Academia Journal of Medicine (AJM) is a distinguished, bi-annual, peer-reviewed international journal that publishes advanced research in clinical medicine. The journal covers a wide range of topics, including etiology, diagnosis, treatment, and prognosis, contributing to the broader understanding of medical science. While available both online and in print, AJM operates under a subscription-based model, requiring a fee for full access to its content. This ensures the journal's sustainability while maintaining high editorial and publication standards. Academia Journal of Medicine is now the Official Journal of Central Asian University, School of Dentistry, Tashkent. ISSN (Online): 2663-8290 ISSN (Print): 2663-8282 Key Features: Publishes original research articles, reviews, and case studies. Subscription-based model for full access to content. Bi-annual publication frequency, ensuring timely updates on critical research findings.
Artificial Intelligence in Oral Cancer Diagnosis and Prognosis: A Review
Oral cancer, predominantly oral squamous cell carcinoma (OSCC), remains a major global health burden with high morbidity and mortality rates due to late diagnosis and limited prognostic accuracy. Artificial Intelligence (AI), encompassing machine learning (ML) and deep learning (DL), has emerged as a transformative tool in healthcare, offering enhanced diagnostic precision, early detection, and prognostic prediction. AI-based systems analyze large datasets including clinical images, histopathological slides, radiographic scans, and molecular profiles to assist clinicians in decision-making. This review explores the applications of AI in oral cancer diagnosis and prognosis, highlighting recent advancements, advantages, limitations, and future perspectives.
Artificial Intelligence, Oral Cancer, OSCC, Machine Learning, Deep Learning, Diagnosis, Prognosis
Role of Early Biopsy in the Diagnosis of Oral Squamous Cell Carcinoma
Aim:The aim of this study was to evaluate the role of early biopsy in the diagnosis of oral squamous cell carcinoma (OSCC) and to assess its importance in the early detection of suspicious oral lesions. Methodology:This retrospective descriptive study included 120 patients who presented with clinically suspicious oral lesions and underwent biopsy for histopathological evaluation. Clinical records were obtained from the departmental archives of Oral Medicine and Radiology / Oral and Maxillofacial Pathology. Data regarding patient demographics, lesion site, clinical presentation, and associated risk factors were collected. Biopsy specimens were processed using routine hematoxylin and eosin staining and examined microscopically to establish the final diagnosis. Results:Out of 120 patients, the majority were males (76) and most cases were observed in the 41–60 years age group. The buccal mucosa (30%) was the most commonly affected site followed by the tongue (23.3%). Non-healing ulcers (33.3%) were the most frequent clinical presentation. Histopathological examination confirmed oral squamous cell carcinoma in 88 cases, with well-differentiated OSCC being the most common type (38.3%). Tobacco chewing (43.3%) was identified as the most prevalent risk factor among the patients. Conclusion:Early biopsy plays a crucial role in the definitive diagnosis of oral squamous cell carcinoma. Timely histopathological evaluation of suspicious oral lesions facilitates early detection, accurate diagnosis, and prompt treatment planning. Early biopsy can significantly improve prognosis and contribute to better clinical outcomes in patients with oral cancer.
biopsy, diagnosis, squamous, carcinoma, suspicious
Interdisciplinary Approach to Dental Trauma: Long-Term Functional and Esthetic Results
Aim: The aim of the present study was to evaluate the effectiveness of an interdisciplinary approach in the management of traumatic dental injuries and to assess the long-term functional and esthetic outcomes following treatment of traumatized anterior teeth. Method: A prospective clinical observational study was conducted on 60 patients aged between 8 and 25 years presenting with traumatic dental injuries involving maxillary anterior teeth. A total of 84 traumatized teeth were included in the study. Patients underwent comprehensive clinical and radiographic examination to determine the type and severity of injury. Based on the diagnosis, an interdisciplinary treatment approach involving restorative procedures, endodontic therapy, orthodontic repositioning, and replantation when required was implemented. Patients were followed clinically and radiographically at 3, 6, and 12 months to evaluate functional recovery, tooth vitality, esthetic outcome, and the presence of complications. Result: The most common type of traumatic dental injury observed was crown fracture (40.5%), followed by luxation injuries (25%), avulsion (15.5%), root fractures (11.9%), and crown-root fractures (7.1%). At the end of the 12-month follow-up period, 85.7% of the treated teeth demonstrated successful outcomes, including normal function, absence of pain, and satisfactory esthetic restoration. However, 14.3% of the cases showed complications, such as pulp necrosis, discoloration, or root resorption. Conclusion: The findings of this study indicate that an interdisciplinary treatment approach significantly improves the prognosis of traumatized teeth. Early diagnosis, appropriate treatment planning, and coordinated management among dental specialties contribute to successful functional rehabilitation and satisfactory esthetic outcomes. Regular follow-up is essential to monitor healing and detect possible complications following dental trauma.
Dental trauma, traumatic dental injuries, interdisciplinary management, anterior teeth, esthetic rehabilitation, functional outcome.
