Introduction: Oral squamous cell carcinoma (OSCC) comprises a bulk of all the oral malignancies and is posing a major health problem among the population. It is an established fact that tumor stroma plays a vital role in tumor progression. Therefore, methods to detect, quantify, and analyze collagen are of immense value in this regard. Picro Sirius red, which has the capability to detect thin fibers, although frequently used, is seldom exploited to the fullest extent. Aim: Our goal is not only to identify nature of fibers, but also to assess the fiber hue and the spatial distribution of different colors in various grades of OSCC and correlate it with the metastasis of the tumor. The study has also analyzed the nature of stromal elements along the clear, close and involved surgical margins of OSCC. Materials and Methods: Ten cases each of well, moderately and poorly differentiated OSCC as well as clear, close and involved margins were stained with haematoxylin eosin and picrosirius red staining for evaluation under polarized microscope. Results: In this study we found that the birefringence of the collagen fiber changed from orange red to yellowish green from well to poorly differentiated OSCC. The collagen fibers in well-differentiated carcinoma revealed polarizing colors of reddish orange around the tumor islands in the majority of the fields. To the best of our knowledge is not being studied so far in the English literature. Conclusion: In the present study, it has been observed that stromal changes at the invading front of the tumor islands and with increasing grade of the tumor can be evaluated more efficiently with the use of Picro Sirius red stain.

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Aim and Objective: The objective of this in vivo study was to evaluate sulcus depth width and thickness of facial attached gingiva in primary, mixed, and permanent dentition. Materials and Methods: The study included 40 subjects (22 males and 18 females) with 480 sites of an age range 4–25 years. Subjects were divided into three groups: the primary dentition (4–6 years), mixed dentition (7–13 years), and adult dentition (16–25 years). All the parameters were measured in the upper and lower anterior segments. Results: Gingival sulcus depth (GSD), attached gingiva width (AGW), and gingival thickness (GT) were measured archwise and toothwise in different dentition and overall dentition wise without differentiating archwise and toothwise. GSD was significantly higher in maxillary mixed dentition (1.75 ± 0.75), followed by permanent and primary dentition. AGW was significantly higher in maxillary permanent dentition (3.4 ± 0.36) followed by maxillary mixed and permanent dentition. GT was significantly higher (P = 0.001) in mixed dentition midbuccally (1.3 ± 0.46) and interdentally (2.31 ± 0.71) in both the arches. In all the dentition, maxillary central incisor showed significant GSD. AGW was significantly higher in permanent maxillary canine (3.5 ± 0.5). GT (midbuccal) was significantly higher in primary dentition (1.4 ± 0.5), and GT (ID) was significant in mixed dentition (2.6 ± 0.7). Conclusion: The sulcus depth and GT increases from primary to mixed dentition and significantly higher in maxilla. The width of attached gingiva was less in mixed dentition than primary with maxillary sites exhibiting higher values than mandibular.

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Enzymes of trace elements are an important part of certain biological and chemical reactions. They work in harmony with proteins and often with certain other co enzymes. They attract substrate molecules and enable their conversion to a specific end product. Some trace elements are involved in redox reactions. Modern day diet, comprising of refined foods is a cause of concern, as it may not have a sufficient amount of these trace elements. Dietary supplements may be of required to combat this shortage. The present paper has thoroughly discussed trace elements, as this area of research has not received the deserved attention. Thus, a comprehensive understanding of these trace elements is essential and significant for disease control and for maintaining optimal health.

