Lectins comprise a stracturally vary diverse class of proteins charecterized by their ability to selectively bind carbohydrate moieties of the glycoproteins of the cell surface. Lectins may be derived from plants, microbial or animal sources and may be soluble or membrane bound. Lectins is a tetramer made up of four nearly identical subunits. In human, lectins have been reported to cause food poisoning, hemolytic anemia, jaundice, digestive distress, protein and carbohydrate malabsorption and type I allergies. The present review focuses on the classification, structures, biological significance and application of lectins.

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The cell damage will cause the release of free radicals. These free radicals will play an important role in any bioactive process of the cells. Antioxidants are one of the important components which plays a critical role to maintain the cell functioning and integrity of the cells. Antioxidants play an important role against the reactive oxygen species and maintain the normal activity of the cell. Antioxidants are preventing the free radical configuration tissue damage by preventing the formation of radicals or promoting their breakdown of free radical species. The review article explains the role of antioxidants in normal healthy conditions as well as diseases.

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Cell death is one of the essential processes. Balance between cell division and cell death is of utmost importance for the development and maintenance of multi-cellular organism. Disorders of either process have pathologic consequences and can lead to disturbed embryogenesis, neurodegerative diseases, or the development of cancers. This article reviews the apoptotic as well as anti-apoptotic molecules along with molecular pathways, which may alter in many diseases.

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Objective: The purpose of this study was to compare the clinical performance of class II composite resin restorations placed by two different bulk-fill techniques according to the United States Public Health Service (USPHS) criteria. Materials and Methods: Sixty class II restorations were placed in 60 patients in the age range of 20-50 years. The patients were divided into three groups according to the technique of the restoration were applied. Group 1: Tetric Evo Ceram (Ivoclar Vivadent) was placed in 2 mm increments. Group 2: Tertic N Ceram Bulk Fill (Ivoclar Vivadent) was placed in single increment. Group 3: Sonic Fill (Kerr, Kavo) was placed in single increment by sonic vibration. The restorations were evaluated using modified USPHS criteria at baseline and then after 3 months, 6 months, 9 months, and 12 months. Results: After 12 months, 58 Class II restorations could be observed. Two cases were dropped out. All the restorations of the three groups showed acceptable clinical performance according to the modified USPHS criteria, and statistically there were no significant differences between the two bulk-fill techniques. Conclusion: Both the bulk-fill techniques performed satisfactorily over the 12-month observation period. Due to the low viscosity of Sonic Fill, it may preponderance Tertic N Ceram Bulk Fill in the regard to depth of cure and marginal integrity and marginal discoloration.

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Background: Benefits of remineralizing agents in a wide variety of formulations have been proved beneficial in caries management. Casein phosphopeptide-amorphous calcium phosphate (CPP–ACP) nanocomplex has been recommended and used as remineralizing agent. Nano-hydroxyapatite (n-HAp) is one of the most biocompatible and bioactive material having wide range of application in dentistry, but does it excel better compared to CPP-ACP. Aims: To evaluate and compare the remineralizing efficiency of the paste containing hydroxyapatite and casein phosphopeptide-amorphous calcium phosphate. Settings and Design: The study was an in vitro single blinded study with lottery method of randomization approved by the Institutional Ethics Committee. Materials and methods: 30 non carious premolar teeth. The teeth were demineralized and divided into 2 groups and subjected to remineralization. The samples were analysed for surface hardness and mineral content. Statistical Analysis: Student t’ test and repeated measures of ANOVA was applied. Results: Average hardness in Nano-hydroxyapatite group increased to 340 ± 31.70 SD and 426 ± 50.62 SD for 15 and 30 days respectively and that of (CPP–ACP), 355.83 ± 38.55 SD and 372.67 ± 53.63 SD. The change in the hardness values was not statistically significant with P value of 0.39 (P > 0.05). Calcium and Phosphorous levels increased in both the groups but was not significant. Conclusion: Both the agents used are effective in causing remineralization of enamel. Nano-hydroxyapatite is more effective as compared to Casein phosphopeptide-amorphous calcium phosphate, in increasing the Calcium and Phosphorus content of enamel, and this effect is more evident over a longer treatment period. Key Message: Remineralizing agents are a boon for caries management. With the advent of many formulations it is difficult to clinically select the agent. This study compares the remineralizing potential of Casein phosphopeptide-amorphous calcium phosphate nanocomplex and Nano-hydroxyapatite and found that both are effective as remineralizing agents.

