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Abstract Objective: To perform the transcultural adaptation to Brazil and validation of the Halitosis Associated Life-quality Test (HALT) for use in adolescents. Material and Methods: Students aged 12 to 15 years, of both sexes, with healthy permanent dentition, attending public schools in Piracicaba, Brazil, were selected for this study. The HALT was translated, backtranslated, reviewed by an expert committee and submitted to a pre-test. In the first phase (n = 13), 15% of the sample did not understand items 2, 12 and 15; therefore, these items were reformulated and resubmitted to 13 adolescents. The version with a sociocultural adaptation was self-applied by 56 adolescents (64% females, 13.4 ± 1.0 years), of whom 25 participated in the test-retest. The presence of visible biofilm, gingival bleeding, calculus and tongue coating, was evaluated. Self-perception of halitosis after exhalation/breathing was assessed by a single question. Results: The HALT score ranged from 0 to 62 points (mean = 10.1±13.4) and the floor effect was 5.4%. Internal consistency was excellent (Cronbach's alpha = 0.92) and reproducibility was moderate (Intraclass Correlation Coefficient = 0.59). Individuals with “excessive” tongue coating had a higher HALT score than those with mild and/or moderate coating (p<0.001). Multiple linear regression analysis indicated that only the male sex was related to a higher HALT score (p<0.05). Conclusion: The Brazilian Portuguese version of the HALT was easily understood by adolescents. Those with greater tongue coating accumulation reported more frequently the presence of halitosis, which was only associated to male sex.

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Abstract Objective: To investigate the longevity of endodontic treatments and the survival of endodontic re-treatments performed in primary teeth. Material and Methods: The sample included endodontic treatments and re-treatments conducted in anterior and posterior primary teeth without sedation or general anesthesia among children attending a university dental service. Information collected retrospectively from clinical records was used for analyzing data. The Kaplan-Meier estimator test was used to analyze the longevity and survival of endodontic treatment and re-treatments, respectively. Results: A total of 73 patients with endodontic therapy in primary teeth were included in the study, and 116 teeth were analyzed. After one year, the longevity of endodontic treatments performed on primary teeth was 65.74% with an annual failure rate (AFR) of 34.2%. From 47 endodontic treatment failures, 14 teeth (29.8%) were endodontically re-treated. When the endodontic re-treatment was considered as survival, the longevity of treatments reached 68.06% with 31.9% of AFR after one year of follow-up. There was a significant increase in functional tooth retention in those patients that received an endodontic re-treatment (p<0.001). Retreatment provided an additional mean survival time of 8.3 months. Conclusion: Endodontic treatments performed in primary teeth presented a limited longevity. Endodontic re-treatment is a more conservative alternative for endodontically treated primary teeth that have failed and significantly increase tooth retention.

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Abstract Objective: To evaluate the inclusion capacity and bactericidal efficiency of diallyl dimethyl ammonium chloride (PDADMAC) diluted in tetrahydrofuran (THF) upon inclusion in the medical grade silicone polymer structure. Material and Methods: It was diluted the PDADMAC in THF at the concentration of 4wt%. It was included in the silicon paste during its vulcanization process. The contact angle measurements were performed to evaluate whether the biocide inclusion into the silicon paste was successful. All samples were sterilized with gamma radiation at 25KGy-dosage prior to the microbiological tests. Microbiological testing strictly followed the Antibacterial products - Test for antibacterial activity and efficacy JIS Z 2801: 201010 and the used of specific bacteria, as Staphylococcus aureus ATCC 6538P and Escherichia coli ATCC 8739. Results: The results showed that PDADMAC, when dissolved in THF at 4wt%, displayed good incorporation in medical silicone and a broad-spectrum antibacterial response. The results of the tests using Escherichia coli ATCC 8739 and Staphylococcus aureus ATCC 6538P showed that the silicone with no biocide addition did not present antibacterial activity. In contrast, the experimental group plus 2 mL of PDADMAC would have an ideal antibacterial response. Conclusion: Medical grade silicone can be used as a material with antibacterial properties, since it has been able to keep PDADMAC compound attached to its structure, thus acquiring antimicrobial property.

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Abstract Objective: To evaluate in vitro the presence of fluoride in saliva after applying professional use products on the surface of dental enamel. Material and Methods: Experimental groups were composed by: Cariostatic 12% (CA), Fluoridated Varnish 5% (FV), Fluorine Acidulate Gel 1.23% (AG) and Fluorine Neutral Gel 2% (NG). Fluoridated dentifrice (FD) and Artificial Saliva (AS) were used as controls. Products (10 μL) were applied to the surface of bovine enamel blocks (4×4×1 mm, n = 18) and immersed in 10 mL of artificial saliva at room temperature. Aliquots of artificial saliva (750 μL) of each sample were collected 1, 2, 4, 8, 24 and 48 hours after application of the products. Analyses were performed in triplicate, using a fluoride ion-specific electrode coupled to a potentiometer. The equipment was calibrated using a standard curve for fluoride analysis from 0.125 to 64 μgF-/mL. Results: Greater fluoride concentration (μgF-/mL) was observed after 1h application, as follows: 197.40 (NG), 172.21 (AG), 20.25 (CA), 14.49 (FV) e 11.81 (FD). Fluoride concentration increased overtime for all groups. After 48h, the following fluoride concentrations were assessed: 428.12 (AG), 267.25 (NG), 65.36 (FV), and 62.52 (CA). Conclusion: Greater fluoride release was observed for AG and NG groups, mostly after 1h application.

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Abstract Objective: To verify the dental age of individuals with Angle Class II, division 2 malocclusion. Material and Methods: The sample consisted of 200 panoramic radiographs of schoolchildren from the city of Fortaleza in the state of Ceará, in the northeast of Brazil. These radiographs were divided into two groups (N=100): a Control group comprising radiographs of patients with normal occlusion and a CIID2 group comprising radiographs of patients with an Angle Class II, division 2 malocclusion. The Demirjian method was used to identify dental age. All the radiographs were evaluated by a sole duly trained and calibrated technician. The Kappa coefficient for inter-annotator agreement was 0.98 based on the criteria of eruption stage of each tooth. Statistical analysis was performed using the Chi-squared test, Student’s t-test and the Mann-Whitney test, with a level of significance of 5%. Results: There was a significant statistical difference between the dental ages of the groups tested. The CIID2 group had a lower dental age than the control group, signifying late eruption in patients with an Angle Class II, division 2 malocclusion. Conclusion: Patients with an Angle Class II, division 2 malocclusion had a lower dental age than patients with normal occlusion, suggesting that orthodontic treatment should be delayed. The first molars, second pre-molars and canines suffered late eruption.

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Abstract Objective: To compare the teaching of the pulpectomy in primary teeth among graduate and undergraduate Brazilian dental schools. Material and Methods: From August 2015 to July 2016, an 11-question survey was sent to 44 graduate and 207 undergraduate dental schools. Data obtained were summarized using descriptive statistics. Results: The response rate was higher from graduate (56.8%) than undergraduate (41.1%) courses. Pulpectomy was taught by all participating schools. More than 90% of the undergraduate and graduate courses recommend the use of hand instruments for canals debridement, but the widening of root canals was advised in 69.4% of undergraduate and in 84% of graduate schools. Regarding the irrigatings, 1% sodium hypochlorite as a single irrigating solution was the most taught for both biopulpectomy and necropulpectomy. The iodoform-based Guedes-Pinto paste as the single indication was the preferred root canal filling material in undergraduate schools (30.6%), while the zinc oxide-thickened calcium hydroxide paste as the single option was the most recommended in graduate courses (36%). Endodontic hand file associated with lentulo drill for filling root canals was recommended by most courses. Overall, biopulpectomy was performed in one session, while necropulpectomy led two sessions. Periapical radiograph for diagnosis and final obturation was the most adopted conduct by undergraduate (68.2%) and graduate (72%) schools. Gutta-percha and glass ionomer cement were preferred materials to seal the entrance of the pulp chamber. Conclusion: There was variability in the techniques and materials taught to perform pulpectomy in primary teeth among Brazilian graduate and undergraduate dental schools. Calcium hydroxide paste has been used in similar proportion to iodoform-based paste.

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Abstract Objective: To evaluate the impact of radiotherapy on enamel around restorations of glass ionomer cement (GIC) and fluoride tooth paste (FTP). Material and Methods: Eighty enamel blocks were made and randomly distributed into two groups, according to the fluoride therapy, non-fluoride tooth paste (NFTP) and FTP (n=40) and in subgroups in conformity with radiation dose (0, 10, 30 and 60 Gy). Roughness and microhardness enamel analyses were conducted before radiotherapy. Enamel cavities were made and restored with two GIC (Ketac Molar Easy Mix or Vitremer). Enamel blocks were submitted to 10, 30 and 60 Gy. Then, artificial enamel caries lesions were created by a pH-cycling procedure and FTP or NFTP were used as treatment. The restored enamel blocks were submitted to final roughness and microhardness analyses. Roughness increase (∆R) and hardness loss (∆H) values of enamel were submitted to ANOVA and Tukey test (p=0.05). Results: The irradiated enamel group showed statistically higher ∆R (0.44 ±0.2) and ∆H (99.26±7.0) values compared to non-irradiated group (∆R = 0.051±0.02; ∆H=66.16±12.7) when a resin-modified GIC and NFTP were used. Conclusion: Higher radiation dose increased dissolution of bovine enamel. The use of GIC associated with FTP decreased roughness and increased enamel hardness after radiotherapy.

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Abstract Objective: To evaluate the influence of gustatory stimuli on the buffering capacity of saliva. Material and Methods: The buccal ph of 18 male volunteers aged 18-35 years was measured after a mouthwash with 20 ml of water as a control, and in individual disposable cups they collected the saliva for two minutes. Then, each of chewed bubble gum with sugar for two minutes, discarding the gum and made new collection of saliva, for two minutes in other disposable cups individualized. After collection, each volunteer was again subject to regular brushing with toothpaste and waited another ten minutes. The same procedure was repeated with all other substances. Salivary buffer capacity was determined by Ericsson technique. Data were submitted to analysis of variance and the means were compared by the Scott-Knott grouping test and Mann-Whitney test at 5% probability. Estimates of Pearson correlations were calculated in order to determine possible associations between the variables. Results: It was not found statistically significant differences between the initial pH variation and after eating food (p>0.05), or between gustatory stimulation and variation of salivary buffer capacity (p>0.05). Conclusion: There is no influence of gustatory stimulus aroma and flavor on the variation of salivary buffer capacity.

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Abstract Objective: To analyze prenatal care in the primary care of the Brazilian Unified Health System. Material and Methods: This is a survey cross sectional research with inquiry-type quantitative-qualitative approach. Data collection was performed in 28 cities of the São Paulo state, through on- site observations and interviews with health secretaries, coordinators of primary and oral health care. The following variables were analyzed: Primary health care services for pregnant woman as educational activities, presence of care and referral protocol and the organization of oral health care. Content analysis was performed for the answers of the open questions and the quantitative treatment of the discursive data was obtained through the categorial analysis. For the answers of the closed questions a descriptive analysis was performed. Results: The total number of participants interviewed was 84 managers. It was observed that 78.6 %% of cities carried out educational activities; 42.9% do not have an active care protocol and 57.1% do not have formal referral guidelines to high-risk pregnancies. The rapid tests for HIV, Syphilis, Hepatitis B and C were confirmed by 53.6% of managers and only 39.3% reported evaluating the vaccine situation. As to dental care, 71.4% of the municipalities do not have an established guideline; 46.4% reported that access occurs through spontaneous demand; 32.1% do not consider pregnant woman a priority care group and 67.9% have instituted prenatal dental care. Conclusion: Prenatal care has guaranteed educational activities, but it has deficiencies related to the work process and to the management of services, due, for the most part, to the inexistence of assistance and organizational protocols.

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Abstract Objective: To determine the effect of scaling and root planning treatment on levels of hs-CRP (C-reactive protein) in patients with risk of cardiovascular disease. Material and Methods: This research is an experimental research with one group pre- and post-test design. This research was performed to the periodontal patients who came to the clinic and have risk of cardiovascular disease. Medical evaluations included measurement of blood pressure and body mass index were performed. Blood samples were obtained from each subject after over night fasting, high-sensitivity C-reactive protein was measured as an index of inflammation. Blood samples were analysed two times before treatment (scaling and root planning) and three weeks later. Statistical analysis used Paired t-test. The level of significance was set at 5%. Results: Means-CRP levels before and after treatment in scaling and root planning were 3.16 ± 2.37 and 2.18±1.56 (p=0.007). Conclusion: There are significant differences between hs-CRP levels before and after treatment.

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Abstract Objective: To analyse economic burden of selected analgesic drugs prescription by dentists in Slovakia over a 24-month period. Material and Methods: In this economic burden study, the data were provided from the largest public health insurance company in Slovakia. It was analysed 23,256 prescriptions of selected analgesic drugs (Acetylsalicylic Acid, Diclofenac, Nimesulide, Tramadol and Metamizole Sodium) by dentists in Slovakia. Results: The highest analgesics prescription by dentists was found in Diclofenac in 2016 with 11.2% prescription increase in 2017. The significant decrease of analgesic drug prescription by dentists in 2017 was observed in Tramadol (-29.9%). The economic burden of selected analgesic drugs by patients were €33,926 in 2017 with 21.3% significant decrease of average percentage differences (APD) in Tramadol and 84.6% significant increase of APD in Metamizole sodium in 2017. Patients participated 65.5% share in payment of selected analgesic drugs and Health Insurance Company participated only 34.5% share in payment of selected analgesic drugs in 2017. It was found increase of percentage analgesic drugs prescription in Diclofenac and Nimesulide and decrease of percentage drug prescription in Metamizole sodium from 1/2016 to 12/2017. Conclusion: Economic burden on analgesic drugs prescribed by dentist was low per Slovak inhabitant in calculated. Diclofenac was most frequent prescribed analgesic drug with the highest economic burden. We recommend prescribing cheaper analgesic drugs with a lower economic burden and with the same effect.

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Abstract Objective: To evaluate the sweetness taste preference levels and their relationship with the nutritional and dental caries patterns among preschool children. Material and Methods: The participants of this cross-sectional study were 191 children aged 4 to 5 years, who were regularly attending public Child Education Centers of a city southern Brazil. Children’s preference for sugar was evaluated by the Sweet Preference Inventory; caries prevalence, according to the World Health Organization criteria, and nutritional status, by anthropometric weight and stature measurements, in accordance with child growth standards of the World Health Organization. Results: High levels of sweetness preference were identified. The majority of children (67.5%) opted for the most concentrated sucrose solutions. Excess weight was recorded in 27.7% of the preschoolers. The prevalence of caries was 51.8%, with the mean dmf-t equal to 1.92 (± 2.72) and the decayed (c) component responsible for 94.2% of the index. No significant association between sweetness preference and the nutritional or the oral health patterns could be established. In addition, no association between excess weight and dental caries was identified. The diseases studied were only associated with sociodemographic variables. Excess weight was associated with maternal age (p=0.004) and caries experience with family income (p=0.013). Conclusion: No significant associations could be stablished between the sweetness taste preference and the diseases studied, nor between excess weight and dental caries. However, the findings of high patterns of sweet preference, excess weight and untreated caries experience, highlight the need for the implementation of integrated public policies aimed at controlling both nutritional and of oral health problems in the studied population.

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Abstract Objective: To know the activity of resistance of flavonoid content in ant nest plant in decreasing the number of colonies S. mutans oral cavity of children as a medic herbal material. Material and Methods: The subjects were plaque sample of 20 children aged 7-12 years. Research begins by making toothpaste from ant nest extract. Samples of children's dental plaque were inserted into BHIB media, after which incubated for 24 hours, 1/10 dilution with BHIB media three times, followed by TYC media planting and incubation of anaerob with temperature 37ºC for 48 hours. After that then count the number of colonies of S. mutans. Results: On ethyl acetate extract of ant nest incubated at room temperature with concentration 20%, 40%, 60%, 80%, 100% obtained a decrease from each treatment amount of Streptococcus mutans colony on TYC media with median value of each treatment was 89, 67, 64, 61, 59 and 51 for the ethyl acetate fraction, and 62, 61, 60, 59, 49 at the ethanol fraction. There was no significant difference between the six concentration groups (p>0.05). Conclusion: Flavonoids extract of ant nest plants have growth barrier on Streptococcus mutans bacteria, the greater the concentration given the greater the number of S. mutans colony.

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Abstract Objective: To evaluate in the vitro effectiveness of three chemical agents for toothbrush disinfection. Material and Methods: Sixteen new toothbrushes were evaluated, previously sterilized and classified in five experimental groups (n=3) and one item as control. Three chemical agents were assessed: 0.12% Chlorhexidine gluconate (CHX), essential oil mouth rinse (Listerine) and 3.5% Sodium hypochlorite (NaOCl). The five selected strains were inoculated on toothbrushes and incubated for a 24 hours period and 37°C temperature in aerobic conditions. The incubated toothbrushes were immersed for a 15 min period into selected chemical agents and after drying in a controlled air stream, again re-cultured into enriched broth. A comparison was made between the initial and final microorganisms density recovered after chemical disinfection based on Mc Farland scale. The data obtained was compared by descriptive analysis and ANOVA methodology. Results: 3.5% NaOCl was the most effective chemical agent for toothbrush disinfection followed by CHX; Listerine was not effective to eliminate the inoculated bacteria in toothbrushes. Conclusion: 3.5% NaOCl and 0.12% CHX are the most effective chemical agents for toothbrush disinfection and Listerine was only effective against C. albicans.

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Abstract Objective: This parallel, randomized, examiner-blind clinical trial aimed to evaluate the efficacy of two different toothbrushes (manual and sonic) on plaque control in adolescents. Material and Methods: This study enrolled 56 volunteers, randomly allocated to two different groups: group A (n = 28) for the manual toothbrush (Curaprox 5460 Ultra Soft®) and group B (n = 28) for the sonic toothbrush (Edel White®). Mean age was 17.2 ± 1.1 years. A calibrated periodontist performed a periodontal evaluation to assess the presence of plaque with the Turesky Modification of the Quigley Hein Plaque Index (PI) and the gingival inflammation with the Silness & Löe Gingival Index (GI). Adolescents received instructions about the mechanical control of plaque at baseline (T0), with a reexamination after 3 months (T1) and 6 months (T2). Non-parametric Mann Whitney test was used to compare the differences between the two toothbrush groups and the Friedman test was used for the comparisons between times. Results: There has been PI reduction concerning the study times (T0, T1 and T2, p<0.05), but not between the groups A and B (p>0.05). As for GI there has been no significant difference between the groups and between the study times (p>0.05). Conclusion: Both toothbrushes were efficient in the control of supragingival plaque (visible biofilm).

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Abstract Objective: To determine the activity of anti-cancer and anti-proliferation of ethyl acetate fraction of ant nest plants (Myrmecodia pendans) in Burkitt’s Lymphoma cancer cells. Material and Methods: The study was conducted in a pure laboratory experimental method using Burkitt's Lymphoma cancer cell culture. Gradual research begins with the determination, extraction and fractionation of ant nest plants, to test for proliferation barriers. Data analysis using two-way ANOVA followed by Post Hoc LSD test with a significance level of 95%. Pearson correlation test was conducted. Results: The results of testing the inhibition of Burkitt’s Lymphoma cell proliferation with ethyl acetate extract treatment showed that there was inhibition of cell growth based on the concentration given, starting from the lowest concentration of 15.625 μg/mL. Likewise, the incubation time factor of 24, 48, and 72 hours showed that the longer the incubation time, the greater the inhibition of cell growth. Antiproliferation analysis of flavonoid ethyl acetate extract based on concentration and incubation time on absorption of optical density Burkitt’s Lymphoma was statistically significant (p = 0.00). Conclusion: Ant nest ethyl acetate extract has the effect of proliferation inhibition on Burkitt’s lymphoma cells.

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Abstract Objective: To determine compatibility between clinical diagnosis and the pathological reports of biopsies from oral lesions. Material and Methods: In this descriptive study, 1146 clinical files of patients referring to Tabriz Faculty of Dentistry from 2004 to 2016 were retrieved and evaluated. The kappa coefficient was calculated for each file for compatibility of clinical and pathological diagnosis. Results: In relation to clinical (40.2%) and pathological (39.2%) diagnosis, irritational lesions of soft tissues exhibited the highest frequency. In 72.3% of cases, the clinical and pathological diagnosis were compatible and in 27.7% of cases these diagnosis were not compatible. The highest compatibility rates were detected for irritational lesions of soft tissues (81.5%) and mucocutaneous lesions (76.9%). There was no compatibility for osseous malignant tumors, inflammatory tissues, granulation tissues, metastatic lesions and hematologic disorders. Conclusion: Approximately one-third of clinical and histopathological diagnosis were not compatible. Therefore, to reach a correct diagnosis, the clinical, radiographic and histopathological views should be evaluated simultaneously.

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Abstract Objective: To compare salivary transferrin levels between patients with oral lichen planus (OLP) and healthy subjects. Material and Methods: In this descriptive, analytical, cross-sectional study, 11 patients with OLP and 22 healthy subjects were selected after matching in terms of age and gender. OLP was confirmed by two oral medicine specialists based on clinical and histopathological criteria. Salivary samples were collected by spitting. The patients were asked to collect their saliva in their oral cavity and then evacuate it into sterilized Falcon tubes. The procedure was repeated every 60 seconds for 5-15 minutes. A total of 5 mL of saliva was collected using this method. The samples were collected from 8 to 9 in the morning in a fasting state to avoid circadian changes. The collected salivary samples were immediately placed next to ice and transferred to the laboratory to be centrifuged at 4°C at 800 g to isolate squamous cells and cellular debris. Then the samples were frozen at -80°C until the samples were prepared. An ELISA kit was used to determine salivary transferrin levels. Data were analyzed with descriptive statistics (means and standard deviations) and t-test for independent groups using SPSS 17. Statistical significance was set at p<0.05. Results: The mean salivary transferrin concentrations in patients with OLP and healthy subjects were 0.9055±0.28229 and 1.5932±0.80041 mg/dL, respectively (p<0.05). Conclusion: The salivary transferrin levels in patients with OLP were significantly lower than those in healthy subjects.

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Abstract Objective: To compared the accuracy of digital radiography in the diagnosis of interproximal caries in permanent teeth with conventional radiography and visual examination. Material and Methods: In this descriptive-analytical study, 78 human premolars, which seem normal in primary examination, are mounted on the plaster in a pair-wise manner and their caries are visually evaluated. Conventional and digital radiographic images are taken under the same conditions and their caries are graded with Confidence Score. To determine the golden standard, after mesiodistal incision, the teeth are examined using stereomicroscopy. Finally, the results obtained by visual observation and conventional radiography as well as digital images were compared with those obtained from the stereomicroscopy to determine their accuracy in detecting the interproximal caries. Results: The consistencies between the visual, digital, and conventional methods with the standard method (microscopic histology) are 53%, 78%, and 50% respectively - all of them are significant (p<0.05). The highest and the lowest sensitivities are related to the digital (96%) and visual (88%) methods respectively, while the highest and lowest specificities are related to the digital (79%) and conventional (50%) methods respectively. The highest and lowest positive predictive value is related to the digital (79%) and conventional (80%) methods respectively. The highest and lowest negative predictive values are related to the digital (90%) and visual (71%) methods respectively. Compared with the standard methodology, the most accurate diagnostic accuracy can be seen for the digital method (91%). Conclusion: There is no significant difference in the diagnosis of interproximal caries by different methods, and the only advantage of digital radiography, compared with the conventional one, is storing radiographs without losing important information and the lower dose of radiation for the patient.