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Background: There is a lack of consensus regarding the relationship between the risk of dental caries and asthma in the child population. Most studies concluded that asthmatic children are at risk of dental caries from the disease status or its pharmacotherapy. The objectives of this study werer to assess the dental caries status of asthmatic patients in the age group of 3-14 years and to examine the possible association of these conditions to various aspects of bronchial asthma and its management. Materials and Methods: The present study is a hospital-based case-control cross-sectional study. One hundred and five asthmatic patients were studied. The children were examined for their dental caries status, and the scores were compared with age-, gender- and socioeconomic status-matched group of 112 nonasthmatic patients selected randomly from public schools (control group). Caries lesions were assessed using decayed, missing, filled teeth/decayed, missing, and filled surfaces (DMFT/DMFS) and dmft/dmfs index according to the WHO criteria (1987). Parents or guardians provided information about oral hygiene and dietary habits by direct interview. Asthma-related data (type and form of medication, severity and duration of asthma) were collected from medical records and/or parental interview. Results: The mean age of asthmatics was (7.7 ± 3.5) years and (7.8 ± 3.5) for nonasthmatics. The results showed significantly higher prevalence and severity of dental caries among asthmatic group. As comparing asthmatic children using β2-agonists to those children using β2-agonists and corticosteroids, the results revealed that there were no statistically significant differences in caries index between the two groups. In their primary teeth, children with severe asthma had higher dmft/dmfs than children with moderate and mild asthma unlike in the permanent teeth. Form of medication used - an inhaler or a noninhaler combination (syrup and tablets) - had no effect on caries index. In this study, there was no correlation between duration of asthma and the caries indices. Conclusion: Children suffering from bronchial asthma appear to be at higher risk of having caries. This risk is increased with the severity of bronchial asthma. Form of the medications being used had no effect on caries experience.

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Background: Data on oral health experiences among pregnant women in developing countries are lacking. The objective of this study was to assess the oral health awareness and experience among pregnant women attending antenatal clinic at the University of Port Harcourt Teaching Hospital, Rivers State Nigeria. Materials and Methods: This was a cross-sectional study carried out during the period between February and March 2013. Pretested, well-structured, and self-administered questionnaire allowing open and closed responses was used for data collection. Results: The age of the subjects ranged from 18 to 49 years and the age group 28-37 years was significantly more (P < 0.00). Majority, 241 (82.0%) significantly had at least secondary education than 53 (18.0%) who had primary education or less (P < 0.01). Less than 10% of the participants were aware of the effect of pregnancy on oral health and the impact of oral disease on pregnancy outcome. In general, the experienced oral health problems among the pregnant women were tooth decay 21.1%, dental pain 42.2%, pain from the gum 22.8%, swollen gum, 23.5%, gum bleeding 32.7%, and excessive salivation 46.1%. However, only 27.9% had visited the dental clinic most of whom, were those with more than three children (P < 0.01). Excessive salivation was significantly experienced more than other oral health problems and in women with three or less children. Conclusion: Oral health awareness among the subjects was poor and a sizeable number of pregnant women experienced oral health problems during pregnancy. There is a need for the development of guidelines that will promote referral and visit of pregnant women for dental consultation.

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Background: The extent of the needle phobia and its effect on the patients in the community is the topic which still remains largely unexplored. The presence of needle phobia may influence the future dental treatment by the patient. Thus, the present study was planned to check the nature and prevalence of needle phobia among dental college patients. Materials and Methods: The study was carried with the help of 16 questionnaires specially formulated for the present study. The study included 343 patients came to the outpatient department of the dental college, and the observation was recorded and analyzed. Results: Most of the male and female participants had the experience of the needle phobia due to the experience shared by parents, friends, or relatives in their previous life. Due to needle phobia the most of the patient becomes somewhat anxious, and needle phobia had little impact on the life of the patients. According to our study, 13.3% of male participants and 14.6% of the female participants had avoided dental treatment due to fear of needles. Conclusion: The procedure of needle injection is a routine procedure in the dental clinics and hospitals for giving anesthesia to the patient. Therefore, these types of studies calculating the prevalence of needle phobia help to know about the view of the patient and ultimately the community toward the needle phobia. Hence that necessary steps can be taken.