Comparative Evaluation of Postoperative Pain Following Different Irrigation Activation Techniques in Single-Visit Endodontics
Postoperative pain following endodontic treatment remains a significant clinical concern influenced by irrigation techniques. This study aimed to evaluate and compare postoperative pain following different irrigation activation methods in single-visit endodontics. A total of 90 patients were divided into three groups based on the irrigation technique used: manual dynamic agitation, passive ultrasonic irrigation, and laser-activated irrigation, and pain was assessed at different time intervals using a numerical rating scale. The results demonstrated variations in postoperative pain among the groups, with advanced activation techniques showing better pain reduction compared to conventional methods. It can be concluded that irrigation activation techniques play a significant role in minimizing postoperative pain, and their appropriate selection can improve patient comfort and clinical outcomes. Advancement of Knowledge This study provides comparative clinical evidence on the effect of different irrigation activation techniques on postoperative pain following single-visit endodontic treatment. It demonstrates that advanced activation methods, such as passive ultrasonic irrigation and laser-activated irrigation, are more effective in reducing postoperative pain compared to conventional approaches.The findings highlight the role of improved irrigant penetration and reduced apical extrusion in minimizing periapical inflammation and patient discomfort. Additionally, this study emphasizes the importance of selecting appropriate irrigation techniques as a key factor in enhancing clinical outcomes and patient satisfaction in endodontic therapy.
Postop erative pain; Endodontics; Irrigation activation; Passive ultrasonic irrigation; Laser-activated irrigation; Manual dynamic agitation; Single-visit root canal treatment
Malignant Transformation of Oral Submucous Fibrosis: Risk Factors and Biomarkers – A Comprehensive Review
Oral submucous fibrosis (OSMF) is a chronic, progressive, potentially malignant disorder predominantly associated with areca nut consumption. It is characterized by fibrosis of the oral mucosa, leading to restricted mouth opening and increased risk of malignant transformation into oral squamous cell carcinoma (OSCC). The rate of malignant transformation varies widely, emphasizing the need for early identification of high-risk individuals. This review aims to summarize the key risk factors and emerging biomarkers associated with malignant transformation in OSMF. Major risk factors include prolonged areca nut use, tobacco consumption, genetic susceptibility, nutritional deficiencies, and chronic inflammation. Recent advances have highlighted the role of molecular biomarkers such as p53, Ki-67, cyclin D1, and various salivary and serum markers in predicting malignant potential. Understanding these factors is crucial for early diagnosis, risk stratification, and timely intervention. The integration of clinical assessment with molecular diagnostics may improve patient outcomes and reduce the burden of oral cancer.
Supernumerary Teeth: Current Concepts and Clinical Implications
Supernumerary teeth are developmental anomalies characterized by the presence of teeth in excess of the normal dentition, occurring in both primary and permanent dentitions. They are most commonly observed in the maxillary anterior region as mesiodens and may lead to various complications such as delayed eruption, crowding, midline diastema, and impaction of adjacent teeth. The etiology is considered multifactorial, with the dental lamina hyperactivity theory being the most widely accepted, along with genetic and syndromic associations. Advances in diagnostic techniques, particularly cone-beam computed tomography, have significantly improved the localization and assessment of these teeth, facilitating precise treatment planning. Management strategies range from periodic observation to surgical removal, often followed by orthodontic intervention, with the timing of extraction remaining a subject of ongoing debate. This review aims to provide a comprehensive and updated overview of the etiology, classification, clinical features, diagnosis, and management of supernumerary teeth, with emphasis on recent advances and their clinical implications
Perceptions and Preferences of Indian Clinicians Towards Metoprolol–Am lodipine Fixed-Dose Combination Therapy in Hypertension Management: A Cross-Sectional Survey-Based Study
Background:Hypertension remains a leading contributor to cardiovascular morbidity and mortality in India. Combination therapy using fixed-dose formulations like Metoprolol (a β-blocker) and Amlodipine (a calcium channel blocker) has gained attention for improved compliance and synergistic efficacy. However, clinician perspectives on such combinations remain underreported in Indian settings. Objective:To assess the perceptions, prescribing preferences, and clinical rationale of Indian medical professionals regarding the use of Metoprolol–Amlodipine fixed-dose combination (FDC) therapy in the management of hypertension.Methods:A descriptive, cross-sectional survey was conducted among 112 practicing clinicians using a structured questionnaire. The tool captured demographic details, prescribing patterns, therapeutic rationale, patient age-related choices, and perceived benefits or limitations of the Metoprolol–Amlodipine FDC.Results:The majority of respondents (78.6%) preferred the Metoprolol–Amlodipine combination over other antihypertensive FDCs, particularly in younger patients and those with coexisting anxiety or high sympathetic tone. Perceived advantages included effective BP control (86%), improved adherence (72%), and symptom relief. Logistic regression revealed significant associations between clinician age group, years of experience, and preference for the combination (p < 0.05).Conclusion:Indian clinicians show a strong preference for Metoprolol–Amlodipine FDC therapy, attributing it to enhanced therapeutic efficacy, tolerability, and patient compliance. These findings support the growing clinical utility of β-blocker–CCB combinations in routine hypertension management and underscore the need for updated guidelines reflecting real-world practices.
