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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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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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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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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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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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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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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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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Background: Oral health of children with special needs is dependent on their parent's knowledge and attitude towards dental care. Thus this study aimed to assess the knowledge, attitude and practice of mothers of children with special needs. Methodology: A cross-sectional questionnaire study was conducted for a period of 4 months among caregivers of 3 to 17 year old children with special needs who visited a tertiary care center (NIEPMD) at Chennai city from February 2018 to June 2018. The data were analyzed using SPSS version 20 (Inc., Chicago, IL, USA). Descriptive statistics was carried out to calculate responses for each question. One way ANOVA was computed to compare means of knowledge, attitude and Practice with Age, Education and Income. Normality of the data was tested using Shaprowilk test. Results: A poor knowledge was seen among the mothers. Education, income and age were found have a statistical significance (p=0.00*) on mean knowledge, attitude and practice scores. Conclusion: More studies exploring the same issue need to be conducted on larger samples covering different populations so as to evaluate, which strategies will be effective and efficient in bringing about a behavior change in mother/parents.

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Introduction: Dental anxiety is an abnormal fear or dread of visiting the dentist for preventive care or therapy and unwarranted anxiety over dental procedures. It is a common problem that affects people of all ages and appears to develop mostly in childhood and adolescence. The present study assesses dental anxiety among children in a nonclinical setting among Saudi Arabian children who underwent preventive treatment procedure using Abeer Children Dental Anxiety Scale (ACDAS). Materials and Methods: The children attending an oral health program were screened for oral health problems and preventive treatment such as topical fluoride applications. The dental anxiety among children was assessed using ACDAS. Results: A total of 51 children participated in the research. The results showed that maximum children were not scared of dentist in nonclinical setting and had low dental anxiety levels. Overall, 74% of the child subjects had ACDAS scores below 26. Conclusions: Knowing the degree of anxiety of dental children is important to guide them through their dental experience and carry on the preventive dental treatments at an early age in nonclinical setting. Their level of cooperation will improve, and anxiety will be reduced as well. Further research is required to compare dental anxiety levels in children between clinical and nonclinical setting.

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Introduction: The color of gingiva influences the smile of person and affects esthetics, the present study was conducted to evaluate the effect of gingival depigmentation by scalpel and electrosurgery. Materials and Methods: A total number of 18 patients, 16 males and two females, aged between 18 and 30 years, reported to the clinic, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, complaining of "grayish-blackish gums" which affected the esthetics of their smile. The treatment done in this study was scalpel surgical technique and electrocautery as they could be easily done and were less time consuming. Healing and recurrence of pigmentation were postoperatively evaluated. Intraoral pictures were taken at every follow-up visit to compare the progress and also to access the occurrence of any repigmentation. One-way ANOVA and unpaired t-test were used for statistical analysis. Results: There was statistically significant reduction seen for both the study techniques after 6 months postoperatively as compared to baseline with no complications leading to pain, infection, bleeding, or scarring postoperatively. During the 6 ^th month follow-up, there were no signs of repigmentation in both the treatment modalities. Cases were followed up for any reoccurrences of pigmentation longitudinally. Conclusion: Satisfactory results were obtained with both the surgical and electrocautery procedures for gingival depigmentation. Hence, the surgical technique still serves as the simplest and effective depigmentation technique. During the follow-up period, no recurrence of gingival hyperpigmentation was found with both the techniques employed in this study.

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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: Aging is a natural process seen in all the individuals. The world is on the brink of a demographic milestone. Since the beginning of recorded history, young children have outnumbered their elders. In about 5 years' time, the number of people aged 65 or older will outnumber children under age 5. Driven by falling fertility rates and remarkable increases in life expectancy, population aging will continue, even accelerate the number of people aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050, with most of the increase in developing countries. India being developing as well as a second highest populated country will be affected badly by both general as well as oral diseases which are noncommunicable in nature. Aim: The aim of the study was to assess oral health problems among geriatric population in a dental institution and its effect on general health. Objectives: The objectives of the study were (1) Common oral diseases/conditions among geriatric population and its prevalence and (2) implications of oral diseases/conditions on general health. Materials and Methods: A cross-sectional survey was conducted among 301 study participants of 65–74 years old from March 2016 to August 2016. A self-structured, pretested questionnaire was used to collect data on common oral health problems as well as systemic diseases along with demographic details. Data were compiled and statistically analyzed using Chi-square test and other descriptive statistics. Results: Out of 301 study participants, 42% were edentulous, 12% had denture-related problems, 16% had root caries, 22% had periodontal disease, and 8% were found to have precancerous lesions. Thirty percent of participants were found to have a combination of two or more oral diseases. Most common systemic diseases reported are malnutrition, hypertension, and diabetes. The implication of oral health on general health was found to be significant at P< 0.05. Conclusion: Oral diseases influence general health. Oral health is an integral part of general health.

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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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Aim: The purpose of this study was to evaluate the Vicker's hardness and surface roughness of eight different composite materials immersed artificial saliva and distill water. Materials and Methods: Five standardized disc shape specimens (2mm diameter X 2mm height) were prepared from eight composite materials (Grandio, Estelite Flow, Filtek Bulk-fill, Charisma, Clearfil, Ultimate, Quadrant and G-aenial for each artificial aging environment. Specimens were immersed during 7, 90 and 180 days in artificial saliva and distill water at 37 °C respectively. The Vicker's hardness and surface roughness values of the samples were measured after each artificial aging period. Mean values and standard deviations were calculated and statistical analysis was performed using one-way ANOVA. Results: In this study Vicker's hardness and surface roughness values of all samples significantly increased after both in artificial saliva and distill environment 7 days aging period. Conclusion: In this study, suggested the similar to mechanical behavior of the bulk-fill and resin-based composite materials both artificial saliva and distill aging periods. However, in this study no linear relationship was found between filler volume and surface roughness both in artificial saliva and distill aging environment.

