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ABSTRACT Objective: To assess the effect of smoking (tobacco) and chewing (betel quid) on the alteration of salivary pH and flow rate. Material and Methods: The sample consisted of 45 participants divided into three groups: G1: Chewers (n=15); G2: Smokers (n=15), and G3 (Control): Healthy individuals (n=15). Unstimulated saliva was collected by the passive drooling method. Salivary pH was measured using a pH meter, and flow rate using a micropipette. One-way ANOVA compared groups; a p-value less than 0.05 was considered statistically significant. Results: Statistical significance was observed in the mean salivary flow rate between Chewers (8.0403) vs. Controls (11.5) (p<0.001) as well as Smokers (7.9333) vs. Controls (11.5) (p<0.001). Statistical significance was observed in the mean salivary pH between Chewers (6.6133) vs. Smokers (6.4067) (p=0.007), Chewers (6.6133) vs. Controls (7.31) (p<0.001) as well as Smokers (6.4067) vs. Controls (7.31) (p<0.001). Conclusion: Salivary pH was more acidic in individuals with smoking than those with chewing habits. Flow rate was less in individuals using tobacco (smoking and smokeless) compared to controls. Long-term consumption of tobacco is one of the risk factors for alterations in salivary pH and flow rate.

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ABSTRACT Objective: To evaluate the impact of nanoliposome papaya seed extract on the number of osteoblasts and RANKL expression in a diabetic periodontitis rat model. Material and Methods: Thirty-six Sprague Dawley rats were randomly divided into three groups; each group was Group T0 (rats induced to become diabetic periodontitis without treatment), Group T1 (rats induced to become diabetic periodontitis and given 96% papaya seed extract) and Group T2 (rats induced to become diabetic periodontitis and given 96% nanoliposome papaya seed extract). They were assessed at three points in time: day 3, day 7, and day 14. The extracts were given orally at 0.5 ml and drops as much as 0.03 ml on the gingival sulcus, and treatments were given once a day in each group at a predetermined time. Osteoblast cells were counted by hematoxylin-eosin (HE) staining, and RANKL expression was counted by immunohistochemistry (IHC) staining. The difference in osteoblast cells and RANKL expression between groups were analysed by one-way ANOVA and post hoc tests. Results: There was a significant difference in the number of osteoblasts on day 14 in the groups; a significant difference was also seen in RANKL expression on day 7 and day 14 in the groups. Conclusion: Administration of nanoliposome papaya seed extract affects the enhancement of the number of osteoblasts and reduction of RANKL expression in vivo.

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ABSTRACT Objective: To evaluate the factors associated with the fear of dental students infecting their relatives with COVID-19 as a result of clinical practice. Material and Methods: Online questionnaires were sent by e-mail and social media to dental students from a Brazilian School of Dentistry. The outcome was "fear of infecting the family." The independent variables were sociodemographic data, personal protective equipment use, adoption of infection control measures, and knowledge and feelings about the pandemic and the future of Dentistry. Data analysis used Pearson's Chi-square and Fisher's exact tests (p≤0.05). Results: With 65 participants, the prevalence of fear was 61.5%. Measures to prevent COVID-19, such as frequent hand cleansing (p=0.028) and avoiding the use of aerosol-generating instruments (p=0.027), not having or not knowing if they have been infected by the disease (p=0.038), and feelings of more significant anxiety during the pandemic period (p=0.047), and that Dentistry will undergo major post-pandemic changes (p=0.020) were associated with fear. Conclusion: Changes in behavior about biosafety and feelings of anxiety and uncertainty about the disease were associated with the dental students' fear of infecting their relatives with COVID-19 as a result of clinical practice.

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ABSTRACT Objective: To know the information available in bibliographic sources about dental pain and its associated factors in Brazilian Indigenous individuals. Material and Methods: Critical review in which a literature search was conducted in the databases: BVS encompassing LILACS, MEDLINE and also PubMed and Scielo. Descriptors in Portuguese and English were used, and the Boolean operator “AND” was used to cross the information. Results: After completing literature searches in the databases and other sources the authors obtained 285 articles, and after exclusion of duplicate journals and articles whose titles, abstracts and texts were not related to the researched subject, 02 articles were included in the review. Conclusion: There are few studies on the topic researched, which highlights the need to develop more research in this area to enable comparisons and obtain the best scientific evidence on the researched topic. The Indigenous adult and adolescent population, when compared to the general population, showed a higher percentage of people with toothache that was associated with poor self-perception of oral health.