Comparative Evaluation of the Antimicrobial Activity of Triphala Hydrogel Against Amoxicillin: An In Vitro Study
Background: Ayurveda is a traditional Indian system of medicine that utilizes plant-based formulations for preventive and curative healthcare. Triphala, a tridoshic rasayana composed of Emblica officinalis, Terminalia chebula, and Terminalia bellerica, possesses well-documented antimicrobial properties attributed to tannins, flavonoids, phenols, and other polyphenolic compounds. Considering the growing concern of antimicrobial resistance, herbal alternatives are gaining attention in dental therapeutics. Aim: To comparatively evaluate the antimicrobial activity of Triphala hydrogel against Escherichia coli and Bacillus subtilis using amoxicillin as the standard control. Materials and Methods: An in vitro study was conducted using Triphala hydrogel formulations prepared at concentrations ranging from 2–10% w/v (F1–F5). Antimicrobial efficacy was assessed by agar diffusion method against Bacillus subtilis and Escherichia coli. Zones of inhibition (ZOI) were measured in millimetres and compared with amoxicillin as the positive control. Results: A concentration-dependent increase in antimicrobial activity was observed against both organisms. Against Bacillus subtilis, ZOI increased from 9.2 ± 0.5 mm (2% w/v) to 21.6 ± 0.9 mm (10% w/v). Against Escherichia coli, ZOI increased from 8.7 ± 0.5 mm to 19.4 ± 0.9 mm across the same concentration range. Amoxicillin demonstrated significantly higher inhibition zones (27.5 ± 1.2 mm and 26.8 ± 1.1 mm against Bacillus subtilis and Escherichia coli, respectively). Triphala formulations exhibited moderate yet significant antimicrobial activity, with the 10% w/v formulation showing optimal efficacy. Conclusion: Triphala hydrogel demonstrated dose-dependent antimicrobial activity against both gram-positive and gram-negative bacteria. Concentrations of 8–10% w/v appear optimal for therapeutic applications. Triphala-based hydrogels may serve as promising adjunctive herbal antimicrobial agents in dental care, particularly in the context of increasing antibiotic resistance.
amoxicillin comparisonRemove Triphala hydrogel
Artificial Intelligence in Dentistry: An Umbrella Review of Systematic Reviews
Background: Artificial intelligence (AI) has rapidly emerged as a transformative technology in healthcare, including dentistry. AI-driven systems are increasingly being used for diagnostic imaging, treatment planning, and predictive analysis. Numerous systematic reviews have evaluated the role of AI across various dental specialties. However, a comprehensive synthesis of these reviews is lacking.Objective: This umbrella review aims to summarize and critically analyze the evidence from systematic reviews evaluating the applications and outcomes of artificial intelligence in dentistry.Methods: Electronic databases including PubMed, Scopus, and Google Scholar were searched for systematic reviews assessing artificial intelligence applications in dentistry. Reviews published in English that evaluated clinical, diagnostic, or educational applications of AI were included. Data extraction included author details, year of publication, focus area, and key findings. Results: A total of eight systematic reviews were included. The evidence suggests that AI is widely applied in dental radiology, orthodontics, pediatric dentistry, and implantology. AI-based systems demonstrated improved diagnostic accuracy in detecting dental caries, periodontal bone loss, and periapical lesions. Additionally, AI has shown promising potential in treatment planning and clinical decision support. However, limitations such as data heterogeneity, limited clinical validation, and ethical concerns were reported.Conclusion: Artificial intelligence demonstrates considerable potential to enhance diagnostic accuracy and clinical efficiency in dentistry. Despite encouraging findings, further high-quality clinical studies and standardized validation protocols are required before widespread integration of AI technologies in routine dental practice.
Emerging Innovations and Clinical Perspectives in Dental Implantology: A Contemporary Review
Dental implants have become a reliable and widely accepted treatment option for replacing missing teeth. Continuous advancements in biomaterials, implant design, digital technologies, and regenerative procedures have significantly enhanced the predictability and long-term success of implant therapy. Modern developments such as surface modification techniques, computer-guided implant placement, and biologically active coatings have improved osseointegration and treatment outcomes. Furthermore, digital workflows and advanced imaging techniques allow clinicians to plan and execute implant procedures with greater accuracy. Despite these improvements, complications such as peri-implant diseases and the need for long-term clinical evidence remain important concerns. This review discusses contemporary advancements in dental implantology and highlights potential future directions aimed at improving patient care and clinical success.
Pit and Fissure Sealants in Caries Prevention: Materials, Techniques, and Evidence-Based Outcomes
Dental caries is among the most common chronic diseases in the world that is disproportionately present in the occlusal surfaces of the posterior teeth with complex morphology of pits and fissures where there is the presence of biofilm and conducive demineralization by acid. Pit and fissure sealants are one of the prevention measures that serve as a strategy due to their ability to cause a barrier between the exposed tooth surface and the oral environment, and hence the prevention of bacterial colonization and consequent carious lesions. This narrative review focuses on the current evidence on the topic of pit and fissure sealants, including the history of sealant materials, the mechanisms of their application, their retention, their caries-preventive effectiveness, and their cost-effectiveness. The review combines the results of clinical trials, systematic reviews, meta-analyses that were carried out during a number of decades to present an all-encompassing evaluation of the purpose of sealants in modern preventive dentistry. Some of the key themes covered are comparative efficacy of resin based and glass ionomer sealants, effects of isolation and surface preparation methods on the retention of sealants, the use of sealants over incipient carious lesions and new bioactive materials. The literature is consistently in favor of the efficacy of pit and fissure sealants in preventing the occlusal caries by 60 to 90 percent when properly retained, and best results are noticed in the high risk groups. Nevertheless, there are some gaps in terms of long term follow up data, the best choice of material to use in different clinical settings, and what should be done to enhance sealant programs in underserved communities. The review shows that the application of sealants must be incorporated into an overall plan of managing caries and also provides an insight into the future opportunities in material science and policy development
Effect of Preemptive Etoricoxib on Postoperative Pain Following Mandibular Third Molar Extraction: A Prospective Study
Background: Preemptive analgesia refers to the administration of analgesic medication before a painful stimulus in order to reduce postoperative pain. This approach helps bridge the time gap between the onset of action of analgesic agents and the waning effect of local anesthesia. Previous studies have also highlighted the role of central sensitization, a condition characterized by increased responsiveness of the nervous system to noxious stimuli, which can intensify postoperative pain. Administration of analgesics prior to the procedure may help prevent central sensitization and provide improved postoperative pain control. Aim: To evaluate the effect of preoperative administration of etoricoxib 90 mg on postoperative pain following extraction of a single mandibular third molar. Material and Method: A double-blinded prospective observational study was conducted on 50 patients undergoing extraction of a single mandibular third molar. Participants were divided into two groups: the study group received tablet etoricoxib 90 mg 30 minutes prior to the procedure, while the control group received a placebo. Postoperative pain intensity was assessed using a visual analog scale (VAS) at 1 hour, 6 hours, 12 hours, and 24 hours after the extraction. The results were analyzed using the independent samples t-test. Results: Patients who received etoricoxib reported lower postoperative pain scores compared with the placebo group at all evaluation intervals. The difference in pain intensity was most notable during the early postoperative period and gradually decreased over time, although the study group consistently demonstrated lower VAS scores than the control group throughout the 24-hour observation period. Conclusion: Preemptive administration of etoricoxib 90 mg prior to mandibular third molar extraction can effectively reduce postoperative pain compared with placebo, particularly during the early postoperative phase. This approach may serve as a useful strategy for improving postoperative pain management in dental extraction procedures.
