The goal of this resident survey study was to investigate preparedness among orthodontic residents in providing orthodontic treatment with clear aligners and manage the digital workflow for in-house fabrication of clear aligners. A survey questionnaire was emailed to all active AAO resident members which included recent graduates of 2021 (n=1,124) to evaluate didactic edu-cation, clinical experience, confidence levels and the residents' future prac-tice plans with regards to clear aligner therapy. Inferential statistics were restricted to bivariate analysis employing Pearson's chi-square tests, CMH tests, and unpaired Student's t-test (p=0.05). A total of 277 Orthodontic residents responded to the survey, with an overall response rate of 25%. Nearly 50% of the residents did not receive didactic classes on clear aligner therapy or fabrication. About 13-17% of the respond-ents did not have access to CBCT, digital teeth alignment software or 3D printed models. A significant decrease in confidence was found among resi-dents who did not receive this training in their residency programs. Based on the findings of our survey, thorough training and education of the technology used in clear aligner therapy has the potential to improve resi-dents' confidence and competence in utilizing 3D technology and clear align-ers in their future practice. (Semin Orthod 2022; 28:80-84) (c) 2022 Elsevier Inc. All rights reserved.

The aims of this study were to describe patient utilization of an urgent care clinic (UCC) in a dental school for one year and to assess dental students' perceptions of the benefits of training in this clinic. Aggregate clinic data from July 3, 2017, through July 6, 2018, were used to determine number of patients, number of new patients, number of new patients who elected to transfer their primary dental care to the university, number who were seen for a follow-up, and service/clinic to which each patient was referred. Student evaluations were used to determine the benefits students perceived in their training in the UCC. Results showed that 1,674 patients were seen in the UCC during the study period. Of these, 67% were new patients, and 53% of these new patients opted to transfer their primary dental care to the university. An average of 7.03 patients were treated per day, and 2.48 new patients per day were generated for the predoctoral student clinic. The most common referrals were to oral surgery (37%), endodontics (30%), and the predoctoral dental clinic (28%). Among these patients, 39% scheduled follow-up appointments, and the attendance rate was 69%. About 80% of eligible students (40/50) completed the questionnaire, and many provided optional comments. Over 80% of the responding students responded favorably regarding the learning experiences and assessments during the UCC rotation. This study found that establishment of the UCC increased the pool of patients and provided students the necessary experiences in triaging and treating dental emergencies.

Introduction: The aim of this in vitro study was to compare the speed, qualitative precision, and quantitative loss of tooth structure with freehand and dynamically navigated access preparation techniques for root canal location in 3-dimensional printed teeth with simulated calcified root canals. Methods: Forty maxillary and mandibular central incisors (tooth #9 and tooth #25) were 3-dimensionally printed to simulate canal calcification. Under simulated clinical conditions, access preparations were randomly performed with contemporary freehand and dynamically navigated techniques. Qualitative precision and quantitative loss of tooth structure were assessed on postoperative cone-beam computed tomographic scans using ITK-SNAP open-source segmentation (http://www.itksnap.org/). The associations between jaw, technique, volume of substance loss, and operating time were determined using analysis of variance models with Tukey-adjusted post hoc pair-wise comparisons. The kappa statistic was used to determine agreement between 2 independent, blinded raters on the qualitative assessment of the drill path. The association between the technique and jaw and qualitative assessment scoring was compared using the Fisher exact test. The significance level was set at .05. Results: Dynamically navigated accesses resulted in significantly less mean substance loss in comparison with the freehand technique (27.2 vs 40.7 mm(3), P<.05). Dynamically navigated accesses were also associated with higher optimal precision (drill path centered) to locate calcified canals in comparison with the freehand technique (75% vs 45%, P>.05). Mandibular teeth were associated with a negligible difference in substance loss between the access techniques (19.0 vs 19.1 mm(3), P>.05). However, qualitatively the freehand technique was still prone to 30% higher chance of suboptimal precision (drill path tangentially transported) in locating calcified canals. Overall, dynamically navigated accesses were prepared significantly faster than freehand preparations (2.2 vs 7.06 minutes, P<.05). Conclusions: Within the limitations of this in vitro study, overall dynamically navigated access preparations led to significantly less mean substance loss with optimal and efficient precision in locating simulated anterior calcified root canals in comparison with freehand access preparations.