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Abstract Objective: To analyze the Biodentine™ capability in guided tissue remineralization. Material and Methods: Four premolar with two cavities per tooth of 3 mm depth were demineralized with EDTA 17% in shaking incubator at 37ºC temperature. After 7 days, the sample were washed with aquabidest then were soaked in 20 ml NaCl 1 M (pH 7.0) at 25ºC temperature for 8 hours. The samples were divided into two groups: G1: The control group (cavity directly restored with composite resin); G2: Biodentine™ group (cavity with Biodentine™ as a base then restored with composite resin). All samples were stored in shaking incubator under PBS solution at 37ºC temperature. SEM, EDX and TEM analysis were performed on the 7th and 14th day. Results: The 14th day Biodentine group had the best SEM remineralization feature with irregular dentine tubular features covered by density of mass. In the EDX analysis, the concentration of calcium ion of the Biodentine group was higher than the control group on the 7th day analysis (Biodentinå 10.2167 and control 1.9667) and on the 14th day analysis (Biodentine™ 29.833 and Control 22.080). The Biodentine™ group and control group of the 7th and 14th day experienced significant increases in calcium ion concentration while the concentration of phosphate ion in the Biodentine™ and control group had a much lower value of calcium either on the 7th or 14th day. The TEM analysis of Biodentine™ group showed more intrafibrillar remineralization than the control group. The feature of intrafibrillar dentin remineralization is analyzed by looking at the density of black dots in collagen. Conclusion: Biodentine™ is able to trigger the process of remineralization by guided tissue remineralization.

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Abstract Objective: To evaluate the oral health conditions of hospitalized children, as well as describe the knowledge and practices of oral health care adopted by their parents/guardians. Material and Methods: The sample was composed of 46 children who had been hospitalized for at least five days, who had erupted teeth in the oral cavity and were accompanied by their parents/guardians. Information was collected in relation to: the oral health status of children (DMFT/DEF), the socioeconomic profile and access to information on health and oral hygiene of the parents/guardians and data regarding the hospitalization of the children. The data were analyzed using the Fisher, Pearson's and Mann Whitney's Chi-squared tests, with a confidence level of 95%. Results: 47.8% of the hospitalized children had experienced caries, and the most relevant component for the determination of the experience of caries was the presence of decayed teeth (0.50 to 1.94). A total of 97.8% of parents/guardians said they had not received information on oral health and hygiene, 100.0% had not received guidance on the sugar contained in medicines or the salivary decrease caused by the medications. 34.8% of the children did not perform oral hygiene during hospitalization. According to medical records, 58.7% took liquid medication orally. Conclusion: The hospitalized children had precarious oral health conditions, with the occurrence of carious lesions of the teeth. The presence of risk factors for dental caries in hospitalized children was observed (poor oral hygiene, low schooling and income of parents/guardians, limited knowledge of parents/guardians regarding health care and oral hygiene, consumption of medicines with cariogenic potential).

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Abstract Objective: To evaluate antibiotic prescribing practices of dentists working in a major teaching hospital in Sudan, and to assess the need for establishing education programmes to enhance dentists’ awareness of antibiotic use. Material and Methods: A cross-sectional study was carried out by distributing an anonymous self-administered questionnaire to a convenience sample of dental practitioners at major teaching hospital in Khartoum/Sudan. The questionnaire investigated knowledge and attitudes of participants in relation to antibiotic prescribing in dental practice. Results: One hundred out of 135 dental practitioners working at the hospital participated in the survey with 48 males and 52 females. Most of the participants (N=44) did not specify their preferable drug reference, while 32 participants specified British National Formulary, and the practice was significantly associated with a higher professional rank (p<0.001). Metronidazole was the most frequently cited antibiotic for dentofacial infections (N=73) and Acute Necrotizing Ulcerative Gingivitis (N=56), while amoxicillin was the most frequently cited antibiotic for dento-alveolar infections and infective endocarditis prophylaxis (N=88 and N=47, respectively). Conclusion: Undergraduate, as well as postgraduate courses,, are required in Sudan to provide up-to-date orientation on antibiotic use, and to increase awareness of dentists about antibiotic prescribing.

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Abstract Objective: To evaluate the effect of a synthetic inhibitor of MMPs (Galardin) and its solvents [ethanol and dimethyl sulfoxide (DMSO)] on the microtensile bond strength (µTBS) of adhesive systems to dentin. Material and Methods: Sound human third molars (n=180) were randomly assigned into 5 based on solution type: DMSO; ethanol; Galardin + DMSO; Galardin + ethanol; and distilled water as control. Then were further subdivided into 6 based on the adhesive system, i.e. 3-step and 2-step etch-and-rinse (ER), one-step and 2-step self-etch (SE) and universal in ER and SE strategies. The samples underwent a 500-round thermocycling procedure at 5±5/55±5°C and were sectioned into 1-mm2 pieces perpendicularly in a cutting machine. The µTBS was measured at a strain rate of 1 mm/min. Data were analyzed with two-way ANOVA and post hoc Games-Howell tests (p<0.05). Results: The adhesive system and the solution had significant effects on the µTBS (p<0.001). The universal adhesive in the SE mode resulted in a significant decrease in µTBS compared to the other adhesives (p<0.05). Ethanol, too, resulted in a significant decrease in µTBS compared to other solutions (p<0.05). Conclusion: Galardin and its solvents, except for ethanol, had no detrimental effects on the immediate µTBS.

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Abstract Objective: To evaluate the relationship of impacted mandibular third molars (M3M) status with caries on distal surface (CODS) of mandibular second molars (M2M). Material and Methods: A retrospective study on digital panoramic radiographs. Information on age, gender, eruption status of impacted mandibular third molars and mandibular second molars caries on distal surface were recorded. Winters' classification and Pell and Gregory classification were used to classify impacted mandibular third molars. The Chi-square test and Poisson regression were used. A p-value of <0.05 was considered statistically significant. Results: A total of 1497 radiographs were evaluated out of which 2704 sites were recorded. A total of 33.2% M3M were impacted and 1053 (38.9%) M2M had caries on distal surface. Among the total M3M teeth, 39.1% of erupted and 38.6% of impacted teeth had CODS of M2M. However, there was no significant difference in the distribution of CODS of M2M in erupted and impacted mandibular third molars teeth (p=0.796). As per Winters classification, mesio-angular and horizontal impaction types were significantly associated with CODS (p<0.001). Conclusion: All impacted mandibular third molars may not be associated with caries on distal surface of mandibular second molars. But, the angulation like mesioangular and horizontal, class I and II may predispose to caries on distal surface of mandibular second molars.

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Abstract Objective: To determine and compare the remineralizing capacity of self-assembling peptide (SAP) P11-4 and casein phosphopeptides-amorphous calcium phosphate (CPP-ACP) on enamel. Material and Methods: Enamel samples were divided into 2 groups. Group I was treated with Self-assembling peptide (SAP) P11-4 and group II with casein phosphopeptides-amorphous calcium phosphate (CPP-ACP). In both groups, remineralizing capacity was assessed at baseline, 2 weeks, 6 weeks and 12 weeks. Student’s t- test and ANOVA were applied, with the significance level set at 5%. Results: The mean calcium weight % was evaluated at baseline, 2 weeks, 6 weeks and 12 weeks. In Group I, there was increase in mean value (62.12 ± 1.24) from baseline to 12 weeks (67.36 ± 2.14). However, there was decrease in phosphate weight % from 37.16 ± 2.52 at baseline to 35.72 ± 2.11 at 12 weeks. In Group II, mean calcium weight % was 64.18 ± 1.52 at baseline, which ultimately increased to 66.01 ± 2.03 at 12 weeks. Phosphate weight % showed reduction from 37.34 ± 2.23 at baseline to 35.04 ± 2.02 at 12 weeks. Ca/P ratio showed significant improvement. There was significant difference in Ca/P ratio at 2 weeks, 6 weeks and 12 weeks in both groups (p<0.05). Conclusion: Self-assembling peptide (SAP) P11-4 found to be more effective and efficient as compared to casein phosphopeptides-amorphous calcium phosphate (CPP-ACP).

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Abstract Objective: To interpret the change in child's behaviour in presence/absence of parents during dental care. Material and Methods: Sixty children were examined till the age of 12 years visiting the out patient department of pediatric dentistry where parents along with the child were allowed in the operatory. After sometime parents were asked to leave and behavioural changes were noted. During revisit again the behaviour was noted according to Frankl scale. McNemar test was applied to test the behaviour response of children with parental absence/presence. The significance level was set at 5 %. Results: In 1st visit, 78.3% showed positive behaviour and 21.7% showed negative behaviour in parental absence, indicating that the child has more likelihood of showing positive behaviour in the presence of parents (p<0.001). More positive behaviour of the children is noticed, when the parents are present in 3 -5 year age group. In other 6-8 and 9-12 year age group, no difference was noticed in the presence or absence of the parents (p>0.05). In second visit, the negative behaviour reduced. When parents were absent 21.7% showed negative behaviour (p=0.000). This indicated that the child has more likelihood of showing positive behaviour in the presence of parents. Age group-wise analysis revealed that in the 3-5 years age group presence or absence of parents is a significant factor for child's behaviour. This factor is a non-issue in the elder age group like 6-8 years and 9-12 years. When the parents are absent, no significant difference was observed (p>0.05). Conclusion: There was no significant difference in parental presence/absence in elder children while the same can't be said for younger children.

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Abstract Objective: To compare self-perceived information and clinically diagnosed dental caries status among Indonesian children aged 12–15 years. Material and Methods: In this cross-sectional study, a questionnaire was used to obtain self-perceived information. Clinical examinations were conducted to determine the mean number of decayed, missing or filled teeth (DMFT) and the presence of severely decayed teeth with visible pulpal involvement, ulceration caused by dislocated tooth fragments, fistula, and abscess (PUFA). The study included 494 children aged 12–15 years recruited from six junior high schools in Jakarta, Indonesia. The clinical examination results and responses to the self-perceived assessment questionnaire were compared to determine the sensitivity and specificity. Results: The proportions of children with dental caries and clinical consequences of untreated dental caries in this study were 69.4% and 17.6%, respectively, with mean DMFT and PUFA index scores of 2.4 and 0.2, respectively. For the DMFT index, the self-perceived need for oral treatment had the highest sensitivity (86%), while the dental pain had the highest specificity (89%). For the PUFA index, the self perceived oral health condition had the highest sensitivity (92%), while the self-perceived dental pain had the highest specificity (82%). However, none of the self-perceived variables had both high sensitivity and specificity. Conclusion: Self-perceived information obtained from the questionnaire can not properly evaluate the clinical status of dental caries.

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Abstract Objective: To evaluate the facial morphology of Caucasian obese adults in relation to normal weight peers, and to study the association between three-dimensional soft-tissue facial measurements and cardiometabolic risk factors. Material and Methods: Nineteen Caucasian obese subjects aged 25 to 73 years underwent anthropometric measurements, blood samples and a stereophotogrammetric facial scan. Soft-tissue facial linear distances, angles, and volumes were obtained and compared to those collected on normal weight subjects by computing z-scores. Spearman correlation was used to assess the associations between facial measurements and metabolic parameters. Logistic regression analysis adjusted for sex and age was used to assess the risk of metabolic syndrome associated to the facial measurements. Results: Overall, when compared to normal weight persons, obese adults had a wider face in the horizontal dimension, with a middle face (maxilla) that was larger both in absolute value and relatively to the lower face (mandible), and a larger right side gonial angle (Wilcoxon test, p < 0.01). Only the mean (left and right) gonial angle was positively associated to serum triglycerides level, while the other facial measurements were associated with none of the cardiometabolic parameters. Moreover, none of the facial measurements was associated with the risk of metabolic syndrome. Conclusion: Despite larger facial dimensions and altered mandible/maxilla volume ratio, three-dimensional soft-tissue facial morphometry in Caucasian obese adults is not related to cardiometabolic risk factors. The actual association between morphological facial characteristics and clinical information on the health conditions of patients is still to be investigated.

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Abstract Objective: To evaluate and compare sensitivity and specificity of ANB, Wits, APDI and AF-BF to diagnose sagittal skeletal malocclusions, in children between 6 to 12 years old, using ROC curves, a widely accepted method for the analysis and evaluation of diagnostic tests. Material and Methods: A descriptive-comparative study of diagnostic tests was conducted. From a population of 3,000 children, a non-probabilistic sample of 209 was selected. The clinical classification of the patients as class I, II or III, made by a group of experts based on the visual inspection of models and photographs, was chosen as the gold standard. After calibration (ICC>0.94) the variables were measured in cephalograms. Eight ROC curves were plotted (I vs II, and I vs III for each one of the variables). The area under the curve was measured and compared (Ji-square test). Cut points were established. Results: To discriminate Class I from II, ANB showed the largest area under the curve (AUC) (0.876) and the cut point (best sensitivity and specificity) was at 5.75°. To discriminate class I from III, Wits showed the largest AUC (0.874) with a cut point of -3.25 mm. There were no statistical differences between the AUC for the four variables (p=0.48 y p=0.38 for class I-II and I-III). Conclusion: ANB and Wits performed better for the diagnosis of class II and III, respectively. Cut points in children were different from those reported in adults.

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Abstract Objective: To evaluate the relationship between excess body weight (EBW) and the prevalence of dental caries in preschoolers considering parental control regarding snack consumption. Material and Methods: An observational, population-based, cross-sectional study was conducted at Municipal Child Education Centers in the city of Curitiba, Brazil, involving a representative sample of 686 preschool children aged four to five years and eleven months and their parents/caregivers. Dental caries was analyzed using the dmft index. Weight and height were measured for the determination of the body mass index, which was categorized for each z-score range considering age and sex. Children with overweight or obesity were considered to have EBW. The assessment of nutritional status was performed with the aid of the WHO Anthro and WHO Anthro Plus programs. The data were analyzed using univariate and multivariate Poisson regression analysis with robust variance (α= 0.05). Results: The children with EBW had a lower prevalence rate of caries, but this association lost its significance when adjusted by the other variables included in the multivariate model. In the multivariate regression analysis, household income per capita (PR=0.804; 95%CI: 0.665-0.972), child's age (PR=1.015; 95%CI: 1.001-1.029) and snack limits (PR=0.839; 95%IC: 0.732-0.962) were associated with a greater prevalence rate of dental caries. Conclusion: Excess body weight was not significantly associated with dental caries, whereas a lower parental limit regarding snack consumption by the children was independently associated with a higher prevalence rate of dental caries.

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Abstract Objective: To perform a clinical and histological evaluation, characterizing and proving the feasibility of the use of beta tricalcium phosphate (HA/βTCP) bioceramics as a bone defect repair material, comparing it with autogenous bone and blood clot in terms of osteoinductive, conductive, and genic capacities. Material and Methods: The experiment was based on 3 critical defects in the mandible of 11 New Zealand rabbits. The defects were filled with HA/βTCP bioceramics and autogenous bone, respectively, collected and ground during the development of defects and blood clots. The animals were euthanized after the 90-day experiment and samples were collected for histomorphological examination. To evaluate differences between the groups, a one-way analysis of variance (ANOVA) was performed with Tukey's post hoc test. An α value lower than 0.05 was considered statistically significant. Results: Microscopy revealed the presence of osteoblasts, osteoclasts, and osteocytes associated or not associated with the presence of mature or immature bone. All the studied materials presented bone neoformation in all cases, with the presence of mature and immature bone. Regarding the presence of HA/βTCP bioceramic residual material, the same was found in 7 of 11 slides. Conclusion: HA/βTCP bioceramics were shown to be a biocompatible bone substitute, with osteoinductive and osteoconductive characteristics, accelerating the process of new bone formation when compared with autogenous and blood clotted bone, thereby showing promise for bone defect repair with safety and efficacy.

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Abstract Objective: To identify the profiles of patients with special needs attended at a Center for Dental Specialties. Material and Methods: This was a cross-sectional and quantitative study using an inductive approach, and a comparative and statistical procedure for analysis of the patients with special needs. Information concerning socioeconomic, medical and dental conditions was collected. The data were analyzed using IBM SPSS, adopting a significance level of 5%. Results: It was observed that 58.6% of the users were males, single (54.7%), in the age group from 19 to 59 years (41.1%), being 97.4% without schooling. The most frequent clinical diagnoses were: deviations in intelligence (18.4%), behavioral deviations (18.4%) and physical defects (17.9%). We observed for oral health the presence of gingivitis (33.0%), and healthy gums (47.8%); the presence of caries (64.9%), with restored teeth (28.5%), and edentulism (12.3%). Dental intervention procedures were initiated with emphasis on: fluoride applications (39.7%) and subgingival scraping (34.9%). Topical fluoride applications (p=0.010) and prophylaxis (p=0.010) were realized in patients without autism. Also, prophylaxis (p=0.007) was more frequently performed and gingival alterations were more often verified (p=0.020) in patients without Down's syndrome. Conclusion: The users of the patients with special needs dental service can be generally described as male, single, aged between 19 and 54 years, with the special conditions of intelligence and behavioral deviation.

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Abstract Objective: To analyze the perception of undergraduates' students in a Dentistry School about the impact of basic disciplines on their professional development, as well the integration of this knowledge with the professional sphere. Material and Methods: It is a qualitative research study carried out through focus groups comprised of dentistry students close to finishing their degree. The data were analyzed by the thematic content analysis. Results: Four categories derived from the empirical material: "Disassociation of basic disciplines within the professional cycle", "Autonomy or transference of responsibility", "Campus-DOD distancing" and "Humanization of health care from first moments". The narratives showed the difficulties faced in order to effect, indeed, integration between the basic cycle and the curricular components of the vocational cycle. It was also evident the decontextualization of the basic cycle with the perspective of approach with professional practice. In addition, student's protagonist posture and learning how to humanize health care were identified as important factors to be debated and improved in the curriculum from the beginning of the course. Conclusion: The difficulties faced in order to effect an actual integration between the basic disciplines and the professional disciplines bring undesirable consequences upon undergraduate, being fundamental that the construction of new pedagogical projects means an effective integration of the contents to the curriculum design, avoiding any fragmentation between the basic and vocational cycle.

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Abstract Objective: To identify the commercially available toothpastes intended for children and their total soluble fluoride concentrations (TSF). Material and Methods: Twelve brands of toothpastes intended for children marketed in supermarkets and pharmacies were found and analyzed: Bitufo®; Colgate Smile®; Lilica Ripilica®; Even Baby®; Turma da Mônica Baby®; Loney Tunes®; Loney Tunes Baby®; Malvatrikds Baby®; Oral B Stages®; Sanifil Kids®; Tandy®; Tra-lá-lá Baby®. Duplicate samples of each toothpaste were weighed (+/- 90 to 110 mg) and diluted in 10 mL of distilled water under stirring. To evaluate soluble fluoride, duplicate aliquots of supernatant suspensions were evaluated on specific ion fluoride electrode calibrated with fluoride standard solutions and results expressed in ppm F according to established protocol. Results: According to information provided by manufacturers, 5 non-fluoridated toothpastes, 3 toothpastes with less than 1000 ppm F and 4 toothpastes with conventional fluoride concentration (1100 ppm F) were identified. After analysis of soluble fluoride of fluoridated toothpastes, only 02 presented TSF concentration equal to or greater than 1000 ppm F. The TSF concentration (mean ± SD) for all samples ranged from 8.2 ± 0.1 to 1065.9 ± 24.7 ppm F. Conclusion: Few toothpastes intended for children presented soluble fluoride concentrations capable of preventing dental caries. Additionally, regulatory measures need to be implemented for the marketing of toothpastes intended for children with at least 1000 ppm of soluble fluoride, especially in locations without other sources of fluoride (fluoridated water) for the population.

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Abstract Objective: To evaluate the use of nanosilver fluoride in the enamel remineralization process through optical coherence tomography. Material and Methods: All samples were submitted to demineralization process by pH cycling during 14 days and randomly distributed into three groups (n = 11): Nanosilver Fluoride (NSF), Sodium fluoride (NaF), and negative control. Optical coherence tomography images were acquired at three different moments: initial stage (T0), post caries formation (T1), and post pH cycling (T2). The integrity of the enamel surface and the measurement of the volume loss for the tissue after pH cycling in comparison to initial images were obtained from optical coherence tomography images. Results: After analyzing the exponential decay of A-scans from each group, it was possible to identify differences in light propagation among samples. In T1 it is not possible to visualize the dentin-enamel junction, probably due to the higher back scattering of the demineralized enamel, which does not allow light to reach the dentin. The decay curves obtained from NaF and nanosilver fluoride groups showed similar behavior, while the negative group showed lower extinction coefficient. Conclusion: Nanosilver fluoride showed the best effect against caries compared to conventional fluoride treatments.

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Abstract Objective: To identify the dental anomalies that can modify the occlusal characteristics and their distribution in these occlusal alterations in the skeletal patterns of children. Material and Methods: We analyzed charts, panoramic and periapical radiographs of children aged 5 to 12 years from 2009 to 2012. The facial pattern was evaluated through subjective face analysis and cephalometric data, as well as the occlusion of patients with and without (control) dental anomalies. The relationship between the presence of dental anomalies and malocclusion was analyzed by the Chi-square test with significance level of 5%. Results: 73 children (27.8%) presented dental anomalies, being 49.3% in girls and 50.7% in boys in a total of 88 teeth involved. Anomalies observed in decreasing order were: enamel hypoplasias, eruptive ectopias, agenesis, supernumerary teeth, corono-radicular dilaceration, microdontia, transposition and imperfect amelogenesis. Of these, 22.2% presented associated dental anomalies, whose ectopic eruption with enamel hypoplasia were the most frequently encountered. When comparing the control group with children with dental abnormalities it was observed a significant relationship between the presence of dental anomalies and malocclusion (p<0.05). The most frequent alteration among patients with dental anomalies was deep overbite (24.6%), followed by crowding (23.3%), posterior crossbite (14.2%), anterior open bite (12.9%) and anterior crossbite (0.3%). onclusion: Dental dysgenesis interferes with the development of occlusion and the resulting occlusal problems are distributed differently, taking into account the skeletal facial pattern in patients with and without dental anomalies.

