Aim: Dental phobia stems from fear and anxiety and is considered a major hurdle in dental treatment of pediatric patients who in turn resist or start avoiding treatment. Endogenous indolamines like melatonin which is produced by pineal gland has a chief role in regulation of circadian rhythms. Melatonin acts like an oncostatic agent, known to possess antioxidant, anti-inflammatory as well as anticonvulsant property. It is mainly administered through oral or sublingual route of drug administration. No substantial side effects have been reported by administration of melatonin. Soon after melatonin intake, it undergoes first-pass effect reaching in about 60 min to its peak plasma levels and within 4 h the blood level falls. Study Design: The present case-control study is a retrospective study with age and sex matched recruitments. Data collection was done as per first visit and then post treatment of 50 subjects who reported to the Department of Preventive and Pediatric dentistry. Methods: In accord with the literature, 25 pediatric subjects were administered with 0.5 mg/ kg body weight Melatonin 60’ prior to their first visit followed by their Pedodontic management. As per record no initial Pedodontic treatment was given to the rest of the 25 recruits. The successful management of treatment was assessed by analyzing their pain experience through FLACC behavioral pain scale. Results: A statistically significant number of children (n=50) both age and sex matched were included in the study and further divided into Group A and Group B with mean age of 7.56 years and 7.08 years respectively. Group A received Melatonin treatment while Group B was not given any preventive treatment. As per the FLACC scale categories, Melatonin was well tolerated by all the children of A Group, out of which 42% of subjects showed relaxed levels or slight discomfort (0-3), 42% presented with moderate discomfort or pain (4-6) while only 16% showed severe or intense pain or discomfort (7-10). Conclusions: The present study thus establishes a positive role of Melatonin on Pedodontic therapy as it has a potent analgesic and anxiolytic potential. Limitation of study is smaller sample size.

Aim: This study aimed to mechanically test the shear bond strength (SBS) of cobalt-chromium (Co-Cr) metal frameworks prepared with three different production techniques with dental porcelain after the thermocycling process. Materials and Methods: Sixty Co-Cr-based metal substructure samples were prepared using traditional casting, CAD/CAM system, and laser sintering methods. The samples were treated with uniform layering porcelain and half of the subgroups (n=10) were thermocycling (5000 cycles, 5–55oC). Metal-ceramic bond strength of all samples was evaluated using the shear bond test under the standard. The shear bond strength values to the normal distribution was examined with an analysis program (SPSS for Windows 22.0, Chicago, IL, USA) was used for statistical analysis of the obtained data. One-way ANOVA test and post hoc test (Tukey’s) performed for data evaluation. Results: A statistically significant difference was observed between the average bond strength (MPa) in the comparison of different production techniques (p˂0.05). The average bonding strength of the samples grouped according to different fabrication methods; was found 16.54 ± 2.42 MPa for the CAD/CAM milling method, 8.98 ± 4.16 MPa for selective laser sintering, and 8.76 ± 3.05 MPa for conventional casting. When comparing the thermocycling application of the prepared samples, a statistically significant difference was found between the means of shear bond strength. The CAD/CAM milling group has the highest value (15.54 ± 2.16) and is statistically different from the others. Conclusions: According to the results of this study, it was determined that the production method affects the metal-ceramic bond strength, but the thermocycling application does not make a significant difference. Milled Co-Cr samples had a higher SBS value than casting and laser sintering samples.