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ABSTRACT Objective: To evaluate the influence of three angles (0°, 45°, and 90°) on the mechanical properties and surface characteristics of the specimens produced by a 3D printer and resin for provisional restorations. Material and Methods: In this in vitro study, ten bars (4 × 2 × 10 mm) were produced for each experimental group (n = 10), designed in the Meshmixer software and printed on a 3D printer. The bars were tested immediately, without aging. They were subjected to a three-point bending test in a universal testing machine, and the surface roughness was measured by a contact profilometer. Microhardness was measured by a microhardness tester and the surface roughness of the specimens was evaluated with a scanning electron microscope. Results: The flexural strength of the 0° group (236.20 ± 29.73) was significantly higher than those of the 45° (155.80 ± 36.19) and 90° (138.70 ± 48.20) groups. Similarly, the surface roughness of the 0° group (0.10 ± 0.06) was significantly lower than the 45° (1.62 ± 0.55) and 90° (0.97 ± 0.22) groups. Microhardness was similar among the groups. Conclusion: The 0° angulation, with deposition of the layers on the printed object so that they are oriented perpendicular to the direction of application of forces, resulted in the best resistance to bending and lower roughness, which may contribute to better clinical behavior.

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ABSTRACT Objective: To evaluate the correlation between caries risk and OHRQoL in middle age and the older population during the COVID-19 pandemic in Indonesia. Material and Methods: The subjects ranged in age from >45. The participants were asked to complete the Caries Management by Risk Assessment (CAMBRA) and the Oral Health Impact Profile-14 (OHIP-14) questionnaires. The data were analyzed using Mann-Whitey Test, Kruskal-Wallis Test, and Spearman Test with a significance level of p<0.05. Results: Two hundred sixteen people participated in this study. The average CAMBRA score for middle-aged and older people was 5.31 ± 1.111 and 5.27 ± 1.094, respectively. The mean scores for the OHIP-14 were 34.90 ± 6.164 for older adults and 35.79 ± 5.908 for middle-aged people. The correlation between caries risk and OHRQoL showed r=-0.400; p=0.00 for the middle age group and r=-0.143; p=0.170 for the older adults. Conclusion: During the COVID-19 pandemic in Indonesia, there was no association between caries risk and OHRQoL in the older adult population and a low correlation between caries risk and OHRQoL in the middle-aged group.

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ABSTRACT Objective: To investigate the methods used by dentists for diagnosis and treatment of dental caries lesions. Material and Methods: This cross-sectional study was developed by sending a validated questionnaire to dentists in the southeastern region of Brazil with questions about detection methods and the indicated procedures for treating lesions. Results: Three hundred and ninety-eight responses were identified after distributing the questionnaire. The state with the highest percentage of respondents was Espírito Santo (n=140). The respondents' mean time since dental school graduation was 12.9 years (±11.4). Regarding the diagnosis, 39.4% of the dentists used the explorer probe to detect occlusal lesions, 79.6% performed drying with an air jet, 65.8% of dentists performed biofilm removal and follow-up for active initial occlusal lesions, and 60.3% applied fluorides. For active caries lesions reaching the enamel dentinal junction, the dentists performed selective caries removal followed by restoration for both occlusal lesions (79.6%) and proximal lesions (78.1%). Conclusion: Visual-tactile and radiographic examinations were the detection methods of most dentists. A conservative approach was identified more frequently for initial, non-cavitated lesions and an operative approach for dentine tissue lesions. Conservative, non-invasive treatment still seems challenging for professionals when lesions reach the dentine tissue.

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ABSTRACT Objective: To evaluate the surface defects in Wave One Gold and Jizai rotary files after 1 and 3 uses. Material and Methods: Ninety-six resin blocks with stimulated canals and 12 files per system were used. The files were pre-examined under scanning electron microscopy (SEM) to exclude files with pre-existing cracks and craters. Instrumentation and SEM evaluation of the files were performed after 1 and 3 uses, respectively. Two independent operators analyzed the images, and scoring was carried out for each file's coronal, middle, and apical thirds. The surface defects at different thirds of the file systems were analyzed using the Chi-Square test and Kendel Tau’s test. Results: After one use, both the file systems did not produce any significant surface defects in the coronal, middle, and apical thirds. However, after three uses, there was minor plastic deformation in the coronal and middle thirds of the Wave One Gold file system. Jizai file system did not produce any surface defects in the coronal, middle, and apical thirds. Conclusion: After one use, no surface defects were created in Wave One gold and Jizai rotary files. Wave One Gold exhibited more significant surface defects after three uses in the coronal and middle thirds.