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Abstract Objective: To characterize the profile of patients with special needs assisted at a Dentistry School of a Brazilian University. Material and Methods: A retrospective and descriptive study was carried out through the analysis of 329 dental records from individuals with special needs assisted at the Dentistry for Special Needs Patients discipline between 2012 and 2017. Data on gender, age, race, monthly family income, schooling, medical diagnosis of the disabling condition, drug used and type of dental procedures performed were reviewed. Data were analyzed by descriptive and inferential statistics (Shapiro-Wilk and t-student tests) with 5% significance level. Results: There was higher prevalence of females (50.5%) aged 45-54 years (18.7%), low schooling (36.2%) and monthly income of 1 minimum wage (61.9%). Most special needs were chronic systemic diseases (67.2%) and endocrine-metabolic diseases (16.7%). Among patients investigated, 66.3% used anti-hypertensive (38.3%) and anti-inflammatory (20.6%) drugs. Of dental procedures performed, curative procedures were the most prevalent in the majority of patients (90.6%). Conclusion: The profile of most patients with special needs was characterized by females with chronic systemic diseases and mean age of 39.6 years, low schooling and monthly family income of up to 1 minimum wage, whose main reason for the visit was the search for curative dental treatment.

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Abstract Objective: To evaluate levels of anxiety in children and adolescents related to age and experience of visits to the dentist using the modified Venham Picture Test (VPTm). Material and Methods: This is a quantitative cross-sectional study with convenience sample. Children and adolescents of both sexes, subdivided into age groups of 6-9 years (A1 and A2) and 10-13 years (B1 and B2), in the waiting room of a Dental Clinic, were grouped according to the experience of visits to the dentist (have been to the dentist / have never been to the dentist). Descriptive statistics were mean, standard deviation and frequency of cases. The Kolmogorov-Smirnov (K-S) was used for normality analysis, with 95% significance level. Inferential statistics was performed using the Chi-Square and Mann-Whitney tests, with p<0.05. Results: In total, 60 children and 60 adolescents were evaluated, 65 (54.16%) males and 55 (45.83%) females. No differences were observed between genders in groups A1 and A2 (p=0.30) and B1 and B2 (p=0.94). The highest means of the VPTm scale were observed in groups A2 and B2 (2.87 ± 2.30 and 2.13 ± 1.29) and the lowest in groups A1 and B1 (1.13 ± 1.45 and 1.20 ± 1.29), respectively. Statistical differences were observed for the mean VPTm scores between age groups A1 and A2 (p=0.004) and B1 and B2 (p=0.018). Conclusion: The level of anxiety was inversely proportional to age, so younger children were more anxious; it was also observed that children and adolescents who had never been to the dentist tended to be more anxious.

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Abstract Objective: To evaluate the dimensional changes in three types of alginate following three different delay times after casting. Material and Methods: In this laboratory study, a maxillary arch-shaped stainless steel model was prepared and three pins with similar and determined diameters and heights were placed (one at mid-line and two on the underside of the model) as reference points to compare the dimensional stability of the three types of alginates. A special metal tray was made from the main model. The main moldel was imprisoned by the metal tray, and these were kept for a specific time in a humid environment. Gypsum Type 4 was poured over the impression to obtain 90 gypsum casts for three types of alginate. The dimensions of casts obtained from each alginate were compared in two lateral and anterior-posterior dimensions, they were compared with each other, and the alginates were also compared to the main model. Results: At a time interval of 15 minutes, the dimensional accuracy of the casts obtained from the three types of alginates, with the main model in both anterior-posterior and transverse dimensions was not significantly different (p<0.05); but there was a significant difference at 60 minutes and 24 hours in both dimensions (p<0.05). Although there was no significant difference between the alginates in both dimensions and all three studied time periods, the least difference with the main model was related to Zhermack and the highest difference was related to Golchai alginates. Pairwise comparisons showed that none of the samples had a significant difference in terms of dimensions. Conclusion: The dimensional stability of alginate was a time-dependent type of alginate and had no significant effect on the dimensional accuracy of casts.

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Abstract Objective: To identify the exposure of lead through saliva and the presence of gingival pigmentation in the risk group. Material and Methods: The type of this research is analytic observational with cross-sectional study design. The sample consisted of 40 subjects, who were divided into two groups of 20 each: G1: Gasoline Fuel Station and G2: Officer in Dental Hospital. To determine the level of leads in saliva is measured by atomic absorption spectrophotometry and assessment of the severity of lead-gingival lead line in this study based on the area of the gingival surface based on the number of dental areas. The data were analyzed with the t-test and Chi-square test. The level of significance was set at 5%. Results: The average lead content in saliva group exposed was 6.66 µg / ml and control group 4.72 µg / ml (p≤0.05). There is a correlation between gingival lead line incidence with exposure to lead (OR = 3.33; p = 0.001). Conclusion: The identification of exposure to lead poisoning can be determined by examination in saliva and ginggiva state, it is proven that the risk of gingival lead (Ginggival Lead Line) in the worker group at the gas station station is 3.3 times more risk than the control group. Occupational safety factors are important for workers at high risk of exposure to the element of lead for additional education on the importance of using masks to prevent the severity of the occurrence of lead effects on overall health.

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Abstract Objective: To identify factors affecting dental center service quality in Bantaeng Regency, Indonesia. Material and Methods: This study used a pilot pathfinder design and analysed a sample of 114 subjects. Data were collected using a questionnaire designed for the study based on model of service quality which consists of two parts: the subject's demographic characteristics and a 30 item questionnaire to measure the five dimensions of the service quality, include tangibility (7 question), reliability (9 question), responsiveness (6 question), assurance (4 question) and empathy (4 question). Five points Likert Scale were used to evaluate all dimension in questionnaire (1= strongly disagree, 5=strongly agree). The data were analyzed using SPSS 24.0 and Amos 18.0 to get the mean, standard deviation and confirmatory factor. Results: The most important thing of each dimensions were “the clinic employees should be clean, neat, tidy and appropriate to their professions”(4.08) on tangibility, “The dentist should give patients useful and necessary advice for preventing them from other diseases” (4.12) on reliability, “A secretary should always be accountable for arranging the time of treatment session by phone or in person“ (4.06) on responsiveness, “In a good dental clinic, the employees should always behave towards patients with respect and courtesy and ensure their privacy” (4.11) on assurance and “The clinic employees should pay particular attention to each patient's costs of dental services and should be assured that they are affordable for patients“ (4.22) on empathy. Results showed that tangibility, reliability, and assurance have the highest effect on dental service quality in Bantaeng District. Meanwhile, the responsiveness dimensions have the lowest effects. Conclusion: Assurance, reliability, tangibility/physical condition are the factors affecting dental service quality in Bantaeng Regency.

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Abstract Objective: To find out the effectiveness of specially made brushes with special grips for use by groups of ischemic stroke sufferers for oral hygiene. Material and Methods: A sample of 30 stroke patients were taken at the Makassar Stroke Center, Indonesia, with criteria for extreme hemisphere ischemic stroke patients and willing to participate in the study and fill out informed consent. Brush making with a special grip design (modified brush) with Clay mixed material. The oral hygiene assessment procedure of the sample using a modified toothbrush was done in 3 stages before the brush, after brush and on the seventh day. Oral and oral hygiene was measured using the index of Oral Hygiene Index Simplified (OHI-S). The oral hygiene assessment procedure was done in 3 stages before the brush, after brush and on the seventh day. To find out the difference in effectiveness before and after the intervention was analyzed using the paired t-test. The level of significance was set at 5%. Results: The highest percentage of stroke patients were female (53.3%), aged 40-60 years (66.7%) with an education level below junior high school (56.7%). There is a difference in the average OHIS score before and after using a special grip toothbrush (p<0.01). Conclusion: A special grip toothbrush that is used for Stroke sufferers can help to clean his teeth and mouth.

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Abstract Objective: To evaluate self-medication for toothache and its associated factors in children and adolescents. Material and Methods: A cross-sectional study was carried out with 252 children/adolescents aged 6-16 years. A questionnaire was applied with questions related to demographic and socioeconomic characteristics; experience of, and self-medication for, toothache; as well as aspects related to the condition. Descriptive and inferential statistical analyses (Pearson's Chi-square test and Fisher's exact test) were performed, with a 5% significance level. Results: The prevalence of toothache was 41.7%. In 96 cases analyzed, there was prevalence of 69.8% of self-medication for toothache. There were no statistically significant associations between self-medication for toothache and variables related to the children/adolescents (gender and age), their parents or guardians (age and schooling), socioeconomic characteristics (family income and number of people in the household) and aspects related to toothache (fever, crying and school absenteeism) (p>0.05). The most commonly used drug was paracetamol (60.7%), whose choice was based to its previous use by the study population for conditions not related to toothache (47.8%). Conclusion: There was a high prevalence of self-medication for toothache in the study population. No independent variable was associated with self-medication practice.

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Abstract Objective: To evaluate the postoperative pain at different times after endodontic treatment with and without the use of photodynamic therapy (PDT) of asymptomatic teeth with apical periodontitis. Material and Methods: In this cross-sectional randomized clinical trial, the treatment was performed in a single visit with and without the use of photodynamic therapy. The sample consisted of 10 patients with two teeth in the same jaw, but on different sides (split-mouth), subjected to the same endodontic treatment with reciprocating instrumentation in the apical foramen instrumentation limit. The teeth from each patient were randomly divided into two groups: G1 (Control): endodontic treatment without photodynamic therapy and G2 (PDT): received methylene blue 0.005% and irradiation with a low-level laser. The fillings were performed with a Touch'n Heat technical device and Ah Plus sealer. The treatments of G1 and G2 in the same patient were performed in an interval of 3 weeks between them and the blinding study was ensured during all long treatment. Postoperative pain was recorded using an adapted VAS scale in times of 6, 12, 24, 36, 48, and 72 hours. Results: In both groups, the highest value recorded at the VAS scale was 2 mm (no pain), and there were no statistically significant differences in postoperative pain between the groups at any observation times (p<0.05). Conclusion: The photodynamic therapy did not have advantages to control postoperative pain in endodontic treatments of asymptomatic teeth with apical periodontitis, since both groups showed low levels of pain in all patients evaluated.

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Abstract Objective: To evaluate the applicability of two different non-radiographic mixed dentition analysis in school going children of Aligarh district, India. Material and Methods: Mesiodistal dimension was measured on the dental casts of 120 school going children with electronic digital vernier caliper. The following inclusion criteria were adopted: presence of all fully erupted permanent teeth; no congenital craniofacial anomalies; no previous history of orthodontic treatment; and presence of intact dentition with no proximal caries, restoration, or age related attrition. Predicted values of canines and premolars were obtained from Moyer's at 75th percentile and Tanaka and Johnston mixed dentition analysis. Descriptive statistics were used to calculate the mean and standard deviation. Paired observations were compared by t-test. The level of significance was at p<0.001. Results: The mean difference between the predicted and the actual value of canines and premolars using Moyer's probability table at 75th percentile and Tanaka and Johnston regression equation were statistically significant. No significant differences were found between Moyer's analysis 75th percentile and Tanaka and Johnston mixed dentition analysis in both arch and sexes. Conclusion: These two non-radiographic mixed dentition analysis overestimated the mesiodistal width of canines and premolars.

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Abstract Objective: To determine the occurrence of dental anomalies in patients with special needs from Barranquilla, Colombia. Material and Methods: An observational, cross-sectional descriptive study with a sample of 59 patients chosen at convenience for 6 months during the course of 2017. With prior approval by experts, an instrument that identified dental anomalies was applied, followed by an institutional clinical history, intraoral clinical examination and final evaluation of the study variables, with descriptive statistics. Results: With regards to age ranges, 25% of subjects were between 14 to 17 years, and 19% between 22 to 25 years. The average age was 14 (± 7.9). No cases were found in the age range of 26 to 29 years. In terms of gender, males predominated with 78%. The anomaly that predominated was fluorosis (50.8%), followed by agenesis (23.7%). The syndrome and / or disorder with the highest frequency of dental anomalies was mental retardation with 39%, followed by behavioral disorders (22%) Conclusion: The frequency of dental anomalies in patients with special needs was evidenced, showing higher prevalence of dental fluorosis in patients with mental retardation, and a higher incidence in males; in the patients with syndromes and / or disorders who were observed, there were a few oral findings unrelated to dental anomalies.

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Abstract Objective: To evaluate in vitro the effect of gamma-secretase inhibition on the survival of dental pulp stem cells. Material and Methods: Sound teeth have been used. Dental pulp stem cells were isolated by enzymatic digestion. An appropriate number of cells were treated with different concentrations of gamma secretase enzyme (DAPT) (1, 3, 6.25, 12.5, 25.5, 37.5, 50 and 100 µM). The metabolic activity of cells and the distribution of cells in different phages of cell cycle was evaluated by MTT assay and flow cytometry, respectively. Statistical analysis was made one-way ANOVA. Comparison was made between the groups on the level of p<0.05. Results: In low concentration of DAPT (1, 3, 6.25, 12.5) the growth rate of the cells increases, whereas in high concentration of DAPT (25.5, 37.5, 50, 100) can significantly reduce the viability of the treated cells. The results also indicate that DAPT can interrupt the cell cycle in G1 phase. Conclusion: The DAPT for dose-dependent survival rate of dental pulp stem cells and affect cell population increase in the G1 phase of the cell cycle.

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Abstract Objective: To evaluate the effect of pharyngeal pack on postoperative throat pain and nausea in rhinoplasty patients. Material and Methods: Twenty-eight patients were randomly selected and divided into two groups (n=14). The participants were randomly divided into two groups: G1 - the pharyngeal pack was used (Intervention group) and G2: not used (Control group). Both groups were anesthetized by the same protocol. Throat pain was measured by visual analog scale and nausea by presence / absence. Fischer's exact test, ANOVA, Friedman and Wilcoxon test were used. Results: There was no significant difference in mean pain and presence or absence of nausea between the two groups (p>0.05). But there was a significant difference in mean pain and the presence or absence of postoperative nausea with the intervals (p<0.05). Mean pain had a significant difference 2 hours postoperatively with other times, 6 hours postoperatively with 24 and 72 hours postoperatively, and 24 hours postoperatively with 72 hours (p<0.05). There was no significant difference in the presence or absence of postoperative nausea, between 2 hours and 6 hours postoperatively (p>0.05). The presence or absence of postoperative nausea had a significant difference between 2 hours postoperatively with 24 and 72 hours postoperatively and 6 hours postoperatively with 24 and 72 hours postoperatively (p<0.05). There was no significant difference in nausea between 24 hours and 72 hours postoperatively (p>0.05). Conclusion: None of the two groups were significantly superior in terms of reduction of pain and nausea, but because of the possible effectiveness of the pharyngeal pack in preventing aspiration of objects and tissues during the operation, the use of pharyngeal pack is recommended in patients.

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Abstract Objective: To determine the coefficient of inbreeding of consanguinity (F) and its correlates in Aligarh city, India. Material and Methods: Cross sectional household survey with a sample size of 2000 (1600 non-consanguineous and 400 consanguineous couples) using systematic random sampling. Researcher conducted the study by visiting every tenth household of every tenth ward of Aligarh city. Information was recorded on a pre-tested questionnaire, which had questions pertaining to religion, details regarding relationship between couples (consanguineous / non consanguineous marriage), type of consanguinity (first cousin/second cousin/third cousin), level of education and occupation (a proxy for socioeconomic status). Descriptive statistics, Chi-square, and multivariate logistic regression were used. Results: Multivariate logistic regression analysis showed that Islam (p<0.001) and Christianity (p<0.001) were significantly associated with consanguinity. Private employment with (-) B value (p<0.001) showed a significant association of the variable with non-consanguineous group. Coefficient of inbreeding for the present study was 0.0538, highest reported from any part of India. Conclusion: Consanguinity is a prevailing problem in Aligarh city, India. Evidence based guidelines needed. Information - education - communication and pre-marital counseling suggested to make population aware of the consequences of consanguinity and to help couples make a decision.

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Abstract Objective: To evaluate of the microstructure of the salivary glands of experimental animals born from of females rats, who were subjected to different modes of motor activity during the pregnancy: limited and compensated by regular moderate training. Material and Methods: The sample was composed 84 three-month-old descendants of Wistar rats which were divided into three groups: G1 (n = 27): posterity of female rats, who during gestation were in standard conditions; G2 (n = 25): posterity of female rats, who during pregnancy were in hypokinesia conditions; G3 (n = 32): which stayed in conditions of hypokinesia, but had running load in running wheel regularly 5 times a week. Results: In adult descendants of G2, morphological structure of the submandibular salivary glands was characterized by decrease size and number of glandular cells; reduction of their cytoplasm; increase in heterochromatin amount and decrease in the intensity of fuchsinophilia. Microstructure of the submandibular salivary glands of the offspring of G3 indicates positive effect of regular short-term physical activity on the morphofunctional state of the specified glands. An increased number of tissue basophils in their stroma is also in favor of greater functional activity of salivary glands. Conclusion: This study indicates deceleration of the metabolic processes in salivary glands of animals under the influence of hypokinesia of their mothers during pregnancy. It was also confirmed that regular physical activity completely eliminates the negative effect of mothers' hypokinesia on morphology the salivary glands of the descendant.

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Abstract Objective: To compare the success of self-drilling and self-tapping methods in the retraction of maxillary anterior teeth. Material and Methods: The study was conducted in 57 subjects with Cl II malocclusion who needed to be treated with extraction of four maxillary teeth. The self-tapping method was used on the left side and the self-drilling method was used on the right side. Then, the pain rate of each method was recorded by the numerical rating scale (NRS). Statistical analysis was done by t-test and Chi-square test. The significance level in this study was considered at p-value<0.05. Results: Considering the clinical mobility as the failure, the success of treatment was equal in both methods and was 93%. The inflammation around the mini-screws was 8.8%. A significant relationship was found between the variables inflammation and success (p<0.05). The mean pain was 2.47, but there was no significant difference between the two methods in terms of pain score (p>0.05). There was a significant difference between the groups (p=0.03). The pain was significantly higher in the female. Conclusion: There is no difference between self-drilling and self-tapping methods in terms of success. Comparison of the pain between two genders, according to the replantation method, showed a significant difference in pain sensation between two genders. The pain sensation mean in female group was greater than male group.

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Abstract Objective: To investigate the efficacy of transdermal high-frequency ozone therapy in the management of pain and pain-related restricted jaw movements in patients with internal derangement of the temporomandibular joint (TMJ). Material and Methods: This retrospective study included 40 patients who had received transdermal high-frequency ozone therapy for the management of disc displacement with reduction of the TMJ. Subjects were treated 3 times for one week with a bio-oxidative high-frequency ozone generator with an intensity of 80% for ten minutes bilaterally. Pain scores and maximal interincisal opening (MIO) values of the patients were evaluated before and after the treatment. Results: An increase in the mean MIO value was achieved following the ozone therapy, however, the difference was not statistically significant (p=0.350). A statistically significant decrease in the mean pain score (48.13 ± 27.75) was observed following the ozone therapy. Conclusion: Transdermal application of high frequency ozone may be a good alternative for management of pain and pain-related restricted jaw movements in patients with internal derangement of the TMJ.

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Abstract Objective: To evaluate awareness of medical and dental students of Kerman University of medical science about the infection and vaccination of the human papilloma virus. Material and Methods: This descriptive cross-sectional study was conducted on 290 medical and dental students. The data were collected using a questionnaire, which consisted of demographic data, and awareness-raising questions whose validity and reliability were confirmed. Mann-Whitney U and linear regression test were used for statistical analysis, and significance level of 0.05% was measured. Results: From 290 participants, 44.5% were male, 69.7% were single, 51.7% were medical students and 92.4% of individuals had awareness about HPV. The most common source of information (83.7%) was textbook. 39.9% of respondents were not familiar with the HPV vaccine and 62.1% tended to be vaccinated. Most of individuals (69.4%) were willing to pay a vaccination fee of less than $10. Most of respondents were not aware of HPV vaccination in Iran (68.3%). The mean score of knowledge was 6.1 ± 2.4. There was a statistically significant relationship between gender, field of study and marital status with mean score of knowledge (p<0.05). Conclusion: The students' knowledge was moderate. The awareness of men and women about HPV was poor. Further studies are recommended on other community groups, especially young people. Risk groups should be identified and referred to the relevant organs for vaccination.

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Abstract Objective: To compare the use of Fresh Frozen Amniotic Membrane (FFAM) and Buccal Pad of Fat (BPF) for reconstruction of oral mucosal defect after surgical excision of leukoplakia. Material and Methods: Twenty patients were randomly selected and divided into two groups. Group 1 use amniotic membrane graft and Group 2 BPF. Both groups were evaluated preoperatively and postoperatively. Incisal opening, epithelialization and fibrosis were evaluated after one month of surgery. Chi square and Student t tests were used. Results: According to the presence of smoking habits, the highest frequencies were for smoking (30%) and betel leaf areca nut with tobacco (30%). Regarding the diameter of oral leukoplakia, in 40% of the participants it was 2x3 cm2. In Group1, after one month of surgery preoperative and postoperative inter-incisal opening values were 44.20 ± 3.37 and 42.05 ± 3.47 (p<0.001). In Group 2, preoperative and postoperative inter-incisal opening values were 44.09 ± 3.32 and 43.01±3.38 (p>0.05). When FFAM was used complete epithelialization in 70% and incomplete epithelialization in 30% patients. When BPF was used the results were almost similar. Fibrosis occurred in 30% in Group 1. There were no complications like flap necrosis, infectiona and hematoma formation. Conclusion: Incisal opening was significantly better in Fresh Frozen Amniotic Membrane Group, epithelialization and fibrosis were almost same in both groups after surgical excision of oral leukoplakia.

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Abstract Objective: To determine the risk factors of caries among adolescents in Padang City, by assessing the frequency of sugary snack consumption. Material and Methods: A cross-sectional study was conducted on 150 randomly selected junior high school students using a self-administered questionnaire along with oral examinations. The questionnaire consisted of questions on socio-demographic characteristics, oral health behavior, and frequency of consumption of sugary foods. Data were analyzed using the Chi-square tests and multivariate analysis. Results: Dental caries was found in 61% of the total students and was more prevalent in males when compared with females. The mean DMFT score was 1.3±1.4. Sugary snack consumption, attitude, and protective factors were significantly related to the occurrence of caries (p<0.001). The risk of dental caries in subjects with high amounts of sugary snack consumption was 5.67 times higher (OR=5.7; CI: 2.7-11.9) than those with low consumption. Subjects with low protective factors, high consumption of sugary foods and drinks, and bad attitude presented with a caries prevalence of 94%. Conclusion: The consumption of sugary foods was found to play an important role in the development of caries in the current study.

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Abstract Objective: To compare the prostaglandin E2 (PGE2) levels of gingival crevicular fluid in generalized chronic periodontitis between healthy and type 2 diabetic patients. Material and Methods: 56 diabetic and non-diabetic participants with generalized chronic periodontitis were selected randomly. They were divided into two groups (G1: generalized chronic periodontitis patients with normal blood sugar; and G2: generalized chronic periodontitis patients with diabetes). Gingival crevicular fluid samples were obtained from both groups. The average of 2 samples per day were centrifuged in a laboratory at 2500 rpm and temperature of 4°C for 5 minutes and placed in a refrigerator at -20°C. The level of PGE2 was measured using ELISA and Abcam kit. Data were analyzed by Kolmogorov-Smirnov, Mann-Whitney U Test, Pearson and independent T tests. The significant amount was considered 0.05 in this test (α<0.05). Results: The mean level of PGE2 was significantly different in the two groups and the mean level of PGE2 in the control group was lower than the case group. There was no statistically significant relationship between PGE2 with pocket depth, fasting blood sugar (FBS) and HBA1C (p>0.05). Conclusion: PGE2 level of diabetic patient group with chronic generalized periodontitis was significantly more than non-diabetic group with generalized chronic periodontitis.