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Background: Post-retained crowns are indicated for endodontically treated teeth (ETT) with severely damaged coronal tissue. There are still controversies for the most suitable choice of restorative material and the placement method that will result in the highest success rate. This clinical study compares the metal post and fiber post ins the restoration of the endodontically treated teeth. Materials and Methods: Forty endodontically treated and indicated for the post and core were selected for the study and divided into 2 groups equally. In, one group patient's teeth were restored by metal post, while other group patient's teeth were treated by fiber post. Comparative evaluation was done on follow-up of the patients on the basis of selected clinical and radiographical criteria. The results were compared using student's t test with the help of IBM SPSS Statistics 20. Results: More number of failures was noted in patients whose teeth restored with the metal post as compared to those of the fiber post, both clinically as well as radiographically. (Student's t test, P < 0.01). Conclusion: From the present study, it was shown that fiber post retained restored teeth has less chances of failure as compared to that of metal post. But the results of the present study should be supported by carrying out study on large scale.

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Objectives: The purpose of this in vitro study was to evaluate and compare the efficiency of four protocols of adhesive remnant removal and polishing after bracket debonding on enamel surfaces using scanning electron microscope (SEM) and to compare the time spent to remove resin remnants. Materials and Methods: The present study was a comparative study, in which brackets were bonded on forty freshly extracted human premolar teeth. They were debonded after 24 h and removal of remnant adhesive to as close as possible to the original condition using tungsten carbide burs (TCBs) (30 flutted) with low-speed contra-angle handpiece, Super Snap ^® discs (course, medium, fine, and superfine), TCB + Brownie and Greenie (BG) polishers, and TCB + Super Snap ^® discs. The surfaces were evaluated under SEM and graded according to the modified surface roughness index. Time taken to remove the residual adhesive was recorded using a stopwatch. Results were subjected to statistical analysis. Results: Super Snap ^® discs showed a smooth surface with minimal scratches. TCB resulted in an irregular enamel surface in SEM evaluation, showing horizontal scars with a consistent pattern and left remnants on the enamel surfaces. TCB followed by Super Snap ^® discs produced some scratches on the enamel surface. The mean time was significantly higher in Group I than the other three groups (P = 0.000). The mean time was significantly lower in Group II than the other three groups (P = 0.000). TCB took the least amount of time followed by TCB + stainless steel and TCB + BG polishers. Conclusion: Enamel surface was restored as close to the original using the Super Snap ^® discs. TCB produced a very rough surface, but it is an efficient and least time-consuming procedure. The resultant enamel surface with enamel scars needs to be finished by other polishing techniques after bulk removal using TCB as the sequential use of Super Snap ^® discs and polishers is less aggressive in removing residual bonding resin and results in apparently better surface finish causing less damage to the enamel.

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Introduction: Halitosis can be tested using two main methods, organoleptic and assessment of volatile sulfur compounds (VSCs), using an electronic meter like Halimeter. Therefore, the present study was conducted to measure the oral malodor of volunteers by means of the organoleptic method and VSCs monitoring and to evaluate the diagnostic value of the Halimeter in the diagnosis of halitosis. Materials and Methods: A cross-sectional observational study was conducted to compare the two diagnostic aids for halitosis. The study population included 110 volunteers, all males, between the ages of 18 and 45 years selected from academic staff, students, and patients of college. Evaluation and comparison of two main methods for halitosis were done, namely, organoleptic and Halimeter. Specificity, positive predictive value (PPV), negative predictive value (NPV), and disease prevalence were calculated for the sulfide monitor test. Receiver operating characteristic (ROC) curve was used to determine the diagnostic values of Halimeter to differentiate individuals with and without halitosis. Results: The correlation coefficient between VSC grading and organoleptic score (Kendall's tau-b) was −0.1090, which was not significant (P = 0.2170). Sensitivity and specificity of sulfide monitor grades for detecting individuals with and without halitosis were 20.75% and 66.67%, respectively. The PPV for the Halimeter was 36.67%, and the NPV was 47.50%. A total of 48.18% of all subjects were accurately identified and differentiated. The area under the ROC curve was 0.5790 (95% confidence interval: 0.4600-0.6980). Conclusion: In the present study, the Halimeter was not found to have a good correlation with the organoleptic method. However, due to the diverse influencing factors, proof of halitosis should always be obtained with two different methods.

