Implant stability plays a critical role for successful osseointegration. Successful osseointegration is a prerequisite for functional dental implants. Continuous monitoring in an objective and qualitative manner is important to determine the status of implant stability. Implant stability is measured at two different stages: Primary and secondary. Primary stability comes from mechanical engagement with cortical bone. Secondary stability is developed from regeneration and remodeling of the bone and tissue around the implant after insertion and affected by the primary stability, bone formation and remodelling. The time of functional loading is dependent upon the implant stability. Historically the gold standard method to evaluate stability were microscopic or histologic analysis, radiographs, however due to invasiveness of these methods and related ethical issues various other methods have been proposed like cutting torque resistance, reverse torque analysis, model analysis etc. It is, therefore, of an utmost importance to be able to access implant stability at various time points and to project a long term prognosis for successful therapy. Therefore this review focuses on the currently available methods for evaluation of implant stability.

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Purpose: The purpose of this study was to evaluate and compare the flexural strength and microhardness of provisional restorative materials fabricated utilizing rapid prototyping (RP), Computer Assisted Designing and Computer Assisted Milling (CAD-CAM) and conventional method. Materials and Methods: Twenty specimens of dimensions 25 mm × 2 mm × 2 mm (ADA-ANSI specification #27) were fabricated each using: (1) Three dimensional (3D) printed light-cured micro-hybrid filled composite by RP resin group, (2) a milled polymethyl methacrylate (CH) using CAD-CAM (CC resin group), and (3) a conventionally fabricated heat activated polymerized CH resin group. Flexural strength and microhardness were measured and values obtained were evaluated. Results: The measured mean flexural strength values (MegaPascals) were 79.54 (RP resin group), 104.20 (CC resin group), and 95.58 (CH resin group). The measured mean microhardness values (Knoop hardness number) were 32.77 (RP resin group), 25.33 (CC resin group), and 27.36 (CH resin group). The analysis of variance (ANOVA) test shows that there is statistically significant difference in the flexural strength values of the three groups (P < 0.05). According to the pairwise comparison of Tukey's honest significant difference (HSD) test, flexural strength values of CC resin group and CH resin group were higher and statistically significant than those of the RP resin group (P < 0.05). However, there was no significant difference between flexural strength values of CC resin and CH resin group (P = 0.64). The difference in microhardness values of the three groups was statistically significant according to ANOVA as well as the intergroup comparison done using the Tukey's HSD (post oc) test (P < 0.05). Conclusions: CC-based CH had the highest flexural strength whereas RP-based 3D printed and light cured micro-hybrid filled composite had the highest microhardness.

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The corrosion of dental biomaterials is a pertinent clinical issue. In spite of the recent innovative metallurgical and technological advances and remarkable progress in the design and development of surgical and dental materials, failures do occur. The present article describes the problem of corrosion in titanium dental implants. The clinical significance of the dental implant corrosion is highlighted and the most common form of corrosion i.e. galvanic corrosion is emphasized both in vitro and in vivo conditions. The article is presented keeping in view of carrying out different studies for indigenous titanium dental implant and indigenous alloys. The Department of Dental Research at Institute of Nuclear Medicine & Allied Sciences has developed indigenous Titanium Dental Implants and Base metal Alloys. The studies carried out have proven their biocompatibility and suitability to be used for oral defects. The aim of the study is to evaluate galvanic corrosion current around indigenously developed Titanium Dental Implant when coupled to a Base metal Alloy.

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Internal derangements of the temporomandibular joint are conditions in which the articular disc has become displaced from its original position the condylar head. Relevant anatomic structures and their functional relationships are briefly discussed. The displacement of the disc can result in numerous presentations, with the most common being disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening). These are described in this article according to the standardized Diagnostic Criteria for Temporomandibular Disorders, as well as the less common posterior disc displacement. Appropriate management usually ranges from patient education and monitoring to splints, physical therapy, and medications. In rare and select cases, surgery may be necessary. However, in for the majority of internal derangements, the prognosis is good, particularly with conservative care.

