Silver nanoparticles (AgNP) have unique properties which help in molecular diagnostics, in therapies, as well as in devices that are used in several medical procedures. AgNP are nanoparticles of silver which are in the range of 1 and 100 nm in size. The major methods used for AgNP synthesis are the physical and chemical methods. The major applications of AgNP in the medical field include diagnostic applications and therapeutic applications. In most of the therapeutic applications, it is the antimicrobial property that is being majorly explored though the anti-viral property has its fair share of applications. This review provides a comprehensive view on the synthesis and applications of nanoparticles in the medical field. The focus is on exploring their various prospective applications besides trying to understand the current scenario.

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Oral cancer is one of the usual causes of mortality all over the world, with a five-year survival rate of only 50%. Oral cancers are treated primarily by surgery with / without adjuvant radiotherapy and / or chemotherapy. However, there is significant post-treatment morbidity and mortality secondary to recurrences. Dietary supplements like fruits and vegetables are rich in phytochemicals and provide a variety of antioxidants like vitamin A, C, E. Spirulina, Selenium, Green tea (EGCG), Neem, Tomatoes (lycopene), Turmeric (curcumin), and some medicinal mushrooms are also used as chemopreventive and chemotherapeutic agents. This overview emphasizes on natural therapies to fight against oral cancer. Thus, there are several natural compounds that can enhance the prevention of oral cancer.

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The concept of conventional tooth-retained overdentures is a simple and cost effective treatment than the implant overdentures. When few firm teeth are present in an otherwise compromised dentition, they can be retained and used as abutments for overdenture fabrication. This helps improve the retention and stability of the final prosthesis significantly. Bone is a dynamic tissue. The extraction of teeth results in the initiation of the bone resorption pattern. However, when tensile stress is received by bone, additional bone formation takes place. Such stresses occur when occlusal forces are transmitted to the alveolar bone by the periodontal ligament. This principle helps preserve bone. The concept of overdentures may not be the elixir, but it is a positive means for delaying the process of complete endentulism and helps in the preservation of bone. To top it all, it gives the patient the satisfaction of having prosthesis with his natural teeth still present. In this article, case reports with three different types of Overdentures are discussed: Overdenture with cast copings with short dowels, O-ring attachments, and a customized bar supported overdenture with copings.

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Introduction: Dental caries and periodontal diseases are multifactorial oral health problems that have dental bacterial plaque as their main etiological agent. Dental plaque removal plays an important role in oral health maintenance, which could be achieved by either mechanical or chemical plaque control. Disclosing agents in dentistry are being used to identify bacterial plaque for instruction, evaluation and research purposes. Hence, the current study is aimed at evaluating the effect of at home use of disclosing agent in improving the quality of daily oral hygiene. Materials and Methods: The present randomized, prospective case-control study was conducted among 100 subjects who were selected from the outpatient department of periodontology and divided into two groups. Group A (n = 50) is the case group who were instructed to use a disclosing agent and Group B (n = 50) is the control group who were not instructed to use a disclosing agent. Plaque status of the subjects was assessed using "Turesky-Gilmore-Glickman Modification of the Quigley Hein Plaque Index" at baseline. Both the groups were trained to perform the similar brushing technique along with same oral hygiene instructions. After 21 days, both groups were recalled, and their plaque status was re-assessed by the same method. The pre and postplaque scores of both the groups were evaluated by unpaired t-test and value of P < 0.05 was considered significant. Results: Preevaluation plaque score of Group A was 2.02 ± 0.24 and postevaluation score was 1.08 ± 0.26. Similarly in Group B, the preevaluation plaque score was 1.80 ± 0.92 and postevaluation score was 1.62 ± 0.48. The difference in the plaque scores was statistically significant with a P = 0.00001. Conclusion: The result shows that usage of plaque disclosing agent improves the quality of daily oral hygiene measures performed at home.