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ABSTRACT Objective: To evaluate the properties of fermented milk beverages containing probiotics and their potential demineralization on enamel after consumption. Material and Methods: Seven fermented milks were analyzed by titratable acidity and pH, and five were considered for erosive cycling. The beverages' calcium (Ca) and Phosphorus (P) were measured. For measurement of potential erosive, bovine dental enamel blocks (n=8) were individually treated (2 min - 4x/day for five days) with 1% citric acid solution pH 3.5 (control) and strawberry, grape, traditional, and orange fermented milk beverages. At treatment intervals, the blocks were immersed in artificial saliva (1h). The samples were evaluated by profilometry and scanning electron microscopy (SEM) at the end of cycling. The results were submitted to ANOVA and 5% Tukey tests. Results: For titratable acidity, the traditional flavor had the lowest value, 3.36 ± 0.46 mmoles, and the grape flavor had the highest value, 10.7 ± 0.1 mmoles. The lowest pH value was the strawberry flavor at 3.61 ± 0.07, and the highest was the orange flavor at 4.10 ± 0.07. The orange flavor showed the highest values of Ca (48.19%) and P (9.69%). The fermented milk beverages promoted surface loss; however, citric acid promoted higher values. Conclusion: Fermented milk is an acidic beverage with variations in inorganic components. Their erosive potential is lower compared with citric acid.

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ABSTRACT Objective: To investigate the effect of fluoridated solution based on silver nanoparticles (AgNano) associated or not with toothpaste containing high fluoride concentration (TP) on dental erosion. Material and Methods: Ninety-six enamel blocks from bovine incisors were prepared and analyzed for microhardness and initial roughness. Then, divided into 8 experimental groups (n = 12): G1 - brushing with water (H2O); G2 - brushing with TP; G3 - AgNano + TP; G4 - AgNano + H2O; G5 - SDF + TP; G6 - SDF + H2O; G7 - FV + TP; G8 - FV + H2O. SDF, AgNano, and FV were applied and, after 24 hours, all samples were submitted to erosive challenge with 0.3% citric acid (pH 2.6) and brushing with TP or H2O for 5 days. After treatments and erosion challenge, microhardness and roughness were again evaluated. The data were statistically analyzed by ANOVA followed by Tukey's test (microhardness) and Kruskal-Wallis test (roughness), α=0.05. Results: There was no difference between treatments (AgNano, SDF, and FV), (p>0.05); however, brushing with toothpaste with high fluoride concentration significantly decreases loss of enamel microhardness. Conclusion: AgNano associated or not with toothpaste containing high fluoride concentration was not able to reduce dental erosion in the enamel, as well as SDF and FV.

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ABSTRACT Objective: To evaluate the effectiveness of various orthodontic retention protocols, including removable retainers, fixed retainers, and a combination of both. Material and Methods: A cohort of orthodontic patients (n=240) was divided into four groups: Removable Retainer Group, Fixed Retainer Group, Combination Protocol Group, and Control Group. Tooth alignment stability, patient satisfaction, compliance, and adverse event occurrence were assessed over two years. Data analysis included regression analysis and comparisons between groups. Results: Fixed retainers demonstrated superior effectiveness in maintaining tooth alignment stability compared to removable retainers and the combination protocol, with the slightest deviation from baseline alignment. The Fixed Retainer Group also reported the highest patient satisfaction and compliance rates. Adverse events and complications, such as retainer breakage and discomfort, were more frequent in the Removable Retainer Group. Conclusion: Fixed retainers offer superior tooth alignment stability, patient satisfaction, and compliance, while adverse events are relatively infrequent and manageable. However, patient preferences and needs should be considered when choosing the most appropriate retention strategy.

