International Poster Journal of Dentistry and Oral Medicine, 01/2021

Background: Dental caries are caused by localized dissolution and destruction of the calcified tissues. Many papers have evaluated the effectiveness of allopathic or herbal interventions on enamel remineralization. However, no paper has evaluated the combined effectiveness. This paper compares the remineralizing effect of hydroxyapatite-incorporated herbal dentifrice and conventional fluoridated dentifrice on artificial enamel lesion. Materials and methods: An in-vitro study was carried out on 14 extracted sound human maxillary premolars. Nano-hydroxyapatite crystals were formulated by a wet chemical precipitation method and characterization was done using an X-ray diffractometer. Stems of miswak were collected, cut into small pieces, shade dried, and coarsely powdered. A dentifrice formulation was then prepared using them. The prepared tooth samples were processed through a pH cycling for 7 days. The depth of the lesion was assessed using a confocal microscope. Comparison of the lesion depth between the groups was done using the independent t-test Result: A significant reduction in the depth of the lesion was observed in both groups. Initially, before treatment, the depth of the lesion was 763.13+66.18 and 763.14±66.18 in group I and group II respectively. The depth of the lesion in group I reduced to 240.33 ± 23.47 after treatment with the respective dentifrice. The reduction in the depth of the lesion was observed in group II (272.55+29.38) also. However, this reduction was comparatively higher in group I, which was found to be statistically significant (p=0.043). Conclusion: Herbal dentifrice incorporated with hydroxyapatite had higher remineralizing potential compared to a fluoride dentifrice. Keywords: Demineralization, remineralization, enamel caries, fluoride, toothpaste

Introduction: For the 3D FDM printing of working models, not only the selection of the optimal material are of interest, but also the print settings. Objective: Optimisation of the printing process using FDM printers with regard to the print settings between mechanical stability, low material consumption, and short printing times. Method: For the investigation, print-optimised stl files with a horseshoe base were printed with a 3D printer (TEVO Tornado, TEVO 3D Electronic Technology Co., Ltd., China) in both PETG (glycol-modified polyethylene terephthalate) and PLA (polylactide). The parameters infill (0-30%), top and bottom layers (1-4), and number of shells (1-4) were varied. From the total of 256 possible combinations, the optimisation was carried out through gradual reduction. The models were measured with a digital caliper (tooth widths, dental arch width). After that a 0.8 mm foil (Erkodent Erich Kopp GmbH, Pfalzgrafenweiler) was vacuum formed with a Scheu Biostar (Scheu-Dental GmbH, Iserlohn) and, after removing the aligner, the model was measured again. The models were also scanned at these times (S600 Arti, ZirkonZahn GmbH, Gais, It). The *.stl were compared with GOM Inspect (GOM GmbH, Braunschweig). Results: Models without infill (0%) are in principle printable, but may have holes in the occlusal surface due to a lack of support. The bottom layers proved to be indispensable for reasons of torsional stability. Due to the better temperature stability of PETG, these models can be printed with reduced wall thickness (shells) and infill compared to PLA. With lower thicknesses, changes in shape due to vacuum forming could be observed, especially with PLA. The buccal surfaces of the teeth are susceptible to this. Metric measurements, however, remained almost unchanged. Conclusion: With the right parameters, models that are suitable for the vacuum forming process and optimised in terms of material consumption and printing speed can be produced. Because of the heating that occurs, heat-stable filaments have an advantage. Keywords: 3D-printing, vacuum forming, aligners

In order to deliver successful dental treatment, the assessment of children’s anxiety is important. Drawing is a self-reported, projective and non-invasive technique and may be helpful in achieving this goal. Therefore a cross-sectional study was conducted in 100 children aged 4-6 years. Children were asked to draw dental operatory on an A4 sheet and colour it. The drawings were scored using the Child Drawing: Hospital Scale (projective scale) and the results were compared with pulse oximeter readings (physiological parameter) and Venham Picture Test scores. On evaluation of results, it was concluded that drawing has a positive correlation with physiological parameters for assessing children’s anxiety. Keywords: Anxiety, drawing, psychology

Introduction. Oral health is a risk factor for interference with cognitive function. The number of teeth lost is associated with of oral health-related quality of life (OHR-QoL). Objective. This study aimed to examine tooth loss distribution and the impact on OHR-QoL perception in cognitively impaired and cognitively normal groups. Materials and Methods. This cross-sectional study examined community-dwelling elderly aged ≥60 years in Indonesia. Cognitive status was assessed by a clinical psychotherapist by using the mini mental state examination (MMSE) with a score range of 0-30. Participants with a total score of <25 were defined as having cognitive impairment and normal have total score ≥ 25. Dental status was examined by a dentist involved the number of anterior and posterior teeth lost. An interview was conducted to collect information on socio-demographic characteristics and self-reported perception of oral health and functional status using part of an oral health-related quality of Life (OHR-QoL) questionnaire. The questionnaire used 0-4 scale. A Mann-Whitney test for numerical and Chi-Square for categorical data were used to compare the groups. The Spearman correlation test was used to analyse the correlation between number of anterior teeth lost and self-reported oral health with the MMSE score. For all tests, a p-value < 0.05 was considered statistically significant. Results. There were 13 subjects in the cognitive impairment group and 42 subjects in the normal cognitive group. The cognitive impairment group showed a significantly lower education level compare to normal groups, p<0.05. There is a significant difference of anterior tooth loss between cognitive impairment compared to normal the group, p<0.05. The Spearman correlation test showed anterior tooth loss related the MMSE score with a weak association (r= -0.294; p<0.05) in our study. The feeling of embarrassment due to the appearance of the teeth was significantly different between the groups, p<0.05. There was a weak correlation between the feeling embarrassed due to the appearance of the teeth with MMSE score (r= 0.298 ; p<0.05). Conclusion. Elderly with a low education level have cognitive impairment, anterior tooth loss, and feeling embarrassed due to the appearance of their teeth. There is a weak association between anterior tooth loss and feeling embarrassed due to the appearance of the teeth with cognitive function. Keywords: tooth loss, cognitive function, self oral health perception

