In the recent years, numbers of suspected bite mark cases examined by forensic odontologist are increasing. Human bite mark analysis is most demanding and complicated part of forensic dentistry, involving identification of assailant by comparing record of their dentition with record of bite mark left on a victim. Like fingerprints and DNA, bite marks are unique to individual such as distance and angles between teeth, missing, and teeth fillings. This type of impression evidence can be left in the skin of a victim and also in food, chewing gums, pens, pencil, etc., In some crimes, bite mark evidence is the only evidence on which conviction has been achieved, particularly alleged rape and child abuse cases. The current protocol for collection, management, preservation analysis, and interpretation of evidences should be employed if information is to be obtained for the court. The aim of this article is to give brief overview of bite mark analysis, its clinical applications, and limitations.

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Some patients with Class II subdivision malocclusions have Class I characteristics on one side and Class II characteristics on the other. The resulting asymmetric occlusal relationship complicates orthodontic treatment. Traditionally, four premolars are extracted in such cases to achieve a bilateral Class I molar relation which needs patient compliance with the use of Class II elastics. The present case report shows one such Class II subdivision malocclusion case which was treated by asymmetric extractions. This approach is independent of the patient compliance and saved one premolar, with no compromise in dental occlusion or esthetics.

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Background: The most common dental disease facing the human race is dental caries. For caries, management of early lesions, prevention of initiation, and interruption of progression are desirable. Remineralization is an effective way of preventive management of caries. Aim: To evaluate remineralization efficacy of two different remineralizing agents. Materials and Methods: Forty enamel samples were taken, and they were divided into four groups (n = 10). Demineralization was carried out with Groups A, B, and C. Remineralization was carried out with Groups A and B for 7 continuous days using casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) and calcium sucrose phosphate (CaSP). Group D was kept as positive control with intact enamel without any surface treatment, whereas Group C was kept as negative control with surface demineralization of enamel. Microhardness testing was done using Vickers microhardness tester after 7-day remineralization cycle. Statistical Analysis: One-way analysis of variance and post hoc Tukey tests were performed. Results: Microhardness of CaSP and CPP-ACPF was comparable. Conclusion: Both remineralizing agents showed surface remineralization.

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Peripheral reactive lesions of gingiva are common lesions of the oral cavity that dentists come across in daily life. Among these are focal fibrous hyperplasia, pyogenic granuloma, peripheral giant cell granuloma, and peripheral ossifying fibroma. Localized irritation fibroma is a gingival growth, usually arising from interdental papilla due to the presence of some chronic irritation due to dental calculus or other iatrogenic factors. This article reports a case of a 39-year-old male with a recurrent irritation fibroma in the maxillary anterior gingiva treated by excision. The presence of growth in the esthetic maxillary anterior segment and the possibility of unesthetic defect due to excision of the growth have been discussed. The importance of treating the chronic infectious irritational factor and regular follow-up to prevent long-term recurrence of the growth has been discussed.

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Background: Biopsy is an important tool which aids in the diagnosis of lesions ranging from simple non-neoplastic growths to malignancies. The choice of technique depends on factors such as anatomic site and morphology of the lesion. Oral biopsies can be performed using different techniques, in which scalpel biopsy is the conventional method. Punch biopsies are also quite popular because they are safe and can be rapidly performed. However, the above techniques cannot provide hemostasis which is required on highly vascular tissues. As a result, lasers have been gaining popularity. Nevertheless, laser-tissue interactions may produce some artifactual changes, especially at the margins, such as thermal damage and coagulation which may impair the histopathological diagnosis. Aim: The aim of this study was to compare artifacts produced in scalpel, punch, and laser biopsies and to determine the most effective tool of the three in terms of oral biopsies. Materials and Methods: Thirty hematoxylin and eosin stained sections, ten each of conventional scalpel, punch, and laser biopsies, were retrieved from the archives and analyzed for artifacts under a light microscope. Results: There was no statistically significant difference between the three techniques in terms of orientation, crush, and hemorrhage. Both horizontal and vertical splits were seen in scalpel biopsies (70%) while none were present in the other two techniques. Loss of epithelium was maximum with laser biopsies, and thermal damage was also exclusively seen in this technique. Conclusion: Punch biopsy revealed the least number of artifacts. Laser, compared to scalpel and punch, produces artifacts which may render the margins of the lesions uninterpretable.

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This case report elaborates the management of white spot lesion (WSL) using air microabrasion as minimally invasive treatment modality. Air microabrasion can remove the outermost layer of enamel to manage superficial discolorations and incipient carious lesions. A WSL on the maxillary left incisor was treated conservatively with air microabrasion technique. This technique might be an alternative to chemical microabrasion, macroabrasion, and invasive restorative treatments for the management of WSLs.

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Aims: The dental clinical setting is a significant learning environment for dental undergraduates which may induce anxiety, which adversely affects the clinical performance. Hence, the aim of this study was to determine the clinical anxiety-provoking situations among dental students in Chennai. Subjects and Methods: A questionnaire-based cross-sectional survey was conducted among 375 clinical dental students in Chennai. The questionnaire used in the study consisted of 37 clinical anxiety-provoking situations. The situations were assessed using a 4-point Likert scale. The questionnaire was distributed and the students completed the questionnaire under the supervision of research assistance, who collected the completed questionnaires immediately for evaluation. Statistical Analysis Used: Data were analyzed by computerized SPSS (version 21). Results: Of the 375 respondents, 21% were male and 78.8% were female. About 98.7% of the population reported anxiety with the majority of study population experiencing moderate anxiety. Examination failure (88%), meeting clinical requirement (82.5%), fracturing a tooth while extraction (94%), extracting a wrong tooth (92%), and getting infected by the patients (92.7%) were considered as more common clinical anxiety-provoking situations. Conclusion: The challenges and stress at different stages of dental education may elicit and increase the level of anxiety which can be prevented by creating a friendly learning environment for better learning with less anxiety and fear