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Background: To evaluate the prevalence of malocclusion and its common characteristics in young male population of Aseer province. Methods: One thousand eight hundred and twenty Saudi male students between the age of 15 and 17 years were chosen from 3408 pupils studying in different middle schools of Abha region. Oral examination was performed to check the prevalence of malocclusion according to Angles classification and the individual traits including crowding, spacing, deep bite, anterior open bite, and anterior cross bite. Results: The prevalence of Class I, II, and III malocclusions was 62.3%, 28.4%, and 9.3%, respectively. Crowding was the most common individual trait (43.8%) while anterior open bite was the least prevalent (7.2%). Conclusion: There was high prevalence of malocclusion observed in the study population. Nearly half of them were suffering from crowding of teeth.

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Undergraduate dental students acquire their clinical skills through the hands-on training on phantom heads. This is essential to develop their skills and experience and to ensure they can undertake safe and competent dental procedures on patients. However, the literature lacks a comprehensive approach capable of assessing dental clinical simulation skills objectively and at the same time incorporating all the tools necessary for effective learning. A brief overview of the literature regarding clinical skills assessment was performed to define specific recommendations for implementation of dental clinical skills assessment tools. Selected best theories and methods for a successful package of tools were gleaned from the existing medical and dental literature. This paper defines specific recommendations for implementation of dental clinical skills assessment tools necessary for effective teaching of tooth cavity preparation in clinical simulation laboratories. The recommended approach of comprehensive assessment was broken down into three main components (1) clinical simulation skill assessment, (2) self-assessment, and (3) student feedback and reflection. The conclusions and recommendations offered herein are intended to enhance course design and current teaching methods in dentistry rather than replace them. The following recommendations were made: (1) Dental schools need to seek to ensure that valid and reliable standard settings are applied to their assessments which, if accomplished, are very likely to enhance their educational outcomes. (2) It is important to get students to understand and positively respond to feedback which can be achieved by creating a module culture in which students are encouraged to share and discuss their mistakes openly. Proper feedback will ensure better performance and improved self-assessment skills. (3) Staff members should utilize a more consistent pattern of feedback and review their techniques periodically to continually improve the teaching process. Such recommendations, if enforced thoroughly, would be helpful in aiding tutors and course instructors assess dental clinical simulation skills components objectively and identify the clinically weaker students.

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Background: The development of fibrosis is pathognomic in the potentially malignant oral disorder, oral submucous fibrosis (OSF). Strong evidence exists to implicate the chewing of areca nut in the pathogenesis of the lesion. The constituents of areca nut activate several pro-fibrotic cytokines, chiefly transforming growth factor beta 1 (TGF-β1), which leads to an increased deposition and decreased degradation of extracellular matrix and collagen. TGF-β1 probably represents the major pathway in the deposition of collagen fibers in this condition. The present study aims to identify and correlate the expressions of TGF-β1 immunohistochemically on paraffin sections of various stages of OSF. Materials and Methods: The expression of TGF-β1 antibody was detected immunohistochemically using the anti-TGF-β1 mouse monoclonal antibodies (8A11-NovusBio USA) on paraffin sections of 58 cases of OSF, 10 cases of normal buccal mucosa tissue and 5 cases of scar tissue. The site, extent, and intensity of expression and quantification of TGF-β1 were noted and a comparative evaluation between various grades of OSF. Scar tissue and normal oral mucosa was made using image analysis software (Jenoptik optical system-ProReg ^® Capture Pro 2.8.8 software [2011]). Results: Cells of spinous layer of the epithelium showed more intense staining in all grades of OSF, Grade II showed the highest percentage of expression, same as that of keloid (17%) but less than that of normal mucosa (12%). Positive staining was seen around blood vessels, muscles, fibers in the submucosa and perimuscle fibers. Highest expression was in the muscle in Grade III (80%) compared with normal oral mucosa (37%). Conclusion: These results suggest that the pathogenesis of OSF and scar/keloid could be linked through the TGF-β1 pathway. Interventions directed at the TGF-beta pathway may hold the key in the future management of this oral potentially malignant condition.