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Saliva is the most valuable oral fluid is critical to the preservation and management of oral health. Saliva containing various organic and inorganic substances provides primary natural protection for teeth and soft tissues in the oral cavity assists in mastication, deglutition and digestion of food. The secretion of saliva can be affected due to various local and systemic causes. However if a patient is taking medication and has altered salivary secretion the differential diagnosis should include the possibility of an adverse drug reaction. The drugs may lead to alteration in the flow rate of saliva, which can be either increased or reduced, however certain drugs have been reported to cause change in the color of the saliva. Several drugs may lead to sialadenitis associated with altered salivary secretion. These symptoms may simulate systemic diseases, Hence oral physicians need to be vigilant in recognizing these adverse drug reactions in the patients and it is incumbent upon the practitioner to try to stay abreast of this ever evolving field especially as it relates to dental therapeutics.

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Objective: A preliminary study was conducted to investigate the feasibility of using an oral cancer chemopreventive agent (−)-epigallocatechin-3-gallate (EGCG), the most biologically active component in the green tea extract, in a form of "swish-and-spit" mouthwash. Such application of EGCG is beneficial as it maximizes exposure of the oral mucosa to the agent but minimizes systemic side effect. Materials and Methods: The study was conducted on individuals suspected to have oral field cancerization who are at a high risk for developing recurrent oral precancerous and carcinomatous lesions. EGCG was used as a daily mouthwash for 7 days. EGCG's ability to modulate target molecules implicated in oral carcinogenesis was assessed by measuring the change in the expression levels of biomarkers. Results: Immunohistochemical expressions of phosphoactivated epidermal growth factor receptor (pEGFR), cyclooxygenase-2 (cox-2), and ki-67 were evaluated at baseline and at the endpoint (day 8). Although not statistically significant, overall decrease in expression levels of pEGFR (27.5%), cox-2 (15.9%), and ki-67 positive cells (51.8%) was observed following EGCG treatment. Moreover, a detectable level of EGCG was found in saliva but not in plasma after the 1-week treatment regime, demonstrating local availability of EGCG in oral mucosa without significant systemic absorption. Conclusion: To the best of our knowledge, this is the first study to explore use of oral cancer chemopreventive agent in the form of mouthwash in patients with oral field cancerization. Although a definitive conclusion was not reached due to limited sample size, if proven effective, EGCG therapy may offer a non-invasive preventive modality for oral field cancerization.

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Aims: Liquid dish washing solution (DWS) was used as a substitute for xylene to dewax tissue sections during hematoxylin and eosin (H and E) staining. The aim was to test and compare the hypothesis that xylene-ethanol free (XEF) sections deparaffinized with diluted DWS are better than or at par with the conventional H and E sections. Materials and Methods: Fifty paraffin-embedded tissue blocks was included. One section was stained with conventional HandE (group A) and the other with XEF HandE (group B) staining method. Slides were scored for parameters: nuclear, cytoplasmic, clarity, uniformity, and crispness of staining. Z test was used for statistical analysis. For accuracy of diagnosis, sensitivity, specificity, positive predictive value, and negative predictive value were tested. Results: Adequate nuclear staining was noted in 94% in group A and 96% in group B, ­adequate cytoplasmic staining in 92% in group A and 86% in group B, clarity in 94% of group A and 96% of group B sections, uniform staining in 92% of group A and 80% of group B sections, crisp stain in 96% of group A and 88% of group B sections, and 94% of group A sections stained adequately for diagnosis as compared with 90% in group B sections. Conclusion: Liquid DWS can be used as an alternative and effective substitute to xylene and ethanol in routine HandE staining procedure.

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Sialolithiasis is the most common salivary gland disease accounting for more than 50% of the cases. Majority of salivary calculi occur in the submandibular gland and its duct. It has male predilection and is often seen in adults. Majority of the calculi are less than 10 mm in size. Calculi > 15 mm in size are considered giant. Giant sialoliths within the parenchyma of the salivary glands are frequently reported in the literature, but they are uncommon in the salivary ducts. The purpose of this article is to report a case of giant sialolith in the Wharton's duct of a 65-year-old male, which had caused sialo-oral fistula. Literature in English language on "giant sialolith in Wharton's duct" is reviewed since 1990. Also etiology, pathogenesis, clinical features, diagnosis and management aspects are discussed.

