Introduction and aims There has been a substantial increase in the number of umbrella reviews (URs) published in dentistry. To ensure their conclusions are accurate, these URs must be assessed for methodological quality. Therefore, the present study aims to evaluate the methodological quality of URs in paediatric dentistry, and to identify predictive factors associated with their methodological quality. Method A literature search was conducted to identify URs published in paediatric dentistry and their methodological quality assessed using an 11-item checklist. Further analysis examined the relationship between 6 predictive factors and the methodological quality scores for each UR (H-index, publication year, number of authors, JCR impact factor, a priori protocol registration, and continent of the corresponding author). Results Twenty-six URs were included. Item 1 (including the selection criteria), Item 7 (describe the included systematic reviews), and Item 8 (use a satisfactory tool for assessing the risk of bias or methodological quality) were reported adequately in all URs. The majority (73%) of URs did not adequately report item 9 (sources of funding for the systematic reviews included in the UR)A priori protocol registration was the only significant predictor of quality. Conclusion URs published in paediatric dentistry exhibited a range of methodological flaws. A priori protocol registration was associated with greater quality. In the future, authors intending to conduct systematic reviews should take into account the deficiencies identified in this study. Clinical Relevance Authors who conduct URs in paediatric dentistry should consider the deficiencies identified in this study in order to improve their design, implementation and reporting and thus ensure their findings are valid.

INTRODUCTION:This study evaluated the effect of adding pachymic acid (PAC) to an epoxy resin root canal sealer (AH Plus) on the postoperative pain and periapical (PA) healing in teeth with necrotic pulp and apical periodontitis. METHODS:Fifty single-rooted teeth with necrotic pulp and apical periodontitis were randomly assigned to two groups according to the sealer (n = 25), AH Plus (AHP) and AHP modified with PAC (AHP/PAC). Endodontic treatment was conducted in 2 visits, with calcium hydroxide as an intracanal medicament. Pain scores were recorded using visual analog scale at baseline, 24 hours and 7 days postoperatively. PA healing was evaluated by measuring lesion size at baseline and postoperatively at 3, 6, 9, and 12 months using digital radiograph. Cone-beam computed tomography (CBCT) was used to assess PA lesion volume and PA volume index score at baseline and 1-year follow-up. Statistical analysis was done using Mann-Whitney U test. RESULTS:Postoperative pain in AHP/PAC was significantly lower than AHP at 24 hours (P = .03), with no pain in either group at day 7. PA lesion size at 3-month follow-up showed no significant difference (P = .10) between the groups, but a significant reduction was seen in AHP/PAC at 6-, 9-, and 12-months (P < .001). A significant reduction in lesion volume and PA volume index score score were also seen in AHP/PAC at 1-year follow-up (P < .001). CONCLUSIONS:The addition of PAC to AHP decreased the immediate postoperative pain and improved the long-term healing of PA lesions, with a marked reduction in lesion size from 6-month onward.

Objectives: To investigate whether hypodontia and other developmental dental anomalies were more common in children with MIH than their unaffected peers, and to determine if sex or geographical location had any effect on hypodontia prevalence. Methods: This analytical cross-sectional study was conducted in specialist paediatric dentistry clinics across 14 countries, categorised into six geographical regions. A total of 1279 children (aged 6- 17 years) underwent a clinical examination and were allocated to the MIH (n = 649) or comparison group (n = 630). A validated MIH index was used to record the presence/extent of any hypomineralisation and a standardised approach was used to establish the clinical and/or radiographic presence of ten developmental dental anomalies. Results: Four anomalies were significantly more prevalent in participants with MIH than those without this condition: hypodontia (p = 0.047), dens invaginatus (p = 0.004), dens evaginatus (p < 0.001) and microdont maxillary lateral incisors (p = 0.01). Additionally, the adjusted odds of hypodontia were 1.49 times higher in children with MIH compared to those without MIH. There was considerable disparity between geographic locations with the highest prevalence of hypodontia in participants from the Western Pacific region (11.21 %) and the lowest (2.92 %) in the Americas. No statistically significant association was found between sex (male vs. female) and hypodontia (p = 0.839). Conclusions: Accepting that the study group may not be representative of the wider population, the findings still have important clinical relevance. Furthermore, they lend support to the concept of shared genetic and epigenetic influence in the aetiology of MIH and other developmental dental disorders.