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The periodontal epithelium neighboring the tooth is precise to form a seal and attachment around the tooth. This exclusive function imparts unique challenges to the tissue and leads to certain vulnerabilities allied with periodontal disease, particularly in view of the continual exposure to the bacterial biofilm (dental plaque) that form that is formed on the tooth surface at the junction of the soft tissue. It is obvious that oral epithelial cells can counter unbroken microbial challenges from dental plaque by the production of antimicrobial peptides (AMPs), chemokines and cytokines that boost inflammation and immune response in periodontal tissues. AMPs are early responders of the innate immune system that search and destroy invading pathogens. The large variety of AMPs presumably allows for an effective response to the large variety of microorganisms that invade the mouth and airways. The present paper portrays the association between altered expression of AMPs and some types of periodontitis along with AMPs and their clinical significance in other oral diseases.

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Apexification using calcium hydroxide has many disadvantages, such as, it needs more time for the treatment, chance for fracture of the tooth, and incomplete calcification of the bridge. There are many alternative treatments introduced, which have gained popularity, such as, forming an apical plug using mineral trioxide aggregate (MTA), for excellent results. In cases of wide open apices, it is difficult to limit the restoration to the working length, as such situations lead to the apical extrusion of the material into the periapical region, which prevents further healing. Such conditions can be best treated with the use of a resorbable collagen membrane, which limits the restoration till the working length and prevents the extrusion of the material beyond the apex. The present case reports highlight the non-surgical management of immature teeth by using a membrane as a barrier, with an MTA apical plug, followed by crown rehabilitation.

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Background: Class ll sandwich restorations are routinely performed where conventional Glass ionomer cement (GIC) or Resin-modified GIC (RMGIC) is used as a base or dentin substitute and a light curing composite resin restorative material is used as an enamel substitute. Various authors have evaluated the microleakage of composite resin restorations where glass ionomer cement has been used as a base in class II sandwich restorations, but a literature survey reveals limited studies on the microleakage analysis of similar restorations with biodentine as a dentin substitute, as an alternative to glass ionomer cement. The aim of this study is:

1. To evaluate the marginal sealing efficacy of a new calcium-silicate-based material (Biodentine) as a dentin substitute, at the cervical margins, in posterior class II sandwich restorations.
2. To compare and evaluate the microleakage at the biodentine/composite interface with the microleakage at the resin-modified GIC/composite interface, in posterior class II open sandwich restorations.
3. To compare the efficacy between a water-based etch and rinse adhesive (Scotch bond multipurpose) and an acetone-based etch and rinse adhesive (Prime and bond NT), when bonding biodentine to the composite.
4. To evaluate the enamel, dentin, and interfacial microleakage at the composite and biodentine/RMGIC interfaces.

Materials and Methods: Fifty class II cavities were prepared on the mesial and distal surfaces of 25 extracted human maxillary third molars, which were randomly divided into five groups of ten cavities each: (G1) Biodentine group, (G2) Fuji II LC GIC group, (G3) Biodentine as a base + prime and bond NT + Tetric N-Ceram composite, (G4) Biodentine + scotchbond multi-purpose + Tetric N-Ceram composite, (G5) Fuji II LC as a base + prime and bond NT+ Tetric-N Ceram composite. The samples were then subjected to thermocycling, 2500× (5°C to 55°C), followed by the dye penetration test. Scores are given from 0 to 3 based on the depth of penetration of the dye at the cervical, dentin, and interfacial surfaces. The data was analyzed with the nonparametric Kruskal-Wallis and Mann Whitney U test. Results: No statistically significant differences were found between the five groups in the enamel, dentin, and interfacial regions. Conclusion: Within the limits of this in vitro study, biodentine is a new calcium-silicate-based material, which can be used as a dentin substitute in class II open-sandwich restorations, where its scores better than resin-modified GIC.