Indications for Zygomatic Implants: A Narrative Review
Zygomatic implants represent a reliable graftless solution for the rehabilitation of patients with severe maxillary bone deficiency. Originally developed for maxillary defects following tumor resection, their clinical indications have expanded considerably with advances in surgical techniques and prosthetic protocols. This narrative review aims to summarize and critically discuss the contemporary indications for zygomatic implants based on evidence synthesized from recent systematic reviews and key clinical studies. Severe maxillary atrophy remains the most common indication, followed by avoidance of bone grafting procedures, management of failed grafts or implants, oncologic and traumatic defects, congenital anomalies, and medically compromised patients. Despite high reported survival rates, zygomatic implant therapy is technique sensitive and requires careful patient selection and surgical expertise. Standardization of indication criteria and high-quality prospective studies are needed to further refine clinical guidelines.
Zygomatic implants, Maxillary atrophy, Implant dentistry
Regenerative Endodontics: Biological Basis, Clinical Protocols, and Outcomes
Regenerative endodontic procedures have emerged as a paradigm-shifting approach in the management of immature permanent teeth with pulp necrosis, offering a biologically driven alternative to traditional apexification techniques. Unlike conventional approaches that merely create an apical barrier, regenerative strategies aim to restore functional pulp like tissue within the root canal system, thereby promoting continued root development, dentinal wall thickening, and apical closure. The biological foundation of regenerative endodontics rests upon three fundamental pillars of tissue engineering: stem cells, bioactive scaffolds, and growth factors. Stem cells of the apical papilla, surviving within the periapical region even after pulp necrosis, represent a critical cellular resource capable of differentiating into odontoblast-like cells and contributing to the formation of mineralized tissue. Clinical protocols have evolved considerably since the earliest case reports, with contemporary guidelines emphasizing thorough canal disinfection using minimally cytotoxic irrigants and intracanal medicaments, followed by the intentional induction of a blood clot scaffold through periapical instrumentation. Bioactive materials such as mineral trioxide aggregate and bioceramic cements serve as coronal barriers, providing a biocompatible seal that supports tissue regeneration. Reported clinical outcomes include resolution of periapical pathology, continued root lengthening, increased root wall thickness, and apical closure, although the histological nature of the regenerated tissue remains a subject of ongoing investigation. This narrative review comprehensively examines the biological underpinnings, contemporary clinical protocols, and documented outcomes of regenerative endodontic procedures, while critically evaluating current controversies, limitations, and future directions in this rapidly evolving field.
Regenerative endodontics; revascularization; stem cells; apical papilla; tissue engineering; immature teeth; pulp regeneration
Dental caries is among the most common chronic diseases in the world that is disproportionately present in the occlusal surfaces of the posterior teeth with complex morphology of pits and fissures where there is the presence of biofilm and conducive demineralization by acid. Pit and fissure sealants are one of the prevention measures that serve as a strategy due to their ability to cause a barrier between the exposed tooth surface and the oral environment, and hence the prevention of bacterial colonization and consequent carious lesions. This narrative review focuses on the current evidence on the topic of pit and fissure sealants, including the history of sealant materials, the mechanisms of their application, their retention, their caries-preventive effectiveness, and their cost-effectiveness. The review combines the results of clinical trials, systematic reviews, meta-analyses that were carried out during a number of decades to present an all-encompassing evaluation of the purpose of sealants in modern preventive dentistry. Some of the key themes covered are comparative efficacy of resin based and glass ionomer sealants, effects of isolation and surface preparation methods on the retention of sealants, the use of sealants over incipient carious lesions and new bioactive materials. The literature is consistently in favor of the efficacy of pit and fissure sealants in preventing the occlusal caries by 60 to 90 percent when properly retained, and best results are noticed in the high risk groups. Nevertheless, there are some gaps in terms of long term follow up data, the best choice of material to use in different clinical settings, and what should be done to enhance sealant programs in underserved communities. The review shows that the application of sealants must be incorporated into an overall plan of managing caries and also provides an insight into the future opportunities in material science and policy development.
pit and fissure sealants, dental caries prevention, resin-based sealants, glass ionomer cement, caries risk assessment, evidence based dentistry, preventive dentistry
Tobacco and Tobacco-Related Oral Lesions: Current Concepts and Updates
Tobacco use remains a leading preventable cause of morbidity and mortality worldwide and is strongly linked to numerous oral mucosal lesions, ranging from reversible keratotic changes to Oral squamous cell carcinoma. Both smoked and smokeless tobacco damage oral tissues through chemical, thermal, and immunologic mechanisms. Emerging products such as electronic cigarette and heat-not-burn device present new challenges for dental professionals. Tobacco-related lesions include smoker’s palate, tobacco pouch keratosis, oral leukoplakia, erythroplakia, oral submucous fibrosis, and OSCC, many classified as oral potentially malignant disorders. Early detection is essential to reduce malignant transformation and improve prognosis. Advances in molecular biology and salivary diagnostics, including biomarker and immunologic testing, have enhanced early identification. Dental professionals play a vital role in screening, patient education, tobacco cessation counseling, and timely intervention to improve overall oral and systemic health outcomes.