AIMS:To evaluate the reporting quality of abstracts of systematic reviews (SRs) with meta-analyses (MA) related to traumatic dental injuries (TDI) using the PRISMA for Abstract (PRISMA-A) 2020 checklist and to determine potential predictive factors associated with the overall reporting quality. METHODS:SRs with MA identified in PubMed, SCOPUS, and EBSCOhost databases from inception to May 2024 within the scope of TDI were included. The abstracts were evaluated for reporting quality in accordance with the 12 items of the PRISMA-A checklist. Each item was awarded a score of "1" or "0" for adequate or inadequate responses, whereas items that were partially addressed were awarded a score of "0.5". Utilizing multiple regression analysis, the association between six predictor variables (journal impact factor, publication year, number of authors, a priori protocol registration, word count of the abstract, and continent of the corresponding author) were examined in relation to the total PRISMA-A scores. The p-value was set at 5%. RESULTS:Abstracts from 53 SRs with MA were included. All adequately reported the "Title" and "General interpretation of the results and important implications". However, none adequately addressed the "Source of funding". A significant positive association was identified between the reporting quality of the abstract and both the year of publication (p = 0.032) and the word count of the abstracts (p = 0.002). CONCLUSION:The adherence of abstracts of SRs with MA to the PRISMA-A checklist was deficient in several items. Authors should ensure their abstracts comply with the PRISMA-A checklist, as this will enhance their reporting quality and ultimately benefit patients, clinicians, and other stakeholders.

The remineralizing effect of eggshell-derived nano-hydroxyapatite prepared by microwave (MnHAp) and aging (AnHAp) methods on demineralized dentin was compared with commercial nHAp (CnHAp). Forty dentin discs were prepared from extracted teeth and mounted on acrylic resin, and baseline microhardness values (MHVB) were recorded. The discs were etched with 37% phosphoric acid, and microhardness post-demineralization (MHVD) was recorded; and randomly divided into four groups (n = 10 each) and immersed in artificial saliva (AS), 1% MnHAp, 1% AnHAp, and 1% CnHAp (groups 1-4, respectively) solutions for 48 h. Post-treatment microhardness (MHVR) was recorded again. MHVD of all groups reduced significantly compared with their MHVB. Remineralization with AS, AnHAp, and CnHAp increased MHVR; however, it was significantly less than MHVB. Remineralization with MnHAp was significantly higher than in other experimental groups, comparable with MHVB.

Introduction and aims: To evaluate knowledge regarding the management of deep carious lesions and exposed pulps among undergraduate and postgraduate endodontic students from ten dental institutions across ten countries, and the impact of operator (material, antibiotic prescription) and patient-related (age, symptoms) factors on their treatment protocols. Methods: An online questionnaire was distributed to evaluate student knowledge of the management of deep caries and exposed pulp related to four clinical scenarios. Simple descriptive statistics were used to describe the data and McNemar tests were employed to identify significant differences between the scenarios. The P-value was set at 5%. Results: A total of 435 undergraduates and 139 postgraduates from ten dental schools participated in this survey. The final survey included 401 responses from undergraduates and 127 from postgraduates for statistical analysis. When symptoms were present, the majority of undergraduate and postgraduate students preferred non-selective (complete) caries removal over selective (partial) caries removal in young patients. The majority of postgraduates preferred partial pulpotomy in younger patients and pulpectomy and root canal treatment (RCT) in older patients. The majority of undergraduates preferred pulpectomy and RCT in both young/old patients when symptoms were present. The majority of undergraduates and postgraduates opted for mineral trioxide aggregate and Biodentine, respectively, when treating the exposed pulp. Systemic antibiotics were not recommended by both undergraduates and postgraduates, regardless of the patient's age and symptoms. Conclusion: Among the scenarios surveyed, the majority of undergraduates and postgraduates preferred: a) pulpectomy and RCT for older patients in the presence or absence of symptoms; b) hydraulic calcium silicate cements as pulp capping material; and c) did not recommend systemic antibiotics. Clinical relevance: The majority of students choose non-selective (complete) caries removal in all cases and if the pulp is exposed, the use of hydraulic calcium silicate cements iwas the preferred material. Systemic antibiotics are considered unnecessary, irrespective of the patient's age and symptoms.