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Introduction: Patient desire or preference has been documented as one of the reasons for tooth extraction, but the affected patients have not been properly characterized. The objective of this study was to determine the characteristics of patients requesting for tooth extraction in a Nigerian secondary health-care setting. Materials and Methods: This study was a prospective study of patients attending the Dental Clinic of Central Hospital, Benin City, Edo State, Nigeria. An interviewer-administered questionnaire which elicited information on age, gender, educational status, dental attendance pattern, tooth extraction experience or that of close relative or friend, reasons for tooth extraction request, and awareness of tooth restoration options was the data collection tool. Data analysis was done using the IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY, USA) and P < 0.05 was considered statistically significant. Results: A total of 137 patients aged between 17 and 65 years that met the inclusion criterion were studied. The majority of the patients who requested for tooth extraction were males, aged between 26 years and 65 years, had tertiary education, and had previously visited the dental clinic. A total of 48.9% and 62.0% of the participants had previous tooth extractions and had relatives that have undergone tooth extractions, respectively. Dental visit pattern was significantly associated with tooth extraction experience. The leading reason for requesting for tooth extraction was a permanent stoppage of pain. Age and gender were not significantly associated with the reasons for requesting tooth extraction. Conclusion: Data from this study revealed that adult patients of both genders, varying ages, educational attainments, and dental attendance patterns requested for tooth extraction in the studied Nigerian secondary health-care setting, and their leading reason for the request was a permanent stoppage of pain.

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Objectives: To assess oral health status and treatment needs of the health workers in Shimla district, Himachal Pradesh. Materials and Methods: A cross-sectional study was conducted among health workers in Shimla district, Himachal Pradesh. A sample of 130 was selected by selecting three blocks randomly to get a required sample size of 126. Clinical recordings were done according to the World Health Organization diagnostic criteria 1997. The data were analyzed using SPSS package, Chicago, IL, version 16.0. The statistical tests used were t-test and ANOVA. A P < 0.05 was considered to be statistically significant. Results: The mean age of the study population was 48.42 ± 5.94 with a range of 25-57. The prevalence of dental caries in the present study was 80%. The mean decayed, missing, and filled teeth were 6 ± 5.42 and were higher in females and the age group of 55-64 years. Only 17 (13.1%) had healthy periodontium and calculus was found in 49 (47.7%) subjects. The need for prosthesis in upper jaw and lower jaw was for 33 (25.3%) and 61 (46.9%), respectively. Conclusion: The caries experience of the population was quite high. Hence, there is a need for treatment camps, and regular follow-up checkups for the health workers in Shimla district.

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Endo-perio lesions are common clinical finding in the day-to-day dentistry. The treatment approach with respect to periodontal regeneration still remains point at issue. Endodontic treatment not always leads to complete healing of periapical and periodontal tissue. In literature, surgical periodontal intervention along with the use of bone grafts, guided tissue regeneration has been attempted for regeneration. Recently, use of platelet concentrates such as platelet-rich fibrin (PRF) releasing growth factors is extensively used in dentistry for periodontal regeneration. This case report aims at evaluating the efficacy of PRF as regenerative biomaterial in the treatment of Endo-perio lesion.

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Context: Comparison between antemortem and postmortem dental records and radiographs produces results with a high degree of reliability and relative simplicity. Kvaal et al. introduced an age estimation method by indirectly measuring secondary dentin deposition on radiographs. Cameriere et al., later, put forth a method based on radiographic estimation of pulp/tooth area ratio (AR) in canines. The purpose of the present study was to assess the reliability of various teeth in Kvaal's and Cameriere's methods of age estimation in a specific populace in Central India. Materials and Methods: One hundred and ten patients aged between 15 and 75 years were selected, and the variables P = complete pulp length/root length (from enamel-cementum junction [ECJ] to root apex), r = complete pulp length/complete tooth length, a = complete pulp length/root width at ECJ level, b = pulp/root width at midpoint level between ECJ level and mid-root level, and c = pulp/root width at mid-root level and pulp/tooth AR were recorded as devised in Kvaal's and Cameriere's methods of age estimation, respectively. Statistical Analysis: Statistical analysis was performed with SPSS (version 10.5) package. Mean comparison of morphological variables was carried out using Student's t-test. Intra- and inter-observer reproducibility of measurements was studied using the concordance correlation coefficient. Results: Comparing between Kvaal's and Cameriere's methods, results of the latter method were found to be more accurate in predicting age. Conclusion: Kvaal's method showed varying results for different teeth, but Cameriere's method was more consistent, accurate and showed less variability.

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Aim: Pemphigus, life-threatening illness affects only 1-5 patients per million populations per year. Cell junctions (desmosomes) are best visualized using either conventional or freeze-fracture electron microscopy. This is the first study in itself to document cellular morphologic details in patients of pemphigus vulgaris (PV) by scanning electron microscopy (SEM) in Indian population. This study was carried out with the aim of studying the cellular morphology and changes in the cell structures in patients of PV by SEM. Materials and Methods: The study consisted of four smears each from six patients belonging to the age group of 20-45 years comprising of two males and four females diagnosed for PV. The slides were then viewed under SEM. Results: The pathologic cell showed uneven cell boundaries with irregular arrangement of ridges forming a complex pattern; also the irregular elevations of plasma membrane formed a "plaque" like appearance on the cell boundaries. Conclusion: This study has added new observations related to the cellular changes and morphology seen in patients of PV, and numerous hypotheses are also stated to correlate with the possible etiopathogenesis of PV. In future, these observations may be useful in learning the pathogenesis of the disease even in the absence of frank lesions of the disease.

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