Tobacco, Oral potentially malignant disorders, Oral leukoplakia, Oral submucous fibrosis, Smokeless tobacco, Oral cancer
Clinical Outcomes Of Curcumin And Ornidazole Gel As Adjuncts To Nonsur gical Periodontal Therapy
Background: Local drug delivery systems are frequently used as adjuncts to scaling and root planing (SRP) to improve clinical outcomes in the management of chronic periodontitis. Curcumin, a naturally derived anti-inflammatory and antimicrobial agent, has emerged as a potential alternative to conventional antimicrobials such as ornidazole. Aim: To comparatively evaluate the clinical efficacy of curcumin gel and ornidazole gel as adjuncts to nonsurgical periodontal therapy in patients with chronic periodontitis. Materials and Methods: This randomized split-mouth clinical study was conducted on twenty systemically healthy individuals of both sexes aged 30–45 years, diagnosed with chronic periodontitis and presenting with bilateral periodontal pockets ≥5 mm. Following full-mouth scaling and root planing, curcumin gel and ornidazole gel were locally delivered into periodontal pockets in symmetric quadrants. Clinical parameters including plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline and at 30 days post-treatment. Results: Both treatment groups showed significant improvement in all clinical parameters at the 1-month follow-up. However, sites treated with curcumin gel demonstrated a statistically greater reduction in PPD and PI, along with superior CAL gain, compared to sites treated with ornidazole gel. Conclusion: Within the limitations of the present study, curcumin gel showed more favorable clinical outcomes than ornidazole gel when used as an adjunct to scaling and root planing. Curcumin may therefore be considered an effective and biocompatible adjunct in the nonsurgical treatment of chronic periodontitis.
Evaluation of White Spot Lesions Following Fixed Orthodontic Treatment: A Clinical Study
Background: White spot lesions are a common undesirable effect associated with fixed orthodontic treatment due to prolonged plaque accumulation around brackets and bands. These lesions represent early enamel demineralization and may compromise esthetics and long-term oral health. Aim: To evaluate the prevalence and severity of white spot lesions in patients following fixed orthodontic treatment. Materials and Methods: This clinical study was conducted on patients who had completed fixed orthodontic treatment. A total of 60 subjects were examined immediately after debonding. The presence and severity of white spot lesions were assessed using visual examination under standardized lighting conditions and scored according to the International Caries Detection and Assessment System (ICDAS). The distribution of lesions was analyzed with respect to tooth type and surface involved. Statistical analysis was performed using descriptive statistics and chi-square test. Results: White spot lesions were observed in a significant proportion of patients following fixed orthodontic therapy. Maxillary anterior teeth showed a higher prevalence compared to posterior teeth. The majority of lesions were classified as early enamel changes without cavitation. A statistically significant association was found between treatment duration and occurrence of white spot lesions (p < 0.05). Conclusion: White spot lesions remain a prevalent complication following fixed orthodontic treatment. Early detection and preventive strategies are essential to minimize enamel demineralization during orthodontic therapy. Clinical Significance: Regular monitoring, patient motivation, and the use of preventive measures such as fluoride applications can reduce the incidence and severity of white spot lesions during fixed orthodontic treatment.
White spot lesions, Fixed orthodontic treatment, Enamel demineralization, Orthodontic brackets, ICDAS, Preventive dentistry
Case Report on Capillary Hemangioma of the Maxillofacial Region
Capillary hemangiomas are benign vascular proliferations that commonly present in childhood but can persist or appear in adulthood. This case report discusses a rare presentation of an extensive capillary hemangioma involving the maxillofacial region. The patient presented with progressive swelling over three months, with significant facial asymmetry. Diagnosis was confirmed through clinical, radiological, and histopathological examination. The lesion was surgically excised, with post-operative recovery documented. This case highlights the clinical presentation, diagnostic approach, and surgical management of capillary hemangiomas in the maxillofacial region. A comprehensive discussion is included to explore the histopathological features, pathogenesis, differential diagnoses, psychosocial considerations, and therapeutic approaches including current advancements and consensus guidelines.