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ABSTRACT Objective: To analyze the differences in oral health-related quality of life (OHRQoL) for children aged five with early childhood caries (ECC) based on oral health behavior risk factors in Indonesia. Material and Methods: 181 mother-child pairs participated in this study. Due to the pandemic during data collection, ECC status was examined by mothers through online guidelines provided by the researcher by four clinical stages of ECC. Parents completed questionnaires regarding their child's oral health behavior (tooth brushing, feeding, and dental visit related) and perceived quality of life using the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) Questionnaire. Children are also involved in rating their quality of life. Spearman correlation, Mann-Whitney U, and Kruskal-Wallis were used to identify differences between multiple characteristics of children's oral health behavior. Results: OHRQoL is significantly correlated with ECC status. There are significant differences between oral health education (p=0.045 and 0.046), falling asleep while feeding (p<0.001 and 0.021), the frequency of sugar consumption (p=0.002 and 0.001), and the condition of the teeth (p<0.001) compared to children's oral health-related quality of life (OHRQoL) perceived by their mothers and themselves, respectively. No significant differences were found between the frequency of tooth brushing in a day, assisted child while tooth brushing, the starting age of a child's teeth brushed, dentist visits, food intake, and number of siblings (p>0.05). Conclusion: Oral health behavior related to early childhood caries and consequences in decreasing quality of life, both perceived by mothers or children themselves.

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ABSTRACT Objective: To evaluate the antimicrobial activity of soyabean and pumpkin seeds methanolic extract against oral microbiome. Material and Methods: An in vitro study compared the antimicrobial activity of methanolic extract of soyabean and pumpkin seed along with 0.2% chlorhexidine (positive control) by Agar well diffusion method against Streptococcus mutans, Streptococcus pyogenes, Staphylococcus aureus, Lactobacillus and Candida albicans. Suitable dilutions of each seed extract determined Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC). Qualitative phytochemical analysis and Thin Layer Chromatography (TLC) was done to determine the phytochemical components. Results: Both the methanolic extracts showed the highest zone of inhibition, 26±0.31 mm and 24±0.82 mm, followed by 22±0.87 mm and 21±0.55 mm against Streptococcus mutans and Streptococcus pyogenes, respectively. The zone of inhibition was higher at concentrations in both extracts, which was not statistically significant (p>0.05). MIC values fluctuated from 1.56 to 4.5 mg/ml and 3.5 to 5.0 mg/ml for soyabean and pumpkin seed extract, respectively. Phytochemical analysis showed the presence of alkaloids, glycosides, terpenoids, tannins, and flavonoids. Conclusion: Both extracts were effective against S. mutans and S. pyogenes and contain compounds with therapeutic potential.

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ABSTRACT Objective: To estimate the frequency of preschool children who attended a dental visit and identify associated factors. Material and Methods: A cross-sectional study was conducted with children aged 2-5 years enrolled in preschools (n=200) in southern Brazil. Parents/guardians completed a questionnaire, and oral exams were performed using the CAST instrument. The outcome was whether the children had consulted a dentist in their lifetime. Andersen's behavioral model was applied to assess associated factors, including predisposing factors (sex, age, maternal education), enabling factors (family income), need factors (dental caries severity, dental pain, oral health-related quality of life (OHRQoL), and oral hygiene habits), and psychosocial factors (dental fear). Associations were tested using Poisson's regression, obtaining the prevalence ratio (PR) and 95% confidence interval (CI). Results: The majority of the children had never visited a dentist (71%; n=141), while 15% (30) had done so for prevention and 14% (29) for oral health problems. Need factors associated with having consulted a dentist included severe dental caries (PR=3.11; 95%CI=1.85-5.20), dental pain (PR=2.04; 95%CI=1.32-2.17), toothbrushing performed by parents (PR=1.99; 95%CI=1.05-3.77), and presence of an impact on OHRQoL (PR=1.87; 95%CI=1.21-2.89). The psychosocial factor of the absence of dental fear (PR=2.28; 95%CI=1.45-3.59) was also associated with the outcome. Conclusion: Most preschool children have never visited a dentist. Using a dental service was associated with both need and psychosocial factors.

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ABSTRACT Objective: To aim at the preparation and characterization of a chitosan and betel leaf extract biopolymer followed by an assessment of mechanical and antibacterial properties. Material and Methods: A chitosan-betel leaf stock solution was prepared and dip-coated on thermoformed aligner cubes. The groups (five samples per group) involved were one control (only chitosan coating) and three test groups based on the duration of coating (coating with chitosan and betel extract coated for 5, 10, and 15 minutes, named B5, B10, and B15 respectively). The coating of the samples was confirmed by an FTIR test and anti-microbial properties were assessed by the disc diffusion method. Wear resistance assessment of the coating was carried out by scratch test. Results: Coating of the aligners with the extract was confirmed with FTIR. The zone of inhibition against S. mutans was noted to be the widest for aligners coated for 15 minutes (7± 0.5mm), and the intergroup difference was statistically significant (p<0.05). The samples dip-coated for 15 minutes demonstrated the highest wear resistance (3.2 ±0.17 N) with statistically significant intergroup differences (p<0.05). Conclusion: Betel leaf extract prepared and incorporated with chitosan biopolymer was successfully coated on thermoformed aligners. A higher antibacterial activity and scratch resistance were evident with aligners dip-coated for 15 minutes, owing to the antibacterial activity of Piper betel.