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Purpose: Clinical success of implant prosthodontics is dependent in part upon the type of implant thread design. The selection of implant thread design plays an important role in the outcome of the treatment. This study was undertaken to evaluate the pattern of stress distribution using a finite element analysis; hence, the area which would be bearing maximum load for a given design would be arrived. Materials and Methods: Three implants with different thread designs, namely V-thread, buttress, and reverse buttress thread designs were considered and dimensions were standardized. The site considered was the mandibular molar region with cortical and trabecular bone assuming to be isotropic and homogeneous. The implant modeling was done with the CATIA software. Vertical loads of 100N were applied. The stresses were calculated as Von Mises stress criterion. Results: Maximum stresses were seen at the cortical bone and were transferred to the implant. Minimum Von Mises stresses were seen with reverse buttress thread design at the cortical bone. The stresses were observed least at the cancellous bone and maximum at the implant. Conclusion: Hence, within the limitations of this study the results obtained can be applied clinically for appropriate selection of implant thread design for a predictable success of implant therapy.

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From the point of view of implant dentistry, this review discusses the development and clinical use of demineralized dentin matrix (DDM) scaffolds, produced from the patient's own extracted teeth, to repair alveolar bone defects. The structure and the organic and inorganic components of DDM are presented to emphasize the similarities with autogenous bone. Studies of DDM properties, such as osteoinductive and osteoconductive functions as well as efficacy and safety, which are mandatory for its use as a bone graft substitute, are also presented. The clinical applications of powder, block, and moldable DDM are discussed, along with future developments that can support growth factor and stem cell delivery.

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Intraoral scanners (IOSs) are used for capturing the direct optical impressions in dentistry. The development of three-dimensional technology and the trend of increasing the use of IOSs in dental office routine lead to the need to assess the accuracy of intraoral digital impressions. The aim of this review was to assess the accuracy of the different IOS and the effect of different variables on the accuracy outcome. An electronic search using PubMed with specific keywords to obtain potential references for review. A search of MEDLINE (PubMed) identified 507 articles. After title and abstract screening, 412 articles were excluded for not meeting the inclusion criteria and discarding duplicate references. Ninety-five articles were followed for full screening; only 24 articles were included in the final analysis. The studies indicated a variable outcome of the different IOS systems. While the accuracy of IOS systems appears to be promising and comparable to conventional methods, they are still vulnerable to inaccuracies.

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Purpose: To determine the efficacy of hard, liquid, and soft splints in the management of myofascial pain dysfunction syndrome. Materials and Methods: In this randomized clinical trial, 45 patients with myofascial pain were diagnosed and were randomly assigned into three groups of 15 patients each. Group 1 - subjects were given hard splint, Group 2 - soft splint, and Group 3 - liquid oral splint for 3 months. Subjective pain analysis using Modified Symptom Severity Index (Mod-SSI) and objective pain analysis muscle palpation was performed at 7 days, 1 month, 2 months, and 3 months after splint insertion. The changes in mean pain value by both methods, in all three groups, were analyzed with Tukey test and Kruskal-Wallis H-test, respectively (P < 0.05). Results: Both Mod-SSI and palpation scores showed statistically significant reduction in pain for all three groups at the end of 3 months. However, the hard splints proved to be very effective in a shorter period of time, followed by liquid splints and finally soft splints. Conclusion: The result of this study advocates the use of any one of the three types of the occlusal splints in the therapeutic management of myofascial pain due to temporomandibular disorders.

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Purpose: The purpose of this within-subject crossover clinical trial was to compare and evaluate the chewing efficiency, masticatory bite force, and patient satisfaction with conventional dentures and two implant-retained mandible overdentures after 4 weeks of usage. Method: This within-subject crossover clinical trial was carried out in the Department of Prosthodontics in K.D Dental College and Hospital. A total 15 patients were selected for the study. To report the changes in chewing efficiency by chewing 6gms of peanuts with 40 chewing strokes and comparing the particle size of the chewed material between two implant retained mandibular overdenture with that of conventional denture using micro vu excel gantry type visual measurement machine. To report changes in masticatory bite force after transition of conventional complete denture patient to implant retained overdenture after using the prosthesis for four weeks each and recorded by digital transducer. To assess the patient satisfaction after transition of conventional complete denture patient to implant retained mandibular overdenture with help of OHIP edent patient satisfaction questionnaire. Results: The chewing efficiency for implant retained overdenture increased significantly than that of conventional denture. The particle size decreased to 76.34% for implant supported overdenture than that of conventional denture. The chewing strokes required by conventional denture was 69 strokes and that by implant supported overdenture which was 40 strokes to get the same mean particle size. The patients satisfaction after receiving the implant retained overdenture was significantly higher than that of complete denture. Conclusion: The provision of two mandibular implants significantly improves measures of oral function and better quality of life for edentulous patients.