Aim: The present study aimed to evaluate peri-implant immunological parameters along with clinical and radiographic parameters amongst subject’s vaping e-cigarettes and non-smokers (NS). Two immunological parameters that were included were measurement of tumor necrosis factor alpha (TNF- α) and interleukin (IL)-1β. Materials and Methods: A statistically significant no. of subjects were included in the study and further divided into two groups: Group-1: Vaping e-cigs (n=47) Group-2: Non-smokers (n=45). A structured questionnaire was used at baseline for data collection related to demographic and peri-implant data of each individual. Baseline parameters included Plaque Index, Bleeding on probing, probing pocket depth and peri-implant bone loss (PI, BOP, PD and PIBL respectively) for those vaping e-cigs and non-smokers with the aid of standardized digital radiographs. ELISA kit was used to assess immunologic parameters using sulcular fluid collected from peri-implant region (PISF). Results: Bleeding on probing (BOP) was found significantly high in non-smokers compared to the vaping group. But probing depth greater than 4mm and PIBL scores were significantly higher in vaping group than non-smokers. Mean concentrations of immunologic parameters were significantly higher in vaping group than in non-smokers. TNF- α levels and IL-1β levels were found to have a positive correlation with bone loss around implants (PIBL). Besides TNF- α also had a positive correlation with bleeding on probing in vaping group compared to non-smokers. Conclusions: Owing to the effect of nicotine on the peri-implant tissue, levels of inflammatory mediators as detected by ELISA test were found to be higher showing a greater amount of localized inflammatory tissue destruction and a compromised peri-implant area in vaping subjects. PISF concentrations were also found relatively higher than non-smokers.

Root canal therapy, demands adequate accessibility of the pulp chamber followed by a proper biomechanical preparation and three dimensional obturation of the root canals. Permanent maxillary first molar undergoing endodontic management are generally found to have three roots and four canals, although multiple variations in this configuration have been documented in the literature so far. A thorough understanding about predicting and managing such aberrant root canal morphologies is the key to achieve long term success in the field of endodontics. This paper aims to add in the literature, a unique case of permanent maxillary right first molar with a rarest arrangement of 6 root canals. The author(s) have attempted their best to review the literature and enhance the knowledge on aberrant root canal morphology of permanent maxillary molars.

Background and Purpose: Fractures of mandible frequently result in inferior alveolar nerve (IAN) injury and altered neurosensory function. This may be due to primary injury which lies in the line of fracture or a secondary insult due to manipulation at the time of fixation of the fracture. The purpose of this study is to measure post-injury/pre-treatment and immediate postoperative IAN sensory changes during the management of mandibular fractures and to identify risk factors for adverse perioperative IAN neurosensory changes. Materials and Methods: This study was conducted on the patients admitted in the Department of Oral and Maxillofacial Surgery, Bapuji Dental College and Hospital, Davangere. Fracture location was divided into two categories as Fracture location 1 (L1) which was between the lingula and mental foramen which place the IAN at direct risk for injury & Fracture location 2 (L2) included fractures distal to the mental foramen. In these cases, the IAN is out of the bone and hence at risk for injury indirectly (i.e., via soft tissue trauma). Treatment was rendered in a non-randomized manner by the surgeon. To assess neurosensory function, protocol described by Zuniga and Essick will be used. All the required parameters were measured & recorded pre-operatively & post-operatively. Results: The results of the present study showed that fracture displacement of more than 4 mm at L1 site & excess manipulation of soft tissues at L2 site was associated with Significant Neurosensory Deficit. Conclusion: Identifying the factors associated with poor long term outcome of NSD would need a larger sample size and detailed documentation of the use of various diagnostic tools to arrive at a conclusive observation.

An epidermoid cyst or epidermal inclusion cyst is a benign cyst usually found on the skin. The slow growing benign cysts develop out of ectodermal tissue. Epidermoid cyst may have no symptoms, or it may be painful when touched and release macerated keratin. The treatment of epidermoid cyst is surgical removal with entire removal of capsule to minimize the recurrence or minimize the chance of malignant transformation. Here we report a case of a 64 year male old patient with epidermoid cyst in forehead, total surgical resection of the cyst was done in department of Oral and Maxillofacial Surgery in K.D. Dental College and Hospital with optimal exposure to avoid recurrence.

Background: Oral candidal infections are predominantly caused by Candida albicans. There are multiple clinical presentations of oral candidiasis. Main observations: We describe two cases of atypical clinical manifestations of oral candidiasis. Patients presented with white reticular plaques, painful ulcers, erosions, and significant oral mucosa atrophy mimicking oral lichen planus. Histopathological findings are detailed. Conclusions: To our knowledge, this is a novel clinical presentation of oral candidiasis, and we propose to consider this variant, particularly in patients with predisposition to develop chronic oral candidiasis.