BackgroundMaternal and child oral health (MCOH) plays an important role in preventing early childhood caries and improving pregnancy outcomes. Despite global recognition of this link, India has no formal incorporation of oral health into maternal care. Public Health Dentists may be well-positioned to address this gap; however, their roles within maternal and child oral health services have received limited attention. The present exploratory workforce study, therefore examined the perceptions, roles, and systemic barriers experienced by Public Health Dentists in India.MethodologyA mixed-methods study design was employed. Quantitative data were collected from 150 Public Health Dentists between February and June 2025 using a structured questionnaire that underwent a validation process. This phase was followed by in-depth qualitative interviews with 25 participants to obtain a more detailed understanding of their experiences. Quantitative data were analysed using chi-square tests and multivariable binary logistic regression, while qualitative data were analysed through thematic analysis. The findings were incorporated using triangulation.ResultsA large proportion of respondents (85%) reported being confident in providing oral health education to pregnant women; however, 60% indicated that they had not received formal training in maternal and child oral health. The most commonly reported barriers include limited awareness among patients (40%), financial constraints (25%), and prevailing cultural beliefs (20%). Participants practicing in rural settings reported greater challenges related to accessibility and health literacy. Qualitative findings further highlighted the educator and advocacy roles of Public Health Dentists, while also emphasising systemic limitations and the need for stronger interdisciplinary collaboration. Formal training was significantly associated with higher confidence in service delivery (p = 0.002).ConclusionThe findings suggest that the Public Health Dentists may currently be underutilised in maternal and child oral health services, largely due to structural and training-related limitations. Strengthening the integration of oral health within national maternal health initiatives, including the Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH + A) programme, together with competency-based training and improved interprofessional collaboration, could help enhance service delivery and address existing gaps in maternal and child oral healthcare in India.
AIM:To establish a novel comprehensive three-dimensional coding system for the classification of teeth with dens invaginatus (DI) using cone beam computed tomography (CBCT) imaging. METHODOLOGY:An initial draft classification of teeth with DI was developed by the project directors and steering group based on the interpretation of CBCT images. A group of 26 global experts then provided their perspectives on the classification via a consensus-building online Delphi process. Following the achievement of consensus, six endodontists independently examined CBCT images of teeth with DI to evaluate the reliability of the draft classification. Inter-rater reliability was employed to ascertain the agreement among the six assessors and intra-rater reliability was assessed following the re-evaluation of the identical CBCT images 3 weeks later. The steering group then revised and finalized the classification. RESULTS:The online Delphi process was completed in a single round with a 100% response rate. The inter-rater reliability score of 0.89 and the intra-rater reliability score of 0.88 revealed "almost perfect" agreement among and within the evaluators. The final CARES classification of teeth with DI includes five domains: Communication (C), cross-sectional Anatomy (A), Root formation (R), vertical Extent (E), and Supplementary features (S). CONCLUSION:The three-dimensional CARES classification system provides stakeholders with a consistent and unambiguous method of categorizing teeth with DI. The system has the potential to enhance the precision of diagnosis and clinical decision-making during the management of DI and ensures clinicians can communicate more accurately with patients and other healthcare professionals.
BACKGROUND:Chronic periodontitis affects 10-15% of adults, worsened by diabetes. Effective therapy reduces inflammation and bacteria, with laser therapy emerging as a promising non-surgical adjunct or standalone option. This study systematically reviews clinical papers on various lasers (low-level laser therapy [LLLT], diode, Er:YAG/Er, Cr:YSGG, Nd:YAG) as adjuncts in periodontal flap microsurgery for patients with diabetes mellitus (type 1 or type 2), assessing their effects on periodontal health, glycaemic control, and safety. METHODOLOGY:The study protocol was prospectively registered on PROSPERO. A search strategy was conducted across multiple databases; 13 studies were included in this systematic review. Risk of bias was assessed using the Cochrane Risk of bias tool 2.0 (RoB 2), and RevMan 5.4 and STATA 18 software were used for quantitative assessment of the selected studies. Results : Out of the 13 studies selected, only one study showed a high risk of bias, while the other 12 showed moderate risk. In the quantitative assessment, I 2 = 77% for Plaque Index (PI) values, I 2 = 83% for Gingival Index (GI), I 2 = 84% for bleeding on probing (BOP), I 2 = 86% for clinical attachment level (CAL), and I 2 = 92% for pocket probing depth (PPD). CONCLUSION:Laser adjuncts, particularly Er:YAG and LLLT/diode, enhance periodontal treatment for type 2 diabetes mellitus (T2DM) patients, improving clinical outcomes and inflammation. Nd:YAG lasers aid healing and inflammation regulation, but benefits are often limited, and long-term effects are unclear. Comprehensive, large-scale trials are needed to shape clinical guidelines. Clinicians should consider laser adjuncts for complex cases, balancing benefits with costs and patient needs.
INTRODUCTION:Periodontitis, a chronic inflammatory disease, may necessitate surgical intervention when non-surgical methods are ineffective. This systematic review and network meta-analysis investigates the efficacy and safety of various laser types in periodontal flap microsurgery, consolidating clinical trial results on diode lasers, which show promising yet variable outcomes. METHODS:The review was registered in PROSPERO and follows the PRISMA 2020 reporting guidelines. Search strategy was carried out in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Directory of Open Access journals (DOAJ), PubMed, which yielded 15 randomised controlled trials. The data extraction was conducted, followed by both qualitative and quantitative analysis, by assessing risk of bias using Cochrane RoB-2 tool, and network meta-analysis. RESULTS:In the qualitative analysis, out of the 15 studies two showed high risk of bias (RoB), four studies showed low risk and nine studies showed moderate risk. Network meta-analysis was conducted including nine studies, for pocket depth, clinical attachment level (CAL), Gingival Index (GI) and Plaque Index (PI), which demonstrated a connected evidence structure. Effect size ( Z ) for probing depth (PD) = 4.23 ( P < 0.0001), CAL = 1.45 ( P = 0.15), GI = 1.78 ( P = 0.08) and PI = 1.39 ( P = 0.17). CONCLUSIONS:The combined evidence shows that both erbium and diode lasers offer tangible advantages in periodontal flap microsurgery, particularly with respect to postoperative comfort, early healing, and soft-tissue response. Erbium lasers seem to be more flexible because they may be used on both soft and hard tissues. Diode lasers constituted majority of available evidence, and have powerful biostimulatory and antibacterial effects. The superiority of any given wavelength remains indeterminate owing to inadequate head-to-head experiments and the lack of protocol standardization.
Glass ionomer cement (GIC) is widely used in dentistry because of its chemical adhesion to tooth structure, fluoride release, biocompatibility, and stability in an aqueous environment. However, its relatively low compressive strength restricts its use in stress-bearing areas. Hydroxyapatite [Ca₁₀(PO₄)₆(OH)₂], a bioceramic material structurally similar to natural tooth mineral, has demonstrated potential to enhance the mechanical properties of dental materials, particularly in nanoscopic form. This study evaluated the effect of incorporating naturally synthesized nano-hydroxyapatite into glass ionomer luting cement on compressive strength. Nano-hydroxyapatite was added at 4% by weight to Fuji I commercial GIC, and the compressive strength of the modified cement was compared with that of conventional GIC. Within the limitations of the study, incorporation of nano-hydroxyapatite resulted in a 42% increase in compressive strength, exceeding improvements reported with synthetic nano-hydroxyapatite. These findings suggest that naturally synthesized nano-hydroxyapatite is a promising additive for glass ionomer luting cements, warranting further biocompatibility and clinical investigations..