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Abstract Objective: To assess the levels of nickel and chromium ions in hair and Gingival Crevicular Fluid (GCF) of orthodontic patients and to evaluate the corrosion of orthodontic bracket surfaces. Material and Methods: Nickel and chromium ion concentrations were measured in hair and GCF of 15 patients (9 females and 6 males, aged 16-28 years old) who had fixed orthodontic treatment using atomic absorption spectroscopy. The samples were taken before treatment (baseline), 4, 8, and 16 months later during treatment. Along with ionic sampling, microscopic sampling was done. One of each patient brackets was removed to get 15 brackets per group. Five brackets were taken randomly from each group to be examined under scanning electron microscope (SEM). Data obtained were analyzed using paired t-tests. Results: After 16 months, compared with the baseline, average hair nickel level changed from 0.125 µg/g to 0.956 µg/g with statistically significant difference (p=0.00); average chromium level changed from 0.090 µg/g to 0.295 µg/g but no significant difference (p>0.05); average GCF nickel level changed from 3.335 µg/g to 10.410 µg/g; average chromium level changed from 1.859 µg/g to 9.818 µg/g. Both of these increases were significant (p=0.000). SEM examinations showed that the corrosion on brackets was seen in the fourth month, and more severely visible after 8 and 16 months of uses. Conclusion: After 16 months of treatment, compared with the baseline, the hair nickel level was increased by 7.7 times; while for chromium was by 3.3 times. Gingival crevicular fluid nickel level was increased by 3.1 times and chromium level was by 5.3 times. The longer time of treatment, the more ions released and the more corrosion of brackets will be.

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Abstract Objective: To investigate internet anxiety among the dentistry students at Kerman University of Medical Sciences and its relationship with electronic journals use. Material and Methods: In this cross-sectional study, all 72 postgraduate dental assistants at Dentistry School of Kerman University of Medical Sciences were considered. Internet anxiety questionnaire included demographic questions and questions measuring online journals use and the barriers of using. The data then analyzed using independent t-test and linear regression, with significance level set at 5%. Results: The use of printed books was reported by 78.2% of the sample while the use of electronic books was 45.8%. The use of atlas was 28.9%, while the use of indexes and abstracts was 57.2. The participants used online journals mostly for research (30.8%) and education (27.7%). The most important advantages of online journals were fast access (25.1%) and easy use (19.9%). To get informed about online journals contents, they mostly used search engines and online databases (79%). The most important criterion was indexing in Web of Science (20.8%). A significant relationship between Internet anxiety and academic year was detected (p<0.05) also increase in internet use significantly increased Internet anxiety (p=0.001). We suggested increasing the knowledge and skill of dental students with online resources toward decreasing the level of their Internet anxiety. Conclusion: A reverse relationship was observed between the academic year and internet anxiety, in other words, senior students were more anxious than the junior ones. This study did not ask about computer literacy, other studies have reported a negative relationship between computer literacy, Internet literacy and internet anxiety, so it is suggested to increase the knowledge and skill of students with computer, internet and online resources.

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Abstract Objective: To investigate the pattern and severity of early childhood caries (ECC) by using the decayed and filled surface (dfs) index in preschool children in Al-Jouf, Saudi Arabia. Material and Methods: A convenience sample of 270 preschool children below 5 years of age (144 boys, 126 girls) attending outpatient pediatric dental clinics was selected for the study. World Health Organization criteria were used to diagnose caries through assessment of the dfs index. Information regarding oral hygiene practices, socio-economic status, and educational status of the mother was obtained through a structured questionnaire given to mothers. The data were statistically analyzed with the Chi-square test and Student's t-test. Results: 73% of children were not brushing regularly; 74.4% of them were using fluoridated toothpaste. In the maxillary teeth, boys had a higher mean dfs index (10.25), as well as a higher number of decayed surfaces (ds), than girls. In the mandibular teeth, boys and girls had similar mean dfs indices. Significant differences were observed between boys and girls regarding filled buccal surfaces (p=0.001) and occlusal surfaces (p=0.001) in maxillary teeth. The mandibular first molar was the most commonly affected tooth (93.3%); lower anterior teeth were the least affected teeth (2-4%) among the primary dentition. Conclusion: The ECC pattern in the northern region of Saudi Arabia follows the typical pattern of nursing caries.

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Abstract Objective: To compare the reliability of cone beam computed tomography (CBCT) in assessing the tooth length in comparison to orthopantomography (OPG). Material and Methods: Forty patients scheduled for extraction as result of caries or periodontal involvements were randomly selected. Panoramic radiographs and CBCT images were obtained and subsequently patients were subjected for extraction. Teeth with poor prognosis were extracted and stored in 10% formalin. Radiographic teeth measurements were carried out on OPG and CBCT images using a software and the actual tooth length (A-L) measurements were carried out with a digital vernier caliper. The data collected were statistically analyzed for paired “t” test significance of differences and Pearson's correlation at 5% level of confidence. Results: There was significant difference comparing all three actual tooth length (A-L) and CBCT- and OPG-measured tooth lengths. A significant positive correlation was observed among all the measurements. Conclusion: CBCT images exhibited accuracy over panoramic images even though the measurements are still significantly different from actual anatomical tooth lengths.

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Abstract Objective: To evaluate the craniofacial morphology of Japanese patients with unilateral cleft lip and palate and to evaluate the multiple congenital factors that affects craniofacial morphology in unilateral cleft lip and palate patients. Material and Methods: Lateral cephalograms of 140 subjects with unilateral cleft lip and palate were taken before any orthodontic treatment and alveolar bone graft. Subjects mean age was 6.85 ±1.56 years. Primary surgeries performed by surgeons from Hokkaido University Hospital. The craniofacial morphology of the 140 subjects was assessed by angular and linear cephalometric measurements. Gender, side of cleft, complete/incomplete type of cleft, presence/absence of lateral incisor in the affected side, family history of cleft and family history of skeletal Class III was chosen as congenital factors. To compare the assessments using congenital factors affecting craniofacial morphology in the unilateral cleft lip and palate subjects, angular and linear cephalometric measured values from each individual subject (control group) were converted into Z scores in relation to the means and standard deviation of the two parameters. Results: Twelve out of 13 craniofacial morphology outcomes were insignificant in 5 out of 6 dependent variables. Only 1 dependent variable showed 3/13 significant differences. Conclusion: Current study revealed the evidence that there were almost no significant differences in the craniofacial morphology outcome among various congenital factors. This will provide base line information and help determine the effectiveness of such factors.

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Abstract Objective: To determine linear regression equation to predict the mesiodistal widths of the permanent canines and premolars based on the sum of the widths of the two permanent mandibular first molars and two mandibular central incisors. Material and Methods: The sample consisted of 800 (400 males and 400 females) permanent dentition casts of Chhattisgarh population. Mesiodistal crown widths of teeth were measured with digital caliper. The correlation and linear regression equations between the calculated four teeth (two permanent mandibular first molars and two central incisors) and the canine-premolars segments of both the arches were developed. Results: No significant differences were found in right and left side of the arch. Sexual dimorphism was significant in teeth sizes with higher mesiodistal dimension in males. A good correlation values varying from 0.51 to 0.67 was found. New standardized regression equations were formulated for the prediction of the mesiodistal widths of unerupted canines and premolars for Chhattisgarh population. Conclusion: Calculating mesiodistal widths of unerupted canine and premolars with help of two permanent mandibular molars and two mandibular central incisors, which erupt early in the oral cavity, can be an alternative and best predictor for the mixed dentition analysis.

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Abstract Objective: To compare the amount of apical debris extrusion in samples instrumented by EndoStar E5, ProTaper Universal, and M-two rotary files. Material and Methods: Forty-five freshly extracted non-carious mandibular premolar teeth with single roots and single canals were acquired, and randomly divided into 3 groups (n=15). Samples in Groups 1, 2, and 3 were instrumented using EndoStar E5 (EE5), ProTaper Universal (PTU), and M-two (MTO) rotary file, respectively. Following instrumentation, the debris extruded was collected in pre-weighed Eppendorf tubes and stored in an incubator at 70°C for 5 days. Tubes containing the dry extruded debris were then weighed. One-way analysis of variance was applied to the weights obtained followed by Tukey’s post hoc test for multiple comparison. Results: The mean debris extruded (mg) for the 3 groups were 1.23 (±0.72), 2.16 (±0.66), and 1.39 (±0.86) for EE5, PTU, and MTO respectively. Samples instrumented with PTU were associated with significantly higher debris extrusion (p<0.01) compared to EE5 and MTO. The groups EE5 and MTO did not differ in the amounts of debris extrusion (p>0.05). Conclusion: The novel EE5 and M-two rotary files result in less debris extrusion compared to PTU in mandibular premolars.

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Abstract Objective: This cross-sectional research evaluated caries prevalence and treatment need in pre-school children using different indexes. Material and Methods: A sample of 931 children (3-5 years old) attending public schools were examined by two calibrated researchers, who recorded the caries prevalence using dmf-t and ICDAS II. The clinical records obtained directed the decision regarding the treatment needs, which were divided into non-invasive and invasive procedures according to the scores registered in the different caries indexes. Descriptive statistics were used to present the data related to each index; qui-square test was used to compare the need of invasive and non-invasive treatment in the different ages. Results: The mean dmf-t was 1.8 ± 2.9, with a 42.9% caries prevalence. Using cut-off points of ICDAS II (≥1, ≥3 and ≥4), the caries prevalence values found were 50.7%, 40.8% and 30.7%, respectively. Five-year-old children exhibited the highest caries prevalence, assessed with dmf-t or ≥3 and ≥4 cut-off points of ICDAS II (≥3: p=0.032; ≥4: p=0.015). The percentages of caries-free children were 49.1% and 57.1%, respectively for ICDAS II and dmf-t. Restorative treatment in at least one tooth was required by 30.7% and 40% of the children for ICDAS II and dmf-t. Only ICDAS II could establish the percentage of non-invasive treatments (20%). Both indices pointed out the expressive need of restorative treatment. Conclusion: The use of dmf-t in epidemiological surveys may underestimate caries prevalence whereas the ICDAS II allowed the identification of early carious lesions and the viability of the use of non-invasive procedures as caries control measures in a child population.

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Abstract Objective: To evaluate and compare the remineralization potential of a dentifrice containing bioactive glass and a topical cream containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in remineralizing artificial carious lesion on enamel. Material and Methods: Forty-five freshly extracted human permanent premolar teeth were selected. Samples were divided into three groups: GI - regular tooth paste without specific remineralizing agent; GII - tooth paste containing calcium sodium-phosphosilicate (novamin) and GIII - topical cream containing casein phosphopeptide-amorphous calcium phosphate. All the sound enamel samples were viewed under scanning electron microscope (SEM) to assess the topographical pictures of enamel surface and energy dispersing x-ray analysis (EDAX) was done to estimate quantitatively the amounts of mineral (calcium and phosphorous). The mineral content of calcium and phosphorus after demineralization in each group was noted. The samples were then subjected to SEM and EDAX. Results: GI does not show any increase in the calcium and phosphorus after applying toothpaste without any remineralizing agent but GII and GIII showed a net increase in calcium and phosphorous values after applying concern-remineralizing agents. Inter group comparison showed GIII yield higher net calcium and phosphorous values than GII. Conclusion: Two remineralizing agents showed remineralization potential on enamel surfaces. Casein phosphopeptide-amorphous calcium phosphate showed better remineralizing potential than calcium sodium phosphosilicate. Hence CPP-ACP can be considered as the material of choice in remineralizing early enamel carious lesions.

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Abstract Objective: To evaluate the postoperative outcome in standard Comma Shaped incision and Ward’s incision on postoperative complications in surgical removal of impacted mandibular third molar. Material and Methods: In this study, 100 patients with impacted mandibular third molar were selected for study. The patients were divided in to two groups. Each group contains 50 patients. A standard Ward’s incision was made on one group and a Comma incision was made on another group to reflect the mucoperiosteal flap, after the common steps for removal of impacted third molars were followed. The postoperative parameters were recorded immediately on the postoperative days 1, 3 and 7. For bivariate analyses, Chi square and Student t test were used. The significance level was set at 5%. Results: The pain and swelling scores were found to be significantly lower in the surgical area with Comma incisions, which was recorded on days 1, 3 and 7 as compared to the area where standard Ward’s incision were made. In mouth opening, there was a sufficiently great difference seen between the two incisions on first postoperative day, but on day 3 and 7 there was no statistical significance. Conclusion: The Comma Shaped incision design was preferable over the standard Ward’s incision, considering the lesser degree of postoperative complications.

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Abstract Objective: To determine the DUSP6 gene mutation in three generations of Malaysian Malay subjects having Class III malocclusion. Material and Methods: Genetic analyses of DUSP6 gene were carried out in 30 subjects by selecting three individuals representing three generations, respectively, from ten Malaysian Malay families having Class III malocclusion and 30 healthy controls. They were submitted Clinical Evaluation to clinical examination, lateral cephalometric radiographs, dental casts, and/ or facial and intra-oral photographs. Buccal cell was taken from each participant of Class III malocclusion and control groups. DNA extractions from buccal cell were carried out using Gentra puregene buccal cell kit. Bio Edit Sequence Alignment Editor software was used to see the sequencing result. Results: A heterozygous missense mutation c.1094C>T (p. Thr 365 Ile) was identified in DUSP6 gene in three members of one family with Class III malocclusion, whereas no mutation was found in the control group. Conclusion: Current study successfully identified a missense mutation in DUSP6 gene among one Malaysian Malay family affected by Class III malocclusion. The outcome of this study broadened the mutation spectrum of Class III malocclusion and the importance of DUSP6 gene in skeletal functions.

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Abstract Objective: To qualitatively investigate whether a prototype brush composed of metal bristles collects oral epithelial cells effectively for cytological evaluation of oral mucosal lesions. Material and Methods: Twenty patients with suspicious oral mucosal lesions were enrolled. Patients were asked to gargle with saline and to deposit the oral rinse into specimen cup. Then, oral mucosal cell samples were collected using a metal oral brush, via sweeping motion. Punch biopsy was performed for histological examination. All samples were evaluated with liquid based cytology (LBC) according to the cellularity, the depth of the epithelial layer, cellular integrity by an oral pathologist. Results: Oral rinse provided samples with 100% cellular integrity and cellularity, mostly from the intermediary layers. With metal brush, both inadequate cellularity and cellular integrity was observed in 25% of the cases. Cellular integrity was adequate in 65%, cellularity was adequate in 45% of the lesions. Samples were dominantly from the intermediary layers, but in one case, metal brush collected cells from the parabasal layer. Conclusion: The narrow spiral pitch and width of metal bristles may have resisted to release the cellular samples collected. With adjustment of the spiral pitch and diameter of metal brush bristles, its’ efficacy could be enhanced.

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Abstract Objective: To evaluate in situ the effect of toothpastes containing casein phosphopeptide - amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium phosphate associated to fluoride (CPP-ACPF) on initial erosion prevention. Material and Methods: Bovine enamel blocks (n = 192) were randomly assigned into 4 phases according to the baseline surface hardness: GI: CPP-ACP Paste (MI Paste™), GII: CPP-ACPF Paste (MI Paste Plus™), GIII: Fluoridated paste and GIV: Placebo Paste. In each of the 4 crossover phases, twelve volunteers wore intraoral palatal appliances containing 4 enamel blocks for 2 hours, then the tested treatments were applied intraorally (3 min) and the appliance was maintained in the mouth for another 3 hours. After, the appliances were removed and immersed in hydrochloric acid (0.01 M, pH 2.3) for 30 seconds to promote erosive demineralization. The final surface hardness was evaluated and percentage of surface hardness loss was calculated. The data were analyzed by ANOVA and Tukey’s test (α = 5%). Results: The application of CPP-ACP paste, independent of fluoride content, resulted in significant lower enamel hardness loss (GI: 9.26% ±3.48 and GII: 9.14% ±1.73) compared to NaF (GIII: 15.5% ± 3.94) and placebo (GIV: 16.7% ± 4.07) pastes, which did not show difference between them. Conclusion: The CPP-ACP pastes were able to reduce initial erosive demineralization in relation to fluoride and placebo pastes. Nevertheless the formulation of CPP-ACP with fluoride did not provide an additional benefit.

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Abstract Objective: To compare retention, preventive effectiveness and longevity of two different high-viscosity glass-ionomer sealants Ketac Molar® and Maxxion R® in the sealing of erupting and out-of-occlusion first permanent molar in children aged 5-7 years. Material and Methods: Children with past caries experience with healthy erupting first permanent molar were included in the study. Teeth 16 and 46 were sealed with Ketac Molar® and teeth 26 and 36 were sealed with Maxxion R®. After 8 months, the retention of sealants was evaluated using the following criteria: total retention; presence of sealant in two thirds of the occlusal surface; presence of sealant in one third of the surface; and total absence of the sealant. Results: Statistical difference between materials was observed, and Ketac Molar® retention was superior to that of Maxxion R® (p<0.05). Regarding the development of caries in sealed first permanent molar, none of the teeth sealed with Ketac Molar® or Maxxion R® developed caries lesion. Conclusion: Ketac Molar® retention is significantly superior to that of Maxxion R®, but the preventive effectiveness in the development of carious lesions is similar for both, which is extremely interesting for the field of public health, since the cost of the material is significantly lower.

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Abstract Objective: To assess the prevalence of incidental findings in relation to the side of a patient’s face, location, and age group on cone beam computed tomography. Material and Methods: 175 CBCT examinations were performed on patients aged between 12 and 77 years, consisting of recordings of the anatomical location and findings following each examination. For standardization of tomographic evaluations, acquired images were analyzed by two previously trained expert radiologists. After positional adjustment of the multi-dimensional images on the monitor screen, examination of each scan was conducted simultaneously on the coronal, axial, and sagittal planes. Fisher’s exact tests and Chi-square tests were used to compare the frequencies of incidental findings using a significance level of 0.05. Results: The most frequent incidental finding was maxillary sinus mucosal thickening, which occurred on the right and left side in 46.3% and 46.9% of the patients, respectively. The second most frequent incidental finding was flattening of the mandibular condyle, occurring on the right and left side in 29.7% and 24% of the patients, respectively. No significant difference was observed among the individual age groups. The number of incidental findings per patient varied from 0 to 5 on the right side and left side and from 0 to 12 in total. The Kendall correlation coefficient for the number of incidental findings between the sides was 0.25 (p<0.0001), indicating a weak but significant and positive association between the sides in relation to the number of incidental findings. The mean total number of incidental findings was 4.07. Conclusion: The prevalence of the individual incidental findings and the total number of findings were not statistically different. However, some alterations were more likely to be observed bilaterally.

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Abstract Objective: To evaluate the cephalic indices among Bataknese school students. Material and Methods: An observational study was performed by measuring 95 Bataknese children aged 3-5 years using a purposive sampling technique. The vertical cephalic index was measured directly in children, while the dental arch and palatal depth were measured on maxillary impressions. Vertical cephalic index data were obtained by measuring the height and length of the child's head directly. Measurement was performed three times by three different people. Cephalic height was measured by a digital calipers by placing each edge of the calipers on the nasion and gnathion. Descriptive statistics were used to calculate the mean and standard deviation. Results: The analysis of height and cephalic length showed that the highest values were 9.28 cm and 18.13 cm, while the lowest were 7.43 cm and 13.43 cm, respectively. The means for Maxillary canine arch width and Maxillary molar arch width were 30.66 mm and 46.69 mm, respectively. For the Maxillary canine arch depth, the mean was 12.0 mm, while for the Maxillary molar arch depth was 28.65 mm. The palatal depth was 14.33. Conclusion: The majority of Bataknese children have a dolichocephalic head shape with a tapered maxillary dental arch and a narrow one.

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Abstract Objective: To identify the social representations of children in relation to the image of the dentist. Material and Methods: This is a descriptive cross-sectional study with quantitative-qualitative approach. The sample consisted of 80 children of both sexes aged 7-10 years attended at a clinic-school of a university in eastern Minas Gerais, Brazil. For data collection, the Test of Free Words Association (TALP) was used, with the word "dentist" as its inducing theme. The four items included in the research instrument were: 1) evoke up to five words or expressions related to the dentist; 2) to order each of them numerically, with number one being the most important and number five being the least important; 3) to conceptualize the one elected as number one; and 4) to justify the reason for that choice. The EVOC software was used to carry out quantitative analyses and the Analysis of Content of Bardin for qualitative analyses. Results: The words that composed the central nucleus of social representations were "tooth", "pain", "brushing" and "treats". This grouping of ideas points to the following conceptual formulation: "The dentist is someone who 'brushes' and 'treats' teeth, but sometimes performs procedures that cause 'pain’. The categories abstracted from participants' discourse were "oral health", "personal characteristics of the dentist" and "child-dentist interaction". Conclusion: Children presented predominantly positive image regarding the dentist.

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Abstract Objective: To describe the Early Childhood Caries (ECC) in Indonesian preschool children based on biopsychosocial risk factors. Material and Methods: This research is an analytic observational with a cross sectional design toward 506 preschool children aged 2-6 years at East Luwu Regency, Indonesia. The biopsychosocial data studied were gender, ethnicity, personal hygiene, child psychology, age, nutritional status, and dental and oral health behavior. These data were obtained through a questionnaire and clinical examination (nutritional status). Multiple linear regression analysis was performed. The statistical tests were performed at the significance level of 0.05. Results: Characteristics of respondents based on parents' origin, found that the majority of respondents were parents from Bugis tribes (68.4%) with ECC frequency of 72.2%. Regarding the visit to the dentist, 12.6% were afraid of the dentist, with ECC frequency of 71.9%. Most children had normal nutritional status (67%) with ECC frequency of 69.3%. Biopsychosocial factors, which significantly affect the Early Childhood Caries, were parents’ tribe (p=0.022) and age (p=0.011). There was an association between ECC with brushing teeth before going to bed (p=0.049), use of mouthwash (p=0.002) and consumption of snacks (p<0.001). Conclusion: Biopsychosocial factor indicators are affect the Early Childhood Caries towards Indonesian preschool children.

