Background: Dysfunctional social behavior deriving from work distress is common among practicing dentists. Aim: This paper appraises prevalent stressors for practicing dentists, not only in North America, but also in dental practices in all other continents. This critique aims to describe from a dentists’ viewpoint, what is wrong, why it is wrong and what can be done about it. Deconstruction of stressors: Among the main reasons are misdirected motivations, unfulfilled performances, inadequate coping strategies, unsatisfied needs and frustrations arising from unreasonable expectations. Social changes, financial constructs and professional stressors can all play a part. Discussion: Abuse by financiers, patients and staff, with inadequate skills, muddled management of resources and jumbled attitudes, may precipitate anything from unexplained mood changes to psychotic episodes. These forces may work to convert stress to distress. Concluding remarks: Hopefully this exposition provides answers, novel thinking, fresh insights, orderly approaches, practical skills and coping strategies for dentists to improve their role as health care providers in a community.

Permanent mandibular second molars usually show two roots, one mesial and the other distal root with four root canals (two mesial and two distal canals). Variation in root number and canal morphology rarely occur in these teeth. Cone Beam Computed Tomography is a new advent in the diagnostic field which provides three dimensional clear picture of the root/canal. The present article describes the endodontic management of permanent mandibular left second molar with Vertucci II canal configuration using cone beam computed tomography.

Objective: The aim of this study was to investigate the levels of Human Beta Defensin (hBD) 2 and 3, chemokine and cytokine expressions between teeth endodontically diagnosed with symptomatic irreversible pulpitis (SIP), asymptomatic irreversible pulpitis (ASIP) and normal pulps. We hypothesized that there would be a correlation between hBD’s and the immunoregulatory response. Design: Pulpal samples were collected with paper points. Six samples were obtained from normal teeth, 21 from SIP, 18 from ASIP. Levels of cytokines and beta- defensins were measured by Luminex technology and ELISA, respectively. Data were statistically analyzed using Kruskal-Wallis, Wilcoxon Mann-Whitney test and Spearman correlation test. Differences were considered significant at p<0.05. Results: hBD-2 levels correlated with samples obtained from patients in the ASIP group, but not in the samples obtained from patients with SIP or the control group. HBD-3 concentrations associated with all of the cytokines and chemokines in both SIP and ASIP groups. However, in the normal group, hBD-3 correlated with only TNFa, IL-8, MCP-1, IL-1ß, MIP-1a, RANTES, IL-17 in normal group. When comparing control levels of hBD-2 and hBD-3 with patients samples from either the ASIP or the SIP groups, hBD- 2 and hBD-3 concentrations were highest in the ASIP group. Conclusions: The hBD-2 and-3 were highly associated with the levels of the chemokines and cytokines in ASIP group. HBD-3 concentrations correlate with the levels of the chemokines and the cytokines in the SIP and ASIP groups

Objective: To evaluate the impact of soft tissue factors in dental implants. Data: Studies evaluating the role of soft tissues in dental implants were included in this review. Sources: A comprehensive literature search of English and Chinese language articles was performed via electronic databases (PubMed, Cochrane Library, Web of Science, CNKI and VIP) using the appropriate key words(esthetic; evaluation; impact factor; soft tissue). The most recent search took place in January 2016. Study selection: Potentially appropriate articles were identified and evaluated for eligibility through a predefined review process conducted by two examiners. Only 16 out of the 346 identified records met criteria and were included in the final analysis. Conclusion: The success of dental implants depends on two outcomes, the functional utility of the implant and its beauty. During the early phase of treatment, the main objective of a dental implant is to achieve adequate function. In clinical practice, however, subsequent soft tissue retraction and implant exposure have a significantly negative impact on implant esthetics, especially in young women’s teeth, which can also be considered as implant failure. It is particularly important to understand how to support the surrounding soft tissue so that it is esthetically pleasing

Synchrotron Radiation (SR) Wide-angle X-ray Diffraction (WAXD) and Small-angle X-ray Scattering (SAXS) techniques were used to assess microstructure of bovine enamel white-spot lesions (WSL) evaluated in a 10-day pH cycling model comprising three different dentifrice groups: (A) 0.21% NaF plus TCP (Clinpro Tooth Crème), (B) 1.1% NaF plus TCP (Clinpro 5000), or (C) 0% NaF (Tom’s of Maine) dentifrice. Each day consisted of four 2-minute treatments, one 4-hour acid challenge (pH=5.0), and immersion in artificial saliva (pH=7.0) between these events. These specimens were also examined with cross-sectional microhardness, digital light microscopy and FE-SEM (field emission scanning electron microscope), and demonstrated the remineralization model effected changes in subsurface microstructure. X-ray diffraction data from WAXD and SAXS were collected on enamel slab cross-sections extending from 0 µm to 150 µm, in 6 µm microbeam increments. A primary outcome of this observational study was that simultaneous WAXD and SAXS measurements were able to resolve significant differences (ANOVA, Student’s t-test, p<0.05) between the effects of the two fluoride- containing dentifrices on subsurface lesion microstructure. In particular, enamel lesions treated with 1.1% NaF dentifrice group manifested an abundance of nanometer-sized crystallites, while treatment with the 0.21% NaF dentifrice produced larger apatite-like crystals. While the presence of fluoride in both cases promoted regularity in crystal size and orientation, this was not observed for lesions treated without fluoride. Altogether, our observations demonstrate the pathological processes for remineralization are markedly influenced by the presence and concentration of fluoride, the microstructural characteristics of which can be distinguished using the simultaneous WAXD and SAXS technique.

The aim of this study was to correlate the morphological facial index and canine relationship in adults. Materials and method: The research was conducted on 1000 subjects (563 males and 437 females), aged 18-40 years, selected randomly. The parameters were morphological facial height and 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. Result: Euryprosopic facial type (53.2%) was most common in majority of the subjects followed by Mesoprosopic (21.6%), Hypereuryprosopic (19%), Leptoprosopic (5.6%) and the least common was Hyperleptoprosopic (0.6%). The canine relation was mostly Class I in both the genders, females showed a higher value of Class II and Class III canine relation. Conclusion: The overall majority had 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 left side.

Mouth is an important source of infections and oral infections increase the risk of mortality. Invasive Candida infections (ICI) are associated with high mortality and non-albicans Candida are responsible for most of such cases. Candida may even play a role in the development of cancer.

Dental local anesthetics contain vasoconstrictors, such as adrenaline and felypressin, to enhance the anesthetic effects and reduce bleeding in the surgical field. Adrenaline has been used for long periods of time as an additive to local anesthetics. With a typical dose range of 10 - 12.5 µg /mL, adrenaline is believed to prolong duration by its vasoconstrictive properties that prevent systemic reabsorption of local anesthetics. Several reports have warned against the use of dental local anesthetics containing adrenaline in patients with cardiovascular diseases.