Aim: Patient anxiety during dental procedures impacts oral health and well-being. Dental practitioners are vital in managing this stress. Our study aims to explore, analyze, and draw comparisons regarding the understanding and awareness levels of stress and anxiety assessment during routine dental procedures among general dental practitioners and specialists. Method: A self-administered questionnaire was sent to 503 Indian dental practitioners, encompassing both general dentists and specialists. Comprising 13 sections, the questionnaire covered demographic information and delved into topics such as dental anxiety assessment tools, familiarity with stress-reducing techniques, and awareness of the impact of anxiety on treatment outcomes. Following this, data analysis was performed using SPSS software, employing a range of descriptive and inferential statistics, including the Chi-square test. Results: Significant knowledge disparities were observed. While 78.3% of specialists assessed patient stress, only 75% of general dentists did, with no statistical difference (p=0.386). Both groups recognized the impact of gender dynamics and environmental factors on stress, but these findings lacked significant differences (p=0.314, p=0.40, p=0.86). However, specialists showed significantly more awareness of the link between stress and periodontal disease (p=0.043), genetics’ role in stress (p=0.008), and the implications of epigenetics for stress and oral health (p=0.000). Conclusion: This study highlights a noticeable knowledge gap between general dentists and specialists in assessing patient stress during dental procedures. While both groups share similar views on gender dynamics and environmental factors, significant differences exist in their awareness of connections between stress, periodontal disease, genetics, and epigenetics. Targeted educational efforts are necessary to bridge this knowledge gap, improve patient care, and advance dental medicine.

In endodontics, the number of umbrella reviews has increased significantly over the last few years, but there is no evidence that they were methodologically sound. The aim of the current study was to appraise the methodological quality of umbrella reviews in endodontics, and to identify possible predictive factors associated with methodological quality. Umbrella reviews published in the discipline of endodontics until December 2023 were included. The methodological quality of the reviews was evaluated using a checklist consisting of 11 items. Each item in the checklist was evaluated by two independent assessors who assigned a score of ‘1’ if it was fully addressed, ‘0.5’ if it was partially ddressed, and ‘0’ if it was not addressed. Bootstrapped multiple linear regression analysis was used to examine the association between the total scores awarded and five predictor variables ( a priori protocol registration, year of publication, number of authors, journal impact factor (IF) and continent of the corresponding author). The statistical significance level was set as 5%. A total of 27 reviews were included. Ninety-six per cent of the reviews adequately reported: eligibility criteria for selecting the reviews, details of the reviews, techniques for assessing the risk of bias or methodological quality of the individual systematic reviews they included. Only 30% of the reviews adequately managed overlapping primary studies within individual systematic reviews. Among the five predictors analysed, a priori protocol registration and journals with IFs were associated with significantly greater total methodological quality scores. Several methodological shortcomings in the umbrella reviews published within the field of endodontics were revealed. Umbrella reviews published in journals with IFs and those with protocols registered a priori had significantly superior methodological quality scores. In endodontics, authors intending to publish umbrella reviews should consider the limitations revealed in this study and follow the appropriate rules to ensure their reviews comply with the highest standards and provide accurate and dependable information and conclusions.

INTRODUCTION:In endodontics, the number of umbrella reviews has increased significantly over the last few years, but there is no evidence that they were methodologically sound. The aim of the current study was to appraise the methodological quality of umbrella reviews in endodontics, and to identify possible predictive factors associated with methodological quality. METHODS:Umbrella reviews published in the discipline of endodontics until December 2023 were included. The methodological quality of the reviews was evaluated using a checklist consisting of 11 items. Each item in the checklist was evaluated by two independent assessors who assigned a score of '1' if it was fully addressed, '0.5' if it was partially ddressed, and '0' if it was not addressed. Bootstrapped multiple linear regression analysis was used to examine the association between the total scores awarded and five predictor variables (a priori protocol registration, year of publication, number of authors, journal impact factor (IF) and continent of the corresponding author). The statistical significance level was set as 5%. RESULTS:A total of 27 reviews were included. Ninety-six per cent of the reviews adequately reported: eligibility criteria for selecting the reviews, details of the reviews, techniques for assessing the risk of bias or methodological quality of the individual systematic reviews they included. Only 30% of the reviews adequately managed overlapping primary studies within individual systematic reviews. Among the five predictors analysed, a priori protocol registration and journals with IFs were associated with significantly greater total methodological quality scores. DISCUSSION:Several methodological shortcomings in the umbrella reviews published within the field of endodontics were revealed. Umbrella reviews published in journals with IFs and those with protocols registered a priori had significantly superior methodological quality scores. CONCLUSION:In endodontics, authors intending to publish umbrella reviews should consider the limitations revealed in this study and follow the appropriate rules to ensure their reviews comply with the highest standards and provide accurate and dependable information and conclusions.