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Aim: The accuracy of a dental impression is determined by two factors: “trueness” and “precision.” The scanners used in dentistry are relatively new in market, and very few studies have compared the “precision” and “trueness” of intraoral scanner with the extraoral scanner. The aim of this study was to evaluate and compare accuracy of intraoral and extraoral digital impressions. Materials and Methods: Ten dentulous participants (male/female) aged 18–45 years with an asymptomatic endodontically treated mandibular first molars with adjacent teeth present were selected for this study. The prepared test tooth was measured using a digital Vernier caliper to obtain reference datasets. The tooth was then scanned using the intraoral scanner, and the extraoral scans were obtained using the casts made from the impressions. The datasets were divided into four groups and then statistically analyzed. The test tooth preparation was done, and dimples were made using a round diamond point on the bucco-occlusal, mesio-occlusal, disto-occlusal, and linguo-occlusal lines angles, and these were used to obtain reference datasets intraorally using a digital Vernier caliper. The test tooth was then scanned with the IO scanner (CS 3500, Carestream dental) thrice and also impressions were made using addition silicone impression material (3M™ ESPE) and dental casts were poured in Type IV dental stone (Kalrock-Kalabhai Karson India Pvt. Ltd., India) which were later scanned with the EO scanner (LAVA™ Scan ST Design system [3M™ ESPE]) thrice. The Datasets obtained from Intraoral and Extraoral scanner were exported to Dental Wings software and readings were obtained. Repeated measures ANOVA test was used to compare differences between the groups and independent t-test for comparison between the readings of intraoral and extraoral scanner. Least significant difference test was used for comparison between reference datasets with intraoral and extraoral scanner, respectively. A level of statistical significance of P < 0.05 was set. Results: The precision values ranged from 20.7 to 33.35 μm for intraoral scanner and 19.5 to 37 μm for extraoral scanner. The mean deviations for intraoral scanner were 19.6 μm mesiodistally (MD) and 16.4 μm buccolingually (BL) and 24.0 μm MD and 22.5 μm BL for extraoral scanner. The mean values of the intraoral scanner (413 μm) for trueness were closest to the actual measurements (459 μm) than the extraoral scanner (396 μm). Conclusion: The intraoral scanner showed higher “precision” and “trueness” values when compared with the extraoral scanner.

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Background: Following the extraction of a tooth, bone resorption can cause significant problems for a subsequent denture implant and restorative dentistry. Thus, the tooth extraction socket needs to be maintained to reduce the chance of any alveolar ridge bone resorption. Objective: The objective of this study is to determine whether the administration of mangosteen peel extracts (MPEs), combined with demineralized freeze-dried bovine bone xenograft (DFBBX) materials for tooth extraction socket preservation, could potentially reduce inflammation by decreased the expression of nuclear factor κβ (NfKb) and receptor activator of nuclear factor-κβ ligand (RANKL), to inhibit alveolar bone resorption, and increased of bone morphogenetic protein-2 (BMP2) expressions to accelerate alveolar bone regeneration. Materials and Methods: This study consists of several stages. First, a dosage of MPE combined with graft materials was applied to a preserved tooth extraction socket of a Cavia cobaya. Second, the C. cobaya was examined using immune histochemical expression of NfKb, RANKL, BMP2, as well as histology of osteoblasts and osteoclasts. The research was statistically analyzed, using an analysis of variance test and Tukey honest significant difference test. Results: The results of this research were that it was determined that MPEs combined with graft materials on a preserved tooth extraction socket can reduce NfKb, RANK, and osteoclasts also increase of BMP2 and osteoblast. Conclusion: The induction of MPEs and DFBBX is effective in reducing inflammation, lowering osteoclasts, decreasing alveolar bone resorption, and also increasing BMP2 expression and alveolar bone regeneration.