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Background: Search for a root-end filling material fulfilling all the ideal characteristics is an ongoing process. The present study aimed to evaluate the marginal seal of the following materials when used as root-end filling materials, MTA Angelus, White ProRoot MTA, Biodentine and Glass ionomer cement (GIC). Materials and Methods: Sixty single-rooted maxillary central incisors were included in the study. The crowns were resected followed by cleaning and shaping with hand files and protaper rotary files followed by obturation of the roots. The root ends were resected at 3 mm level. Then, root-end cavity preparation of 3 mm depth was done using ultrasonic tips. The samples were randomly divided into four groups of 15 each and cavities restored with, such as (1) Group 1: MTA Angelus, (2) Group 2: ProRoot MTA, (3) Group 3: Biodentine, and (4) Group 4: GIC. The root samples were coated with two coats of nail varnish and immersed in methylene blue dye 2% for 48 h. Longitudinal root resection was done. The depth of dye penetration was evaluated under the stereomicroscope to examine the extent of microleakage. The amount of dye penetration was measured in millimeters. The results were then statistically analyzed using one-way analysis of variance and post-hoc Tukey's test. Conclusion: Microleakage was present in all the samples. Least amount of apical dye microleakage was seen in biodentine with mean value of 0.16 mm followed by ProRoot MTA 0.68 mm, MTA Angelus 0.74 mm, and GIC 1.53 mm. The best sealing ability was seen in biodentine, and this difference was statistically significant.

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Objective: The objective of the study was to assess and compare the oral health knowledge, attitude, and behavior of medical, pharmacy, and nursing students at the University of Port Harcourt, Nigeria. Subjects and Methods: A total of 189 students including 94 males and 95 females involved in the cross-sectional surveyed. Data were collected using pretested, self-administered, structured questionnaire. The mean percentage scores, standard deviation, and frequency distribution were calculated. The Student's t-test and ANOVA test were used to test the association between variables. The linear regression analysis was used to establish any association of behavior with knowledge and attitude. Results: The total mean percentage scores for knowledge, attitude, and behavior were more than 50% among the students. The mean percentage scores for knowledge, attitude, and behavior were significantly higher for the medical students compared to pharmacy and nursing students. All the scores were significantly higher in females than in males except for the mean score of knowledge. There was no significant association between knowledge, attitude, and behavior with age. Linear regression analysis showed a significant linear relationship between behavior and attitude, but there was no significant linear relation between behavior and knowledge. Conclusion: The present study indicates that although the mean scores for knowledge, attitude, and behavior were more than 50% among the participants, the students' oral health knowledge, attitude, and behavior was inadequate and needs to be improved upon. The study also revealed that attitude is a determinant of oral health behavior among the students.

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Neopterin is a catabolic product of guanosine triphosphate, a purine nucleotide and belongs to the group pteridines. When the cytokine interferon gamma stimulates the human macrophages, they synthesize the neopterin. It is an indicative of a pro-inflammatory immune status and hence serves as a cellular immune system marker. In most of the diseases, in which the cellular immune system is involved, we find that the neopterin concentrations are usually high. In the periodontal diseases, the levels of neopterin usually fluctuate which is proved by its increase in disease progression and a decrease after treatment. Periodontal diseases are characterized by enhanced macrophage infiltration to the periodontal lesion, so neopterin being a macrophage activation marker may be seen in higher levels. This review deals with neopterin and its mechanism and its use as a marker in the diagnosis of the periodontal diseases.

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Bone resorption is a natural phenomenon and can occur due to old age, loss of teeth, prolonged denture wear, or as a result of systemic conditions. For the replacement of teeth by fabrication of prosthesis or the use of implants, a minimum amount of bone density is required. Bone grafting is a method by which bone-deficient areas are built up, with the use of different materials, such as autografts, allografts, alloplasts, and xenografts. Over recent times, the use of frozen bone matrix formulations and synthetic ceramics has been used in greater frequency. This article discusses the use of human bone material (allografts), synthetic materials (alloplasts) and blood components as successful grafting materials. Their use has shown an effective amount of bone formation and proliferation in the defective sites and proves to be a beneficial choice in bringing back lost bone.