Capillary Hemangioma, Vascular Tumor, Maxillofacial Swelling, ISSVA classification, Surgical Excision, Immunohistochemistry, MRI, Psychosocial Impact
Comparative Evaluation of the Efficacy and Onset of Local Anesthesia Using Buffered 2% Lidocaine with 1:100,000 Adrenaline and Non-Buffered 2% Lido caine with 1:100,000 Adrenaline in Dental Extraction – A Clinical Study
Aim: To comparatively evaluate the onset time and efficacy of buffered 2% lidocaine with 1:100,000 adrenaline and non-buffered 2% lidocaine with 1:100,000 adrenaline in patients undergoing dental extraction. Materials and Methods: This randomized, single-blind clinical study was conducted on 40 patients indicated for simple dental extraction. The patients were randomly divided into two groups (n = 20 each). Group I received non-buffered 2% lidocaine with 1:100,000 adrenaline, while Group II received buffered 2% lidocaine with 1:100,000 adrenaline. The buffered solution was prepared by adding 8.4% sodium bicarbonate to the anesthetic solution immediately before administration. The onset time of anesthesia was recorded using a stopwatch from completion of injection to the first subjective sign of numbness. Pain during injection and pain during extraction were assessed using a Visual Analog Scale (VAS). The need for supplementary anesthesia was also recorded. Statistical analysis was performed using the independent t-test and Chi-square test, with the level of significance set at p < 0.05. Results: The buffered lidocaine group demonstrated a significantly faster onset of anesthesia compared to the non-buffered group (p < 0.05). Pain scores during injection and during extraction were significantly lower in the buffered group. Additionally, fewer patients in the buffered group required supplementary anesthesia. Conclusion: Buffered 2% lidocaine with 1:100,000 adrenaline provides faster onset and improved anesthetic efficacy with reduced pain perception compared to non-buffered lidocaine during dental extraction. Its use may enhance patient comfort and clinical efficiency in routine dental practice.
Buffered local anesthesia, lidocaine, onset time, dental extraction, pain perception
Comparative Evaluation of Shear Bond Strength of Glass Ionomer Cement, Resin-Modified Glass Ionomer Cement and Alkasite Restorative Material to Human Dentin: An In-Vitro Study
Background: Durable adhesion between restorative materials and dentin is essential for the longevity and clinical success of restorations. Conventional glass ionomer cement (GIC), resin-modified glass ionomer cement (RMGIC), and alkasite restorative materials are widely used because of their fluoride release, chemical bonding potential, and simplified clinical application; however, their comparative bonding performance remains inconclusive. Aim: To compare the shear bond strength (SBS) of conventional GIC, RMGIC, and alkasite restorative material to human dentin. Materials and Methods: Thirty extracted human premolars were sectioned to expose flat mid-coronal dentin surfaces and randomly allocated into three groups (n = 10): Group I—conventional GIC, Group II—RMGIC, and Group III—alkasite restorative material. Restorations were placed according to manufacturers’ instructions using a standardized cylindrical mold. After storage in distilled water at 37 °C for 24 hours, specimens were subjected to shear bond strength testing using a universal testing machine at a cross-head speed of 1 mm/min. SBS values were calculated in megapascals (MPa) and statistically analyzed using one-way analysis of variance followed by Tukey’s post-hoc test (α = 0.05). Results: Alkasite restorative material demonstrated the highest mean shear bond strength (14.06 ± 1.87 MPa), followed by RMGIC (11.52 ± 1.74 MPa) and conventional GIC (8.94 ± 1.58 MPa). The differences among the three groups were statistically significant (p < 0.001). Conclusion: Within the limitations of this in-vitro study, alkasite restorative material exhibited superior bonding to dentin compared with both types of glass ionomer cements. Conventional GIC showed the lowest shear bond strength.
Shear bond strength; glass ionomer cement; resin-modified glass ionomer cement; alkasite; dentin adhesion; restorative dentistry
Effect of Immediate Versus Delayed Chlorhexidine Rinse on Post-Extraction Pain: A Randomized Clinical Study
Background: Chlorhexidine mouth rinse is routinely prescribed after tooth extraction to reduce microbial load. However, the optimal timing of its use remains unclear and may influence postoperative pain. Aim: To compare the effect of immediate versus delayed chlorhexidine mouth rinse on post extraction pain following simple tooth extraction. Materials and Methods: Sixty systemically healthy patients undergoing simple tooth extraction were randomly allocated into two groups. Group I used 0.12% chlorhexidine mouth rinse immediately after extraction, while Group II initiated the rinse 24 hours post-extraction. Postoperative pain was evaluated using a Visual Analog Scale (VAS) on postoperative day 1 and day 3. Statistical analysis was performed using the independent t-test with significance set at p < 0.05. Results: Patients in the immediate rinse group reported significantly higher pain scores on postoperative day 1 compared to the delayed rinse group (p < 0.05). By postoperative day 3, pain scores decreased in both groups, with no statistically significant difference observed. Conclusion: Delaying the use of chlorhexidine mouth rinse for 24 hours after tooth extraction reduces early postoperative pain. Avoidance of immediate rinsing may help preserve the blood clot and enhance patient comfort during the initial healing period.
Tooth extraction, chlorhexidine mouth rinse, postoperative pain, timing, oral surgery
Knowledge, Awareness, and Practices Regarding Oral Cancer Screening Among General Dentists: A Cross-Sectional Study
Background Oral cancer is a major public health problem in India, with high morbidity and mortality largely due to late diagnosis. General dentists are often the first healthcare professionals to examine the oral cavity and thus play a critical role in early detection through routine oral cancer screening. Aim: To assess the knowledge, awareness, and clinical practices related to oral cancer screening among general dentists. Materials and Methods: A descriptive cross-sectional questionnaire-based study was conducted among 150 general dental practitioners. A validated, self-administered questionnaire comprising demographic details, knowledge, awareness, and practice-related questions was distributed. Data were analyzed using descriptive statistics and chi-square test to assess associations between variables. Results: Out of 150 participants, 62% demonstrated moderate knowledge, 24% had good knowledge, and 14% had poor knowledge regarding oral cancer screening. Although 78% were aware of oral cancer screening methods, only 46% reported performing routine oral mucosal examinations for all patients. Lack of training (48%) and time constraints (41%) were identified as major barriers. A statistically significant association was observed between years of clinical experience and knowledge scores (p < 0.05). Conclusion: While general dentists demonstrated fair awareness of oral cancer screening, gaps were observed in routine screening practices. Structured continuing dental education programs and hands-on training are recommended to enhance early detection and reduce oral cancer burden.