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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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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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Introduction: Microleakage has been regarded as a primary concern of use of composites in class II cavity restorations. Many products have attempted to minimize the interfacial gap between the tooth and restoration, the main pathway of microleakage. The aim of this in-vitro study is to quantitatively evaluate the microleakage of class II composite restoration done with incremental and bulk fill technique. Materials and Methods: In an in-vitro study, a total of 40 sound extracted molars were used for class II preparations and restoration with incremental (Group I, 20 teeth) and bulk fill technique (Group II, 20 teeth). Samples were accessed for dye penetration and pairwise comparison was done using Wilcoxon rank test. Results: Both the composite insertion techniques were not able to completely eliminate the microleakage. Two specimens of bulk filling technique show microleakage, extending to the axial wall. There is no statistically significant difference in microleakage irrespective of the insertion technique used. Conclusion: It can be concluded from the results that there is no significant difference in microleakage for composite restorations done by a bulk layering technique using the newer generation composites and the conventional incremental layering technique.

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Background: Oral submucous fibrosis (OSMF) is a potentially malignant collagen - metabolic disorder linked to consumption of betel quid and areca nut. The deposition of collagen and its major subtypes have been the subject of intense scrutiny in the etiopathogenesis of the disorder. Aims and Objectives: The present study was planned to immunohistochemically identify the expression of collagens I and III (COL I and III) in different grades of OSF and compare it with normal oral mucosa and scar tissue. Materials and Methods: Archival paraffin sections of 72 cases of various grades of OSMF, ten cases of normal mucosa as controls and four cases of scar tissue were stained with antibodies to COL I and III (BioGenex Laboratories, CA, USA) to evaluate the collagen subtypes on paraffin sections. The expression was quantified by image analysis software (Jenoptik Optical System, ProgRes ^® Capture Pro, version 2.8.8) and statistically analyzed. Results: COL I and III stained all the tissues ubiquitously. COL I was more in ratio and quantity in all the grades of OSMF, normal mucosa, and scar tissue. The proportion of COL I to COL III seemed to increase with progressive grades of OSF. Interestingly, during the process of fibrosis COL III seems to be deposited earlier and gradually replaced by COL I resulting in a skewed ratio vis a vis normal oral mucosa and scar tissue. Conclusions: COL I expression was found to be proportionate with advancing grades of OSF while COL III expression increased in Grade I but subsequently decreased as severity of OSF increased. The increase in COL I at the expense of COL III showed a similar pattern in the submucosa while in the deeper muscle only Grade III cases reflected the trend. While all cases of OSF revealed excessive expression in comparison with normal oral mucosa, the comparison with scar tissue was variable.

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Background: Areca nut has been listed as a carcinogenic agent in humans and is linked to cancers of oral cavity, gastrointestinal tract, and hepatobiliary system. Liver function tests (LFTs), the estimation of enzymes specific to the hepatic system, give an assessment of its cellular integrity, and functionality. Aim and Objectives: This study aimed to evaluate the state of the liver in patients consuming areca nut and its products over a period. Materials and Methods: LFTs were carried out on 10 nonareca nut chewers and thirty patients with a history of areca nut, quid or a combination of tobacco and areca nut chewing, extending from 6 months to 30 years. The LFTs included estimation of aspartate transaminase (AST), alanine transaminase, alkaline phosphatase (ALP), direct bilirubin, albumin, and total protein content. A comparative analysis was done for each biochemical marker with duration, form (betel nut alone, quid, and betel nut with tobacco), and frequency of chewing areca nut. Results: A mild increment in AST was seen in 33.3% cases. Statistically significant association (P < 0.05) was observed between the control and cases for AST, ALP, and total protein content. A significant positive Pearson's correlation (+0.417) was obtained for a form of areca nut chewing (areca nut and tobacco) and AST. A significant negative Pearson's correlation (−0.05) was observed between total protein content and form of chewing (areca nut and tobacco). Conclusion: The results of the study seem to indicate that even long-term chewing of areca nut is not hepatotoxic. Minor alterations in LFTs were well within limits.

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Background: Civil servants are adults that cut across all ages, educational status, and social class. This study describes and compares dental service utilization among federal and state civil servants in Port Harcourt and identifies the determinants and barriers to the utilization of dental services among these groups. Materials and Methods: This study was a comparative cross-sectional study carried out among Federal and State civil servants in Port Harcourt, Rivers State, Nigeria. The study units were selected using multistage sampling technique. Data were collected using pretested self-administered questionnaires and analyzed using the Statistical Package for Social Sciences version 20.0. Results: A total of 638 participants comprising of 313 and 325 civil servants from the federal and state civil service respectively, completed and returned the questionnaires.Only 143 (22.4%) of the participants had visited the dentist in the past 1-year, this is made up of 80 (25.6%) federal and 63 (19.4%) state civil servants. Most of the federal workers 55 (68.8%) and state workers 45 (71.4%) had visited the dentist based on need. Participants with tertiary education were significantly more likely to utilize dental services (P = 0.009). The reasons for nonutilization of dental services reported among the respondents were no need for treatment 59%, cost of treatment 20%, being scared 13.5%, and fear of infection 10.3%. Conclusion: Dental visits were based on the need for treatment. Whereas education was a determinant of dental service utilization, perceived lack of treatment and cost of treatment constituted barriers to utilization of dental services.

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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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