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The Egyptians called Aloe the "plant of immortality" because it can live and even bloom without soil. Aloe vera is well-known for its marvelous medicinal properties. These plants are one of the richest sources of health for human beings coming from nature. It has been grown as an ornamental plant widely. Products of the plant are used in the treatment of various ailments. A. vera is gaining popularity in dentistry as it is completely natural and there are no side effects being reported with its use. This paper gives an overview of the uses of this miracle plant and its uses in dentistry. A. vera has been used in dentistry for its wound-healing effects, gingivitis, plaque control, and curing oral mucosal lesions. A. vera may also reduce the pain and duration of oral ulcers while speeding healing. The dentists should use A. vera at a level high enough to maximize its therapeutic benefit.

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Malignant melanoma is a rare tumor arising from the uncontrolled growth of melanocytes found in the basal layer of the epithelium. Although cutaneous malignant melanoma is the third most common malignancy of the skin, it accounts only for 3-5% of all dermal malignancies. Primary malignant melanoma of the oral mucosa is extremely rare, accounting for only 0.2-8% of all malignant melanomas. The incidence is slightly higher in males while others report a higher incidence in females. In the oral cavity, 80% of the cases occur in the maxilla with the prevalence of the hard palate or combined with the gingival or alveolar ridge. In this paper, we present a rare case of a 47-year-old female patient who reported with completely asymptomatic, pigmented growth in the maxillary anterior region.

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Oral submucous fibrosis (OSMF) is a precancerous condition. It causes difficulty in swallowing, chewing and speaking due to the presence of microstomia. Limited mouth opening is considered as a hindrance in prosthodontic rehabilitation of a patient. Special impression procedures and techniques should be considered for making an impression in such cases. This article describes the fabrication of a split impression tray to make a secondary impression of an edentulous patient having OSMF.

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Objectives: To evaluate the knowledge and practices of general medical practitioners (GMPs) in Lagos on screening for oral cancer (OC). Materials and Methods: A 43-item self-administered questionnaires was filled by each GMPs recruited into the study. Analysis was done using the SPSS version 17.5. Descriptive analyses were used and results were presented in percentages, graphs, and tables. Results: One-hundred and twenty GMPs participated in the study, 58.7% were males and 41.3% females; their ages ranged 22-61 years (36.1 ΁ 7.97). While most participants answered correctly that smoked tobacco (96.1%), increasing age >45 years (97%), oral sex (99%), and patient with a previous OC (93.7%) were risk factors for OC; there was misinformation on the nonrisk factors as only 5.5%, 7.9%, and 18.9%, respectively, answered correctly that family history of cancer, dental infections, and poor oral hygiene were not identifiable risk factors associated with OC. Furthermore, although majority of subjects (81.1%) identified the floor and the tongue as the most common sites of OC and leukoplakia (75.6%) as a common precursor of OC; only 29.1% identified correctly that OC had one of the worst morbidity and mortality rates of the most common cancers due to late presentation. Only 0.8% of GMPs had a consistent high score in the indexes. Conclusion: The knowledge and practices of GMPs in the Lagos environment on OC needs a lot of improvement for them to become significant in the screening for the disease entity.

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Aim: The aim of the present study is to investigate the role of female reproductive hormones estrogen and progesterone in temporomandibular disorder (TMD) in female patients. Materials and Methods: Serum estrogen and progesterone levels of 200 female participants who had varying grades of TMD were measured by enzyme immunoassay competition method in the luteal phase of menstrual cycle. Results: Mean serum concentration of estrogen was 302.1 ± 3.16 pg/mL, and the mean serum concentration of progesterone was 1.68 ± 38.3 ng/mL. Mean serum levels of estrogen and progesterone increased with increasing severity of TMD. Conclusion: Increased serum levels of estrogen and progesterone with increased grade of severity of TMD suggest role of these hormones as etiological factors for TMD.