Oral cancer, Screening, Knowledge, Awareness, General dentists, Early detection
Effect of Sugar-Free Chewing Gum on Salivary Flow Rate and Dental Plaque Levels: An Observational Study
Background: Saliva plays a crucial role in maintaining oral health by neutralizing acids, providing antimicrobial action, and aiding in mechanical cleaning. Chewing sugar-free gum has been suggested to stimulate salivary flow and reduce plaque accumulation, but clinical evidence remains limited. Aim: To evaluate the effect of sugar-free chewing gum on salivary flow rate and dental plaque levels in healthy adults. Materials and Methods: A Clinical trial was conducted on 40 healthy adult volunteers. Participants were instructed to chew sugar-free gum for 10 minutes, three times daily, after meals for 7 days. Unstimulated and stimulated salivary flow rates were measured at baseline and after the intervention. Plaque levels were assessed using the Plaque Index (Silness & Löe) at baseline and post-intervention. Data were analyzed using paired t-tests, with significance set at p < 0.05. Results: Chewing sugar-free gum significantly increased stimulated salivary flow rates (p < 0.01) and led to a significant reduction in plaque scores (p < 0.05) compared to baseline. Conclusion: Sugar-free chewing gum effectively stimulates salivary flow and reduces plaque accumulation. It can be recommended as an adjunct to routine oral hygiene, particularly in individuals with low salivary flow or at high risk of dental caries.
Salivary flow, Den tal Plaque, Sugar-free
Evaluation of Oral Hygiene Status in Patients Using Clear Aligners Versus Fixed Orthodontic Appliances
Background:Orthodontic appliances can adversely affect oral hygiene by promoting plaque accumulation and gingival inflammation. Fixed orthodontic appliances are associated with increased plaque-retentive areas, whereas clear aligners, being removable, may facilitate better oral hygiene maintenance. Aim:To evaluate and compare the oral hygiene status in patients undergoing orthodontic treatment with clear aligners and fixed orthodontic appliances. Materials and Methods:A comparative clinical study was conducted on 60 orthodontic patients divided into two groups: Group A comprised 30 patients treated with clear aligners, and Group B comprised 30 patients treated with fixed orthodontic appliances. Oral hygiene status was assessed using the Plaque Index (Silness and Löe) and Gingival Index (Löe and Silness). The collected data were statistically analyzed using the independent t-test. Results:The mean plaque and gingival index scores were significantly lower in the clear aligner group compared to the fixed appliance group (p < 0.05), indicating superior oral hygiene and gingival health among aligner-treated patients. Conclusion: Patients treated with clear aligners demonstrated better oral hygiene status than those treated with fixed orthodontic appliances. Clear aligners may therefore be considered a favorable treatment option for patients where maintenance of periodontal health is a priority.
Clear aligners, fixed orthodontic appliances, oral hygiene, plaque index, gingival index
Validation of the HEART Score in Patients with Undifferentiated Chest Pain: A Prospective Cohort Study
Background: Chest pain represents one of the most common and challenging presentations in emergency medicine, requiring rapid differentiation between life-threatening cardiac conditions and benign etiologies. The HEART score was developed to risk stratify patients with chest pain for major adverse cardiac events (MACE), yet validation across diverse populations and healthcare settings remains essential for confident clinical implementation. Methods: A prospective observational cohort study was conducted at our tertiary care hospital over 20 months, enrolling 892 adult patients presenting with chest pain suggestive of possible acute coronary syndrome. HEART scores were calculated at presentation, and patients were followed for 6 weeks. The primary outcome was occurrence of MACE, defined as acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, or all-cause mortality. Results: The mean age was 54.8 ± 14.2 years, with 58.4% male patients. The mean HEART score was 4.2 ± 1.8. MACE occurred in 142 patients (15.9%). The area under the ROC curve for MACE prediction was 0.867 (95% CI: 0.838–0.896). Low-risk patients (HEART score 0-3) experienced MACE in 2.1% of cases (8/386), intermediate-risk (score 4-6) in 18.4% (68/370), and high-risk (score 7-10) in 48.5% (66/136). A HEART score ≤3 demonstrated 94.4% sensitivity and 65.7% specificity with negative predictive value of 97.9%. Conclusion: The HEART score demonstrates excellent discriminatory ability for predicting MACE in patients with undifferentiated chest pain, effectively identifying low-risk patients suitable for early discharge and outpatient management.
HEART score; chest pain; acute coronary syndrome; major adverse cardiac events; risk stratification; emergency department; validation study
Utility of NEWS-2 in Predicting ICU Admission from Emergency Department and Mortality Risk: A Prospective Cohort Study
Background: The National Early Warning Score 2 (NEWS-2) is a standardized clinical tool designed to detect acute deterioration in hospitalized patients. Its utility in predicting critical outcomes directly from the emergency department (ED) remains an area of active investigation. Methods: A prospective cohort study was conducted at a tertiary care hospital over 18 months, enrolling 847 adult patients presenting to the ED. NEWS-2 scores were calculated upon arrival, and patients were followed until hospital discharge or death. Primary outcomes included ICU admission within 48 hours and 30-day in-hospital mortality. Receiver operating characteristic (ROC) curve analysis, logistic regression, and survival analysis were performed. Results: The mean age was 58.4 ± 16.7 years, with 54.3% male patients. The mean NEWS 2 score was 5.8 ± 3.4. ICU admission occurred in 127 patients (15.0%), and 30-day mortality was 8.7% (n=74). Patients requiring ICU admission had significantly higher NEWS-2 scores (9.2 ± 2.8 vs. 5.2 ± 3.1, p<0.001). The area under the ROC curve (AUC) for predicting ICU admission was 0.847 (95% CI: 0.812–0.882), and for mortality was 0.891 (95% CI: 0.854–0.928). A NEWS-2 score ≥7 demonstrated 78.7% sensitivity and 81.2% specificity for ICU admission prediction. Conclusion: NEWS-2 scores at ED presentation demonstrate excellent discriminatory ability for predicting ICU admission and mortality, supporting its implementation as a triage and risk stratification tool in emergency settings.
