behaviors in conservative communities needs to be verified.

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ABSTRACT Objective: To evaluate the improvement in masticatory performances two weeks after posterior implant restoration. Material and Methods: Nine patients with missing first and second molars were included in the study. Masticatory performances were evaluated using subjective and objective methods utilizing color-changeable chewing gum and the visual analog scale (VAS) assessment. The subjects were asked to chew the color-changeable chewing gums before and two weeks after the posterior implant restoration. Their expectations regarding aesthetics and function were verified on the VAS before implant placement. Additionally, the VAS was used for the posttreatment completion rating two weeks after the implant restoration. Results: Significant differences in masticatory performance were noted at baseline (before implant posterior restoration) and two weeks after implant restoration (p<0.05). The posttreatment aesthetic and functional expectations ratings significantly exceeded the expectations (p<0.05). Conclusion: Masticatory performances were improved two weeks after implant restoration. In addition, the significant posttreatment ratings of the patients exceeded their initial expectations. In particular, patients with poor masticatory functions demonstrated significant improvements and satisfaction following implant restoration compared to those with good mastication. These findings indicate that a posterior implant restoration can increase the masticatory performance.

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Abstract Objective: To make the readers cognizant about the use of Personnel Protective Equipment (PPEs) and infection control practices which should always form a part of basic patient management and not arise with every emerging disease. Material and Methods: Authors personal clinical experiences and existing literature were summed up to infer relevant information related specifically to dentistry. A comprehensive review was done for the last 15 years in an attempt to explain the current state of understanding on the topic. Results: The authors have tried to compile the most probable reasons as to why PPEs have been a forgotten protocol, which can be enumerated as follows: decreased awareness, financial issues, boredom and lethargy, time constraints, unavailability, carelessness, and burnout due to long procedure and patient feeling discomfort/offended. Conclusion: COVID-19 being highly infectious, a dental clinic is a potential and genuine point of source for many new infections, and no confabulation is less to underline the importance of using PPEs during this pandemic or even otherwise.

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ABSTRACT Objective: To determine the impact of distinctive instrumentation systems of the root canals on the endotoxin lessening through the root canals. Material and Methods: From the electronic databases, MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google Scholar have been used to perform a systematic literature review between 2015 and 2020. Therefore, a software program (Endnote X9) has been utilized for managing electronic titles. Searches were performed with keywords, “root canal,” “instrumentation,” "endotoxin,” "root canal preparation,” “biofilm” “endodontics,” and “lipopolysaccharide.” This systematic review has been conducted on the basis of the key consideration of the PRISMA Statement-Preferred Reporting Items for the Systematic Review and Meta-analysis. Results: Hence, 163 potentially important abstracts and research topics have been discovered by electronic searches and three studies (3 RCTs) have been included. According to the outputs, any statistically significant differences have been not found between the rotary files and reciprocation (SMD 0.51, 95% CI [0.11, 0.90], p=0.011) (I2 = 49.5%; p=0.138). Conclusion: Analyses indicated that instrumentation methods decreased the content of endotoxin from the root canals.

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ABSTRACT Objective: To reconnoiter the IL-1A (-889) and IL-1RN (+2018) gene polymorphisms and their association with EARR. Material and Methods: The Science Direct, PubMed and Scopus databases were comprehensively searched by two independent reviewers. In addition, the bibliographies of all relevant publications and textbooks were searched manually. A meta-analysis was performed using data available up to May 9, 2020. Results: A total of 13 and 9 publications were selected for the systematic review and meta-analysis, respectively for both IL-1A and IL-1RN genes. Odds ratio (OR) was used to evaluate the association of the gene polymorphism and the risk of EARR. The risk of EARR was estimated using the overall OR from the published studies. No association was found for IL-1A gene for the risk of EARR. However, the dominant and co-dominant models of IL-1RN gene polymorphism were associated with the risk of EARR. Conclusion: More studies are warranted to determine the relationship between IL-1A and IL-1RN gene polymorphisms and EARR for a clearer understanding of their interactions.