Humans are often exposed to various environmental contaminants, among which phthalates are prevalent due to their extensive use as plasticizers in various consumer goods. Di(2-ethylhexyl) phthalate (DEHP), a widely used phthalate, is recognized as an endocrine disruptor chemical (EDC). DEHP is reported to affect various organs. Few studies have addressed the effects of phthalates on bone. However, the effects of DEHP on the bone forming cells (osteoblasts) are obscure. The present study was peformed to determine the cytotoxic effects of DEHP on human osteoblasts in vitro and to delineate the mechansims. In this study, we exposed the human osteo-blastic cell line MG-63 to various concentrations of DEHP (1, 25, 50 and 100 µM) for 24, 48 and 72 h. Cell viability was assessed by MTT assay. Total RNA and protein were collected after 48 h treatment with 1 and 100 µM DEHP and determined for the mRNA and/or protein expression of alkaline phosphatase (ALP), sex steroid receptors (androgen and estrogen receptors), receptor activator of nuclear factor kappa-Β ligand (RANKL), runt-related transcription factor 2 (RUNX2) and peroxisome proliferator-activated receptor alpha (PPARα). The mRNA expression was stud-ied by real-time RT-PCR analysis and the protein expression was determined by western blot analysis. Statistical analyses were done by one-way analysis of variance (ANOVA) followed by the Students–Newman–Keuls (SNK) test. The exposure of MG-63 cells to DEHP caused a signifi-cant decrease in osteoblast viability in all the treatment groups and at all the time points stud-ied. Interestingly, DEHP exposure decreased the mRNA expression of ALP, a bone formation marker. DEHP had differential effects on estrogen receptor alpha (ERα) mRNA and protein ex-pression. However, DEHP treatment downregulated the mRNA and protein expression of ERβ, and androgen receptor (AR). Surprisingly, DEHP downregulated the RANKL mRNA expression. DEHP decreased the protein expression of RUNX2, the key transcription factor and master regu-lator of bone formation. Furthermore, DEHP increased the PPARα protein expression in the os-teoblasts. Importantly, DEHP increased the reactive oxygen species (ROS) molecules and thus oxidative stress in osteoblasts, as observed by increased hydrogen peroxide, hydroxyl radical levels and lipid peroxidation. On the other hand, it decreased the enzymatic and non-enzymatic antioxidant levels namely catalase, superoxide dismutase, glutathione peroxidase activity and reduced glutathione. Our study demonstrated that in vitro exposure to DEHP reduces the osteo-blast viability possibly through alterations in the oxidant-antioxidant system and modulation of the key genes involved in bone formation, highlighting the cytotoxic effects of DEHP on bone forming cells.

AimTo evaluate the current status of endodontic education and assessment at an undergraduate/predoctoral level in dental schools worldwide.MethodologyThe current survey comprised a 50-item online questionnaire related to undergraduate endodontic education. The project leaders emailed the survey's details to faculty members responsible for endodontic teaching at one dental school in every country to seek their willingness to participate in the survey. After the faculty members accepted, the survey details were sent to participants along with the survey link. Simple descriptive statistics were used to represent the data.ResultsAmongst the 44 faculty members from different countries who agreed to participate, 36 completed the survey. Endodontic training starts in 50% of dental schools from the third year of the curriculum. Each dental school employs a diverse range of educational methods. During pre-clinical training, 19.4% of the participating dental schools used only natural teeth. Stainless-steel hand instruments, syringe irrigation with a needle, resin-based sealer and the cold lateral compaction technique are the most frequently used in pre-clinical and clinical training. A significant percentage of dental institutions necessitate that students treat a predetermined quantity of canals or teeth throughout their pre-clinical and clinical education. Dental institutions conduct formative, summative or a combination of the formative and summative throughout the clinical and pre-clinical phases of endodontic training.ConclusionsAccording to the data collected from this survey, there are considerable variations in the curriculum for undergraduate/predoctoral endodontic programmes amongst the surveyed dental schools. Pre-clinical and clinical education should integrate a larger array of modern tools and procedures.