Introduction: This study presents a novel method to deliver intraosseous anesthesia using dynamic navigation technology. The study aimed to evaluate its safety and 3-dimensional (3D) accuracy in comparison to traditional freehand injection of intraosseous anesthesia. Methods: Six identical sets of 3D-printed surgical jaw models (TrueJaw; DELendo, Santa Barbara, CA) comprising simulated alveolar and dental anatomy with 54 interradicular sites were used in this study. The injection sites were equally distributed based on the range of the inter-radicular distance (ie, 1.5-2.5 mm, 2.5-3.5 mm, and 3.5-4.5 mm). A board-certified endodontist randomly completed intraosseous drilling at inter-radicular sites of varying distance using freehand technique and the Navident dynamic navigation system (ClaroNav, Toronto, Ontario, Canada) with the X-Tip system (Dentsply Sirona, York, PA). The rate of root perforation associated with inter-radicular distance was compared between the 2 groups using the Fisher exact test. Two-dimensional (2D) and 3D horizontal, vertical, and angulation discrepancies between the planned and dynamically navigated guide sleeves were digitally measured using superimposed cone-beam computed tomographic scans. Analysis of variance models were used to determine if the interdental distance was associated with the accuracy measures from the dynamic navigation system. The significance level was set at 0.05. Results: The rate of root perforation was significantly higher for the freehand group than the dynamic navigation (22% vs 0%, P < .05). For dynamic navigation, the 2D entry deviation was 0.71 mm (95% confidence interval [CI], 0.56-0.87). The mean 2D horizontal deviation was 0.96mm(95% CI, 0.79-1.14), and the mean 2D vertical deviation was 0.70 mm (95% CI, 0.55-0.84). The 3D deviation at the tip was on an average 1.23 mm (95% CI, 1.05-1.42). The overall 3D angular deviation was on average 1.36 degrees (95% CI, 1.15-1.56). The inter-radicular distance was not significantly associated with any 2D or 3D discrepancies. Conclusions: Successful and accurate drilling of dynamically navigated intraosseous delivery occurred in 100% of injection sites irrespective of the inter-radicular distance. It was significantly safer in comparison to freehand intraosseous drilling to prevent injury of the roots of the adjacent teeth in close proximity.

Introduction This study aimed to present a novel dynamic navigation method to attain minimally invasive access cavity preparations and to evaluate its 3-dimensional (3D) accuracy in locating highly difficult simulated calcified canals among maxillary and mandibular teeth. Methods Three identical sets of maxillary and mandibular 3D-printed jaw models composed of 84 teeth in their anatomic locations with simulated calcified canals (N = 138 canals) were set up on dental manikins. The Navident dynamic navigation system (ClaroNav, Toronto, Ontario, Canada) was used to plan and execute access preparations randomly with high-speed drills by a board-certified Endodontist. Two-dimensional (2D) and 3D horizontal, vertical, and angulation discrepancies between the planned and placed access preparations were digitally measured using superimposed cone-beam computed tomographic scans. Analysis of covariance models were used to evaluate the associations and the interaction between tooth type and jaw, the canal orifice depth, and the discrepancies between planned and prepared access cavities. The significance level was set at .05. Results The mean 2D horizontal deviation from the canal orifice was 0.9 mm, and it was significantly higher on maxillary compared with mandibular teeth (P < .05). The mean 3D deviation from the canal orifice was 1.3 mm, and it was marginally higher on maxillary teeth in comparison with mandibular teeth (P ≥ .05). The mean 3D angular deviation was 1.7 degrees, and it was significantly higher in molars compared with premolars (P < .05). The 3D and 2D discrepancies were independent of the canal orifice depths (P > .05). The average drilling time was 57.8 seconds with significant dependence on the canal orifice depth, tooth type, and jaw (P < .05). Conclusions This study shows the potential of applying dynamic 3D navigation technology with high-speed drills to preserve tooth structure and accurately locate root canals in teeth with pulp canal obliteration.