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Abstract Objective: To determine the prescribing patterns of the general dental practitioners in Kerman province in Iran. Material and Methods: In this cross sectional study 1200 prescriptions, which were prescribed by general dentists in Kerman province during one-year period, were evaluated. Each prescription was assessed for the number of drugs per prescription, drug (category, name, route of administration, frequency) and duration of treatment. Descriptive statistics were used to calculate the absolute and relative frequencies, mean and standard deviation. The Chi-square test, analysis of variance (ANOVA) and t-test were used. The statistical tests were performed at the significance level of 0.05. Results: The mean number of drugs per prescription was 2.59. Antibiotics, Analgesics, corticosteroids and antiseptics were the most common drug category prescribed drugs by general dentists. Oral route was the commonest route of drug prescription (84.1%). Amoxicillin capsule (60.5%) was the commonest drug prescribed by general practitioners followed by ibuprofen derivatives (55.4%). Spelling errors was found in 62.7% of prescriptions. The mean score of prescriptions for logical prescription pattern was 7.36 ± 1.32 out of 9. Conclusion: Dental prescribing patterns should be considered as a potential area for improvement in the treatment process and patient safety. It is suggested to emphasis more on principles of prescription at university and retraining courses for dentists.

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Abstract Objective: To compare the effect of three different fiber reinforcement strategies on the fracture strength of composite resin restored endodontically treated premolars. Material and Methods: Seventy-two sound human premolars extracted for orthodontic reasons were divided into 6 groups (n=12) after endodontic treatment. Group 1: intact teeth (positive control); Group 2: endodontically treated teeth without restoration (negative control); Group 3: composite resin restoration; Group 4: placement of fibers at occlusal position; Group 5: splinting the buccal and palatal walls with horizontal fiber posts; Group 6: placement of fibers at the occlusal position after splinting the buccal and palatal walls with horizontal fiber posts. Then fracture strength was measured at a crosshead speed of 0.5 mm/min in a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests at α=0.05. Results: There were significant differences between the negative and positive control groups (p<0.001) and between the negative control group and all the other study groups (p<0.001). However, there were no statistically significant differences between the positive control group and all the experimental groups and between the experimental groups (p>0.05). Conclusion: Fiber insertion had no additional reinforcing effect on the fracture strength following composite resin restoration.

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Abstract Objective: To evaluate the change of diameter of different injection-molded thermoplastic materials. Material and Methods: Four thermoplastic injection-molded materials were analyzed (Bre.flex 2nd edition, Vertex ThermoSens, Perflex Biosens and Polyan IC). A total of 432 test samples were made in the form of an "hourglass". All samples were divided into three groups: Group I (Control) - consisting of 36 test samples for each type of material, that was not exposed to artificial aging or a wet environment; Group II - consisting of 36 test samples for each type of material, that were artificially aged through dehydration; Group III - specimen were subjected to artificial aging without dehydration. The diameter of each specimen was measured with a digital caliper. Data were analysed using the Student's t-test. Results: Regarding to shrinkage, the samples from the Bf Control group have a mean value of 1.56 mm and was observed a shrinkage of the injection-molded polyamide material within 0.25%. The comparison between the samples from Group II and Group III showed statistically significant differences (p<0.001). There were no significant differences between groups for Thermosens and Biosens (p>0.05). The comparison between Group II and Group III for Polyan IC samples shows that Group III has a higher arithmetic mean value (p<0.01). Conclusion: Shrinkage of the polymers during the injection process is present in all materials. The thermocycling and the storage in a dry or in a wet environment of the samples results in a change of the diameter in almost every single type of material.

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Abstract Objective: To verify the relationship of feeding practices of potential risk to dental caries in early childhood with sociodemographic variables, prematurity and Neonatal Intensive Care Unit admission (NICU). Material and Methods: Data from medical records of infants and preschool children, including feeding practices (breastfeeding, bottle feeding, feeding during sleep, introduction and frequency of sugar use), sociodemographic variables, prematurity and NICU admission were collected. Chi-square, Fisher and Maximum Likelihood Ratio tests were used. Results: The number of medical records was 222 in the age group of 01-45 months. Breastfeeding was not present in 66.7% of preterm infants (p=0.003) and 66.1% of infants admitted at NICU (p=0.011). The use of feeding bottle occurred in 58.4% of infants whose mothers work / study; 58.4% of preterm infants and 60.9% of children admitted at NICU (p<0.001). Feeding during sleep occurred in 70.5% of infants aged 1-24 months (p<0.001); 51.4% were single children (p=0.010) and 76.7% did not attend daycare centers (p=0.003). The introduction of sugar occurred in 60.6% in the age group of 01-24 months. The use of sugar more than 3x / day occurred in 52.6% of infants aged 25-45 months (p=0.003) and; 51.8% with mothers whose schooling corresponded to elementary school (p=0.039). Conclusion: Among caries-risk feeding practices, there was relationship between breastfeeding and prematurity and NICU admission; use of feeding bottle and mothers who worked and / or studied, prematurity and NICU admission; feeding during sleep and younger children, single child and those who did not attend daycare centers; and higher frequency of sugar use and older infants, and maternal schooling corresponding to elementary school.

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Abstract Objective: To evaluate the presence of clinical and radiographic sequelae in primary teeth affected by dental trauma and its association with age at the time of trauma in children attended at a Public Higher Education Institution. Material and Methods: This is a longitudinal clinical study, in which 229 patients with history of dental trauma in primary teeth were examined, totaling 390 traumatized teeth. Relative frequency analysis was used, and for associations, the Chi-square test was used to verify the relationship of age at the time of trauma with variables such as type of trauma. Results: The most prevalent age group was over 24 months, and fall from own height as the main etiological factor; 71.0% of traumas had involvement of 2 teeth, 9.5% had history of anterior trauma and 66.6% of traumas involved supporting tissues. Regarding the type of injury to dental tissue, the most prevalent was enamel fracture (58.3%) and to periodontium, lateral dislocation (30.8%). Children older than two years had less trauma related to dental tissue (p<0.01), higher number of injuries to the periodontium (p=0.03); and most of them did not present extra-oral changes associated with trauma (p=0.01). During the 12-month period, 325 teeth were examined, and the most frequent clinical sequelae observed was crown discoloration. In the radiographic evaluation, inflammatory root resorption was the most prevalent. Conclusion: Children older than two years presented more injuries to the periodontium. After 12 months, the main clinical sequelae observed was enamel discoloration and the main radiographic sequelae was inflammatory root resorption.

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Abstract Objective: To determine the extent of bleeding on probing, probing pocket depth and the level of oral hygiene and caries prevalence among pregnant women. Material and Methods: Random samples of pregnant women attending eight public health centers were examined. Their periodontal and caries statuses were examined using the Community Periodontal Index, Simplified Oral Hygiene Index and DMF-T. The good criteria of OHI-S ranged from 0 to 1.2, the fair from 1.3 to 3.0 and the poor from 3.1 to 6.0. Descriptive statistics were used to calculate the absolute and relative frequencies. Results: 84.7% had caries and the DMF-T index score was 4.34 (fair). 73% suffered gingival bleeding, 34% with 4-5 mm pocket depth, 2% with 6 mm or deeper pocket depth, while the majority had good oral hygiene. The prevalence of 4-5 mm probing pocket depth increased between the first and second trimesters (12.1% to 48.5%), before undergoing a slight decrease in the third trimester (39.4%). Gingival bleeding was found to be most prevalent in the third trimester. Pocket depth of 4-5 mm was found to be highest in the second trimester. Pocket depth of 6 mm or more was restricted to the third trimester. Oral hygiene scores increased in tandem with gestational age. Conclusion: The majority had caries, which strongly suggests that the awareness of the pregnant women regarding their oral hygiene remains limited.

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Abstract Objective: To analyze the effect of immediate placement of implants with extract from the new bone formation histometically. Material and Methods: In this true-experimental design with randomized post test control group, 9 mongrel dogs weighing 10 to 12 kg were used, which were divided into 3 groups, based on observation time of 14 days, 28 days and 56 days. On the installation of implants (∅3.5x10 mm) sequentially, the former socket extraction of the lower jaw’s right second premolar tooth in the study sample injected 10% Aloe vera gel extract and left second left premolar tooth without injection of 10% Aloe vera extract. To compare independent groups use the Mann-Whitney test. All analysis were carried out using SPSS version 20. Results: There was an increase in the number of osteoblast cells in both treatment and control groups, but the value of the treatment group was greater. There were significant differences in the number of osteoblast cells between the treatment and control groups 14 days (p=0.019), 28 days: (p=0.018), and 56 days (p=0.009). There were no significant differences in the number of fibroblast cells between the treatment and control groups (p>0.05). But at observations 28 and 56 days, it was showed a significant difference in the number of fibroblast cells between the treatment and control groups (p=0.353 and p=0.024, respectively). Conclusion: Immediate placement of implants with 10% Aloe vera extract gel on extracted socket increases the number of osteoblasts and suppresses the number of osteoclasts and fibroblasts.

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Abstract Objective: To evaluate in vitro the effect of a red propolis ethanolic extract (RPE) in the prevention of growth of a cariogenic biofilm and its cytotoxic potential. Material and Methods: Minimum inhibitory and bactericidal concentrations (MIC and MBC) of RPE against Streptococcus mutans and Lactobacillus casei were determined. The cytotoxic potential of 0.4% RPE in oral fibroblasts was observed after 1, 3 and 5 min of contact. Cellulose membrane disks (13 mm, N=12) were used for biofilm formation (24 h) of S. mutans and L. casei, which were treated (1 min) with 0.4% RPE or 0.12% Chlorhexidine (CHX). The control group of biofilm formation was not submitted to any treatment. Serial dilutions were then made to evaluate microbial viability. Descriptive data analysis and, for microbial viability, Mann Whitney test were performed (p≤0.05). Results: RPE showed similar MIC and MBC (4.46 mg/mL) against S. mutans and, for L. casei, they were 8.92 mg/mL (MIC) and 17.85 mg/mL (MBC). CHX presented MIC and MBC <0.00002 mg/mL for S. mutans and 0.00047 mg/mL for L. casei. After 1, 3 and 5 min, the RPE exhibited, respectively, 69.38%, 43.91% and 40.36% of viable cells. The RPE (6.55) and CHX (6.87) presented similar efficacy to reduce the total number of viable bacteria (p>0.05). Regarding the total number of viable bacteria (Log10 CFU/mL), the RPE (6.55) and CHX (6.87) presented similar efficacy (p>0.05). Conclusion: Red propolis extract showed antibacterial activity against the tested strains, exhibited acceptable cytotoxicity and reduced the colonization of S. mutans and L. casei in a biofilm membrane model.

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Abstract Objective: To evaluate the effect of cavity dimensions on the amount of microleakage in two different types of bulk-fill composite resins. Material and Methods: Forty class II cavities were prepared in the mesial and distal surfaces of human molars without any carious lesions. The samples were divided into 4 groups (n=10): Group 1: cavities with 3 mm of buccolingual width (known as the smaller cavity), filled with Tetric N-Ceram Bulk Fill composite resin; Group 2: cavities with 6 mm of buccolingual width (larger cavity), filled with Tetric N-Ceram Bulk Fill composite resin; Group 3: cavities with 3 mm of buccolingual width, filled with X-Tra Base composite resin; and Group 4: cavities with 6 mm of buccolingual width, filled with X-Tra Base composite. After the specimens were thermocycled for 500 cycles at 5/55°C, they were immersed in 1% methylene blue for 24 hours, and then cut into sections mesiodistally in the longitudinal axis of each tooth. Then, the samples were scored regarding the amount of dye penetration in two occlusal and gingival areas under a stereomicroscope (x32). Data was submitted to Kruskal-Wallis and Mann-Whitney tests. Results: The highest degrees of microleakage in larger cavities filled with X-Tra Base among the four groups. There was a significant statistic difference (p=0.012) between large and small cavities filled with X-Tra Base (Groups 3 and 4); however, there was no significant difference between the two cavity sizes of Tetric N-Ceram Bulk-filled groups. Conclusion: Microleakage of composite resins depends on the dimension of the cavity and the type of composite resin used.

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Abstract Objective: To compare the effectiveness of conventional rotatory and piezosurgery technique for surgical removal of lower third molars. Material and Methods: Twenty patients with impacted lower third molars (with no acute symptoms) were divided into two groups (G1 and G2) and evaluated clinically and radiographically. They were allotted alternately into rotatory (G1) and piezotome (G2). Parameters assessed were the pain, swelling, trismus, comfort, analgesics consumed, the time taken for the procedure, intraoperative soft tissue damage and any other complications. Findings were then tabulated and analyzed. Results: Findings of pain, swelling, trismus, analgesics consumed and tissue damage were favorable in the piezosurgery group. However, the time taken for the procedure was significantly more as compared to the rotatory group. Post-operative trismus, values from the piezosurgery group were found to approach normality by day seven while in the rotatory group, a significant difference was found to exist up to day 14, suggesting that patients tend to return to normal function faster in the piezo group. Conclusion: Piezosurgery was found to be a good alternative to the conventional rotatory handpiece in select cases where extraction of the tooth could be carried out with minimal bone removal.

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Abstract Objective: To determine relationship between access to dental health services with dental health conditions of adult communities in urban areas represented by Somba Opu and rural districts represented by Patalassang subdistrict in Gowa subdistrict. Material and Methods: This was pilot pathfinder survey, conducted in Gowa District in April 2018 with 420 subjects. Data were collected using a CoHRE questionnaire. Information regarding gender, age and location (rural and urban), transportation (public and private), toothache in past one year, dental treatment in past one year, dental treatment frequency (regular and irregular), smoking, alcohol consumption, routine activity, drugs intake, oral problems, driving car, distance to health facility (near and far) were collected. The number of teeth was dichotomized to less than 20 and 20 or more. Data were analyzed using Chi-square test and the level of significance was set at 5%. Results: In the urban area there was an association between routine activities with dental health conditions (p=0.002). There is no significant association between distance or access to health care facility with dental condition in adult society in urban area (p>0.05). In rural area there is a significant association between distance or access to health care facility with dental condition (p=0.046). Conclusion: There is an association between access to dental health services with dental health conditions of adult communities in urban areas represented by Somba Opu and rural disparities represented by Patalassang subdistrict in Gowa district.

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Abstract Objective: To assess paternal education, parental occupation, family income, level of knowledge and to determine the attitude and awareness of cases and controls in relation to dental caries and its risk factors in 6-18 years old respondents. Material and Methods: A case-control study was carried out in the outpatient Department of Pediatric and Preventive Dentistry. A total of 800 subjects, 400 each in case and control group were enrolled. The cases were subjects in designated age group with dental caries while controls were subjects without dental caries but matched with the cases on three confounding factors - age, sex, and religion. Multivariate logistic regression was used, with a significance level set at 5%. Results: Paternal education [illiterate (p=0.002), high school (p=0.005), intermediate (p=0.001), graduate (p=0.002)], family income per month [2000 INR (30 USD) (p=0.016); 5000-10,000 INR (75USD -145 USD) (p=0.035)], attitude of short visit duration to dentist (p<0.001), knowledge about sweets causing dental caries (p<0.001), awareness about symptoms of dental caries (p<0.001) and need of lifestyle change (p<0.001) were significantly associated with dental caries. Conclusion: The present research showed that in cases, knowledge was higher as compared to controls whereas contrasting results were observed with attitude and awareness. These results necessitate an urgent need of national programme integrated with primary health care under school health and community outreach programmes, so as to encourage the population to adopt and as well as sustain dental health promoting lifestyles and practices and help in reducing the disease burden.

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Abstract Objective: To know the influence of handling child anxiety with modeling and reinforcement technique on changes in pulse rate in dental and oral care. Material and Methods: The sample consisted of 53 children aged 6-12 years who first came to pedodontic clinic in dental and oral hospital education of Hasanuddin University. Anxiety level was measured using objective parameters, measurement of radial pulse. Measurement of anxiety level was done before and after modeling and reinforcement was given through three treatments: I: dental models; II: game and III: video modeling and reinforcement. Data analysis was done using the Kolmogorov-Smirnov test and Friedman test. Results: There was a decrease before and after modeling and reinforcement. Before intervention, the average pulse rates in treatment I, II and III were 90.79, 88.00 and 88.38, respectively. After intervention, the average decrease in pulse rate of five beats per minute seen in the first treatment (85.15), a decrease of seven beats per minute on the second treatment (81.98), while in treatment III the average decrease was eight beats per minute (80.19) (p<0.001). Conclusion: Modeling and reinforcement technique effectively reduces children's anxiety levels for dental and oral care.

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Abstract Objective: To evaluate the prevalence of novel newly identified periodontal pathogenic strains in subgingival plaque samples and relate it with bleeding on probing, probing pocket depth and age. Material and Methods: 268 chronic periodontitis patients with a mean age of 46.0 ± 6.0 years were included. The following microorganisms were evaluated: Campylobacter gracilis (Cg), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf). Full mouth examination was registered; the probing pocket depth and clinical attachment level were assessed at six sites per tooth. Dental subgingival plaque samples were taken in the deepest pocket per arch in the maxilla and mandible. DNA analysis was performed using DNA-strip technology. Pearson’s correlation coefficient was used for statistical analysis. Results: Porphyromonas gingivalis and Tannerella forsythia were detected at high level of 80% and 82% respectively. F nucleatum revealed a rate of 94%. Bacterial load significantly increased by increasing mean probing depth of the examined sites. Pearson’s coefficient was the highest for Pg (r=0.62, p=0.0001) and the lowest for Cg (r=0.08, p=0.04). The bacterial load significantly increased by increasing the number of bleeding sites; Pearson’s coefficient varied from r= 0.14 for Pg (p=0.01) to r=0.39 for Tf (p=0.001). Conclusion: It was confirmed the presence of main putative periodontal pathogens detectable in Saudi periodontal subjects, also providing a comprehensive view for correlation of these putative periodontal pathogens with the increase in probing pocket depth to the presence and load of all the bacterial species.

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Abstract Objective: To evaluate and compare the effect of each congenital and postnatal treatment factors in treatment outcome based on dental arch relationship (DAR) of four different populations at a time using GOSLON yardstick. Material and Methods: 432 unilateral cleft lip and palate subjects (Japanese, Malay ethnic group, Bangladeshi and Pakistani populations) age 5 to 12 years were taken before orthodontic treatment and alveolar bone grafting. The DAR was assessed by GOSLON Yardstick. Independent t-test was performed to compare the GOSLON score for each factors. A multiple comparison (Anova) was also conducted between the GOSLON score of four different populations. The significance level was set at p<0.05. Results: Statistically no significant different was found among the congenital factors. However, the family history of Class III malocclusion showed most likely to associate with, though there was no significant difference (p=0.069). Significant difference revealed between two techniques of cheiloplasty in both Malay ethnic group and Pakistani population (p=0.038 and p=0.000, respectively). Gender and Techniques of palatoplasty also showed significant difference in Pakistani population (p=0.026 and p=0.000, respectively). Japanese and Bangladeshi population showed no significant differences. Also no significant differences found between the GOSLON score and different countries. Conclusion: The treatment outcome based on DAR significantly varies in individual population [Malay ethnic group (cheiloplasty); Pakistan (gender, cheiloplasty and palatoplasty)].

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Abstract Objective: To evaluate the prevalence, cleft types distribution and etiological risk factors among newly born babies with cleft lip and/or palate (CL±P) in four governorate of the Arab Republic of Egypt, beginning the 1st of January 2013 till the 31st of December 2013. Material and Methods: Total 237,783 newly born babies from Cairo (162174), Aswan (42880), Luxor (32729), and New Valley (877) governorate in the Arab Republic of Egypt were included in this study. Incidence of CL±P babies per 1000 births was calculated in each district for the four studied governorates. Percentage distribution of cleft types within each governorate. Chi-square test was used for determining significance of difference of incidence and percentages within and between the governorates. Results: The mean prevalence value of CL±P in the four Egyptian studied governorates was 0.40/1000. The highest percentage of cleft type was cleft lip and palate followed by cleft lip and isolated cleft palate. The highest etiological risk factor was maternal passive smoking in the four studied governorates followed by consanguineous marriage and medicine intake during pregnancy. Conclusion: These data provided a picture of the prevalence of CL±P in four different governorate of Egypt and also provided a useful reference for cleft types distribution and etiological risk factors of CL±P data in Egypt and internationally.

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Abstract Objective: To determine the impact of untreated dental caries on the oral health related quality of life (OHRQoL) of children from low social class in an urban Nigerian population. Material and Methods: The study was conducted among 6 to 15-year-old pupils from low social class in randomly selected primary schools in Ibadan. An interviewer-administered Child Oral Impact on Daily Performances (C-OIDP) questionnaire was used to obtain required information. Oral examination was conducted by calibrated examiners. Data obtained were analyzed with SPSS and test of association done with Mann-Whitney U and Chi-square tests. Results: A total of 1286 pupils participated in the study and 130 (10.1%) had untreated dental caries, out of which 26 (20.0%) had pain from carious tooth. The C-OIDP of children with dental caries was similar to that of children without caries [median 0.0 vs. median 0.0; r = -0.025; p=0.368)]. The median C-OIDP (3.0) of those with untreated dental caries and pain was higher than that of participants with painless caries [0.0; r=-0.768; p<0.001]. There were significant impacts on all eight domains of the OHRQoL of those with untreated dental caries and pain (71.4 - 100.0%) when compared to those with painless caries (0.0 - 28.6%; p<0.05). Conclusion: Untreated dental caries significantly impacts on OHRQoL of pupils from low social class only when associated with pain.

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Abstract Objective: To elicit the structure of isolated compounds from roots of sidaguri (Sida rhombifolia Linn). Material and Methods: Several organic standard protocols were involved, including extraction, fractionation, and phytochemical testing. Further spectroscopy methods, FTIR and 1HNMR, were used to determine the predicted structure of molecules, while their ability to inhibit cyclooxygenase (COX 1 and 2) were tested using in vitro method. Results: Overall assessments showed that the structure of the sidaguri is a long chain aliphatic carboxylic acid and identified as Z-3, 6, 6 trimethylhept-2-en-1-ol (T12) and nonanoic (T13). Both isolates significantly inhibit COX-1 and COX-2 non-selectively (the COX-1/COX-2 ratio for T12 was 0.91 and 0.82; while COX-1/COX-2 ratio for T13 was 0.89 and 0.87 at concentrations of 0.05 and 0.025 µg/mL respectively). Conclusion: The active compounds of Sidaguri have anti-inflammatory effect by inhibiting COX non-selectively.

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Abstract Objective: To determine the prevalence of Candida species in the saliva of patients with clinically suspected oral potentially malignant disorders (OPMD) and healthy cohorts. Material and Methods: Unstimulated saliva was collected from patients with OPMD (n=100) and age and sex matched healthy subjects (n=170). The samples were inoculated onto Sabouraud Dextrose Agar and incubated for a week. The colonies of the isolates were enumerated using a colony counter. The isolates were identified using standard phenotypic methods. The significance of oral candidal carriage was calculated using Independent T test. Odds and Risk ratio was calculated using Pearson’s Chi-square test. Results: Oral candida carriage was present in 51% of patients with OPMD while healthy cohorts had a prevalence of 20.6%. A good statistical significance was observed for the prevalence of oral candidal carriage for patients with OPMD in comparison to healthy cohorts (p=0.013). Significant Odds and risk ratio was observed for the prevalence of Candida species among OPMD. Majority of the isolates in both groups were C. albicans. Colony forming units were high among patients with OPMD. Conclusion: A significant association of oral candidal carriage to oral potentially malignant disorders in comparison to healthy cohorts was observed. Candidal species may be potent risk factor for transition of OPMD to oral Squamous Cell Carcinoma.