Human dentition is unique to individuals and helps in identification of individuals in forensic odontology. This study proposes to study the manually ground sections of single rooted teeth using digital methods for dental age estimation. To assess the dentinal translucency from the scanned digital images of manually ground section of teeth using commercially available image edition software. Corroborating the root dentinal translucency length and region of interest (ROI) of translucency zone in pixels (as a marker of dental age) with the chronological age of the subject, as stratified by different age groups. Twenty single-rooted extracted teeth from 20 patients each from 6 groups divided as per age. Manual sectioning of the teeth followed by scanning the sections was done. Root area in pixels and ROI of translucency zone were measured. From the observed values, translucency length percentage (TLP) and percentage of ROI in pixels (TPP) was calculated and tabulated. Pearson's correlation coefficients were obtained for age with TLP and TPP. Positive correlation existed between age and TLP and also between age and TPP. With the obtained data, multilinear regression equations for specific age groups based on 10-year intervals were derived. By a step-down analysis method, age was estimated with an average error of around ±7.9 years. This study gives a novel method for age-estimation that can be applied in real-time forensic sciences.

Introduction The current evidence linking tooth loss and cardiovascular disease mortality is inconclusive. Thus, the aim of this systematic review was to explore the association between tooth loss and cardiovascular disease (CVD) mortality. Methods A comprehensive literature search of databases and gray literature included: Web of Science, Scopus, PubMed, CENTRAL, Google Scholar, various digital repositories. The included studies reported on CVD mortality and tooth loss. The Newcastle-Ottawa scale was used to assess the quality of included studies. Random-effects meta-analysis method, sub-group analysis (based on the tooth loss categories (edentulous and fewer than 10 teeth present), meta-regression (based on the number. of confounders), publication bias and sensitivity analysis were performed. Results Twelve articles met the eligibility criteria with an overall “Good” quality. A significant association between tooth loss (edentulous or less than 10 teeth present) and CVD mortality was found in the primary meta-analysis, which compiled data from 12 studies. The estimated hazard ratio (HR) was 1.66 (95% CI: 1.32–2.09), and there was high heterogeneity (I2 = 82.42). Subgroup analysis revealed that the edentulous subgroup showed a higher risk with no significant heterogeneity, while the subgroup with fewer than 10 teeth showed a higher risk with substantial heterogeneity. Meta-regression analysis did not reveal any significant impact (p = 0.626) on whether variations in the number of confounders across studies would substantially affect the overall findings. No publication bias was detected and the sensitivity analysis based on the critical confounders also confirmed that tooth loss as a risk factor for CVD mortality (HR = 1.52, 95% CI: 1.28- 1.80), (I2 51.82%). Conclusion The present systematic review reported that being edentulous or having lesser than 10 teeth is a predictive indicator of CVD mortality.