Introduction: Understanding protein expression profiles of apical periodontitis may contribute to the discovery of novel diagnostic or therapeutic molecular targets. Methods: Periapical tissue samples (n = 5) of patients with lesions characterized as nonhealing were submitted for proteomic analysis. Two differentially expressed proteins (heat shock protein 27 [HSP27] and serpin family B member 1 [SERPINB1]) were selected for characterization, localization by immunofluorescence, and association with known biomarkers of acute inflammatory response in human apical periodontitis (n = 110) and healthy periodontal ligaments (n = 26). Apical periodontitis samples were categorized as stable/inactive (n = 70) or progressive/active (n = 40) based on the ratio of expression of receptor activator of nuclear factor kappa-B ligand (RANKL)/osteoprotegerin (OPG). Next, the expression of HSP27, SERPINB1, C-X-C motif Chemokine Receptor 1 (CXCR1), matrix metalloproteinase 8 (MMP8), myeloperoxidase (MPO), and cathepsin G (CTSG) messenger RNA was evaluated using real-time polymerase chain reaction. Data analysis was performed using the Shapiro-Wilk test, analysis of variance, and the Pearson test. P values <.05 were considered statistically significant. Results: Proteomic analysis revealed 48 proteins as differentially expressed in apical periodontitis compared with a healthy periodontium, with 30 of these proteins found to be expressed in all 4 lesions. The expression of HSP27 and SERPINB1 was 2-fold higher in apical periodontitis. Next, an increased expression of HSP27 was detected in epithelial cells, whereas SERPINB1 expression was noted in neutrophils and epithelial cells. HSP27 and SERPINB1 transcripts were highly expressed in stable/inactive lesions (P <.05). Significant negative correlations were found between the expression of HSP27 and SERPINB1 with biomarkers of acute inflammation including CXCR1, MPO, and CTSG. Conclusions: Our data suggest HSP27 and SERPINB1 as potential regulators of the inflammatory response in apical periodontitis. Additional functional studies should be performed to further characterize the role of these molecules during the development/progression of apical periodontitis.

This study was conducted to determine the risk for drug-drug interactions (DDI) and drug-gene interactions (DGI) in a cohort of patients with Complex Regional Pain Syndrome (CRPS).

Introduction: Electric burn patients are increasing every day with increasing use of importance of electricity. This is more common in semi-urban and rural areas where the people are less aware regarding the safety of electrical burns in contrast to develop countries.Aim & Objectives: To assess the incidence of electric burn injuries in head and neck area and enforce strict laws and create public awareness to prevent the same.Materials and Methods: A retrospective analysis was done in our Department of General Surgery from March 2010 to March 2013 with 113 patients affected with burns. Out of them, 89 patients had electric burns with rest of them being chemical, thermal and other burns. Out of 89 patients, 51 patients had electric burns of head and neck region that were included in the study.Results: Electric burns injuries involving head and neck region was seen in 61.4% of total victims. The most common age group was 20-40 yrs. Incidence was higher in rural population with 81.9% compared to urban 28.1%. Electricians, workers in electricity board comprised 59.26% of victims. In all patients, debridement was done and collagen membrane was grafted and some patients required reconstructive procedures 35.2% of patients.Conclusion: Electric burns are not uncommon in rural areas of India. The incidence electric burn injuries can be decreased if there is a public awareness especially among the electric workers regarding hazards of high voltage tension lines explained and use of safety equipments made mandatory.

This study's aim was to investigate on an international scale the reasons why individuals are currently choosing dentistry as a career. An observational, descriptive, cross-sectional study was conducted on a cohort of first-year dental students from thirteen countries on six continents in 2011-12 (n=711). Participants completed the Du Toit Questionnaire for Health Workers and Students, designed for this study, to disclose the reason(s) why they chose a career in dentistry. Data collected from the questionnaire were analyzed in EpiInfo version 7.1.1.14. The response rate was 89.1 percent; the respondents' average age was nineteen years; and their gender was 54 percent female and 46 percent male. The motive selected by the highest percentage (37.4 percent) was "Dentists have enough time off for family life." The second most popular motive at 36.3 percent was "I want to be a dentist who helps poor and underprivileged people." A strong relationship was found between this altruistic motive and students' having been accepted into their program by means of a personal interview or motivational essay as one of the admissions criteria (p<0.05, r(2)=0.89). This study found that the two strongest motivations for these students from around the world to seek a dental career were the flexible work schedule, leaving time for family life, and the opportunity to help those less fortunate. Dental school admissions policies that provide for review of applicants' motivations may produce dentists with stronger altruistic interest in the profession.