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ABSTRACT Objective: To describe a practical way of applying impression compound in stick form using a safe electrical instrument. Material and Methods: Impression compound is a thermoplastic, rigid, reversible molding material in dentistry that requires a temperature of 55-60 °C for plasticization. Take a hot-glue gun for 7 mm tubes, which is the same dimension as the stick of impression compound. The gun nozzle has to be enlarged with a drilling machine and a drill to work to a suitable diameter with the impression compound according to the operator’s preference. A temperature controller needs to be installed to release the compound in a consistency and temperature suitable for use. If the dentist wants to know the exact temperature of 55-60 °C, they can use an infrared thermometer to measure the position of the regulator on the gun's nozzle. Conclusion: Impression compound continues to be widely used for specific procedures, including impressions in severely resorbed ridges and maxillofacial prostheses, which can benefit from the manufacture of the device described.

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ABSTRACT Objective: To evaluate the impact of social distancing and academic circumstances on the self-reported mental health of dental professors and students of master’s and doctorate programs in Brazil during pandemic. Material and Methods: Data were collected using a self-administered questionnaires between September 2020 to January 2021 for students (n=314) and professors (n=294). The survey consisted of 42 questions related to: 1) sociodemographic characteristics; 2) circumstances during the COVID-19 pandemic; 3) academic circumstances; and 4) Brazilian version of the Depression, Anxiety and Stress Scale (DASS-21). Data were analyzed by Chi-squared statistical test and multiple logistic regression model (α=0.0S). Results: The students had higher levels of self-perception of DASS-21 symptoms compared to professors. Being part of the COVID-19 risk group contributed positively for professors’ anxiety. The satisfaction with productivity and pressure to publish papers increased the likelihood of depression and stress for both groups. For students, not having children decreased the likelihood for depression and stress and being married increased the likelihood of DASS-21 symptoms for professors. Conclusion: The social isolation caused by the COVID-19 pandemic negatively affected the self-reported mental health of dental graduate program members, mainly associated with being married and in the risk group, and being under pressure to publish papers.

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ABSTRACT Objective: To evaluate confidence levels in treatment planning decisions among dental students. Material and Methods: A questionnaire about difficulties in diagnostic and performing procedures was distributed to dental students in their third to final year at a private university in Brazil. Respondents rated their confidence on a scale from “none to mild” to “moderate to maximum. The Chi-square test was used to assess whether there was a difference in the students’ responses according to the stage they were in in the course. Statistical significance was set at p<0.05. Results: 137 students participated, and 40% did not consider social data essential in treatment planning. The highest difficulty levels were reported in the diagnosis of Temporomandibular Disorders (TMD) (83%) and oral lesions (79%). The main difficulties in the treatment were reported as therapy for TMD (84%), rehabilitation therapy (70%) and patients with medical conditions (65%). 91% do not feel confident in handling emergencies. When comparing senior students to those in mid-course, significant differences were noted in diagnosing carious lesions (24% vs. 58%) and TMD cases (95% vs. 75%). Conclusion: This study highlighted that a significant portion of dental students do not consider social determinants of health as relevant to treatment planning, as well as issues related to student confidence in TMD treatment and managing patients with medical conditions. Dental schools should monitor the confidence levels of their students, creating an opportunity to address these deficits.