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Objectives: Present study was undertaken to estimate and compare erythrocyte superoxide dismutase (E-SOD) and glutathione peroxidase (GPx) levels in oral submucous fibrosis, oral leukoplakia, oral cancer patients, and healthy subjects. Materials and Methods: E-SOD and GPx levels were estimated in OSF, oral leukoplakia, and oral cancer patients with 25 subjects in each group. The results obtained were compared with the corresponding age-/sex- matched control groups. Results: Statistically significant ( P < 0.001) decrease in E-SOD and GPx levels were observed in OSF, oral leukoplakia, and oral cancer groups as compared to the control group. Oral leukoplakia group showed lower levels in comparison with OSF ( P > 0.05). Oral cancer group had the lowest levels amongst the study groups. Conclusion: Imbalance in antioxidant enzyme status may be considered as one of the factors responsible for the pathogenesis of cancer and may serve as a potential biomarker and therapeutic target to reduce the malignant transformation in oral premalignant lesions/conditions.

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Introduction: Antimicrobial resistance is a well-known entity and the most common factor leading to this is the irrational use of antibiotics. Several studies from the West have substantiated the irrational use of antibiotics in dentistry. Aims: The aim was to assess the knowledge, attitude, and practice (KAP) of antimicrobial drug use among dental fraternity in a tertiary care teaching dental college and hospital. Materials and methods: A cross-sectional survey of various dental fraternities using a structured validated questionnaire. The study was initiated following approval from Institutional Ethics Committee and interns, junior residents and faculty members of various departments in dentistry were enrolled after obtaining written informed consent. A structured validated questionnaire was developed to assess the above-mentioned objectives. Statistical analysis: Descriptive statistics was used for representing each category of response and kappa statistics were used to assess the reliability in the initial cohort. Chi-square test for independence was used to evaluate the difference in proportion between different professional cadres. Results: A total of 120 participants were recruited out of which 81.6% (98/120) of the participants accepted their frequent antibiotic usage. The most common dental indication of antibiotics among dentists was post dental extraction, attributing to 30.8% (37/120), followed by dental abscess 21.6% (26/120) and 60% (72/120) prescribed antibiotics after most minor surgical procedures. Surprisingly, 37.5% (45/120) of the participants opined that they use antibiotics against viral infection. Regarding the spectrum of antibiotic usage, 74.1% (89/120) preferred broad spectrum instead of narrow spectrum 25.8% (31/120). The commonly prescribed antibiotics were amoxicillin 71.7% (86/120), metronidazole 33.3% (40/120), amoxicillin with clavulanic acid 26.6% (32/120). A total of (43/120) 35.8% opted generic name for mentioning the antibiotics while the rest (77/120) 64.2% preferred to prescribe using their brand name. Furthermore, (76/120) 63.3% did not know about the recent antibiotic policy/guidelines from the Government of India. There was no significant difference observed in any of the responses between various academic levels. Conclusion: We found poor KAP regarding antimicrobial use in dentistry thereby conferring increasing potential for the development of more serious antimicrobial resistance. Immediate constitution of hospital antibiotic committee and scrutinizing the prescription of antibiotics is mandatory in dental hospitals as well.

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Objectives: This study was carried out to correlate the relationship between early childhood caries and maternal education level and socio-economic status (SES). Materials and Methods: The study was conducted on 500 pairs of children of ≤6 years age and their mothers, who reported to the private dental clinic in Gurgaon, Haryana, India. The association between mother's educational level and SES of the family were estimated through a self-structured questionnaire. Caries status of the children was estimated using deft index (World Health Organization criteria). Results: Collected data was statistically analyzed. There was an inverse relationship between the education level of mothers and caries status of their children. There was no relationship between the SES of mothers and caries status of their children. Conclusion: It was concluded that, mothers are responsible for their children primary oral health.