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ABSTRACT Objective: To compare the airway changes and risks of sleep apnea after the bimaxillary orthognathic surgery and mandibular setback surgery in the growing patients with skeletal Class III malocclusion. Material and Methods: MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google scholar have been utilized as the electronic databases for performing systematic literature between 2010 to August 2020. The quality of the included studies has been assessed using MINORS. Meta-analysis was performed using Stata 16 software. Results: In electronic searches, a total of 218 potentially relevant abstracts and topics have been found. Finally, 23 papers met the criteria defined for inclusion in this systematic review. The mean difference of upper airway total volume changes between before and after surgery was (MD = 1.86 cm3 95% CI 0.61 cm3-3.11 cm3; p= 0.00) among 14 studies. This result showed that after Mandibular Setback Surgery, there was a statistically significant decrease in the upper airway volume. Conclusion: Class III Patients who undergo bimaxillary surgery show no other significant difference in airways volume after surgery than patients in Class III who undergo mandibular setback alone.

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ABSTRACT Objective: To evaluate resin- and bioceramic root canal sealers affect postoperative intensity and pain occurrence. Material and Methods: From the electronic databases, PubMed, Cochrane Library, Embase, ISI have been used to perform systematic literature until September 2020. Electronic titles were managed using the Endnote X8 software. They performed searches with mesh terms. Two reviewers blindly and independently extracted data from studies that included data for data extraction. Results: A total of 186 potentially relevant titles and abstracts were found. Finally, four studies were included. Pain score was (RR = -0.20; 95% CI -1.09-0.68; p= 0.65). This result showed no statistically significant difference for the resin-based and bioceramic root canal sealers after 24 hours between the VAS scores. Conclusion: Postoperative pain was low in Patients requiring root canal retreatment and obturated with resin-based or bioceramic-based sealers without extrusion beyond the apex. No differences were observed between postoperative pain in resin-based and bioceramic root canal sealers 24 and 48 hours postoperatively.

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ABSTRACT Objective: To evaluate the epidemiological evidence, symptoms, and transmission routes of Coronavirus Disease 19 for clinical dental care. Material and Methods: PubMed, Embase, ISI, Scopus, Medicine have been used to search for articles until October 2020. Therefore, EndNote X9 was used to manage electronic resources. A 95% confidence interval (CI) effect size, random effect model, and the REML method were evaluated. Forty-one articles were found. In the first step of selecting studies, 40 studies were selected to review the abstracts. Finally, six studies were selected. Results: The effect size of symptoms of COVID-19 was fever: 92% (ES = 0.92, 95% CI 0.79-1.06), cough: 73% (ES = 0.73, 95% CI 0.59-0.88), headache: 8% (ES = 0.8, 95% CI 0.06-0.22), myalgia 13% (ES = 0.13, 95% CI 0.01-0.27) and nasal congestion 22% (ES = 0.22, 95% CI 0.06-0.39). The following recommendations are appropriate during COVID-19 for dental emergency management: personal protective equipment and hand cleanliness practices, personal protective equipment (PPE), preprocedural mouth rinse, single-use (disposable), cone-beam computed tomography (CBCT) and periapical (PA) radiography, Rubber dam, sodium hypochlorite for root canal irrigation, disinfect inanimate surfaces, ultrasonic scaling instruments and airborne infection isolation. Conclusion: Fever should be used as the first sign in the diagnosis; dentists should measure the fever of all patients at the time of arrival and before any procedure and then ask about other symptoms.

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ABSTRACT Objective: To evaluate the success rates of resin-based endodontic surgery (RES) and endodontic microsurgery (EMS), and compare their results. Material and Methods: A total of 19 and 34 full-text papers were reviewed, and finally, 2 and 6 studies were selected for RES and EMS, respectively. The stages of the study selection process were illustrated in Figure 1. The demographic characteristics were also described using the IBM SPSS Software, and the meta-analysis was fulfilled via Stata V.14. Results: A total number of 811 teeth were analyzed in this systematic review and meta-analysis, with a mean follow-up of 38.63 months. Besides, the results of the meta-analysis indicated that both methods not only differed in terms of implementation but also produced varying outcomes. Accordingly, EMS demonstrated a higher success rate likelihood with a significant difference from that of RES. Conclusion: An excellent proof was made available through this meta-analysis regarding the resin-based endodontic surgery success rate likelihood (79.9%) and an update for the endodontic microsurgery success rate possibility (100%).