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Objective: The aim of this study was to evaluate the epidemiological aspects and clinical factors associated with avulsion of permanent teeth. Materials and Methods: The sample consisted of 261 avulsed teeth of 170 patients seen in the Dental School of the Federal University of Goiαs, Brazil, from 2000 to 2008. Result: The highest incidence was found among boys (71.18%) aged 6-15 years (61.18%). The main etiologic factors were falls (51.76%) and traffic accidents (29.41%). Most cases occurred in autumn (March to June; 31.18%) and winter (June to September; 27.65%). Most avulsed teeth were the maxillary central incisor (62.45%), followed by the maxillary lateral incisor (21.46%). A high proportion (67.23%) of injured teeth had a completely formed root apex. Replantation was used to treat 119 teeth (45.59%) in 86 patients. Most replantations were delayed (89.08%). Thirty-eight teeth (31.93%) were stored in dry media. Periodontal healing was found in 41 teeth (34.45%), inflammatory root resorption, in 44 (36.97%) and replacement root resorption, in 22 (18.49%). The most frequent treatments for replanted teeth were endodontic treatment and temporary filling of the root canal with calcium hydroxide (58.92%) and endodontic treatment and definitive root canal filling (26.89%). Conclusion: The epidemiological and clinical aspects of tooth avulsion in this study were similar to those reported in other studies. The number of replantation was low, the number of teeth stored in non-physiological conditions was high, and replantation was often delayed.

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Introduction: The main objective of root canal treatment is to disinfect the entire root canal system. Although cleaning and shaping and use of antimicrobial medicaments are effective in reducing the bacterial load some bacteria do remain behind and multiply, causing reinfection of the canal. Considering the ineffectiveness, potential side effects and safety concerns of synthetic drugs, the herbal alternatives for endodontic usage might prove to be advantageous. Aim: To check the antimicrobial efficacy of Neem, Green Tea, Triphala and sodium hypochlorite against the endodontic microflora. Materials and Methods: Mixed cultures of bacteria were isolated from patients, with carious teeth and associated with periapical radiolucencies. A paper point was inserted into the canal to obtain a sample of a mixed culture of micro organisms. These paper points were cultured and agar diffusion test was done for the different irrigants. The irrigants were divided into Group I: Neem (60mg/ml in 10% DMSO),Group II: Green Tea Polyphenols (60mg/ml in 10% DMSO), Group III: Triphala (60 mg/ml in 10% DMSO), Group IV: 3% NaOCI, Group V: Sterile saline. Results: Sodium hypochlorite showed the maximum antimicrobial activity, followed by Neem. There was no statistical difference between the activity of sodium hypochlorite and Neem. This was followed by Triphala and Green Tea, respectively. Conclusion: Neem is as effective as Sodium Hypochlorite against endodontic microflora.

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Introduction: Traumatic dentoalveolar injuries are frequent in children, affecting teeth, their supporting structures, and adjacent soft tissues. Parents are among the first people to deal with tooth avulsion among children at home or at play. This study, therefore, aimed to examine parental knowledge and attitudes about avulsed permanent teeth and their emergency treatment in children. Materials and Methods: A cross-sectional study was carried out with 274 parents of children receiving care at KKU College of Dentistry, Abha. Informed consent was obtained after explaining the nature of the study and data were collected using a self-administered questionnaire. Data were entered in MS Excel Sheet, and descriptive statistics were obtained. Results: Sixty-one percent of the parents reported dental trauma at home or school. 67.2% were not aware of the steps to be taken in tooth avulsion. The percentage for the source of information for avulsed tooth was a dentist (38.8%) and the internet (34.5%). 73.8% were unaware of the fact that permanent avulsed tooth can be replanted. 56.3% parents said that they would discard the knocked out tooth. Regarding knowledge about traumatic dental injuries 43.9% said it is imperative to know about it. Conclusion: This survey reflected the lack of awareness and adequate knowledge regarding the avulsed tooth. There is an imperative need for educating the parents regarding management of avulsed tooth permanent tooth.