Hybrid nanohydroxyapatite/carboxymethyl chitosan (nHAp-CMC) scaffolds have garnered significant attention in the field of regenerative engineering. The current study comparatively analyzed the physicochemical and biological properties of synthetic nanohydroxyapatite (SnHA)- and eggshell-sourced nanohydroxyapatite (EnHA)- based CMC biocomposites for pulp-dentin regeneration. EnHA and CMC were synthesized through a chemical process, whereas SnHA was commercially obtained. Composite scaffolds of SnHA-CMC and EnHA-CMC (1:5 w/w) were prepared using freeze-drying method. All biomaterials were characterized by FTIR, microRaman, XRD, HRSEM-EDX, and TEM analyses, and their in vitro bioactivity was assessed by immersing them in simulated body fluid for 21 days. The biological properties of the composite scaffolds were evaluated by assessing cytocompatibility using MTT assay and biomineralization potential by analyzing the odontogenic gene expressions (ALP, DSPP, DMP-1 and VEGF) in human dental pulp stem cells (DPSCs) using RT-qPCR method. Characterization studies revealed that EnHA displayed higher crystallinity and superior surface morphology compared to SnHA. The composite scaffolds showed a highly interconnected porous microstructure with pore sizes ranging between 60 and 220 mu m, ideal for cell seeding. All tested materials, SnHA, EnHA, and their respective composites, displayed high cytocompatibility, increased ALP activity and degree of mineralization with significant upregulation of odontogenic-related genes on DPSCs (p < 0.05). Nevertheless, the odontogenic differentiation potential of EnHA-CMC on DPSCs was significantly higher when compared to SnHA-CMC. The findings from this study highlight the potential of EnHA-CMC as a promising candidate for pulp-dentin engineering.

BACKGROUND/AIM:The knowledge of dental students about managing traumatic dental injuries (TDIs) may not be uniform, depending on global location and dental education. The aim of this study was to evaluate the level of knowledge of undergraduate and postgraduate students specializing in endodontics and pediatric dentistry at 10 dental schools in 10 countries about the 2020 International Association of Dental Traumatology (IADT) guidelines regarding the management of TDIs. MATERIALS & METHODS:A previously published questionnaire was used in the current survey. It was an online survey with 12 questions regarding the management of TDIs and some additional questions regarding sociodemographic and professional profiles of the participants were added. The survey was distributed to final-year undergraduate students and postgraduate students in pediatric dentistry and endodontics from 10 dental schools. Simple frequency distributions and descriptive statistics were predominantly used to describe the data. Differences in the median percentage scores among the student categories were assessed using the Kruskal-Wallis test followed by Dwass-Steel-Critchlow-Fligner pairwise comparisons. RESULTS:A total of 347 undergraduates, 126 postgraduates in endodontics, and 72 postgraduates in pediatric dentistry from 10 dental schools participated in this survey. The postgraduates had a significantly higher percentage score for correct responses compared with the undergraduates. No significant difference was observed between the endodontic and pediatric dentistry postgraduates. CONCLUSION:The knowledge possessed by undergraduate and postgraduate students concerning the IADT-recommended management of TDIs varied across the globe and some aspects were found to be deficient. This study emphasizes the critical importance of reassessing the teaching and learning activities pertaining to the management of TDIs.

BACKGROUND This systematic review aims to compare the outcomes of Preformed Metal Crowns placed using the Conventional (CT) and Hall Techniques (HT). METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. A literature search of five databases was performed up to 23 August 2022. Clinical studies comparing carious primary molars restored with PMCs using either technique with minimum 12-month follow-up were included. Risk of bias assessment was performed using the National Institutes of Health Quality Assessment tool. RESULTS Five articles met the inclusion criteria and four were included for meta-analysis. The 12- and 24-month success and survival rates were above 85% for both groups, with no significant differences shown at 12 and 24 months. The HT requires a shorter treatment duration, is more cost effective and has a high level of acceptability among parents when compared to the CT. Four articles were rated fair, and one article was rated good in the Risk of Bias Assessment. CONCLUSION Greater consideration may be given towards using the HT as part of standard treatment procedures in managing carious primary molars. Future studies should standardise reporting of outcomes to facilitate a more homogeneous pool of data for future meta-analysis.