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Aim: The aim of this epidemiological study was to assess the prevalence of signs and symptoms of TMDs in Vidarbha population by Fonseca's questionnaire. Materials and Methods: A group of 200 patients were randomly selected from the outpatients attending Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital. Each patient was provided with a questionnaire and points were given accordingly for each question. The sum of points was used to classify participants into TMD free, mild TMD, moderate TMD, and severe TMD. Results: Among all the participants examined sixty participants had no TMD (30%), 110 participants had mild TMD (55%); 28 patients had moderate TMD (14%) and two participants had severe TMD (1%). The reliability of Fonseca's questionnaire was found to be 0.603. Conclusion: The Fonseca questionnaire can be used as effective tool in the prevalence of signs and symptoms of TMDs. Public health services should adopt the questionnaire for screening as it will be obtained in a relatively short period and at low cost covering a wide population.

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Aim: This study aims to examine the Nigerian dental students' permissive tendency to the proposed organized incorporation of stem cells application into undergraduate and postgraduate dental curriculum. Materials and Methods: This cross-sectional study of Nigerian final year dental students was conducted between April and June 2014 using the modified Sede et al. questionnaire on stem cell use in dentistry knowledge and attitude questionnaire as the data collection tool. Results: Of the 110 participants, 63.6% reported awareness of stem cell use in dentistry with their leading information sources as school lecture and internet. Subjective and objective stem cell knowledge assessment revealed inadequate knowledge among the majority of the participants. Subjective knowledge emerged as the significant determinant of objective stem cell knowledge. About a third (32.7%) of the participants reported a positive attitude toward stem cell application and objective stem cell knowledge was the only significant determinant of attitude. The majority (82.7%) of the participants reported a positive permissive tendency to the proposed organized incorporation of stem cells application into undergraduate, and postgraduate dental curriculum and attitude toward stem cell emerged as the only significant determinant. Conclusion: High positive permissive tendency to the proposed organized incorporation of stem cell application into undergraduate and postgraduate dental curriculum was noted among the participants. Increasing stem cell knowledge will improve attitude toward stem cell use which will ultimately increase positive permissive tendency.

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Aim: To compare facial features related to the nose, lips and face between the Caucasian, Asian, and Black ethnicity in the Brazilian population by means of linear measurements and proportion indices obtained from the analysis of three-dimensional (3D) images taken by 3D stereophotogrammetry. Materials and Methods: Thirty healthy subjects, being 10 Caucasians, 10 Blacks and 10 Asians had reference points (landmarks) demarcated on their faces, 3D images were obtained (Vectra M3) and the following measurements were calculated: Facial proportion indices relative to the nose, lips and face. The statistical analysis was performed comparing the ethnic groups (one-way analysis of variance). Results: The Blacks and Asians showed the greatest difference in the face analysis (width, height of the lower face, upper face index and lower face index – P < 0.05). In the comparisons between groups, differences were verified to the mouth width and lower lip vermilion height. In the nose analysis, the biggest differences were obtained for the proportion indices, being that Caucasians versus Asians and Caucasians versus Blacks have showed the largest differences. Conclusion: This study found the presence of some similarities in the proportion indices of nose, lips and face between the ethnic groups of the Brazilian population, as well as some important differences that should be known to guide surgical and forensics procedures, among others.

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Aim: The distribution and severity of oral diseases are significantly influenced by oral hygiene practices. The aim of this study was to assess the oral health practices among secondary school students in Lagos State, Nigeria and investigate the influence of oral hygiene practices on caries experience. Materials and Methods: Questionnaires were administered and dental examinations conducted on 598 schoolchildren aged 11–20 years. The students were recruited from two Local Government Areas of Lagos State. Statistical significance was determined at P < 0.05 using Chi-square tests. Results: Majority of the participants (57.6%) had never visited the dentist. “Lack of pain” (31.1%) and “no reason” (42.5%) were recorded as the reason for not visiting the dentist. While toothbrush alone was used as a cleaning item by 73.9% of the students, 70.4% used fluoride-containing toothpaste, and 76.9% brush their teeth twice daily. The prevalence of dental caries was 9.7%. Caries prevalence was significantly associated with the use of fluoride-containing toothpaste (P = 0.015) and frequency of cleaning (P = 0.04). Respondents who used fluoride-containing toothpaste were about 2 times less likely to develop dental caries (odd ratio [OR] = 0.425 95% confidence interval [CI]: 0.45–1.32) and those who brush twice or more daily were 2.4 times less likely to develop caries (OR = 0.44 95% CI: 0.20–0.94). Conclusion: The oral health practices of the participants were not satisfactory. Although the prevalence of dental caries was low, it was significantly influenced by frequency of toothbrushing and the use of toothpaste containing fluoride.