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Background: Dental students in the community are considered as dentists and are expected or might be asked to provide emergency aid, especially when the problem related to the teeth as in the case of avulsion. Aim: The aim of this study is to assess and compare the knowledge and practice of 2^nd- and 5^th-year undergraduate dental students regarding management of tooth avulsion. Materials and Methods: Descriptive cross-sectional study among registered and regular attendee 2^nd- and 5^th-year dental students from nine dental schools in Khartoum state. The study was conducted during period from November 2015 to February 2016. Sample size was 309 (186 from 2^nd year and 98 from 5^th year) out of total number of 1575. Participants were selected by systematic random sampling technique. Self-administered questionnaire was used to assess the knowledge of emergency management of avulsed tooth. Comparison between variables by Chi-square test with the level of significance set at P < 0.05. Results: Majority of 5^th-year students have enough information about avulsion and its emergency management while very few of 2^nd-year students have the correct knowledge. Only 12.4% of 2^nd-year students mentioned the correct storage media where an avulsed tooth can be placed compared to 64.3% of 5^th-year students. There was also no statistical significant difference of P = 0.186 when knowledge about avulsion in students who personally experienced dental trauma was compared to those who did not have an experience of dental trauma. Conclusion: Second-year undergraduate dental students had poor knowledge about emergency management of avulsed tooth. Experience of dental trauma and students gender have no significant association with the management of tooth avulsion.

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Introduction: Patient health information materials, such as leaflets and posters are widely used by diverse health organizations and professionals as part of patient education or health promotion efforts and in support of preventive, treatment, and compliance objectives. Patient health information can be used to reinforce the information given previously, or it can serve as references to remind people of information they received earlier. Objectives: The objective of this study is to assess the use of the patient health information materials in the hospital waiting halls by the patient and their perception on these health information materials. Methodology: A questionnaire study was conducted among the patients waiting in general hospitals and dental hospitals of Vikarabad district. A pretested (Cronbach α = 0.81) self-administered questionnaire was developed. Patients waiting in the waiting rooms and aged 18 years and above were included in the survey. Results: A total of 564 participants completed the questionnaires. A total of 141 respondents indicated reading the health information materials present in the waiting rooms. Majority of the participants stated that advertisements in the television will be the best method for promotion of health. More than 50% of the patients face difficulty in understanding the medical terms in the health information material. Conclusions: Study suggests that patients value health information materials in the waiting rooms and they perceive such materials as being helpful in improving health-related management and self-management.

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Introduction: Temporomandibular disorder (TMD) is a group of condition affecting the temporomandibular joint, masticatory muscles, and the adjacent structures. The etiology of TMD in children and adolescents is considered multifactorial in nature and has been related to trauma, malocclusion, and parafunctional habits. Aim: The aim of this study is to find whether harmful oral habits are associated with sign and symptoms of TMD among adolescents in Wardha district. Materials and Methods: A short-span study was conducted in Wardha, Maharashtra. A self-administered based study was done among 200 adolescents which comprised of 107 females and 93 males. Data were collected using self-administered questionnaire and clinical oral examination that was conducted. The questionnaire was consist of knowledge responses (yes/no) and attitude responses (never, rarely, sometimes, often, and always). Chi-square test was used to perform statistical analysis and level of significance was set at P < 0.05. Results: The main method used was self-administered questionnaires with sample characteristics of 53.5% female and 46.5% male. Population was divided into two age groups. Total number of adolescents in age Group 1 (9–14 years) was 85 and age Group 2 (15–19 years) was 115. Seventy-seven (38.5%) adolescent reported no sign and symptoms of TMD and rest of them reported yes to at least one statement of questionnaire. Bruxism (67%) was the most frequently observed habit whereas chewing gums (5%) as the least observed habit. Statistically significant gender difference was not observed in the questionnaire. Higher frequency of TMD symptoms was reported in the age group of 15–19 years. Sixteen (8%) subjects reported nonparafunctional habits whereas 184 (92%) subjects had parafunctional habits. During clinical examination, muscle sensitivity to palpation was most frequent sign in the age of group 15–19 years with P = 0.023. Higher severity was reported are morning facial pain, pain while chewing, clicking sound, and using one side while chewing. Conclusion: Result shows that there was no association between parafunctional habits and signs and symptom of TMD. In age group of 15–19 years, it was statistically significant. Hence, while treating patient dentist should give attention to parafunctional habits in this age group especially.