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Recurrent aphthous stomatitis (RAS) is a painful condition, often leading to impairment of the basic functions such as mastication, speech, and brushing. Several treatment modalities have been advocated in the past, but none hasve been proven efficacious. A novel treatment modality in the form of low-level laser therapy (LLLT) has evolved in recent years. LLLT also known as "cold laser" works on the principle of biostimulation. This biomodulatory effect plays a pivotal role in accelerating the healing process and provides analgesia. Hence, it constitutes an alternative to processes that present pain and inflammatory reaction. The present series of cases throw light regarding the use of diode laser for LLLT as an effective and quick tool in the painless management of recurrent aphthous ulcers.

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Introduction: The vitamin D effect on orthodontic tooth movement in pregnant women remains unknown. The aim of this study was to investigate the post administration of vitamin D effect on osteoblast numbers and bone alkaline phosphatase (BALP) expression in the tension side in pregnant rats during orthodontic tooth movement. Materials and Methods: This study was an in vivo animal experiment; 28 healthy female Wistar rats (Rattus norvegicus) (16–20 weeks’ old) were divided into four groups, with or without intramuscular administration of vitamin D, which were to be observed after 7 and 14 days. Pregnancy was induced with pregnant mare serum gonadotropin and human chorionic gonadotropin. Nickel–titanium coil springs with 30 g/mm² of force were connected between the right maxillary incisors and the right maxillary first molar. After 7 and 14 days, the animals were sacrificed. Statistical Analysis Used: Analysis of variance with post hoc test (P < 0.05) was performed based on the results of a Levene’s test and a Kolmogorov–Smirnov test (P > 0.05). Results: The highest number of osteoblasts occurred in the C-7 group with mean ± standard deviation of 20.54 ± 8.4. Statistically significant differences were seen in decreased osteoblast number between groups (P = 0.001, P < 0.05). The highest BALP expression was in the E-7 group (3.40 ± 1.625). Nevertheless, no statistically significant difference was observed between the groups (P = 0.240, P > 0.05) in the expression of BALP. Conclusion: The post administration of vitamin D during orthodontic tooth movement in pregnant rats produced no significant enhancement on BALP expression and osteoblast number.

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Introduction: Over the past 30 years, flap designs for implant surgery have been modified and atraumatic technique was introduced. It has several potential advantages, including reduction of complications at the patient level. The aim of the present study to compare the soft tissue profile and heights of crestal bone levels around the single-stage implants after single-piece implant placement with two different surgical techniques, that is, open flap procedure and flapless (FL) procedure. Materials and Methods: Thirty participants were randomly selected and categorized into two groups. Group 1 (flap technique) and Group 2 (flapless technique) consisted of 15 participants each. All of these participants underwent evaluation of soft tissue parameters of papillary index, probing pocket depth, sulcus bleeding index, and hard tissue evaluation such as crestal bone levels by radiovisiography at 0, 3, and 6 months. Results: All clinical parameters improved in FL technique when compared with the flap technique. Conclusion: The results concluded that the FL implant surgery results in lesser loss of interproximal bone and also results in better soft tissue changes when compared with the flap technique. However, controlled, further studies are needed to confirm this possibility.

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Introduction: Dental trauma till date has been one of the most common injuries affecting school children. Aim: The aim was to evaluate the prevalence and associated factors on dental trauma in 11-16 year old school going children of Davangere city. Materials and Methods: A cross-sectional study was conducted among 2000 school children who were randomly selected. A questionnaire was given to the children that included personal demographic details, place and cause of injury. Ellis and Davis classification was used to record traumatic dental injury. The values were subjected to Chi-square test and multivariate logistic regression analysis. Results: The prevalence of dental trauma was found to be 10.6%. Chi-square test showed significant results obtained with respect to all the variables-age, gender, type of school, profile, and overjet. Most commonly affected teeth were maxillary central incisor (79.6%). Conclusion: The prevalence of dental trauma was found to be comparable when compared to various studies done all over the world.