Introduction: Early post operative pain is the most common complain after elective laparoscopic cholecystectomy. The aim of this study is to determine the efficacy of intravenous tramadol compared to intravenous diclofenac for post operative pain relief.Materials and methods: A randomized doubled blinded study with a cohort of 50 patients was carried out at Teerthankar Mahaveer Medical Hospital, Moradabad between August 2012 and September 2013. Intravenous tramadol 50 mg or intravenous diclofenac 75 mg were eight hourly given to randomly allocated groups after laparascopic cholecystectomy by draw of chits. VAS score was taken at 4, 12, 20 and 28 hours. Data was analysed using SPSS version 16.Results: A significant difference in VAS scores was found at 12 hour post operative (p= 0.0007) with tramadol being more efficacious but having increased incidence of nausea and vomiting.Conclusion: Tramadol an analgesic acting on opioid receptor appears to be more efficacious in providing pain relief post laparoscopic cholecystectomy over diclofenac.

HYBROSONIC : The name derives from Heat + Sonic Vibration. The invention relates to Root Canal Obturating Device for fillling of Root Canal after removal of tooth pulp. Root canal treatment is the removal of tooth's pulp, a small thread like tissue in the centre of the tooth. Proper root canal filling should achieve three dimensional obturation of the root canal space to prevent micro organisms from entering and re-infecting the root canal system and to prevent tissue fluids from percolating back into the root canal system to provide a culture medium for any residual bacteria. It should seal all portals of exit to impede any sort of communication or exchange between the endodontium(within the tooth) and periodontium(outside the tooth). If the tooth is not sealed properly the root canal may leak and lead to failure of treatment. Conventional obturation techniques like cold lateral condensation technique and warm vertical condensation technique have limitations and are very technique sensitive hence a novel machine was developed which transforms gutta percha (root canal filling material) into alpha phase and using sonic vibrations the gutta percha is f orced to flow into lateral canals(accessory canals in horizontal planes), thus achieving 3-Dimensional fuild tight hermetic seal and thus preventing any chances of re-infection, and fulfilling one of the amin goals of endodontic treatment. Hence, an innovative, efficient, fast yet economical method to achieve perfect obturation thus, enhancing the prognosis of the tooth.

Dental fluorosis was first described in 1916 by GV Black and FS McKay.4 The process occurs beginning with fluorides being absorbed via the stomach and small intestine, and then largely excreted via the kidneys. Any ingested fluoride is stored in the mineralized tissues – bone, teeth – and at a level that increases with age.5 Odontogenesis is a sequential process moderated by epithelial-mesenchymal interaction.6 The interactive processes result in the secretion of tissue specific proteins, the transport of ions, and then the precipitation of these ions in to enamel crystal form, viz amelogenesis. Ameloblasts in this process are responsible for the regulation of the mass transporting of ions from systemic circulation to local circulation, and back again. Ameloblasts are also responsible for both protease and protein synthesis. Amelogenin, ameloblastin, and enamelin are important examples of such proteins.7 These proteins are responsible for the tissue architecture which will result in enamel prism formation, and the orientation of the crystal structures within these. Proteases act on the secreted enamel proteins by creating soluble cleavage products, providing areas of the enamel structure to mineralize further. This mineralization is achieved by forming octa-calcium phosphate crystals, and thereafter by reinforcing these crystals in to sheet-like structures.8 Aesthetic treatment of severely fluorosed teeth with prefabricated composite veneers: a case report

This article presents a review of the history of the dental-operating microscope and how it experienced slow acceptance. Following its introduction in 1982, it wasn’t until 1997 that microscopy training became mandatory for Advanced Specialty Education Programs in Endodontics. Undoubtedly, microscopic enhanced endodontics ultimately reshaped clinical practice and created a potential for a higher standard of care.