NEWS-2; emergency department; ICU admission; mortality prediction; early warning score; critical care; triage
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Comparative Evaluation of Retention of Different Luting Cements for Im plant-Supported Crowns: An In Vitro Study
Background: Retention of implant-supported crowns is a critical factor influencing the long-term success of implant prostheses. The choice of luting cement plays an important role in determining the retentive strength, retrievability, and clinical performance of cement retained implant restorations. Aim: To comparatively evaluate the retention of implant-supported crowns cemented with zinc phosphate cement, resin cement, and resin-modified glass ionomer cement using a universal testing machine in an in vitro setting. Materials and Methods: Thirty implant–abutment–crown assemblies were fabricated and divided into three groups (n = 10) based on the luting cement used: Group I—zinc phosphate cement, Group II—resin cement, and Group III—resin-modified glass ionomer cement. Standardized full-coverage metal crowns were cemented onto prefabricated titanium abutments following manufacturer instructions. All specimens were stored in distilled water at 37°C for 24 hours. Retention was evaluated by applying a tensile load along the long axis of the implant using a universal testing machine at a crosshead speed of 1 mm/min until crown dislodgement occurred. The maximum pull-out force required was recorded in Newtons and statistically analyzed. Results: The highest mean retentive strength was observed in the resin cement group, followed by resin-modified glass ionomer cement, while zinc phosphate cement demonstrated the lowest retention. Statistical analysis revealed a significant difference in pull-out force values among the three groups (p < 0.05). Conclusion: Within the limitations of this in vitro study, resin cement provided superior retention for implant-supported crowns compared to resin-modified glass ionomer cement and zinc phosphate cement. Selection of luting cement should consider the balance between retention requirements and the need for retrievability in implant prosthodontics.
Implant supported crowns; Luting cements; Retention; Pull-out force; In vitro study
Pneumonia Severity Assessment: CURB-65 versus PSI in Predicting Admission Need and Mortality — A Prospective Comparative Study
Background: Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality worldwide. Accurate severity assessment is crucial for determining appropriate disposition and treatment intensity. The CURB-65 and Pneumonia Severity Index (PSI) are widely utilized scoring systems, yet their comparative performance in diverse clinical settings continues to be debated. Methods: A prospective cohort study was conducted at two teaching hospitals over 24 months, enrolling 634 adult patients with confirmed CAP. Both CURB-65 and PSI scores were calculated at presentation. Primary outcomes included requirement for hospital admission and 30-day all-cause mortality. Receiver operating characteristic (ROC) curve analysis and comparative statistics were performed. Results: The mean age was 62.7 ± 18.4 years, with 56.8% male patients. Hospital admission was required in 412 patients (65.0%), and 30-day mortality occurred in 58 patients (9.1%). For mortality prediction, PSI demonstrated an AUC of 0.842 (95% CI: 0.798– 0.886) compared to 0.814 (95% CI: 0.766–0.862) for CURB-65 (p=0.089). For predicting admission need, PSI showed superior discrimination (AUC 0.812 vs. 0.758, p=0.012). PSI risk class IV-V had 87.9% sensitivity and 72.4% specificity for mortality, while CURB-65 ≥3 showed 79.3% sensitivity and 78.6% specificity. Conclusion: Both scoring systems demonstrate good predictive accuracy for mortality in CAP patients. PSI shows superior performance for determining admission need, while CURB-65 offers comparable mortality prediction with greater simplicity. Clinical context should guide score selection.
Effect of Ice Pack Application on Post-Extraction Pain and Swelling: A Ran domized Clinical Study
Background: Post-extraction pain and facial swelling are common complications following dental extraction and can adversely affect patient comfort. Cryotherapy using ice pack application is a simple, economical, and non-invasive method used to reduce postoperative inflammation; however, its clinical effectiveness needs further evaluation. Aim: To evaluate the effect of ice pack application on postoperative pain and facial swelling following dental extraction. Materials and Methods: This randomized clinical study included 30 patients requiring routine dental extraction. The patients were randomly allocated into two groups with 15 patients in each group. Group I (Ice Pack Group) received extraoral ice pack application intermittently for 20 minutes during the first postoperative hour, while Group II (Control Group) received standard postoperative care without ice pack application. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 6, 12, and 24 hours, and facial swelling was evaluated using standardized facial measurements at 24 and 48 hours post extraction. Statistical analysis was performed with the level of significance set at p < 0.05. Results: Group I demonstrated significantly lower mean pain scores and reduced facial swelling at all postoperative evaluation intervals compared to Group II (p < 0.05). The reduction in pain and swelling was more pronounced during the first 24 hours following extraction. Conclusion: Extraoral ice pack application is an effective adjunct in reducing postoperative pain and facial swelling following dental extraction. Its routine use can enhance patient comfort and postoperative recovery.