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Primary stability in dental implants is an essential factor for achieving successful osseointegration. Surgical procedure and bone quality are among the most common factors that affect primary stability. It is also crucial to achieve high-insertion torque which is important for obtaining primary stability. Maintaining sufficient bone bulk and density is essential to achieve necessary bone-to-implant contact for obtaining a biomechanically stable implant. A new concept for osteotomy called osseodensification (OD) has been at the forefront of changes in surgical site preparation in implantology. This relatively new concept with universally compatible drills has been proposed to help in better osteotomy preparation, bone densification, and indirect sinus lift and also achieve bone expansion at different sites of varying bone densities. This procedure has also shown improvement in achieving better implant primary stability and better osteotomy than conventional implant drills. A systematic review was undertaken to analyze if OD procedure had any advantages over conventional osteotomy on bone density and primary stability. An electronic database search was conducted in PubMed using keywords such as “OD,” “implant primary stability,” “implant bone density,” and “implant osteotomy.” A total of 195 articles were collected and subjected to screening using inclusion and exclusion criteria. A literature review was done, following which it was seen that the use of versah drills for bone OD resulted in undersized osteotomy compared to conventional drills. It also resulted in improved bone density and increase in percentage bone volume and bone-to-implant contact, thereby improving implant stability.

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Purpose of study : Proper color match of a dental restoration with the adjacent teeth is important not only at the initial stage of giving the restoration but also over a longer period of time. Out of different materials Porcelain has established itself as being color stable and durable but composites are known to be susceptible to discoloration because of internal mechanisms, external contamination and staining. The newer universal composite systems are optimized in terms of composition to minimize internal discoloration but still not much attention is given to resistance to external staining. Procedure : Visual shade matching and color determination being a psychophysical phenomenon suffer from subjective variations in interpretation, therefore the present study was undertaken to evaluate and compare the color stability of a porcelain (Vitadur alpha) and two universal composites (Filtek Z 250 and Tetric Ceram) after exposure to commonly consumed beverages i.e. tea, coffee, coca-cola and distilled water (as control) by using a reflectance spectrophotometer and CIELAB system. Conclusion : T0 he color match of esthetic restorations in the oral cavity is affected by dietary habits

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Aim: This study aimed to compare three different methods used for shade selection, i.e., visual method, spectrophotometer, and digital photography method. Materials and Methods: Fifty participants were selected from the Out Patient Department of Prosthodontics. Presence of the maxillary right central incisor with no history of any restorative or endodontic procedures was the primary inclusion criterion. The shade of the right maxillary central incisor was determined using all the three shade selection procedures, namely, visual, spectrophotometric, and digital photography method for all the selected participants. The shades obtained in the visual method using a shade guide were noted down for further comparisons. The spectrophotometer reported the L*, a*, and b* values along with the actual shade whereas the digital photography method reported only the L*, a*, and b* values. The agreement between the readings obtained by the three different methods was compared and subjected to appropriate statistical analysis. Results: The results showed that when the three methods studied were compared, there was a statistically significant proportion of agreement between spectrophotometric and visual method (P < 0.01) with higher proportion of “yes” (agreement) and between the spectrophotometric and digital photography method (P < 0.01) with higher proportion of “yes” (agreement). Coefficient of agreement (using Kappa coefficient) between spectrophotometric and visual shades revealed a fair agreement. The mean ΔE was 1.69. There was a statistically significant difference between the proportion of ΔE more than and <2, between spectrophotometric and digital photography methods (P < 0.01) with higher proportion of <2 ΔE. Furthermore, percentage of agreement between shades obtained by the visual and spectrophotometric method showed maximum agreement with A1 shade. Conclusion: It was concluded that the digital photography method emerged as a reliable method for shade selection in a clinical setup.