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Abstract Objective: To assess potential for early detection of oral infection by B. anthracis spores for preparedness of a bioterrorism attack. Material and Methods: The laboratory study used saliva with a range of initial anthrax concentrations, to compare detection by direct observation from conventional blood agar culture and by anthrax-specific PCR after a shorter culture in BHI broth. Three types of saliva were collected: stimulated saliva, unstimulated/whole saliva, and unstimulated/whole saliva with antibiotic treatment (for negative control). Using bivariate Kruskal-Wallis and Mann-Whitney tests for statistical analysis for factors that could affecting anthrax detection, significant differences between the test groups was assumed at p<0.05. Results: From unstimulated whole saliva heat shock treated at 62.50C, B. anthracis growth was detected with both methods. PCR detection from a BHI broth culture could shorten the time to diagnosis in comparison to conventional culture in blood agar. Conclusion: Saliva can provide useful samples for diagnosis of oropharyngeal anthrax. In comparison to conventional culture on blood agar, shorter-term culture in BHI broth provides potential for earlier detection and diagnosis.

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Abstract Objective: To analyze the potency of Javanese turmeric extract in inhibiting and eradicating the mature phase of C. albicans biofilm. Material and Methods: C. albicans ATCC 10231 was cultured in Sabouraud Dextrose Broth on a 96-well plate and was incubated at 37ºC. To analyze its inhibitory effect, C. albicans cultures were incubated for 1.5 hours before being exposed to various concentrations of Javanese turmeric extract, followed by a further 48-hour incubation to reach the maturation phase. To analyze the eradication effect, the 48-hour C. albicans cultures were exposed to the extract and incubated further for 24 hours. Nystatin (100,000 IU) was used as a positive control. The percentage of viable C. albicans cells on the 48-hour biofilm was determined by a methylthiazol tetrazolium assay. This value was converted into the percentage of the extract’s minimum inhibitory and eradication concentrations. Results: Against the mature phase C. albicans biofilm, the minimum biofilm inhibitory concentration of the Javanese turmeric extract was 40%, while the minimum biofilm eradication concentration was 45%. There were significant differences between the inhibition percentage of the positive control and that of the solutions exposed to Javanese turmeric with all the tested concentrations (p<0.05). There was a strong positive correlation between the increase in extract concentration and the eradication percentage of the mature C. albicans biofilm (r=0.981). Conclusion: Javanese turmeric extract is potential for inhibiting and eradicating mature phase C. albicans biofilm. The extract is more effective in inhibiting than in eradicating the biofilm.

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Abstract Objective: To analyze the total antioxidant capacity (TAoC) of saliva in smokers based on type of cigarette, duration and frequency of smoking. Material and Methods: 51 male smokers, aged 20-55 years were enrolled. Information regarding cigarette type and smoking duration and frequency was collected using a questionnaire. Unstimulated saliva samples were collected in the morning following fasting for 2 h, and TAoC was measured using a commercial kit. The data were evaluated through the independent t-test and Kruskal-Wallis test. Results: Mean TAoC for the consumption of Kretek cigarettes was 0.29 (±0.15) and for that of non-Kretek cigarettes was 0.36 (±0.10). Mean TAoC based on smoking duration was 0.31 (±0.14) for 5-10 years and 0.27 (±0.15) for >10 years. Median TAoC based on smoking frequency was 0.23 (0.11-0.44), 0.31 (0.06-0.64), and 0.27 (0.06-0.68) for 1-5, 6-10, and 11-20 cigarettes/day. Mean TAoC of the saliva from participants who consumed Kretek cigarettes was lower than that of the saliva from those who consumed non-Kretek cigarettes (p=0.3). Mean TAoC for a duration >10 years was lower than that for a duration of 5-10 years, although the difference between these two groups was not significant (p=0.4). Conclusion: There were tendencies of lower total antioxidant capacity on smokers with kretek type cigarettes, smoking duration >10 years and frequency of 1-5 cigarettes/day. This study indicates that the type, duration, and frequency of smoking may affect the salivary total antioxidant capacity.

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Abstract Objective: To analyze the relationship between age, body mass index (BMI), bone mineral density (BMD), and alveolar bone resorption with menopause duration in postmenopausal women. Material and Methods: A cross-sectional study was developed involving 59 subjects, aged 45 to 80 years and categorized the duration of menopause as ≤5 years and >5 years. Body mass index measurement and menopause duration were collected. Bone loss seen on radiography was measured by drawing a vertical line from the cementoenamel in the distal part of the 36 teeth and the mesial portion of 46 teeth to the base of the bone marked by the lamina dura intact. Categorical determinations of age, BMI, BMD, and alveolar bone resorption were based on receiver operating characteristic (ROC) curves. Were used Pearson correlation and Spearman correlation tests with the significance level set at 5%. Results: The majority of subjects (54.2%) with menopause duration >5 years were aged >54.5 years, most had BMI >24.2 kg/m2 (39%), had bone resorption >2.95 mm (52.5%), and had bone density ≤73.89 (49.2%). Pearson and Spearman correlation tests showed no significant correlation between age, BMI, bone density, and alveolar bone resorption (p>0.05). Conclusion: The longer the duration of menopause showed a tendency for lower bone density and higher age, BMI, and bone resorption.

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Abstract Objective: To observe the outcomes of dental implant treatment based on the evaluation of bone conditions using Cone Beam Computed Tomography (CBCT). Material and Methods: A total of 31 dental implants were collected for the present study. Subsequently, mesial and distal bone losses were examined, while buccal and lingual bone thickness were measured at 7 levels. Evaluation and interpretation of CBCT results was performed by 3 independent examiners. Results: The average of mesial bone loss was 1.08 mm and 1.36 mm on distal bone. Every dental implant had lingual/palatal bone on level 1 to 3, only 1 (6.5%) didn’t have bone on level 4, 3 implants (9.7%) had no bone at level 5 and 6, and 22 implants (74.2%) had no bone at level 7/implant platform. There were 8 implants (25.8%) didn’t have buccal bone at level 7, only 1 implant (3.2%) didn’t have buccal bone at level 2,4,5 and 6, and there were 2 implants (6.5%) had no buccal bone on level 3. Dehiscence / fenestration can be seen on 90% of the implant subjects. Conclusion: These bone loss condition could be consequence of several factors such as infection, diagnosis, treatment plan, and operator’s surgery skills. The implants that placed without CBCT could lead to operator miscalculation on bone condition, therefore in moderate to advanced cases, the use of CBCT should be mandatory for treatment plan.

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Abstract Objective: To determine and compare the corrosion resistance (based on the release of nickel and chromium in artificial saliva) of various brands of stainless steel brackets after thermal recycling by direct flaming. Material and Methods: This research study employed 40 stainless-steel maxillary premolar brackets from different brands (Ormco, GAC, Versadent, S-Ortho, and Protect), which were divided into 5 groups consisting of 8 brackets. The nickel and chromium content of the metal brackets were analyzed by inductively coupled plasma mass spectrometry (ICP-MS), conducted before immersion. For the first treatment, each group was immersed in artificial saliva without direct flaming (recycling); for the second treatment, each group was immersed in artificial saliva with direct flaming (recycling) for 30 days in a pH-neutral (pH=7) solution. ICP-MS was employed to analyze the nickel and chromium released in saliva. The mean differences were measured with Wilcoxon, Kruskal Wallis test, and Post-Hoc Mann Whitney test. Differences were considered statistically significant when p-value<0.05. Results: The mean corrosion resistance based on the nickel content released by the new brackets was 99.95%, 99.87%, 87.09%, 90.58%, and 90.26% for groups A, B, C, D, and E, respectively. The mean corrosion resistance based on the nickel content released by the recycled brackets was 99.90%, 99.80%, 98.19%, 89.76%, and 72.82%, respectively. There was a significant difference in corrosion resistance among the 5 groups after recycling by direct flaming and between new and recycled brackets in each group. Conclusion: The corrosion resistance of the brackets in groups A (Ormco), B (GAC), D (S-Ortho), and E (Protect) decreased after thermal recycling by direct flaming. The Ormco brackets had the highest corrosion resistance after thermal recycling by direct faming.

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Abstract Objective: To evaluate the sealing capacity and retention of apical barriers made with mineral trioxide aggregate (MTA) and Portland cement (PC). Material and Methods: Fifty-six bovine incisors were sectioned 8 mm above and 12 mm below the cement-enamel junction. The root canal was enlarged with a diamond drill to create a standard 2.5 mm diameter opening. Apical sheets of 5 mm thickness were placed using white MTA-Angelus or white PC. Fifteen samples of each material were exposed to human saliva in a dual chamber apparatus and casting was evaluated at 30 days. Samples without apical barriers and fully sealed samples were used as positive and negative controls (n = 3), respectively. Data were analyzed by Fisher's exact test (p<0.05) after 3 periods: 1 to 10 days (P1); days 11 to 20 (P2); and days 21 to 30 (P3). Then, three 1 mm thick sections were obtained at the apical level of other root samples of each material (n = 10) and the push-out test was performed Results: The leakage rates in P1, P2 and P3 were 60%, 73.3% and 100% for the MTA; and 73.3%, 86.7% and 100% for CP, with no significant difference between materials, regardless of the period analyzed. There were no significant differences between the bond strengths for both cements (p>0.05) Conclusion: Mineral trioxide aggregate and Portland cement apical barriers presented similar sealing ability and bond strength values.

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Abstract Objective: To compare gingival and dental health indices between breastfeeding and non-breastfeeding women during the first 6-month period after childbirth. Material and Methods: In this longitudinal study, 25 lactating mothers and 25 non-lactating mothers who had delivered a month ago were examined. The groups were identical in terms of educational level, age, income, and delivery time. Periodontal and dental indices including Pocket Depth (PD), Gingival Index (GI), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) and DMFT were checked initially and after 2-4-6 months. Data were presented with the use of descriptive statistics (means, standard deviations, and frequencies). The gingival health parameters were compared between the two groups with the use of Chi-square, Wilcoxon, and Kruskal-Wallis tests Results: Evaluation of PD showed that in the breastfeeding mothers increased from 1.97 mm at baseline to 2.44 mm after six months, while in the non-breastfeeding mother, the PDs increased from 2.03 mm at baseline to 2.11 mm after six months and at the 6-month interval, the PDs were significantly higher in the breastfeeding mothers (p>0.001). In breastfeeding mothers, the rate of dental caries was 12.68, with 11.52 in non-breastfeeding mothers (p>0.05). The rates of white spots in breastfeeding and non-breastfeeding mothers were 1.64 and 0.88, respectively. The degree of CAL and the rate of GI were similar between the two groups of mothers Conclusion: Some periodontal indices (Pocket Depth and Bleeding on Probing) in lactating mothers were significantly higher than non-lactating mothers others (Clinical Attachment Level and Gingival Index) were similar. There were no significant differences in dental indices between lactating and non-lactating mothers. However, the rate of the white spot was more in the lactating group. Breastfeeding can be one of the risk factors in gingival inflammation and dental caries.

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Abstract Objective: To verify differences between salivary flow in pediatric cancer patients before starting antineoplastic treatment and in healthy pediatric patients. Material and Methods: This is an observational, cross-sectional, paired study with sample of 120 children and adolescents (3-18 years). Thirty pediatric cancer patients were selected for convenience at “Napoleão Laureano” Hospital (G1). Another group was composed of 90 individuals attended at the School of Dentistry Clinics of the Federal University of Paraíba, matched by age (G2). Data collection was performed in two steps for both groups. Information regarding pediatric cancer patients was obtained by interview with parents / guardians and searching medical records, while in the other group by interview with parents / guardians. Saliva collection was performed using standard method in both groups: unstimulated salivary flow rate (USFR) being the mean volume expelled in 1 minute. Data were analyzed by the Shapiro-Wilk, Kolmogorov-Smirnov and Mann-Whitney tests (α = 5%) Results: Mean USFR for G1 and G2 was 0.52 mL / min and 0.66 mL / min, respectively (p>0.05) and, in both groups, significant difference was observed (p <0.05) between the mean USFR values of its subgroups, and values of adolescents being higher than those of children Conclusion: There is no difference in unstimulated salivary flow of pediatric cancer patients before starting antineoplastic treatment compared with healthy pediatric patients.

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Abstract Objective: To evaluate the effectiveness of gargling the solution of ant nest extract against plaque formation in children who experience Early Childhood Caries (ECC) when used as a mouthwash. Material and Methods: This study uses a pretest-posttest design with a control group. Thirty children with ECC, which were divided into three groups, namely the treatment group which was given a solution of extracts of ant nests concentrations of 5% and 10% and the control group gargling Aquades. Plaque scores were measured using the Greene and Vermillon method before and after the intervention. The paired t-test was used, with a significance level of 0.05 Results: Significant differences were found before and after the treatment of ant nest extract (r<0.05). The increase in OHI-S mean in the control group before treatment was 2.41 ± 0.72 and after treatment 2.53 ± 0.69 while in the treatment group there was a decrease in the OHI-S average in the group of 5% before treatment 2.66 ± 0.90 and after treatment 2.29 ± 0.95 and group concentration of 10% before treatment 2.51 ± 0.89 and after treatment 1.82 ± 0.75 Conclusion: The distribution of ant nest extract solution extract with the concentration of 5% and 10% would be more effective with ant nest concentration of 10% where it can inhibit dental plaque formation, and there is a significant difference in mean plaque scores between the control group and the treatment groups.

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Abstract Objective: To determine the proportion of Saudi population in the Asir region that displayed discordance between the facial and maxillary midline and intermaxillary midline, to form an informative guideline for esthetic rehabilitation of patients. Material and Methods: We evaluated 2418 Saudi citizens using positioning guides of the orthopantomography machine to record the relationship of the dental midline to the facial midline. The relationship of the maxillary midline to that of the mandible was observed clinically, and diagnostic mounting of particular cases was performed for confirmation. The examination was carried out by four trained observers (two dentists and two radiology technicians) to overcome the parallax effect. The cases with disagreements were repeated. The record was grouped into (1) coincidence, (2) deviation of the mandible to the right, and (3) deviation to the left. The relationship between facial-dental midline concordance and intermaxillary concordance was assessed using the Chi-squared test Results: Facial and maxillary midline did not coincide in 42.5% participants, whereas intermaxillary midline discordance was observed in 51.5%. Among those exhibiting discordance, 57% had right discordance and 43% had left discordance Conclusion: A significant proportion of the population displayed discordance between the facial-maxillary midline as well as the intermaxillary midline. The female population showed not only a higher number of intermaxillary discordance than males but also a significant number of intermaxillary discordance towards the right.

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Abstract Objective: To evaluate the hearing efficiency of Oral Submucous Fibrosis (OSF) patients using Pure Tone Audiometry (PTA) and to correlate between the hearing efficiency and clinical stage of OSF. Material and Methods: Twenty-five patients clinically diagnosed as OSF were evaluated for hearing loss using ‘PTA’. Patients were grouped as mild cases and severe cases. Mild cases comprised of Group A and B, and severe cases comprised of Group C and D. Patients suffering from the previous hearing were excluded from the study. The data were submitted to statistical evaluation using the Chi-square test. The level of significance was set at 5% Results: Out of the total patients, 52.4% were diagnosed as mild cases (Group M) OSF and 47.6% as severe cases (Group S). The analysis of the data of mild cases and severe cases revealed a significant association between advancing stages of OSF and hearing loss (p = 0.026). The cases in Group M after otoscopic evaluation demonstrated no visible ear defect. However, 30% of cases in Group S showed retraction of the tympanic membrane Conclusion: The results indicate an association between stages of OSF and hearing loss. With advancing stages of OSF, there may be involvement of muscles of soft palate namely the levator veli palatine or tensor veli palatine, which may lead to the narrowing of the Eustachian tube leading to a decrease in air conduction demonstrating it as hearing loss of varying degrees depending upon the involvement.

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Abstract Objective: To discover the ideal concentration of Advanced Platelet Rich Fibrin (A-PRF) as modification of PRF, for human Dental Pulp Stem Cells (hDPSCs) differentiation. Material and Methods: hDPSCs were devided into five experimental groups: Group I (control group) consist of hDPSCs cultured in 10% FBS, Group II consist of hDPSCs cultured in 1% A-PRF, Group III consist of hDPSCs cultured in 5% A-PRF, Group IV consist of hDPSCs cultured in 10% A-PRF and Group V consist of hDPSCs cultured in 25% A-APRF. All group have been observed for 7 and 14 days and each group had three biological replicates (triplo). Formation of the mineralized nodules was detected after 7 days by Alizarin red-based assay and Dentin Sialophosphoprotein (DSPP) expression after 7 and 14 days quantified by ELISA reader. Statistical analysis was proven with Kruskal-Wallis and post hoc Mann-Whitney test Results: The differentiation of hDPSCs in all A-PRF groups was significantly different on day-7 (p<0.05) compare to control group (Group I). There were no significant differences between all groups on day-14 (p>0.05). Significantly differences between Group II (1% A-PRF) and Group I (control), Group II (1% A-PRF) and Group III (5% A-PRF), also Group II (1% A-PRF) and Group V (25% A-PRF) was found from post hoc test analysis Conclusion: The ideal conditioned media concentration for differentiation of human dental pulp stem cells was on 1% up to 5% A-PRF group.

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Abstract Objective: To evaluate the association of publication bias with obtaining positive or negative results in the Doctoral thesis of Iranian dental schools. Material and Methods: In this cross-sectional study firstly we collected all the abstracts of Doctoral and post-doctoral thesis belonging to electronic archives of five Iranian dental schools there after the analytic abstracts were included and in the second phase, we try to search resulting articles with searching in Google Scholar. Data were analyzed using descriptive statistics and a Chi-squared test, Pearson’s correlation coefficient, Fisher’s exact test, and Logistic Regression Results: Out of 483 reviewed thesis abstracts 269 cases were included (55.7%) 153 of which were accessible as papers (56.9%). In 67.7% of the reviewed thesis, positive results were obtained. There were significant relationships between publishing and publishing in international journals with two variables: Study type and field (p<0.05). In vitro studies, clinical trials and studies in the field of oral diseases and periodontics had a higher rate of publication in the form of articles. Retrospective studies and those in the fields of endodontics and oral pathology had a higher rate of publication in journals with international indexes. Using regression logistic model showed that the probability of publishing positive data was greater (18-31%) than negative data. It was shown that the specialty field affected the relationship between the chance of publication of the article and the positive/negative results (p=0.008), increasing the chance of publication to 31% Conclusion: There was publication bias in reviewed dental articles.

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Abstract Objective: To evaluate the knowledge of elementary school teachers about the management of dental trauma. Material and Methods: An observational study, with the cross-sectional design, was conducted among primary school teachers in Hail, Saudi Arabia during January 2017. The questionnaire distributed among 400 primary school teachers from 18 different schools using convenient sampling. Data were gathered and analyzed using SPSS version 20 Results: 378 (94.5%) respondents to the questionnaire. It was found that only 37.8% of the primary school teachers were able to distinguish between the primary and permanent teeth. Only 59.5% reported starting the management of a child with trauma immediately. Merely 38.4% believed that it is important to search for the missing tooth or the broken pieces, whereas 31% would re-implant the permanent tooth into the socket by themselves. Regarding the storage media, only 16.6% respond correctly. According to school teachers, the best way of learning the management of dental trauma at school is through videos (36.2%) and phone application (33.9%) Conclusion: School teachers lack knowledge regarding the management of dental trauma. We strongly recommend planning for dental trauma educational based on the teacher's perception after pilot testing its effectiveness.

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Abstract Objective: To assess agreement between reports of parents and children about children’s oral health-related quality of life (OHRQoL). Material and Methods: A total of 50 pairs of preschool-aged children, aged 5-6 years and their parents, who sought dental care at the Faculty of Dentistry of the Federal University of Amazonas, answered the Brazilian version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). SOHO-5 was completed through face-to-face independent interviews. A specific instrument containing information about demographics and socioeconomic conditions of children and their families was also applied to parents. Children’s oral examinations were performed for the diagnosis of dental caries (dmft). The agreement between total and items scores was evaluated using the means comparison and the correlation analysis, calculated by the Intraclass Correlation Coefficient (ICC) Results: There was a significant difference between the means of parent-child reports in total scores (p=0.0028) and items associated with difficulty speaking (p=0.038) and difficulty playing (p=0.0034). Children reported worse OHRQoL than their caregivers, suggesting different perceptions between them. The ICC for the total score of parent-child reports was 0.44 (95% CI, 0.02-0.68). Higher SOHO-5 scores were found in children with dental caries experience Conclusion: Moderate agreement was observed, suggesting that the reports of parents should be complementary to those of preschool children about the OHRQoL, allowing the clinician to make the best treatment decision, according to the different views and expectations of both.

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Abstract Objective: To verify the impact produced by oral disorders on the quality of life of adolescents. Material and Methods: This is a cross-sectional study with a random sample of 680 individuals aged 15-19 years from public schools of Vitória, Brazil. The impact was assessed using the Oral Health Impact Profile (OHIP 14). Data were descriptively analyzed and then univariate analyses were performed with the Chi-square test and Fischer's exact test. The Mantel-Haenzsel test was used to evaluate the effects of the combined dimensions and Odds Ratio to evaluate the strength of the association. Logistic regression models were adjusted for each OHIP dimension Results: The impact on the quality of life was 26.2%, more frequently in the psychological discomfort dimension. The highest perception of impact was in female subjects, in physical pain (p=0.009, OR=1.998) and psychological discomfort dimensions (p=0.050, OR=1.495). In variable maternal education, children of mothers with only complete elementary education are 1.6 times more likely to have an impact on the quality of life in the psychological discomfort dimension (OR=1.6 95% CI=1.037, 2.474). Halitosis was the independent variable with the highest frequency of impact in the combined Mantel-Haenszel test, and OR was found to be 2.81 (95% CI=1.670, 3.366) for individuals who perceive halitosis. In the logistic regression analysis in the seven OHIP dimensions, the results confirm that the variables that explain impact are gender (p=0.035, OR = 1.502) and halitosis (p<0.001, OR=2.365) Conclusion: Oral health problems significantly affect the quality of life of adolescents and that subjective indicators are important tools to determine the need for treatment, improving oral health and quality of life of this population.

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Abstract Objective: To assess the knowledge of school nurses in Dubai, United Arab Emirates, about the emergency management of Traumatic Dental Injuries (TDIs) at schools. Material and Methods: A cross-sectional questionnaire survey was conducted amongst 68 school nurses (SN) prior to inviting them to an educational workshop on the emergency management of TDIs. The educational workshop covered all the topics in the questionnaire and provided basic necessary information to the SN regarding the emergency management of TDIs. Descriptive statistics were used to describe the characteristics of the sample; the Kolmogorov-Smirnov test was used to test normality for the score of knowledge and Mann-Whitney U test to correlate score of knowledge with different demographical variables (p<0.05) Results: An overall lack of knowledge about the emergency management of TDIs was observed. The overall average for the score of knowledge for all the participants was 10.75 out of a total of 16 correct answers. Female participants had significantly higher scores of knowledge compared to males (p=0.02). None of the other demographic variables were significantly associated with the score of knowledge Conclusion: More training programs are essential for school nurses to improve their knowledge and awareness for better future handling of traumatic dental injuries.