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ABSTRACT Objective: To assess the influence of social support, smoking, and alcohol use on the oral health-related quality of life (OHRQoL) of pregnant women. Material and Methods: A cross-sectional study was conducted on a random sample of 256 pregnant women at a public healthcare service in southern Brazil. OHRQoL was measured using the Oral Health Impact Profile (OHIP-14) questionnaire. A semi-structured questionnaire was administered to collect demographic, socioeconomic, social support, and deleterious habits data. Clinical examinations were performed to diagnose dental caries (DMFT index) and gingivitis (marginal gingival bleeding). A Poisson regression model was used to investigate the influence of pregnant’ characteristics on OHRQoL. With this approach, we calculated rate ratio (RR) and 95% confidence intervals (95% CI). Results: The mean overall OHIP-14 score in the sample was 9.74 (SD=9.00). Pregnant women who presented poor social support reported the worst OHRQoL. Regarding deleterious habits, women who drank alcohol (RR=1.18; IC 95%: 1.05-1.33) and smoked (RR=1.20; 95% IC: 1.07-1.35) during pregnancy had higher means in OHIP-14. In addition, older and non-white women who presented untreated dental caries, ≥15% of marginal gingival bleeding, and low household income also reported worse OHRQoL. Conclusion: Our findings suggest that low support social and poor habits during pregnancy influence women’s OHRQoL.

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ABSTRACT Objective: To assess the prevalence and determine the factors associated with Internet Addiction among Indian dental students. Material and Methods: A cross-sectional study was conducted among 250 dental students from different academic years of the Institute of Dental Sciences, Bhubaneswar. Information on demographic characteristics, purpose, and duration of Internet use was recorded. Internet Addiction was assessed using Young’s 20-item Internet Addiction Test (IAT) questionnaire. Chi-square, One-way analysis of variance (ANOVA), and Pearson’s Correlation tests were used for statistical analysis. The level of significance was set at p≤0.05. Results: The prevalence of Internet Addiction was found to be 20.4%. Third-year students showed the highest mean Internet Addiction (46.74 ± 10.26) score. Social networking was the main purpose of Internet use. Bivariate analysis showed that daily hours of Internet use were strongly associated with Internet Addiction, which was statistically significant (p=0.033). The major domains identified in our study towards the contribution of Internet Addiction were Dependence (10.74 ± 2.79) followed by Overuse (10.52 ± 2.58), Emotional state (9.70 ± 3.10), Inhibiting the Flow of Life (8.16 ± 2.74) and Non-restraint (6.37 ± 1.98). Conclusion: Internet Addiction often coexists with other psychological problems. Therefore, early interventions should be implemented, and students should be aware of the adverse effects of spending unnecessary time online.

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ABSTRACT Objective: To determine the relationship between skeletal malocclusion and upper pharyngeal airway space in the United Arab Emirates population using linear cephalometric measurements. Material and Methods: A retrospective cross-sectional study was performed on lateral cephalogram radiographs acquired from the University Dental Hospital. Through convenience sampling, 70 lateral cephalograms were selected from 200, meeting the inclusion criteria for this study. Study subjects were divided into three groups: Class I (n=2S), Class II (n=2l), and Class III (n=24). The study groups were compared based on the linear upper pharyngeal airway space measurements. Results: The three groups observed significant differences between the upper pharyngeal airway measurements. No differences in parameters were noted within the male and female study subjects. A highly significant difference (p<0.00l) in the Palatal Pharyngeal Distance was observed among the groups. Similarly, when the mean Middle Pharyngeal Distance and mean Inferior Pharyngeal Distance were compared among the three study groups, a highly significant difference (p<0.001 and p<0.004, respectively) was observed. Conclusion: The highest variation in the linear dimensions of the upper pharyngeal airway space among the different skeletal malocclusion was observed in the Nasopharynx, Skeletal Class III having the most prominent dimensions followed by Class I and the least in Class II skeletal malocclusion.

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ABSTRACT Objective: To analyze the availability of equipment, supplies and specialized reference in oral radiology in primary care health by comparing Brazilian geographic regions. Material and Methods: The time series analysis was carried out with secondary data extracted from official databases of the Brazilian Ministry of Health of the external evaluation cycles of the National Program for Improvement of Access and Quality of Primary Health Care (PMAQ-AB). The comparisons of Brazilian regions were performed using Chi-square and Z tests adjusted by the Bonferroni method, and among cycles (years) using the Cochran’s Q test (p<0.05). Results: In Brazil, there was an increase in the availability of X-ray equipment between 2014 and 2018 (21.9% vs. 36.3%), and supplies where there was X-ray equipment, which included lead aprons (75.6% vs. 86.4%), dark chamber (darkroom) (86.4% vs. 93.9%) and chemical products for the X-ray film processing (80.7% vs. 86.1%) (p<0.001). The specialized reference in oral radiology was higher in 2018 (71.4%) compared to 2012 (46.8%) and 2014 (66.9%) (p<0.001), with the same trend in the Northeast region (p<0.001). North and Northeast showed growing numbers for most items evaluated, with a reduction in regional inequalities. Conclusion: The availability of equipment, supplies, and specialized reference among Brazilian regions increased. Although regional inequalities persist in Brazil, a reduction was observed in the analyzed period.