OBJECTIVE:Patients with moderate to severe preoperative pain have a high incidence of postoperative pain. The objective of this trial was to evaluate the efficiency of oral premedication with Aceclofenac (immediate release and controlled release) in the management of post-instrumentation pain in root canal treatment, in patients with moderate to severe preoperative pain.METHODS:Three-arm parallel, triple blinded randomized controlled trial was planned. Patients with moderate to severe endodontic pain, requiring primary endodontic treatment were enrolled. Aceclofenac 100mg- immediate release (Aceclofenac-IR), Aceclofenac 200mg- controlled release (Aceclofenac-CR), and Ibuprofen 400mg were compared. The tablets were given one hour before the root canal treatment. Postoperatively, patients rated their pain at various time points. The duration of pain relief (primary outcome), the intensity of post-instrumentation pain, and the need for additional medicine were calculated. Statistical analysis was done using Kruskal-Wallis followed by Dunn post-hoc, Chi-square tests, and Binominal logistic regression.RESULTS:Aceclofenac-CR had a statistically significant longest duration of pain relief when compared to Ibuprofen (p=0.037) and Aceclofenac-IR (p=0.026). The intensity of post-instrumentation pain was lowest in Aceclofenac-CR, followed by Aceclofenac-IR and Ibuprofen. Additional medicine was required for only 8% of patients in Aceclofenac-CR group; whereas for 32% in each of Aceclofenac-IR and Ibuprofen groups. The odds of taking additional medicine were reduced to 0.16 in Aceclofenac-CR; increased to 1.05 with age.CONCLUSION:Aceclofenac-CR had the longest duration of pain relief compared to Aceclofenac-IR and Ibuprofen. (EEJ-2022-03-037).

Abstract Objective To analyse the available evidence regarding the incidence and severity of white spot lesions (WSLs), plaque accumulation and salivary caries-associated bacteria(SCB) in clear aligners (CA) verses conventional fixed (CF) orthodontic appliances. Methods Electronic searches of MEDLINE, Scopus, Embase, Google Scholar, Clinical trial registry, OpenGrey and ProQuest were done for all relevant studies. Eligibility criteria were; Randomized Controlled Trials and Non-Randomized Studies that compared the incidence and severity of WSLs, plaque accumulation and SCB between CA and CF appliances in patients undergoing orthodontic treatment. The risk of bias(ROB) and certainty of evidence was assessed independently by two reviewers using Cochrane’s ROB and GRADEpro, respectively. Standardized mean difference (SMD) was used to estimate the effect size using STATA 17 software. Results A total of 14 studies met the eligibility criteria, and eight were suitable for meta-analysis. The qualitative results showed lower incidence and severity of WSLs, plaque accumulation, and SCB in CA group compared to CF appliances. The pooled results showed significantly lower plaque accumulation(SMD − 1.58;95%CI:-2.57,0.58;p = 0.002) in CA compared to CF appliances. Conclusions A moderate-quality evidence reveals less plaque accumulation and less SCB in CA, which might be related to the reduced incidence and severity of WSLs associated with CA when compared with CF appliances. However, the results of the present study should be interpreted with caution given the high ROB among some of the included studies as well as the marked heterogeneity across the studies. Clinical relevance For patients who can be treated with either CA or CF appliances, CA may be a better choice concerning oral health. Registration Open Science Framework (DOI:https://doi.org/10.17605/osf.io/kcpvb).

The global pandemic outbreak of the coronavirus has instilled the quest amongst researchers on the expedited need for the early detection of viral load. Saliva is a complex oral biological fluid which not only causes the disease transmission but can be an effective alternative sample for detection of SARS-CoV2. This provides an ideal opportunity for dentists to be the frontline healthcare professionals who can collect the salivary samples; however the awareness of this amongst dentists is uncertain. Hence the aim of this survey was to evaluate the knowledge, perception and awareness of the role of saliva in detecting the SARS-CoV2 among dentists worldwide. The online questionnaire comprising of 19 questions was shared to 1100 dentists worldwide and a total of 720 responses was collected. The data was tabulated, statistically analysed using the non- parametric Kruskal-Wallis test (p < 0.05). Based on the principal component analysis, 4 components (knowledge about virus transmission, perception about SARS-CoV2 virus, awareness on the sample collection and knowledge about prevention of the virus) were obtained which was compared with the 3 independent variables (years of clinical experience, occupation and region). A statistically significant difference was observed in the awareness quotient amongst the dentists with 0–5 years and greater than 20 years of clinical experience. In terms of the occupation, a significant difference was noted when comparing the postgraduate students to practitioners knowledge about the virus transmission. A highly significant difference was seen on comparing academicians and postgraduate students and also between academicians and practitioners. No significant difference was evidenced amongst the different regions, however the mean score was in the range of 3-3.44. This survey highlights the deficiency in the knowledge, perception and awareness among dentists worldwide. The imperative need for updating the knowledge, awareness and perception among dentists worldwide on the role of saliva in COVID 19 as it not only transmits the disease but is also a promising diagnostic aid.