Background: Age estimation and gender determination of the skeletal remains are of paramount importance in forensic dentistry. The mandible is a largely dimorphic bone in the skull and largely recovered intact. Hence digital analysis using orthopantomogram and pattern analysis using fractal may aid as a potential tool for forensic determination. Aim: Age estimation and gender determination using digital measurements and fractal dimension (FD) analysis from orthopantomogram. Materials and methods: 20 orthopantomographic images (10 males and 10 females) were selected with age correlation. The digital measurements (bilateral upper ramus breadth, lower ramus breadth, gonial angle, coronoid height and condylar height) were directly measured from SIDEXIS XG- Sirona. The fractal analysis of the bilateral condyle, parasymphysis, and angle were performed using ImageJ software. Results and discussion: The bilateral gonial angles had significant correlation, and multiple regression analysis was elucidated for age. R2 value denoted the variance in the age as revealed change by 87.6%. The bivariate test shows that actual age and predicted age very strongly correlated (r=0.936). The bilateral condylar height had significant correlation with gender, and discriminant function formula / Wilks’ lambda analysis was evaluated. The bilateral condylar fractal dimension was significantly inversely related to age using Pearson’s correlation. The fractal dimension values of parasymphysis and angle were greater than of the condyle in the females compared to males. Conclusion: The condylar height and coronoid height can aid as an adjunct forensic tool for gender determination and the gonial angle for age estimation by further analysis including the geographic and regional variations. The condylar bone density patterns and alterations with age can be considered as a factor in forensic analysis even with remnants of mandible. Keywords: Fractal, forensic, mandible, orthopantomogram

Introduction: Age estimation of both the living and the dead is one of the most important sub disciplines of forensic sciences and is of significance in medicolegal issues. Teeth can also be used to determine the age of a living individual in association with crimes and other purposes. Radiographic assessment of age is a simple, non-invasive and reproducible method that can be employed on the living and unknown dead. After root completion, secondary dentine is deposited throughout one's life, reducing the pulp chamber. The pulp chamber reduces as the chronological age advances and is least influenced by other environmental factors. Aim: The study aimed to evaluate reliability of dental radiographic age assessment for adults using pulp /tooth ratio in digital panoramic radiographs. Materials and methods: Digital orthopantomograms (OPG) of 20 individuals (10 males and 10 females) were taken from the digital archives (October 2019) of the Department of Oral Medicine and Radiology of our college. Good quality radiographs of patients above 18 years and up to 70 years of age were included. The reference teeth were 36, 37, 46 and 47. The measurements were performed on the JPEG images of selected digital OPGs. The measurements were done using GNU Image Manipulation Program (GIMP) [2.10.22] and were recorded by a single observer. Crown Root Trunk Height (CRTH) was calculated by measuring the distance between the central fossa and the highest point on root furcation. Pulp Chamber Height (PCH) was calculated, which is the distance between the roof and floor of the pulp of the pulp chamber. Pulp Chamber Crown Root Trunk Height Ratio (PCTHR) was obtained as the ratio of PCH to CRTH. Chronological age of the subject was recorded based on his/ her date of birth. All data were entered and analysed using SPSS (Statistical Package for Social Science) v11.5TM. The age estimation formula was derived by simple linear regression analysis. Results: The Pearson’s correlation coefficient test shows that the PCTHR value of all the teeth except 36 are significantly correlated with the age of the study population. (As age increases, there is a significant reduction in PCTHR of teeth 37, 46, and 47 in the study). R2 value denotes the variance in the age as explained by the PCTHR value of tooth 47 in the study. It means that 66.2% of change in age is explained by the change in the PCTHR value of tooth 47 in the study. The Pearson’s correlation coefficient test shows that the predicted age and actual age are strongly correlated with each other (r=0.813). Conclusion: This study showed that PCTHR has a negative correlation with chronological age. There was a statistically significant correlation observed between chronological and calculated age by this method. Validation with a larger population of wider geographic and ethnic diversity is recommended to generalize the results of this study. The limitations of the study include a small sample size and a single observer recording the measurements. Keywords: panoramic radiography, forensic sciences, secondary dentin, dental pulp, age determination