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Aim: The aim of this study was to correlate the morphological facial index and canine relationship in adults. Materials and Methods: The research was conducted on 1000 randomly selected subjects of Indo-Aryan North Indian population (563 males and 437 females), aged 18–40 years. The parameters were morphological facial height and morphological facial width. The standard, spreading caliper with its scale was used for the measurement of facial parameters. Canine relationship was observed intra-orally with the subjects seated on the dental chair. Results: Euryprosopic facial type (53.2%) was most common in majority of the subjects followed by mesoprosopic (21.6%), hypereuryprosopic (19%), and leptoprosopic (5.6%), and the least common was hyperleptoprosopic (0.6%). The canine relation was mostly class I in both the genders, but females showed a higher value of class II and class III canine relations. Conclusion: The overall majority owned the euryprosopic facial type, and there was no significant association between facial morphologic types and canine relationship in both the genders in different age groups at either side. The canine relationship association with facial morphologic type was significant only for the left side.

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Introduction: Periodontitis is a chronic inflammatory disease manifested as the destruction of tooth supporting tissues, which may progress to tooth loss. The chemical antimicrobial agents are often applied locally into the periodontal pocket as adjuncts to conventional mechanical periodontal therapy, but these have various adverse effects. Root extract of Saussurea lappa has shown anti-inflammatory and anti-bacterial properties. Hence, the present study was aimed to assess and compare the effect of root extract of S. lappa to chlorhexidine gluconate as subgingival irrigant as an adjunct to scaling and root planing (SRP). Materials and Methods: Thirty chronic periodontitis patients in the age group of 25-45 years were selected for the study. Five hundred and forty periodontal pockets were treated by three different procedures: Group1: Subjects treated by SRP only, Group 2: In addition to SRP, irrigation with S. lappa extract was done and Group 3: Chlorhexidine was used as irrigant along with SRP. Periodontal clinical recordings (modified sulcular bleeding index, probing pocket depth, clinical attachment level, and the presence of pus discharge) were done at 0, 7, 14, 28, and 42 days. Results: The periodontal parameters studied improved in all the three groups over the time period. In 4-5 mm pockets, S. lappa treated group showed significant improvement than chlorhexidine treated group. Furthermore, a dramatic decrease in periodontal pockets with pus discharge was seen in this group. Conclusion: Subgingival irrigation with S. lappa might be a promising adjunct to conventional treatment options in the management of periodontal infections.

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Aims and Objectives: The aim was to evaluate the feasibility of pectoralis major myocutaneous (PMMC) flap in reconstruction of defects in the head and neck region. The study also outlines types of other tissue required, the donor site morbidity and the technical details of the operative procedure. Materials and Methods: This was a retrospective study undertaken on patient of soft tissue defect of head and neck region either traumatic or after resection of the tumor admitted to author's center. A total of 62 patients was included, among them, 59 patients were of malignancy and 3 patients were of traumatic injury to face. All the patients of malignancy underwent wide local excision of the tumor with modified radical neck dissection type III. After resection, the resultant defect was covered with pectoralis major myocutaneus flap (PMMF) with or without deltopectoral (DP) flap or forehead flap (PMMF or PMMF + DP/forehead flap). The operating time was noted from elevation of the flap to completion of flap insetting. Results: All the flaps survived uneventfully except 4, out of this 1 developed total flap necrosis, 1 partial flap necrosis and 2 experienced epidermolysis. Orocutaneous fistula was noted in 3 patients in initial days and after removal of the intraoral suture the fistula spontaneously resolved in all cases. Conclusion: It was concluded that PMMC is the highly versatile and reliable flap with an excellent vascularity, wide arc of rotation, large flap dimension, easy to harvest, economical and with minimal complications.

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Aim: Oral submucous fibrosis (OSMF) is a high risk premalignant condition predominantly seen in the Indian subcontinent. The aim of the present study was to evaluate the efficacy of newer drug pentoxifylline in the management of OSMF. Materials and Methods: A total of 106 subjects with clinic-pathologically diagnosed OSMF were included in the study and divided equally in two groups, Group A (pentoxifylline group) and Group B (placebo group). Group A was administered 400 mg pentoxifylline twice daily and Group B was given multivitamins for 3 months. Evaluation for different clinical parameters was done at regular intervals and data were analyzed using the Chi-square test. P < 0.05 was considered to be statistically significant. Results: The patients in Group A showed significant improvement (P < 0.05) in all the parameters measured, mouth opening, tongue protrusion, pain associated with the condition, burning sensation and difficulty in speech and swallowing. However, few patients from Group A complained of bloating, nausea, anxiety and dyspepsia. Conclusion: Pentoxifylline can bring about significant clinical improvements in the symptoms like mouth opening and tongue protrusion, thereby improving the quality of life of the affected individuals.