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ABSTRACT Objective: To compare the root canal preparation of primary teeth with reciprocating and rotary NiTi instruments. Material and Methods: Electronic databases (PubMed/MEDLINE, Web of Science, TRIP, Lilacs, Embase, and Scopus) were systematically searched until October 2020. In vitro studies comparing the cleaning ability, debris extrusion, file deformation, or working time of rotary and reciprocating NiTi instruments in primary teeth were evaluated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Meta-analyses were conducted using a random-effects model to calculate pooled mean differences between reciprocating and rotary NiTi instruments considering the outcomes: working time (minutes) and debris extrusion (milligrams). Statistical analyses were performed using RevMan 5.3 at a significance level of 5%. Results: From 4,417 potentially relevant studies, 10 were included in the systematic review, and 8 considered in the meta-analyses. There was no significant difference between reciprocating and rotary NiTi instruments considering debris extrusion [3 data sets; effect size: -0.11 (-0.25-0.04); p=0.15] and working time [6 data sets; effect size: -0.37 (-0.98-0.24); p=0.24]. The heterogeneity found was moderate to high. The risk of bias was low in most studies (50.0% of all items across studies). Conclusion: There is no scientific evidence showing superiority of reciprocating or rotary NiTi instruments used for root canal preparation in primary teeth.

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ABSTRACT Objective: To assess the scientific evidence on direct and indirect bonding techniques to analyse the differences related to treatment time, number of appointments and number of bracket detachments. Material and Methods: The MEDLINE and Cochrane Library databases were searched through to March 2021. Reference lists from the retrieved publications were also examined. The following article types that described data on the different types of direct and indirect bonding techniques in orthodontics were included: prospective and retrospective cohort studies, case-control studies and randomized controlled clinical trials (RCCTs). Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: The search strategy initially resulted in 824 articles, and after a careful selection comprising the inclusion criteria, 12 articles were picked for the final review, specifically 2 cohort studies, 4 case-control studies and 6 RCCTs. The methodological quality was low in 4 studies, medium in 2, and high in 6 articles. Conclusion: The evidence currently available suggests that the use of computer-aided bonding is related to a reduction in treatment time and the number of appointments compared to direct and manual indirect bonding. However, the total bonding time for computer-aided bonding technique, including digital bracket placement, was longer than for direct bonding. Further high-quality RCTs on the differences between direct and indirect bonding are necessary to determine more precise data, as well as additional advantages and disadvantages.

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ABSTRACT Objective: To determine the Dentists' practice in compliance with general and guidelines for handling Coronavirus Disease 2019. Material and Methods: PubMed, Embase, ISI, Scopus, Medicine have been used to search for articles until September 2020. EndNote X9 was used to manage electronic resources as a resource. Joanna Briggs Institute reviewer's manual (JBI) tools was used to assess the quality of studies included in the current systematic and meta-analysis review. The 95% confidence interval (CI) effect size, the random effect model, and the Restricted maximum-likelihood (REML) methods have all been calculated. I2 values of more than 50% indicated moderate-to-high heterogeneity. Stata/MP v.16 (the fastest version of Stata) statistical software was used to evaluate the Meta-analysis. Results: 39 articles were found in the initial keyword search. The full text of 16 studies was reviewed, and six studies were selected in the end. 72% of participants used a face mask during the dental procedure (72%, 95% CI; 40%-100%). 63% of participants measured fever when patients arrived during the COVID-19 pandemic (63%, 95% CI; 46%-79%). Moreover, 72% of participants used a face mask during the dental procedure (72%, 95% CI; 40%-100%). According to JBI tools, all studies had a moderate risk of bias. Conclusion: The results show that the performance of dental professionals in the conditions of the COVID-19 epidemic is not favorable. Training should be under the standards of treatment guidelines and further measures so that dental professionals can show proper practice by increasing their awareness of this virus and following up on its infection.

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ABSTRACT Objective: To examine the level of the accumulating success of the modern Resin-Based Endodontic Surgery (RES) and comparison with Endodontic Microsurgery (EMS) and finally offer a replacement at the predicted final results of EMS. Material and Methods: MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google Scholar have been utilized as electronic databases for systematic literature until 2019. Therefore, Endnote X9, which can be provided in the market, has been applied to manage the electronic titles. Searches have been made with keywords “Endodontic Microsurgery OR EMS”, “Resin-Based Endodontic Surgery OR RES”, “Regenerative Endodontic Therapy”, “Root-End Filling”, “Root-End Surgery”, “Periapical Surgery” and “Endodontics”. Thus, this systematic review has been conducted concerningthe basic investigation of the PRISMA Statement-Preferred Reporting Items designed for the Meta-analyses and Systematic Reviews. Results: A total of RES =19 and EMS =31 with potential pertinent abstracts and topics were discovered in manual and electronic searches. Then, three articles for RES and four studies for EMS publications satisfied our inclusion criteria necessary for systematically reviewing the studies. The analysis showed the success rate for EMS as equal to 1.16 times the probability of the success rate for RES. Conclusion: Micro-surgical procedures superiorly achieved the predictable high success rate for the Root-end surgery compared to conventional methods.