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Abstract Objective: To evaluate the relationship between mandibular shape, mandibular bone density, cortical bone thickness, and condylar volume and facial height using a cone-beam computed tomography (CBCT). Material and Methods: Fifteen female patients (16-25 years old) were included in this study. The following measurements were performed on CBCT radiographs; inter-canine and inter-molar width of the mandible at three vertical points (alveolar crest, apex and basal bone), mandibular cortical bone thickness in disto molar and canine sections, bone density of the mandibular body and condylar volume. Afterward, subjects were divided into short face, normal and long face groups according to the Frankfort-mandibular plane angle (FMA) measured on lateral cephalograms obtained from CBCTs. Data were analyzed using Pearson correlation, one-way ANOVA, and post-hoc analysis Results: The inter-canine width of the mandible at the apical point in long face subjects was greater than in the other groups. Likewise, the cortical bone thickness was significantly higher in long face patients compared to the short face and normal subjects. There was no statistically significant difference in mandibular density or condylar volume between patients with various vertical heights (p>0.1) Conclusion: Vertical growth pattern is correlated with mandibular morphology to some extent.

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Abstract Objective: To evaluate the antimicrobial action of the CTZ paste in three different proportions by diffusion in agar with the microorganisms: Enterococcus faecalis,Escherichia coli, and Candida albicans. Material and Methods: Three different proportions of antibiotics were tested: GROUP A - CTZ paste in the ratio of 33.33% chloramphenicol + 33.33% tetracycline + 33.33% zinc oxide, mixed with 2 drops of eugenol (1:1:1 ratio); GROUP B - CTZ paste in the proportion of 25% chloramphenicol + 25% tetracycline + 50% zinc oxide, mixed with 2 drops of eugenol (1: 1: 2 ratio); GROUP C - CTZ paste with 13% chloramphenicol + 13% tetracycline + 74% Zinc Oxide, mixed with 2 drops of eugenol (1:1:6 ratio); PC GROUP - Positive Control (0.12% Chlorhexidine); and NC GROUP - Negative Control (0.9% Saline solution). Data were analyzed through descriptive statistics (means and standard deviation). The one-way ANOVA and Tukey’s test were used, with a significance level of 5% Results: No statistical differences for Enterococcus faecalis between groups A, B, and C (p = 0.1986) were found. There were statistical differences for Escherichia coli between groups B and C (p = 0.029), and for Candida albicans between groups A and C (p = 0.006). Groups A, B, and C had significant differences with both Positive and Negative Controls for all the microorganisms Conclusion: The three different ratios of CTZ paste showed antimicrobial efficacy against Enterococcus faecalis,Escherichia coli, and Candida albicans microorganisms.

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Abstract Objective: To evaluate the efficacy of herbal mouthwash (Himalaya Hiora Regular) against methicillin-resistant Staphylococcus aureus and Acinetobacter baumanni during ultrasonic scaling. Material and Methods: Group B (n=25) received herbal mouthwash and Group A (n=25) received 0.12% chlorhexidine mouthwash respectively as a preprocedural rinse. The aerosols produced by the ultrasonic unit were collected on MeReSa and Leeds Acinetobacter Agar plates. The experimental setting included eight different locations covering all areas of the operatory. The plates exposed to aerosols for a period of 30 minutes were incubated aerobically at 37ºC for 48hrs and the colony forming units (CFU) were statistically analyzed Results: Herbal mouthwash (Himalaya Hiora Regular) showed a significant reduction in mean CFU of MRSA compared to 0.12% chlorhexidine. While herbal mouthwash was on par with 0.12% chlorhexidine in the reduction of A. baumannii Conclusion: Herbal mouthwash was found to be more effective against MRSA than 0.12% Chlorhexidine mouthwash as a pre-procedural rinse. Both herbal mouthwash and chlorhexidine mouthwash was found to be effective against A. baumannii. Herbal mouthwash may be a safe alternative to chlorhexidine against nosocomial pathogens like MRSA and A. baumannii.

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Abstract Objective: To analyze the basis on which the behavioral approach model adopted by Brazilian Pediatric Dentistry throughout its history was built. Material and Methods: A semi-structured interview, applied to six pioneering professors in Brazilian Pediatric Dentistry, dealted with the model that followed the line of behavioral control and how this could be explained historically; on the differences between the Brazilian model and that of other schools, as well as a methodological analysis on the publications related to these models. Data were recorded and transcribed and then submitted to Bardin's qualitative content analysis Results: Three categories emerged from the analysis: "Formulation of a Brazilian theoretical model"; "Behavioral approach in Brazil and in other countries"; and "Analysis of publications under different behavioral approach models". The reports point to the construction of a model based on the sharing of professional experiences, the knowledge acquired through the literature and the compilation of techniques from different fields of knowledge/activity through idiosyncrasies, one's own abilities, such as the ease to deal with children, and personal experiences - leading to a non-scientific result. Methodological limitations in studies in this field have been reported. Qualitative research on the subject is scarce and allows further knowledge of the pediatric dental practice at its interface with Psychology for a successful treatment of pediatric patients Conclusion: The reports point to the possibilities and limitations of the formulation process of the behavioral approach model adopted by Brazilian pediatric dentistry throughout its history. The analyzed categories allowed a broad and deep overview of the historic and academic process of this important construction.

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Abstract Objective: To investigate the correlation Cluster of Differentiation 4+ (CD4+) counts with a high prevalence of dental caries in Children Living with Perinatal Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (CLWPHA). Material and Methods: An analytical observational research with a cross-sectional design was conducted at Tertiary General Hospital, Surabaya, Indonesia. Randomized total sampling consisted of 29 CLWPHA 1-12 years old at outpatient ward Infectious Disease Intermediate Unit (UPIPI) Tertiary General Hospital Doctor Soetomo Surabaya. Demographic details and recent CD4+ counts obtained from medical records. Decayed, missing, filled teeth (dmft) in primary teeth and DMFT in permanent teeth index were used. Pearson's and Spearman's Correlation test (p<0.05) were performed Results: Dental caries prevalence was 86.2%; meanwhile, the dmft/DMFT index score found were high (8.2 / 6.3). CD4+ count and caries showed significant correlation (r=-0.394, p<0.05). Tooth brushing frequency with caries showed a significant correlation (r=-0.419, p<0.05). Antiretroviral (ARV) therapy and caries showed an insignificant negative correlation (p<0.05) Conclusion: The high prevalence of dental caries in CLWPHA correlated with low CD4+ counts.

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Abstract Objective: To evaluate factors associated with the caregivers’ perception of the oral health of children and adolescents with cerebral palsy. Material and Methods: A cross-sectional study was carried out with 80 children and adolescents with cerebral palsy aged 2-18 years, registered at a reference institution and their respective caregivers. Caregivers provided socioeconomic, systemic and health perception and access to dental services data. A calibrated researcher (Kappa=0.75-0.98) performed oral examinations using DMF-T, dmf-t, dental trauma, gingival bleeding index, community periodontal index, malocclusion index and the dental aesthetic index. The Poisson Regression was used (α=0.05) Results: According to the caregivers’ perception, the oral health reports of children and adolescents with cerebral palsy considered good and poor was 73.8% and 26.3%, respectively. The poor oral health perception is associated with the presence of dental caries in anterior teeth (PR 1.34, 95% CI=1.11-1.63) and bleeding during tooth brushing (PR 1.20, 95% CI=1.04-1.40) Conclusion: Children and adolescents with cerebral palsy who presented lesions of caries in the anterior teeth and gingival bleeding during tooth brushing, more frequently, had poor oral health by their caregivers.

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Abstract Objective: To assess the diagnostic accuracy of Ultrasonography (USG) in diagnosing superficial facial fractures. Material and Methods: Patients visiting our facility with facial trauma and suspected fracture of the facial skeleton, those who had undergone CT scans, and conventional radiographic examinations and those who were conscious and cooperative were included in the study. All conventional radiographs, CT scans and ultrasound examinations were done during 0-20 days after trauma in all the patients Results: A total of 20 patients participated in our study, out of which 18 were male (90%) with a mean age of 34.4 years (range of 19-75 years). Eleven sites of the face were examined bilaterally in each patient, i.e., a total of 440 sites. Of these, 84 sites were found to be fractured according to the CT scan examination whereas conventional radiographs detected 59 and ultrasonography detected 74 fractures (of which 70 were true fractures, while 4 were false-positive results). The sensitivity and specificity of USG in all fracture sites were 83.33% and 98.88% respectively. The positive and negative predictive values were 94.59% and 96.17% respectively Conclusion: Ultrasound examination had a better sensitivity when compared to conventional radiography in detecting superficial facial fractures.

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Abstract Objective: To evaluate the knowledge of students and dental practitioners about dental and biomedical waste disposal and to impart emphasis on important aspects such as eco-friendly waste management. Material and Methods: This questionnaire-based study involved 186 participants which comprised of 5 domains, namely laws regarding biomedical waste, steps of waste management, categories of dental waste, general hazards of improper waste disposal and certain material/process specific questions Results: Assessment of the first domain showed that only 58.4% of participants were able to correctly identify the Pollution Control Board of India as the regulatory body for the transport of medical waste. The second domain assessment revealed that 55.9% of subjects were adequately aware of the knowledge handling hospital waste. Assessment of the third domain displayed that the majority of the respondents (91.9%) knew categories of dental waste generated. Evaluation of fourth domain exhibited that 89.8% students agreed that biomedical waste management (BWM) must be made a practical exercise in dental schools to reduce “Know-Do gap” between undergraduates and postgraduates and the last domain demonstrated that only 32.3% of the participants knew the environmentally friendly technique to convert organic waste into commercially useful byproducts Conclusion: It was found that postgraduates had a better awareness of the proper methods to dispose of healthcare waste when compared to students and interns. However, the overall level of awareness was less than adequate. The need for special training in BWM in the clinical set up was highlighted through this study.

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Abstract Objective: To determine the relationship between the Serotonin transporter SLC6A4 (5-HTTLPR) gene polymorphism in cheilitis angularis patients. Material and Methods: We conducted a descriptive analysis of 100 DNA samples extracted from the blood serum of 50 patients with cheilitis angularis and 50 patients without cheilitis angularis. Analysis of the Serotonin transporter SLC6A4 (5-HTTLPR) gene polymorphism was observed by carrying out PCR method followed by electrophoresis for the analysis, without the usage of restriction enzyme. The Chi-square test was used for statistical analysis Results: In the cheilitis angularis group there were 24 samples with SS genotype, 23 samples with LS genotype, and 3 samples with LL genotype. Whereas in the non-cheilitis angularis group, there were 5 samples with SS genotype, 18 samples with LS genotype, and 27 samples with LL genotype. In the cheilitis angularis group found 71 S alleles and 29 L alleles, and in the non-cheilitis angularis group 28 S alleles and 72 L alleles were found. A statistically significant difference was found between the groups (p<0.001) Conclusion: There were significant differences in the distribution of the Serotonin transporter SLC6A4 (5-HTTLPR) gene polymorphism between patients with and without cheilitis angularis.

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Abstract Objective: To determine the oral health status along with the treatment need among Arabian children with special health care needs. Material and Methods: Fifty-seven special health care needs children aged 17 or younger, studying at RAK-RCD were recruited for the study. In addition to demographic data, the subjects were screened for the type of disability, oral health status, dental caries, occlusion abnormalities, and type of treatment required. Dental caries was recorded according to the WHO oral health survey criteria and methods. Oral hygiene status was recorded as good, fair, or poor according to the Simplified Oral Hygiene Index (S-OHI). Occlusion anomalies were categorized using Angle's classification of occlusion Results: Fifty-four subjects aged 3-17year old, comprising 70.4% males and 29.6% females participated in the study. There were 7 (13%) subjects in the 3-5 years age group, 23 (42.6%) in the 6-10 years age group, and 24 (44.4%) in the 11-17 years age group. Twenty-two (26%) subjects had Down Syndrome (DS), 14 (25.9%) Mental Disability, 9 (16.7%) Autism, 5 (9.3%) deafness and hearing loss and 4 (7.4%) multiple disabilities. Forty-six (85.2%) had dental caries with a mean dmft/DMFT score of (5.67± 4.69). Only eight (14.8%) were caries-free. Thirty-five (64.8%) had good oral hygiene, 25.9% fair oral hygiene and 9.3% poor oral hygiene, with statically insignificant differences across gender (p=0.43), age groups (p=0.11). Nevertheless, there was a significant difference between oral hygiene and the types of disabilities (p=0.0004). Up to 41% of the subjects required oral prophylaxis, 89% restorations, 13% extractions, 20% orthodontic treatment, and 11% dental prosthesis Conclusion: There was a high prevalence of dental caries and periodontal diseases among the subjects. The study highly recommends the education of the children’s parents and caregivers on the need for diet modification, meticulous oral hygiene, and regular dental visits. Furthermore, there is a great deal of oral health program the RAK Rehabilitation Center for Disabled need to achieve.

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Abstract Objective: To examine the prevalence of congenital absence of permanent teeth other than third molar teeth in non-syndromic children in the Black Sea and Mediterranean Regions of Turkey, and the correlation between gender and distribution sites in the jaws. Material and Methods: Panoramic radiographs and clinical records of 9831 children (5025 girls, 4806 boys) in the Mediterranean Region and 11372 children (5540 girls, 5832 boys) in the Black Sea region were examined. All panoramic radiographs were evaluated by a dentist. The permanent tooth, which was not seen in radiography, was recorded as a congenitally missing tooth, and the fact that the tooth was not extracted was confirmed by treatment records. The data were statistically evaluated by Chi-Square and t-test Results: The prevalence of congenitally missing permanent teeth was 2.8% (3.52% in girls, 2.5% in boys) in the Mediterranean region and 1.63% (1.82% in girls and 1.45% in boys) in the Black Sea region. Congenitally missing permanent teeth were observed more in the maxilla compared to mandible. The teeth that most frequently have congenitally missing permanent teeth in the Mediterranean Region are mandibular second premolars, maxillary lateral incisors and maxillary second premolars, respectively. The teeth that most frequently have congenitally missing permanent teeth in the Black Sea region are mandibular second premolars, maxillary second premolars and maxillary lateral incisors, respectively. Most of the patients had one or two teeth missing, and the lack of three or more teeth was rare Conclusion: In this study, which is performed in different climatic characteristics of Black Sea and Mediterranean Regions, the frequency of congenitally missing teeth is similar.

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Abstract Objective: To analyze osteopontin mRNA expression levels in subjects with periodontitis prior to (baseline) and 7, 14, and 28 days following scaling and root planing (SRP). Material and Methods: Gingival crevicular fluid was collected as clinical samples from four subjects with periodontitis (pocket depth, 4-5 mm) aged 35-54 years old as well as from three healthy subjects (controls). The osteopontin mRNA expression levels were measured by quantitative real-time polymerase chain reaction. Spearman’s rank correlation between osteopontin levels in gingival crevicular fluid and the modified gingival index (MGI) was also performed Results: The Wilcoxon signed-rank test showed no significant difference in osteopontin mRNA expression levels between baseline and 28 days following SRP (p=0.068). The Friedman test showed no significant difference in osteopontin mRNA expression levels between baseline and following SRP (7, 14, or 28 days) (p>0.05). Spearman’s rank correlation showed no significant correlation between osteopontin mRNA expression levels and MGI (r=0.087; p=0.749) Conclusion: Following SRP of periodontal tissue, there was a decreasing trend in osteopontin mRNA expression; however, this finding was not statistically significant. Nevertheless, osteopontin can be used as a biomarker to monitor the healing process; however, further studies are required to clarify our results.

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Abstract Objective: To determine the skeletal and dental components in patients with facial asymmetry treated at the orthodontic specialist clinic of the Faculty of Dentistry, Universitas Indonesia. Material and Methods: This was a descriptive study using secondary data from the tracing of postero-anterior cephalograms of patients aged >14 years 4.2 months for males and >11 years 6.2 months for females using the Grummons analysis. A total of 46 patients were selected through purposive sampling. Data were analyzed using descriptive statistics Results: The proportions of asymmetric direction based on the deviation of the mandibular menton, maxillary midline, and mandibular midline tending to the left and the right sides of the face were 58.7% and 41.3%, respectively. The skeletal component found in the vertical direction showed a greater mean value difference than that observed in the transverse direction. The mean value difference was greater in the midline of the mandibular teeth than in the maxillary teeth Conclusion: Facial asymmetry tended more towards the left side of the face than the right side. Moreover, the skeletal component was greater in the vertical direction than the transverse direction. In the transverse direction, it was shown that the left side of the face was larger than the right side. In addition, dental asymmetry was more commonly observed in the midline of the mandibular teeth than the maxillary teeth.

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Abstract Objective: To investigate the regeneration of rat’s salivary gland diabetic defect after intraglandular transplantation of Human Dental Pulp Stem Cells (HDPSCs) on acinar cell vacuolization and Interleukin-10 (IL-10). Material and Methods: HDPSCs isolated from the dental pulp of first premolars #34. HDPSCs from the 3rd passage was characterized by immunocytochemistry of CD73, CD90, CD105 and CD45. Twenty-four male Wistar rats, 3-month-old, 250-300 grams induced with Streptozotocin 30 mg/kg body weight to create diabetes mellitus (DM) divided into 4 groups (n=6); positive control group on Day-7; positive control group on Day-14; treatment group Day-7 (DM+5.105HDPSCs); treatment group on Day-14. On Day-7 and Day-14, rats were sacrificed. Histopathological examination performed to analyze acinar cells vacuolization while Enzyme-linked Immunoabsorbent Assay to measure IL-10 serum level. Data obtained were analyzed statistically using multiple comparisons Bonferroni test, Kruskal Wallis, Shapiro-Wilk and Levene’s test result Results: The highest acinar cell vacuolization found in control group Day 14 (0.239 ± 0.132), meanwhile the lowest acinar cell vacuolization found in treatment group Day 7 (0.019 ± 0.035) with significant difference (p=0.003). The highest IL-10 serum level found in treatment group Day 14 (175.583 ± 120.075) with significant difference (p=0.001) Conclusion: Transplantation of HDPSC was able to regenerate submandibular salivary gland defects in diabetic rats by decreasing acinar cell vacuolization and slightly increase IL-10 serum level.

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Abstract Objective: To perform chemical analysis and to evaluate the anti-biofilm and hemolytic effect of the essential oil of Cymbopogon citratus. Material and Methods: Gaseous chromatography coupled to mass spectrometer was performed for chemical characterization of the essential oil. To verify the antimicrobial action, the Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and Minimum Fungicidal Concentration (MFC) were determined. From MIC, MBC and MFC data, concentrations were established to verify the anti-biofilm effect and for the hemolysis test on human erythrocytes. A multispecies biofilm was developed in vitro and mouthwash applications were simulated to determine the inhibition of biofilm formation or its removal. Results were analyzed through ANOVA statistical test, complemented by the Tukey test, considering a significance level of 5% Results: The major component of the essential oil is citral. MIC verified for Streptococcus mutans was 1mg / mL, while for Candida albicans, it was 125 μg/mL, presenting microbicidal effect for both microorganisms tested. The essential oil was able to inhibit biofilm formation (p<0.001), presenting non-toxic hemolysis percentage in concentration below 500 μg/mL Conclusion: The essential oil of Cymbopogon citratus is antimicrobial, antibiofilm and non-toxic to human erythrocytes, representing a natural product with potential for use in Dentistry.

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Abstract Objective: To analyze the differences in the pain thresholds of the masseter and temporalis muscles before and after chewing at the 5th and 10th minutes. Material and Methods: In this cross-sectional study, the pain thresholds of the muscles in both sides of 43 non-TMD subjects were measured using a digital algometer before and after chewing the bubble gum Xylitol for 5 and 10 min. The values of the muscles before and after mastication at the 5th and 10th were analyzed using Repeated ANOVA. A difference in the values between the left and right sides of the muscles were analyzed using independent t-test, and among the age groups using one-way ANOVA. Results: Average pain threshold values were 1.76 and 1.93 KgF/cm2 for the masseter and temporalis muscles. ANOVA tests indicated significant differences in the values of the muscles before and after mastication at the 5th and 10th min (p=0.000 vs. p<0.001). The differences in the values between the left and right sides of the muscles (p>0.05) and among the age groups (p>0.05) showed no significant difference. However, the values between temporalis and masseter and the values between men and women for each session revealed a significant difference (p<0.05) Conclusion: The masseter and temporalis pain threshold values were reduced 10 min after chewing. The values in both sides of the masseter and temporalis muscles and in different age groups were the same. The temporal muscle and men showed a higher pain threshold than the masseter muscle and women, respectively.

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Abstract Objective: To evaluate saliva quantity and content parameters among children of 7 and 12 years old, who permanently living on the territory of Subcarpathia with the registered territory-associated fluoride deficiency in the water, and their association with the caries status of pediatric patients. Material and Methods: The study sample was formed of 48 children (22 of 7 years old and 26 of 12 years old). The content of calcium in the oral liquid was determined by the o-cresolphthalein complexone method. Estimation of concentration rate and fluoride activity in the oral liquid was carried out by using the ion-selective electrode ELIS-131 F and ionometer EV-74. The content of inorganic phosphorus in saliva was determined using the phosphorus reaction with molybdic acid Results: Among all study samples, 18.8% were registered with low caries intensity level (DMF = 1.55 ± 0.16), 33.3% with moderate caries intensity level (DMF = 3.94 ± 0.29), and 47.9% with high caries intensity level (DMF = 9.05 ± 1.11). During the comparison of calcium content and mineralization coefficient values between children with low and high caries intensity levels registered difference was statistically significant (p<0.05), while for salivary flow rate parameter such difference was no significant (p>0.05). Between children with normal salivary flow rate, and children with a lowered salivary flow rate there was no statistical difference in such parameters as fluoride concentration, calcium content, phosphorus content and calcium-phosphorus balance (p>0.05) Conclusion: Caries intensity levels were more statistically associated with parameters of calcium content in saliva and related mineralization coefficient, rather than with the average salivary flow rate.

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Abstract Objective: To evaluate the reliability and validity of the Next Engine 3D Laser scanner. Material and Methods: A total of 30 dental casts of unilateral cleft lip and palate (UCLP) children with 90 linear variables were measured using digital caliper while the laser-scanned 3D dental casts (LS3DM) were measured using Mimics Software. All scanned data coordinates (in x, y, z) were transferred into Mimics software in STL format to be measured. All the variables were measured using a computer mouse accurate to 0.5 mm. The intra-class correlation coefficient (ICC) was used to evaluate the intra- and inter-examiner reliabilities and also for the validity of two methods Results: Intra-examiner reliabilities of digital caliper and LS3DM were found excellent (ICC 0.916-0.995) and inter-examiner reliabilities of LS3DM were good to excellent (ICC 0.816-0.990). The validity of LS3DM measurements was confirmed based on the ICC values were in the range of 0.913-0.996. The overall time frame for conducting measurements was shorter using a laser-scanned model (10 min.) than using a digital caliper (5 hours) Conclusion: The LS3DM is a valid reliable tool for future high impact research in our institution.