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Background: PIK3 and K-ras are signal transducing proteins involved and mediating many responses related to cell cycle growth regulation. Until date, there has been only limited evidence about the expression of K-ras and PKI3CB in oral squamous cell carcinoma (OSCC). AIMS : This study aimed to examine both proteins in OSCC and their relation to clinic- pathological findings. Setting and Design: A total of 31 formalin-fixed paraffin-embedded specimens of OSCC were selected in this study. PIK3CB and K-ras expressions were detected using standard immunohistochemical techniques. Materials and Methods: PIK3CB and k-ras immune reactivity was semi-quantitatively evaluated in at least five representative fields at 400X magnification and recorded as percentage of PIK3CB and k-ras positive tumor cells over the total number of cells examined in the same area. Results and Conclusion: All examined specimens of OSCC were positive for monoclonal antibodies directed against PIK3CB and K-ras proteins especially at advanced stage of the disease. No significant relation was observed between the tested proteins and the clinic-pathological findings of OSCC; however a highly significant direct relationship was observed between K-ras and PIK3CB. This lead to conclusion that both K-ras and PIK3CB signaling pathway were activated in the advanced stage of OSCC, and possibly a cross-talk between them. This could make these mutant proteins a potential target for an effective molecular therapy.

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Introduction: This review sought to present fundamental principles of deep convolutional neural networks (DCNNs) and provides an overview of its applications in medicine and dentistry. Materials and Methods: Scientific databases including PubMed, Science Direct, Web of Science, JSTOR, and Google Scholar were used to search for relevant literature on DCNN and its applications in the medical and dental fields from 2010 to September 2018. Two independent reviewers rated the articles based on the exclusion and inclusion criteria, and the remaining articles were reviewed. Results: The comprehensive literature search yielded 110,750 citations. After applying the exclusion and inclusion criteria, 340 articles remained that pertained to the use of DCNN in medicine and dentistry. Further exclusion based on nonbiomedical applications yielded a total of 26 articles for review. Conclusion: Advances in the development of neural network systems have permeated into the medical and dental fields, particularly in imaging and diagnostic testing. Researchers are attempting to use deep learning as an aid to assess medical images in clinical applications and its optimization will provide powerful tools to the next generation. However, the authors caution that these tools serve as supplements to improve diagnosis and not replace the medical professional.

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The application of medical ultrasound was mainly centered on the soft tissue diagnostic imaging until now. Recently, its use has been widened and adopted for various therapeutic purposes. It has been reported to facilitate the healing of bone fractures, wounds, apthous ulcers and temporomandibular disorders. In addition, ultrasound has also been shown to facilitate delivery of chemotherapeutic drugs into tumors, promote gene therapy to targeted tissues, and deliver thrombolytic drugs into blood clots. This article reviews the principles and current status of ultrasound-based treatments.

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According to Sir William Osler, Mouth is the mirror of the body which reflects systemic ­diseases. The oral mucosa may be affected by a variety of mucocutaneous diseases and oral lesions may occur first or very early in several mucocutaneous disorders. The erosive gingival lesions associated with vesiculobullous diseases such as lichen planus, cicatricial pemphigoid, and pemphigus vulgaris have been collectively referred to as "Desquamative gingivitis" (DG). Gingival desquamation is a clinical sign in which the gingiva appears reddish, painful, glazed and friable with destruction of the epithelium. This gingival desquamation is due to various disease processes in gingiva. The disease process may be a localized disease of gingiva or a systemic disease which manifests in the gingiva. It is important to be aware of this rare clinical entity so as to distinguish DG from plaque induced gingivitis which is an extremely common condition, easily recognized and treated daily by the dental surgeon. Accurate diagnosis and effective treatment of these lesions may greatly diminish or reverse disease progression. Here by, we present a case of mucous membrane pemphigoid presenting as gingival desquamation in a 45 year old female. Our patient presented with generalized erythematous gingiva and gingival desquamation involving the free, attached and marginal gingiva of left maxillary and mandibular dentition. However, other mucosal and skin involvement was not appreciated in the present case. Thorough history, clinical examination, histopathology and immunofluorescence studies helped us to arrive at the diagnosis of this rare sub-epithelial blistering disorder.

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