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ABSTRACT Objective: To evaluate the chemical components and cross-sectional microhardness of primary teeth with hyperbilirubinemia-induced green pigmentation. Material and Methods: The sample consisted of two anterior and two posterior green primary teeth discolored by bilirubin and regular primary teeth, paired according to child age and tooth type. Scanning energy dispersive spectroscopy was used to investigate the mass percentage of calcium, phosphorus, and carbon, and a microhardness tester was used to assess the cross-sectional microhardness of enamel and dentin. The collected data were analyzed using the Student’s t-test and Mann-Whitney (p<0.0S). Results: There was a significant decrease in calcium in the dentin of the green discoloration group compared with the control group. Although the differences in cross-sectional microhardness were not significant, all data showed lower microhardness in both enamel and dentin in the green discoloration group. Conclusion: The calcium content in the dentin of green-discolored primary teeth is lower than in regular primary teeth, but the microhardness of enamel and dentin is not affected.

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ABSTRACT Objective: To comparatively analyze associations between respiratory problems and adenoidectomy with the different manifestations of bruxism in children. Material and Methods: Were analyzed retrospectively on secondary data from the database of a service specializing in bruxism and temporomandibular disorder (TMD) of 279 children, aged 6 to 12 years, from October to November 2022. Two trained and calibrated examiners performed data extraction, checked and organized it. Descriptive and comparative analysis was carried out using the chi-square test, and Pearson’s association test was used for the relationship between variables, both with a significance level of 5%. Results: The sample included secondary data from 2S9 dental records of children with a mean age of 8.6 years (±7.7), 44% male and 51% female. Probable bruxism was diagnosed in 55% of these children. A negative association between adenoidectomy and teeth clenching while awake (p=0.002), clenching during sleep (p=0.004), and grinding during sleep (p=0.040) was observed. Conclusion: The respiratory problems analyzed were not associated with the occurrence of bruxism in its different types of manifestation. However, all manifestations of awake and sleep bruxism were less frequent in association with adenoidectomy.

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ABSTRACT Objective: To evaluate dental trauma care including teledentistry use by Brazilian pediatric dentists in the early pandemic period (2020/2021). Material and Methods: This cross-sectional study, collected through a self-administered online survey, sociodemographic characteristics, use of teledentistry as a resource for remote Traumatic Dental Injuries (TDIs) care, and variables regarding trauma, such as etiology and type of trauma. Data were described by frequencies and analyzed with the chi-square test. Results: Of 374 pediatric dentists, 323 attended TDIs during the pandemic period. Majority of the participants were women (88.5%). Associations were found between some characteristics of pediatric dentists with having attended dental trauma, specifically age 21-39 years (p=0.001) and graduation time (p<0.00l). TDI appointments increased compared to the pre-pandemic period. Teledentistry was used as a valuable resource for remote orientation and monitoring patients who suffered TDIs. Etiology and trauma types remained the same compared to the period before the pandemic. Conclusion: Teledentistry was a useful resource for guidance and monitoring trauma. However, to be implemented in daily practice, it is necessary to develop regulatory norms.

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ABSTRACT Objective: To investigate the preference of parents/caregivers and their children regarding using colored compomer (Twinky Star®, Voco, Germany) as a restorative option and factors associated with its choice. Material and Methods: A dental mannequin containing colored compomers and traditional materials (composite resin, glass ionomer cement, and amalgam) was presented to 260 pairs of adults and children aged 5-11 years, who were examined for dental caries to verify the preference of dental materials in two public health services. The parenting style and child personality profiles were assessed. Bivariate analysis and Poisson regression were performed. Results: Most adults (74.2%) preferred traditional materials, and family income (p=0.00l) and educational level (p<0.001) were associated with this choice. Age up to 7 (p<0.001) was a variable associated with children’s choice of colored restorations (72.3%). Children younger than seven years old showed a prevalence of choosing colored compomers 1.20 times higher than their older counterparts. In contrast, adults with children younger than seven years old and less than 11 years of education presented 1.74 and 2.17 higher prevalence of choosing colored compomers, respectively. Conclusion: Caregivers with higher educational levels showed more excellent resistance to colored restorations, and children younger than seven years old had better acceptance of the material with playful proposals.