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Abstract Objective: To evaluate the differences in the stress distribution on the upper first molar with and without transpalatal arch and a second molar when a 150 g force is applied during canine distalization using finite element analysis. Material and Methods: We constructed several models with data obtained by scanning human skulls using cone beam computed tomography. A robust three-dimensional maxillary model was then constructed by assembling the previously completed robust models of the maxilla and second molar with and without transpalatal arch, and canine distalization was simulated using a 150 g force. The data consisted of color spectrum figures representing the stress distribution Results: For the upper first molar and its alveolar bone, there was a statistically significant difference in the stress distribution between the upper first molar with transpalatal arch, the upper first molar without transpalatal arch, and the upper first molar with transpalatal arch and a second molar as reinforcement Conclusion: Stress distribution on the first molar and alveolar bone, indicated by the maximum and minimum principal stress, as well as the pressure von Mises, exhibited a similar pattern. The highest amount of stress was observed in the model of the first molar without transpalatal arch, followed by the model of the first molar with transpalatal arch and, finally, the model of the first molar with transpalatal arch and a second molar.

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Abstract Objective: To evaluate the relationship between the feeding method and early childhood caries (ECC) in children aged 3-5 years. Material and Methods: An observational study using a cross-sectional approach and convenience sampling method was performed on 165 children aged 36–71 months from eight kindergartens in Grogol Utara, Indonesia. Data on feeding and oral hygiene behavior patterns were obtained through interviews using a structured questionnaire, and an oral examination was performed to collect information on oral health using the decayed, extracted, filled surface and plaque indices. The oral examination was performed by two examiners who were calibrated for intra- and interobserver reliability (Kappa = 0.9) Results: The prevalence of dental caries was 83%, with mean values of decayed, extracted, filled teeth (deft) and of defs being 6.2 and 14.8, respectively. The prevalence of children with anterior dental caries was higher than that of children with posterior-only dental caries. The most severely affected teeth were maxillary central incisors (right = 62.4%; left = 61.2%), followed by maxillary lateral incisors (right = 49.1%; left = 44.2%). The caries pattern was almost symmetrical across the arches. There were significant differences between breastfeeding methods with anterior (p<0.05), but not with posterior dental caries. The complementary feeding initiation age was significantly different between anterior and posterior teeth caries groups (p<0.05), but complementary food type after tooth eruption and infant formula frequency were related only to anterior dental caries (p<0.05) Conclusion: The patterns of breastfeeding and complementary feeding were related to dental caries in anterior and posterior teeth. The feeding method that increases the ECC score in anterior and posterior teeth was the age at initiation of complementary feeding.

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Abstract Objective: To analyze the differences in periodontal severity between perimenopausal and postmenopausal women with chronic periodontitis. Material and Methods: A cross-sectional study with 63 subjects, comprising 27 perimenopausal and 36 postmenopausal women, aged 45–59 years, was conducted in East Jakarta. The women were interviewed regarding their perimenopausal and postmenopausal status; they underwent a periodontal examination for periodontal pockets, attachment loss, gingival recession, plaque index, debris index, calculus index, oral hygiene index, papilla bleeding index, and tooth mobility. Independent T-test and Mann-Whitney U test were used for bivariate analysis Results: There were significant differences (p<0.05) in age between perimenopausal and postmenopausal women (p=0.01); however, no significant differences (p>0.05) in gingival recession (p=0.33) or tooth mobility (p=0.84) were observed. Independent t-test revealed no significant differences in pocket depth (p=0.95), attachment loss (p=0.71), plaque index (p=0.89), debris index (p=0.52), calculus index (p=0.46), oral hygiene index (p=0.48), or papilla bleeding index (p=0.63) between perimenopausal and postmenopausal women Conclusion: There was no difference in periodontal severity between perimenopausal and postmenopausal women; however, the current study obtained valuable information regarding periodontal severity in perimenopausal and postmenopausal women.

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Abstract Objective: To analyze the correlation between palatal depth and duration of the upper airway obstruction since diagnosis among children with habitual mouth breathing. Material and Methods: This cross-sectional analytical study was conducted using the consecutive sampling method on boys and girls who were habitual mouth breathers and presented with allergic rhinitis, adenoid hypertrophy, obstructive sleep apnea, rhinosinusitis, and nasal polyp. Information about the duration of upper airway obstruction was obtained from the medical records of the patients. The patients divided into two groups: those diagnosed with upper airway obstruction for < 4 years, and those diagnosed with upper airway obstruction for > 4 years. Hard palate measurements were obtained from upper arch study models using a caliper with a precision of ± 0,1 mm Results: A strong positive correlation was noted between the duration of the upper airway obstruction since diagnosis and palatal depth in children (r=0.623; p<0.05). Furthermore, the depth of the palates was found to be greater than 40 mm when the duration of upper airway obstruction since diagnosis was more than four years Conclusion: The finding of this study indicates that upper airway obstruction can result in high palates in children with habitual mouth breathing.

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Abstract Objective: To evaluate the oral hygiene status of children with Down syndrome using the busy book Ayo Sikat Gigi as an educational toy. Material and Methods: We ran an experimental study involving 25 educable and trainable children with Down syndrome, comprising 17 males and 8 females aged 7–12 years, who were free from other disabilities and did not use orthodontic or prosthodontic appliances. Parents were instructed to educate their children using the busy book Ayo Sikat Gigi and also to guide their children in brushing their teeth effectively at home. We evaluated the OHI-S score over two visits, one before and the other after education using the busy book Ayo Sikat Gigi over a 7 day period. The Wilcoxon test with the p-value set at 0.05 was used Results: It was noted a statistically significant decrease in the OHI-S scores of children with Down syndrome (p<0.05), reflecting an improvement in their dental health, after education using the busy book Ayo Sikat Gigi (median scores before and after education: 2.30 and 1.84, respectively) Conclusion: The busy book Ayo Sikat Gigi is a highly effective educational toy for children with Down syndrome, and in our study, it was demonstrated to decrease their OHI-S scores after education for 7 days.

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Abstract Objective: To examine the IFN-γ levels in patients with periodontitis and determine the difference in the levels of IFN-γ with the severity of the disease. Material and Methods: The study design was cross-sectional, and the sample consisted of 31 patients, aged between 18 and 64 years. Plaque index (PlI), calculus index (CI), and papillary bleeding index (PBI) were measured. Pocket depth (PD), recession, and clinical attachment loss (CAL) (mm) were measured at six sites per teeth. For mild/moderate periodontitis, pocket depth ≥4 mm in 1–3 sites was required, while the essential criteria for severe periodontitis were pocket depth ≥5 mm, clinical attachment loss >3 mm in more than 3 sites ≥2 quadrants. The IFN-γ levels were measured by performing enzyme-linked immunosorbent assay with the gingival crevicular fluid (GCF) samples. The measurements were made in two different sites, and the severity of periodontitis was categorized based on the pocket depth, attachment loss, and the remaining natural teeth. Kruskal-Wallis test, Mann-Whitney test, and Spearman’s rank correlation coefficient were Results: The levels of IFN-γ (pg/mL) were correlated with the severity of the periodontal status, with p <0.05. Clinical parameters of periodontitis also correlated with the level of IFN-γ (pg/mL) Conclusion: Subjects with periodontitis presented greater levels of IFN-γ (pg/mL) in GCF than the periodontal healthy individuals. This result showed the role of IFN-γ in the inflammation.

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Abstract Objective: To assess the relationships of socio-demography, self-reported oral health status, and behaviour with oral health literacy (OHL) among adults. Material and Methods: A cross-sectional study was conducted during a mega carnival in Kuala Lumpur. Socio-demographic, oral health status, and oral health behaviour data were obtained using a questionnaire, and OHL was determined by a validated Malay version of the 14 items Health Literacy in Dentistry Scale (HeLD-14). A total of 165 data of participating adults were tested using Pearson’s correlation, Independent t-test and One-way ANOVA with a significance level set at p<0.05 Results: The mean age of participants was 30.4 years (S.D. 9.7 years). Malay HeLD-14 scores were higher among those who were from better socio-economic class (household income within the top 20% of the population) (p<0.005) those with good self-reported oral health status (good oral health status, no active caries) (p<0.005) and those with good oral health behaviours (brushed daily, flossed daily, does not vape) (p<0.05) Conclusion: Household income, self-reported oral health status, and behaviours were significantly associated with oral health literacy. Therefore, oral health literacy assessment is vital to help tailor appropriate oral health education and care.

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Abstract Objective: To compare the antibacterial efficacy of Cuminum cyminum (cumin) extract and 2% chlorhexidine. Material and Methods: E. faecalis was isolated from non-vital teeth with chronic apical abscess. Samples were then bred in the ChromAgar medium. Subsequently, E. faecalis bacteria’s DNA extraction was performed. DNA was then amplified by conventional PCR, and the product was run on an electrophoresis gel. Subsequently, we extracted Cuminumcyminum seeds using the steam distillation technique. The extract was diluted at various concentrations: 0.2, 0.5, 0.7, 1.0, and 1.2 mg/mL.The extract’s antibacterial effect was evaluated using an ELISA reader with optical density. Specifically, we assessed the turbidity of E. faecalis in biofilms following immersion in antibacterial agents Results: In the clinically isolated E. faecalis group, the OD values of 0.7 and 1.0 mg/mL cumin extracts were significantly different from that of 0.2 mg/mL cumin extract. A significant difference was also observed between the OD values of 1.0 mg/mL cumin extract and 2% CHX (p<0.05) Conclusion: The antibacterial effect of 1.0 mg/mL Cuminum cyminum extract had higher efficiency than 2% chlorhexidine against E. faecalis biofilms from clinical isolates.

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Abstract Objective: To analyze the efficacy of retraction cord with a hemostatic agent in comparison with retraction paste on lateral gingival displacement, to achieve the success of fixed dental prostheses (FDP). Material and Methods: Test samples included 32 teeth that required treatment with metal-porcelain FDP at RSKGM FKG Universitas Indonesia. Impressions were taken before the gingival retraction procedure. From the 32 samples, 16 teeth were retracted using a combination of retraction cord and hemostatic agent, whereas the other half were retracted with retraction paste. Impressions were then taken. The sample was made using cutting die. Lateral gingival displacement width was measured on die-cast using an optical microscope Results: The mean value of group A before gingival retraction was 0.1695 mm, and after gingival retraction was 0.4705 mm. The mean value of group B before gingival retraction was 0.1767 mm, and after gingival retraction was 0.3289 mm. Lateral gingival displacement width between a combination of cord retraction and hemostatic agent group in comparison with the retraction paste group showed a significant difference (p<0.001). The combination of cord retraction and hemostatic agent group showed higher mean value Conclusion: Gingival displacement width as a result of cord retraction with the hemostatic agent was larger compared to the retraction paste. Even though both of them are still considered to be effective in providing access for impression material.

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Abstract Objective: To examine the relationship between the level of glycemic control and coated tongue in type 2 diabetes mellitus patients with xerostomia. Material and Methods: This study was an analytical survey and involved 64 type 2 diabetes mellitus patients, aged between 17 to 65 years old with 34 males and 30 females. Diagnosis of diabetes mellitus was determined from the patient's medical records. The level of glycemic control was obtained from the patient’s last blood sugar examination. Xerostomia was diagnosed with a questionnaire, while coated tongue diagnosis based on clinical features and the severity of coated tongue was assessed using the Kojima index Results: There was a significant relationship between the level of glycemic control and coated tongue (p=0.0026) in type 2 diabetes mellitus patients with xerostomia. Moreover, there was a significant relationship between the level of glycemic control and the severity of the coated tongue (p=0.001). Specifically, poor glycemic control was associated with a higher occurrence of the coated tongue as well as more severe tongue coating Conclusion: There was a significant relationship between the level of glycemic control in and coated tongue in type 2 diabetes mellitus patients with xerostomia. Therefore, diabetes mellitus patients should control their level of glycemic control to prevent the oral complication of the disease.

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Abstract Objective: To evaluate the relationship between the mRNA transcription level of Matrix Metalloproteinase-9 (MMP-9) and the selected clinical periodontal healing at one month of scaling and root planing. Material and Methods: A total of six chronic periodontitis patients and one periodontally healthy subject were recruited. The gingival crevicular fluid was collected from all subjects, and the expression level of MMP-9 mRNA was measured by quantitative real-time PCR. Pocket depth, papilla bleeding index, and clinical attachment loss were measured on day 1 at baseline and day 30. Scaling and root planing was performed on day 1. Data were analyzed using SPSS 22.0 software Results: In comparison to the control, periodontal clinical parameters in the treatment group were significantly reduced after scaling and root planing. MMP-9 mRNA expression did not show a significant change after the 30th day. A weak correlation was noted between the MMP-9 mRNA transcription level and the changed PBI measurement Conclusion: Scaling and root planing is clinically effective for chronic periodontitis with a 4-6 mm pocket, whereas the expression of MMP-9 mRNA was not altered. Further studies with a more extended observation period are needed to confirm or reject the present findings.

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Abstract Objective: To evaluate the susceptibility of S. mutans during growth as a biofilm in the presence of different concentrations of propolis. Material and Methods: Three different concentrations of ethanolic extract of propolis (10%, 5%, and 2.5%) were used to evaluate its potential to attenuate the biofilm formation of S. mutans (ATCC 25175) on microplates. A crystal violet staining method was performed to measure the optical density (OD) of the biofilm biomass after 3 h and 18 h time periods. All the experiments were performed in triplicate, and the obtained data were expressed as mean ± standard deviation. A two-tailed Student’s t-test was used to determine the different abilities of biofilm formation between the treated and control groups of the bacteria film in the presence of propolis. A p-value of <0.05 was taken as a significant value Results: The OD levels (determined using an ELISA reader) obtained after growing S. mutans as a biofilm in the presence of propolis were similar (p>0.05) to those of the control (S. mutans grown in tryptic soy broth + 1% sucrose) Conclusion: All the tested concentrations of propolis added to the growth medium did not inhibit the biofilm formation of S. mutans. Since biofilms consist of bacterial cells and extracellular matrices, we hypothesize that the extracellular matrix may have interfered with the antimicrobial properties of the tested propolis.

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Abstract Objective: To determine the possible risk factors for temporomandibular disorders (TMD) among amphetamine users in Indonesia. Material and Methods: This cross-sectional study involved 152 male amphetamine users, aged 18-45 years, who were undergoing rehabilitation. Data were obtained from medical records, questionnaires, and clinical examinations. Data obtained from medical records included age, gender, duration of amphetamine use, duration of rehabilitation, and psychiatric status. Collected data were analyzed using the Chi-square and logistic regression tests to identify correlations between TMD and bruxism, oral habits, tooth wear, duration of amphetamine abused, and duration of rehabilitation Results: TMD was found in 84.2% of amphetamine users, with clicking being the most frequently reported sign (72.4%). Tooth wear (72.4%), oral habits (60.5%), and bruxism (56.6%) were also frequently found. Statistically, a significant association was found between TMD and bruxism (p<0.001), tooth wear (p<0.001), and oral habits (p<0.001). However, there was no association observed between TMD and duration of amphetamine abused (p=0.526), and duration of rehabilitation (p=0.679). Odds ratios produced by logistic regression for tooth wear, oral habits, and bruxism were 6.657, 6.2, and 1.659, respectively Conclusion: Tooth wear, oral habits, and bruxism were identified as risk factors for TMD among amphetamine users in Indonesia.

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Abstract Objective: To determine the expression of TLR4 and MMP8 in gingival crevicular fluid [GCF] in patients with periodontitis. Material and Methods: Clinical samples were collected from 23 gingival crevicular fluid of periodontal disease subjects (n = 14) and healthy periodontal subjects (n=9). Measurement of Clinical parameters of probing pocket depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) were included as diagnostic criteria. Pocket Depth (PD) and CAL were defined as present if the PPD was ≥ 4 mm and the CAL ≥ 1 mm. Expression of TLR4 and MMP8 in the gingival crevicular fluid of deep pockets (PD≥ 6mm), shallow pockets (PD 4-5 mm) and healthy periodontal sulcus (0-3 mm) were evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). Statistical analysis to compare the pocket was using Independent t-test and Mann-Whitney test. Correlation between mRNA expression and clinical parameters was analyzed using Spearman’s correlation test Results: Expression of TLR4 was higher in shallow pockets compared to the control group, but the difference was not statistically significant (p>0.05). The expression of MMP8 was higher in shallow pockets compared to the control group, but the difference was not statistically significant (p>0.05) either. There is no significant correlation between TLR4 and MMP8 with clinical periodontal parameters Conclusion: TLR4 and MMP8 mRNA expression levels should not be used as a clinical biomarker in periodontitis diagnostic tools.

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Abstract Objective: To determine the frequency distribution of gingivitis and oral hygiene in individuals with Down syndrome. Material and Methods: This study used a cross-sectional descriptive method and the subjects were 174 individuals with Down syndrome aged ≥14 years attending type C (intellectual disability) special needs schools in Jakarta. Gingivitis was measured using the gingival index, and oral hygiene was measured using the Simplified Oral Hygiene Index (OHI-S). The measurement of the two components of plaque and calculus was completed on six teeth on different surfaces, including the facial side of three maxillary teeth, the lingual side of the two posterior mandibular teeth, and the labial side of one anterior mandibular tooth. Descriptive statistics were used to calculate the absolute and relative frequencies Results: 3.4% had no gingivitis, 47.2% had mild gingivitis, 40.8% had moderate gingivitis, and 8.6% had severe gingivitis. Regarding oral hygiene, 28.2% had good hygiene, 49.4% had fair, and 22.4% had poor hygiene Conclusion: Individuals with Down syndrome had a frequency distribution of gingivitis mainly in the mild and moderate categories, and a majority of subjects had fair OHI-S.

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Abstract Objective: To analyze the relationships between infant birth weight and maternal mastication ability, caloric intake, and body mass index (BMI) of women with posterior tooth loss. Material and Methods: A cross-sectional study was conducted in 52 females aged 20–35 years who gave birth recently and had one or more unreplaced missing posterior teeth. The number and locations of the missing teeth were grouped on the basis of the Eichner Index. Prepregnancy BMI, caloric intake, and subjective mastication ability were recorded Results: A significant difference was observed in the mean infant birth weights between the subjects with good and poor mastication in Eichner A2 (p<0.001), B1 (p=0.039), and B2 groups (p=0.039), that mean infant birth weight was lower in the group of women with poor mastication. The Pearson correlation test revealed a significant relationship between maternal caloric intake and infant birth weight (p<0.001). Mean infant birth weights differed between BMI categories, i.e., underweight, normal and overweight women subjects (2.59 ± 0.18 Kg, 2.99 ± 0.15 Kg, 3.58 ± 0.30 Kg) (p<0.001). The Kruskal-Wallis test revealed significant differences between the prepregnancy BMIs of pregnant women with posterior tooth loss and infant birth weights (p<0.001) Conclusion: We found that decreased subjective mastication ability in pregnant women who lost posterior teeth was associated with decreased infant birth weight, whereas higher mean caloric intake and higher prepregnancy BMI in pregnant mothers who lost posterior teeth were associated with increased infant birth weight.

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Abstract Objective: To determine the frequency distribution of dental anomalies in people with Down syndrome. Material and Methods: This cross-sectional study was developed in Jakarta, Indonesia, and evaluated 174 individuals with Down syndrome aged 14-53 years. Were collected information regarding the tooth number, tooth size, shape, and structure. Descriptive statistics were used to calculate the absolute and relative frequencies. The Pearson chi-square test was used in bivariate analysis. The significance threshold was set at 5% Results: There were 70 female subjects (40.2%) and 104 male subjects (59.8%) with an average age of 19.2 years. In terms of anomalies of tooth number, hypodontia (80.9%), supernumerary teeth (12.4%), and combined hypodontia and supernumerary teeth (12.4%) were identified. In terms of anomalies of tooth size, microdontia (98.8%) is the most common anomaly. Anomalies of tooth shape included fusion (66.67%) and talon's cusp (33.3%), whereas anomalies of tooth structure included enamel hypoplasia (70.8%), enamel hypocalcification (4.2%), combined enamel hypoplasia and hypocalcification (12.5%), and tooth discoloration (12.5%) Conclusion: Individuals with Down syndrome in Jakarta showed a high prevalence of dental anomalies, with hypodontia and microdontia being the most common anomalies showing a tendency to occur predominantly in males.

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Abstract Objective: To analyze the associations between posterior tooth loss and masticatory performance, nutrition intake, and nutritional status in the elderly. Material and Methods: A total of 158 subjects aged 60 years and older from Depok, West Java, Indonesia were enrolled in this cross-sectional study. Posterior teeth contacts were assessed and the subjects were divided into two groups based on Eichner Index; group A2–B3 and group B4–C3. The masticatory performance test was conducted using color-changeable chewing gum. A semi-quantitative food-frequency questionnaire was used to measure nutritional intake in the form of total calories, and the Mini-Nutritional Assessment-Short Form was used to measure nutritional status. Mann Whitney U test was used to determine differences in masticatory performance, nutrition intake, and nutritional status between the two groups Results: Seventy-four percent of participants were female, and 26% were male. A significant difference in the mean masticatory performance score (p<0.001) was noted between Eichner group A2–B3 (5.66 ± 1.80) and B4–C3 (3.20 ± 1.25). However, no statistically significant difference in nutritional status and calorie intake were found between the two groups (p>0.05) Conclusion: Despite the adequacy of nutrition intake and nutrition status in this population, tooth replacement is necessary to improve masticatory performance in both groups.

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Abstract Objective: To analyze the issue of teeth brushing according to age, gender and length in Slovak patients with multiple sclerosis disease (MS). Material and Methods: In this descriptive study, the questionnaires were collected in neurologists from December 2016 until September 2017. The study sample consisted of 103 MS patients (44.7% of men) in the mean age of 38.4 ± 9.95 years. The study sample of MS patients was divided into two sub-groups. The first sub-group consisted of MS patients who were restricted in teeth brushing (n=56) and the second group of MS patients, which had no restrictions in teeth brushing (n=47). Descriptive statistics were used to calculate the absolute and relative frequencies, mean and standard deviation. A two-sample t-test was used to compare the proportion between sub-groups with restrictions and sub-group no restrictions in teeth brushing. The statistically significant level was determined at p<0.05. Results: The significant higher mean age (40.4 ± 10.8 years) was found in MS patients who had restrictions in teeth brushing (p=0.043). Females described often no restrictions in teeth brushing than males (59.6% vs. 40.4%; p<0.05). Length in MS disease (≤3 years) has a significant impact on patients who were not found restrictions in teeth brushing (31.9%; p=0.037). Conclusion: We recommend an individual doctor approach to MS patients in older age and using of electric toothbrushes in MS patients who have hand functioning restrictions.