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The transition from naturally occurring materials to the application of synthetic resins in denture construction indicates the extent of development taking place. Research carried out by workers has promoted the foundation of future knowledge and it can be hoped that the unending search for denture base materials with desirable qualities will always continue. This article summarizes the historical background as well as the development of denture base materials.

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Rehabilitation of a partially dentate postmaxillectomy patient using a novel approach is presented in this report. The patient was referred to our practice by the oral and maxillofacial surgery department of the local general hospital for the evaluation and prosthetic treatment planning. He had undergone biopsy for a lesion located in the right quadrant of his maxilla and was scheduled for a hemimaxillectomy for removal of a squamous cell carcinoma. A surgical obturator was prepared for placement at the time of ablative surgery. Following completion of adjuvant radiotherapy and chemotherapy, a digital intraoral impression of the remaining maxilla and mandible was obtained, and a computer-aided design/computer-aided manufacturing obturator removable partial denture utilizing a selective laser melting -produced metal framework was fabricated and delivered to the patient to restore function and esthetics. The need for conventional impression was eliminated leading to a reduction of necessary appointments and more comfort to the patient.

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Background: The increase of requests for implant-supported prosthesis (ISP) with zirconia as infrastructure has attracted a lot of attention due to its esthetics, biocompatibility, and survival rate similar to metallic infrastructure. The aim of this study was to evaluate the influence of two different framework materials on stress distribution over a bone tissue-simulating material. Materials and Methods: Two ISP were modeled and divided into two infrastructure materials: titanium (Ti) and zirconia. Then, these bars were attached to a modeled jaw with polyurethane properties to simulate bone tissue. An axial load of 200 N was applied on a standardized area for both systems. Maximum principal stress (MPS) on solids and microstrain (MS) generated through the jaw were analyzed by finite element analysis. Results: According to MS, both models showed strains on peri-implant region of the penultimate (same side of the load application) and central implants. For MPS, more stress concentration was slightly higher in the left posterior region for Ti's bar. In prosthetic fixation screws, the MPS prevailed strongly in Ti protocol, while for zirconia's bar, the cervical of the penultimate implant was the one that highlighted larger areas of possible damages. Conclusions: The stress generated in all constituents of the system was not significantly influenced by the framework's material. This allows suggesting that in cases without components, the use of a framework in zirconia has biomechanical behavior similar to that of a Ti bar.

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Burning mouth syndrome (BMS) is a chronic pain condition. It has been described by the International Headache Society as "an intra-oral burning or dysesthetic sensation, recurring daily for more than 2 h/day for more than 3 months, without clinically evident causative lesions." BMS is frequently seen in women in the peri-menopausal and menopausal age group in an average female/male ratio of 7:1. The site most commonly affected is the anterior two-thirds of the tongue. The patient may also report taste alterations and oral dryness along with the burning. The etiopathogenesis is complex and is not well-comprehended. The more accepted theories point toward a neuropathic etiology, but the gustatory system has also been implicated in this condition. BMS is frequently mismanaged, partly because it is not well-known among healthcare providers. Diagnosis of BMS is made after other local and systemic causes of burning have been ruled out as then; the oral burning is the disease itself. The management of BMS still remains a challenge. Benzodiazepines have been used in clinical practice as the first-line medication in the pharmacological management of BMS. Nonpharmacological management includes cognitive behavioral therapy and complementary and alternative medicine (CAM). The aim of this review is to familiarize healthcare providers with the diagnosis, pathogenesis, and general characteristics of primary BMS while updating them with the current treatment options to better manage this group of patients.

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Idiopathic condylar resorption (ICR) is a condition with no known cause, which manifests as progressive malocclusion, esthetic changes, and often pain. Cone-beam computed tomography and magnetic resonance imaging are the most valuable imaging methods for diagnosis and tracking, compared to the less complete and more distorted images provided by panoramic radiographs, and the higher radiation of ^99mtechnetium-methylene diphosphonate. ICR has findings that overlap with osteoarthritis, inflammatory arthritis, physiologic resorption/remodeling, congenital disorders affecting the mandible, requiring thorough image analysis, physical examination, and history-taking. Correct diagnosis and determination of whether the ICR is active or inactive are essential when orthodontic or prosthodontic treatment is anticipated as active ICR can undo those treatments. Several treatments for ICR have been reported with the goals of either halting the progression of ICR or correcting the deformities that it caused. These treatments have varying degrees of success and adverse effects, but the rarity of the condition prevents any evidence-based recommendations.