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ABSTRACT This paper discusses the potential risk that COVID-19 generates for the development of enamel defects. This hypothesis was built based on the etiopathogenesis of enamel defects and the relationship with the symptom's characteristic of COVID-19. Pregnancy is a critical period for the child's development; exposure to pathological agents can cause systemic imbalances and risks of adverse perinatal and prenatal outcomes. The main clinical symptoms of this disease and its association with that dental outcome were considered. Fever, breathing, cardiovascular disorders, and diarrhea were related as potential etiological factors of ameloblast metabolism imbalance, which can interfere qualitatively and quantitatively in the development, maturation and mineralization of the tooth enamel. Molecular disorders derived from COVID-19, as well as their clinical symptoms, can be considered potential risk factors for the development of enamel defects. Individuals with enamel defects experienced high stress levels during pregnancy or early childhood. The approach adopted may help build new research to ensure understanding of the etiology of the development of dental enamel defects and its relationship with COVID-19. However, longitudinal studies need to be conducted to confirm the association between COVID-19 and adverse events during pregnancy.

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ABSTRACT Since the 1980s, the development of neoliberalism has been observed in Brazil, which has led to the progressive weakening of public policies (including those of education) and the population's impoverishment. In the field of education, there was an increase in the privatization of higher education, inadequate to the requirements of national development, characterizing it more as a commodity than as a right. This article aims to discuss some challenges, risks, and possible strategies to face the impact of the COVID19 pandemic in undergraduate dental education. This pandemic had an immediate and dramatic impact on dental education in more than 130 countries, prompting teachers and students to adopt remote teaching activities. In Brazil, theoretical classes were offered remotely, mainly in private institutions where there was an intensification of academic work for both teachers and students. This process requires support in technological and pedagogical aspects, including tools, resources, and training courses. In the resumption of clinical education, changes in biosafety actions are being proposed to preserve the health of the actors involved. The application of these measures will imply a great mobilization of students, teachers, and technicians and extra attention so that the constitutive dimensions of the teaching-learning process in health are not minimized or forgotten.

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ABSTRACT Objective: To provide an overview of the most relevant studies on non-pharmacological behaviour management techniques for contemporary children, the so-called alpha generation, who undergo dental treatment. Material and Methods: A systematic search was performed on the Medline/PubMed and Google Scholar (grey literature) databases. The articles were read and data collected by two reviewers on an independent basis. Two reviewers collected data from the studies selected in tables structured by using the Rayyan QCRI software. The following data were extracted: year of study, child's age, child's gender, technique used. Results: A total of 322 articles were found, remaining only 17 after duplicates were removed and inclusion and exclusion criteria applied. The studies were conducted between 2010 and 2019 in Saudi Arabia, Greece, India, Brazil, USA, Italy, and Switzerland. The samples ranged from 15 to 306 children aged between 3 and 10 years old. The children attended the dental office for different reasons, ranging from simple prevention to endodontic treatment under local anaesthesia. Several behaviour modification methods are known to be used before and during a dental consultation. Conclusion: After reading the articles, we concluded that alpha generation children are inserted in a daily environment of modernization and that conventional non-pharmacological techniques using technology, such as audio-visual glasses, are more interesting and make children distracted and relaxed during dental treatment, thus minimizing their stress, anxiety and fear.

Resumo em Inglês:

ABSTRACT Objective: To evaluate and discuss the prevention and management of dental trauma in primary teeth during the COVID-19 pandemic. Material and Methods: Critic literature review, searching electronic databases and Google for articles and guidelines published in English that described prevention and management of dental trauma in primary dentition during the pandemic of COVID-19. Results: 5 publications regarding management and 1 leaflet about prevention for parents were identified. Urgent care is required when the child presents tooth fracture resulting in pain or causing soft tissue trauma and luxation affecting bite. Avulsed teeth should not be replanted and advice and self-help may be sufficient in some situations. Instructions about soft diet and hygiene must be provided. Remote consults are recommended for non-urgent situations and during follow-up to evaluate the presence of sequelae. Aerosol generating procedures should be avoided and, in cases of poor prognosis, extraction is recommended to prevent recurring visits to the dental office. Conclusion: During COVID-19 pandemic, remote consults should be recommended to evaluate traumatic dental injuries in primary dentition. Follow-up should not be neglected and may be performed through remote consultation.