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Background and Aim: Parents have an important role in making decisions about their child's oral health. The purpose of this study was to determine parental awareness of their children's oral health maintenance and their attitude toward dental treatment. Materials and Methods: Total 284 parents from different socioeconomic groups participated in the study. Data were collected using a self-administered questionnaire addressing various aspects of knowledge and attitude of parents toward oral health and treatment modalities. Results: Awareness among parents was significantly lower in low socioeconomic group. Their attitude toward dental treatment differed significantly in which only 53% parents from high socioeconomic group preferred going to the pediatric dentist. Conclusion: The level of awareness among parents is relatively low and there is need for the implementation of oral health awareness programs for parents to change their attitude toward dental treatment of their children.

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Background: Candida species, mainly Candida albicans, have been related to dysplastic changes and malignant transformation of different oral mucosal lesions. Objective: The objective was to assess the possible influence of Candida detection in oral leukoplakia (OL), oral lichen planus (OLP), and oral cancerous lesions. Search Methods: A PubMed search through February 2018, using the following MESH terms, was performed: “Candida,” “precancerous conditions,” “mouth,” and “mouth neoplasms.” Selection Criteria: The selection criteria included studies with findings on Candida detection in premalignant and malignant oral lesions. Data Collection and Analysis: For continuous outcomes, the estimates of effects of an intervention were expressed as mean differences using the inverse variance method and for dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratios using Haenszel—Mantel method, both with 95% confidence intervals. Results: Fifteen studies on Candida detection in premalignant and malignant oral lesions were included in this meta-analysis. Nearly 61.5% of oral cancers, 32.2% of OLs, and 29.1% of OLP lesions were infected by Candida species. Candida infection does not increase the risk for developing OL (P = 0.32) or OLP (P = 0.31). A higher mean age, male gender, tobacco consumption, and location of the lesions on tongue or floor of the mouth were factors that did not have a significant influence on developing Candida-infected OL. Dysplastic OLs were 10.62 times more likely to be Candida-infected lesions. A greater number of OL lesions infected by Candida species than OLP lesions were found (P < 0.01). Having oral cancer increased 4.92-fold risk of Candida infection. No statistically significant association between Candida-infected oral cancer lesions and Candida-infected OL lesions was observed (P = 0.21). Conclusions: Candida infection worsens the biological behavior of potentially malignant and malignant lesions of the oral cavity.

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Ehlers-Danlos syndrome is a group of clinically and genetically heterogeneous inherited connective tissue disorders with widespread manifestations. The prevalence of this syndrome is 1:5000 worldwide without gender, racial or ethnic associations. This syndrome is characterized by joint hypermobility, dermal hyperelasticity and tissue fragility caused by mutations in genes encoding collagen type I, III, V and enzymes involved in the posttranslational modifications of collagen. The oral manifestations include increased mucosal fragility, delayed wound healing, early onset generalized periodontitis and temporomandibular joint hypermobility. Children presenting with this syndrome are often misdiagnosed for hematological problem as they present with bruising, malignancy and/or child abuse. A thorough assessment of the patient is, therefore, essential for early diagnosis and patient referral. This paper reviews current literature, oral manifestations, diagnostic investigations and effective dental management.

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