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The eye is a vital organ not only in terms of vision but also being an important component of facial expression. Loss of eye has a crippling effect on the psychology of the patient. Treatment of such cases includes implants and acrylic eye prosthesis. Although implant eye prosthesis has superior outcome, due to economic factors it may not be advisable in all patients. So a custom-made ocular prosthesis is a good alternative. A case of a custom-made ocular acrylic prosthesis is presented here, which had acceptable fit, retention and esthetics.

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Aim of the Study: To evaluate and compare the linear dimensional changes of the three representative polyvinyl siloxane (PVS) impression materials and to compare the accuracy of single mix with double mix impression technique. Methodology: A study mold was prepared according to revised American Dental Association specification number 19 for nonaqueous elastic dental impression materials. Three PVS impression materials selected were Elite-HD, Imprint^™ II Garant, Aquasil Ultra Heavy. Two impression techniques used were single mix and double mix impression technique. A total of 60 specimens were made and after 24 h the specimens were measured using profile projector. Statistical Analysis: The data were analyzed using one-way analyses of variance analysis and significant differences were separated using Student's Newman-Keul's test. Results: When all the three study group impression materials were compared for double mix technique, the statistically significant difference was found only between Imprint^™ II Garantand Elite-HD (P < 0.05). Similarly, using single mix technique, statistically significant difference were found between Elite-HD and Imprint^™ II Garant (P < 0.05) and also between Aquasil Ultra Heavy and Elite-HD (P < 0.05). When the linear dimensional accuracy of all three impression material in double mix impression technique and single mix impression technique were compared with the control group, Imprint^™ II Garant showed the values more nearing to the values of master die, followed by Aquasil Ultra Heavy and Elite-HD respectively. Conclusion: Among the impression materials Imprint^™ II Garant showed least dimensional change. Among the impression techniques, double mix impression technique showed the better results.

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Background or Statement of Problem: As, the longevity of provisional restorations is related to, a perfect adaptation and a strong, long-term union between restoration and teeth structures, therefore, evaluation of marginal leakage of provisional restorative materials luted with cements using the standardized procedures is essential. Aims and Objectives: To compare the marginal leakage of the provisional crowns fabricated from Autopolymerizing acrylic resin crowns and bisphenol A-glycidyl dimethacrylate (BIS-GMA) resin crowns. To compare the marginal leakage of the provisional crowns fabricated from autopolymerizing acrylic resin crowns and BIS-GMA resin crowns cemented with different temporary luting cements. To compare the marginal leakage of the provisional crowns fabricated from autopolymerizing acrylic resin (SC-10) crowns cemented with different temporary luting cements. To compare the marginal leakage of the provisional crowns fabricated from BIS-GMA resin crowns (Protemp 4) cemented with different temporary luting cements. Methodology: Freshly extracted 60 maxillary premolars of approximately similar dimensions were mounted in dental plaster. Tooth reduction with shoulder margin was planned to use a customized handpiece-holding jig. Provisional crowns were prepared using the wax pattern fabricated from computer aided designing/computer aided manufacturing milling machine following the tooth preparation. Sixty provisional crowns were made, thirty each of SC-10 and Protemp 4 and were then cemented with three different luting cements. Specimens were thermocycled, submerged in a 2% methylene blue solution, then sectioned and observed under a stereomicroscope for the evaluation of marginal microleakage. A five-level scale was used to score dye penetration in the tooth/cement interface and the results of this study was analyzed using the Chi-square test, Mann–Whitney U-test, Kruskal–Wallis H-test and the results were statistically significant P < 0.05 the power of study - 80%. Results: Marginal leakage was significant in both provisional crowns cemented with three different luting cements along the axial walls of teeth (P < 0.05) confidence interval - 95%. Conclusion: The temporary cements with eugenol showed more microleakage than those without eugenol. SC-10 crowns showed more microleakage compared to Protemp 4 crowns. SC-10 crowns cemented with Kalzinol showed maximum microleakage and Protemp 4 crowns cemented with HY bond showed least microleakage.