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Aim: This study aims to compare the nicotine concentration and pH in commercially available smokeless tobacco (ST) products. Materials and Methods: The pH level and nicotine concentration were determined in five ST products which were obtained from local markets. The pure form of nicotine was used as a standard which was obtained from Sigma-Aldrich Chemicals, Bengaluru. An extract of each product was prepared and the nicotine concentration was determined in triplicates by spectrophotometric method. The estimation of pH was done using digital pH meter. Results: The analysis showed that nicotine concentration was highest in plain tobacco followed by ghutka, khaini, pan masala, and supari, respectively. The pH was highest in khaini followed by pan masala, supari, ghutka, and plain tobacco, respectively. Conclusion: The study results showed that there is a difference in nicotine concentration and pH among ST products. Although other factors could influence the rate of nicotine absorption from ST, manipulating tobacco pH appears to be the primary means by which the speed of nicotine absorption is determined in ST products.

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With the advent of rotary nickel titanium (NiTi) instruments, preparation of curved canals have become easy but chances of instrument separation have increased. Such an instrument separation can cause procedural problems in rendering endodontic therapy. There are various factors that cause separation of rotary NiTi instruments. These factors, various failure mechanisms and impact on the prognosis of instrument separation have to be well understood by the clinician.

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Emblica officinalis (Amla) is widely used in the Indian system of medicine and believed to increase defense against diseases. Amla is called amalaki in Sanskrit. It is one of the oldest oriental medicines mentioned in Ayurveda as potential remedy for assorted ailments. A wide range of phytochemical components present in amla including alkaloids, tannins, and flavonoids have been shown to procure useful biological activities. It is an ingredient of many Ayurvedic medicines and tonics as it removes excessive salivation and internal body heat. Research has been done with amla evaluating its role as an antioxidant. Amla is useful in ulcer prevention, for diabetic patients, and for memory effects. Amla Tonic has a hematinic and lipalytic function useful in scurvy, prevents indigestion, and controls acidity as well as it is a natural source of anti-aging.

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Nonsurgical therapy aims to eliminate both living bacteria in the microbial biofilm and calcified biofilm microorganisms from the tooth surface and adjacent soft tissues. Complete elimination of such pathogenic microorganisms is perhaps over-ambitious. However, a reduction in inflammation of the periodontium due to a lesser bacterial load leads to beneficial clinical changes. In addition, nonsurgical therapy aims to create an environment in which the host can more effectively prevent pathogenic microbial recolonization using personal oral hygiene methods. The concept of critical probing depth was consistently found to be greater for the surgical approach than for the nonsurgical treatment. The various methods used in nonsurgical therapy, such as hand instrumentation, ultrasonic and sonic scalers, and ablative laser therapy.

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The acute-phase response (APR) is a prominent systemic reaction of the organism to local or systemic disturbances in its homeostasis caused by infection, tissue injury, trauma or surgery, or immunological disorders. The tissue macrophage is most commonly regarded as initiating the APR through direct stimulation and secretion of various cell communicating factors. Proinflammatory cytokines and mediators are significantly elevated with gingival inflammation and during the destructive phase of periodontitis. Cytokines appear to play a major role in the clinical symptoms and tissue destruction associated with progressing periodontitis. Many of these cytokines are derived from activated macrophages and can act both locally and distally to amplify cytokine production from other cell types. The host responses to periodontal disease and cardiovascular diseases were reflected by an increase in the acute-phase proteins (serum amyloid A and C-reactive protein).

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