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Aim and Objectives: The aim of the study was to evaluate the prevalence of temporomandibular disorder (TMD) by the use of Helkimo's index (anamnestic [Ai] and clinical dysfunction [Di] component) in the nonpatient population (dental students) of Faridabad college. Settings and Design: A questionnaire-based survey was carried out among students of dental college for signs and symptoms of TMD and also clinical examination was done. The results were scored and according to scoring severity of TMD were assessed in the specified population. Materials and Methods: About 580 students were assessed for TMD by the use of Helkimo's index (Ai and Di component). Descriptive statistical analysis was done. Results: Among the study group, 15% were found to have TMDs. Out of the affected students, 79% females and 21% males were having symptoms. Out of the signs and symptoms present, 7% students were found to have sound in temporomandibular joint followed by pain in 3% and fatigue in 2% of students. On clinical examination, limited mouth opening was found in 6% students followed by locked mandible in 1%, deviation of jaw in 0.6%, and jaw rigidity of mandible in 0.6% of individual. Conclusion: To summarize, Helkimo index is a well-founded index to assess TMD in a specified population. Signs and symptoms of TMD were present among students although low prevalence of TMD was found in the students.

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Aim: Alveolar bone resorption, often occurring after tooth extraction, can be minimized through socket preservation. This process uses a combination of Moringa leaf extract and demineralized freeze-dried bovine bone xenograft (DFDBBX) that is expected to generate both transforming growth factor-beta 1 (TGF-β1) expressions as a transcription factor associated with osteoblast differentiation and osteocalcin accelerating alveolar bone formation. This research aimed to analyze the role of the combination of Moringa leaf extract and DFDBBX induced in socket preservation when generating TGF-β1 and osteocalcin expressions. Materials and Methods: The left mandibular incisors of 56 Cavia cobaya were extracted and divided into four groups subjected to different socket preservation treatments. The first group treated with polyethylene glycol, the second group with DFDBBX, the third group with Moringa leaf extract, and the fourth group with a combination of DFDBBX and Moringa leaf extract. The C. cobaya were examined on days 7 and 30, after which the specimens were sacrificed and examined using an immunohistochemical technique. The resulting data were then analyzed using one-way ANOVA and Tukey's honestly significant difference tests. Results: There was a significant difference in TGF-β1 and osteocalcin expressions between the groups (P < 0.05). The highest mean amount of TGF-β1 and osteocalcin was found in the fourth group on both days 7 and 30. Conclusions: The combination of Moringa leaf extract and DFDBBX can effectively generate TGF-β1 and osteocalcin expressions during the preservation of tooth extraction sockets.

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Aim: To evaluate the methods of the dental shade selection and provide a summary of different factors affecting the shade selection. Design and Setting: The systematic review and meta-analysis. Materials and Methods: The electronic search of the peer-review articles between 2002 and 2018 was carried out the by using the PRISMA guidelines. A total twenty-one studies related to the visual shade methods, instrumental shade methods, and the factors affecting the shade selections was evaluated. The search strategy was based on the PICOS framework. Statistical Analysis: There was statistically significant heterogeneity (Q = 1038.1518, df = 20, and P < 0.0001). The statistics of fixed-effect model reported an MD of − 0.0970 (95% CI = −0.1391, −0.0549). The random-effect model reported an MD of − 0.0862 (95% CI = −0.5866, 0.4142). Result: The review evaluated the 21 studies of tooth colour science that met with the inclusion criteria and search criteria. The meta-analysis of the 21 combined studies reported acceptable homogeneity (i² = 98%) which indicates a statistically significant difference between the treatment and control groups. Conclusion: The VES spectrophotometer reported the highest accuracy, reliability, and repeatability in shade selection followed by photo colorimetric method. The Vita 3D master shows more consistent results in repetitive shade selection. Knowledge and training of the shade selection protocol are necessary for proper shade matching

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