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ABSTRACT Objective: To investigate the knowledge and prevalence of dental trauma among amateur soccer players in a Brazilian subpopulation. Material and Methods: The players responded to a 20-item questionnaire on personal characteristics and the prevalence, education, and management of dental injuries between June and August 2023. Five questions with a five-point scoring system evaluated participant knowledge about managing coronal fractures and avulsion. The Mann-Whitney U-test and the Kruskal-Wallis test (p<0.05) compared the subcategories of personal characteristics and education on dental trauma management. Results: Two hundred forty-four (244) amateur soccer players participated in the study, with 55 (22.55%) reporting experiences of traumatic dental injury during games and a higher frequency of coronal fractures. The median score for correctly managing coronal fractures and avulsion was 2.0 points. Athletes with health education/occupation showed a higher median value (3.0 points). Only 9.43% of participants use or have used a mouthguard during sports practice. The study identified a 22.55% prevalence of dental trauma among amateur soccer players. Conclusion: The knowledge of athletes about managing coronal fractures and avulsion is insufficient and requires improvement.

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ABSTRACT Objective: To develop a questionnaire to describe endodontic treatments in primary teeth among Brazilian dental practitioners, focused on face and content validity (FCV). Material and Methods: An online validation process involved ten judges (panel of experts) and 32 dental practitioners (pre-test). The initial questionnaire (33 items) was developed after a literature review and divided into two parts: 7 questions for characterizing Brazilian dental practitioners (Part 1) and 26 questions for characterizing the endodontic treatment in primary teeth carried out by them (Part 2). The questionnaire was assessed for appearance, comprehension, and relevance using a 4-point Likert scale. Validity was achieved when the Validity Index was equal to or greater than 80% (0.8), considering responses 3 or 4 acceptable. Results: Two rounds were necessary for all items of the data collection instrument to be validated. The Validity Index for the entire instrument was established at 0.97 among the experts and 0.9S among the pre-test participants. The appearance, comprehension, and relevance criteria within the panel of experts achieved Validity Indices of 0.94, 0.97, and 0.99, respectively. The pre-test participants’ values were 0.97, 0.94, and 0.94, respectively. The approximate response time for the data collection instrument ranged between 5-6 minutes. Within the expert panel, 70% of the judges rated the difficulty of filling it out as "easy." Among the pre-test participants, 56.3% judged it "very easy." Conclusion: After this validation process, the questionnaire has acceptable face and content validity and is uncomplicated and quick to fill out.

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ABSTRACT Objective: To analyze the impact of the COVID-19 pandemic on the interval between diagnosis and initiation of treatment for oral cavity and oropharyngeal cancer in Brazil. Material and Methods: A time series study was conducted using secondary data extracted from the DATASUS system. The three-year period from 2019 to 2021 was selected to represent the baseline, onset, and peak of reported COVID-19 cases. The dependent variable of the study was the delay in starting anticancer treatment (>60 days after histopathologic diagnosis). Time series were analyzed using joint-point regression and monthly percentage changes (MPC) were estimated. Results: For oral cavity cancer, there were two periods of decrease in the delay in treatment initiation, from January 2019 to June 2020 (MPC= −0.7S, 95% CI = −0.3 to −3.2, p=0.004) and from November 2020 to December 2021 (MPC= −1.41, 95% CI = −2.2 to −0.6, p=0.00l). For oropharyngeal cancer, there was an increase in the percentage of delays in treatment initiation from January 2019 to February 2020 (MPC= 0.86, 95% CI = 0.2 to 1.5, p=0.014) and from May 2020 to December 2020 (MPC= 3.66, 95% CI = 1.2 to 6.2, p=0.005), with a decrease from December 2020 to December 2021 (MPC= −1.40, 95% CI = −2.3 to −0.5, p=0.003). Conclusion: The COVID-19 pandemic in Brazil had a greater impact on treatment initiation delay for oropharyngeal cancer than for oral cavity cancer. However, the percentage of delay in treatment initiation for oropharyngeal cancer showed fluctuation, with an increase in the pre-pandemic period and a decrease after December 2020.

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ABSTRACT Objective: To investigate the influence of the parents’ attitude on the duration of the pacifier sucking habit and the occurrence of anterior open bite (AOB) in children. Material and Methods: A population-based cross-sectional study was conducted in Ribeirão das Neves, Brazil, including 497 children aged 4–6 years. The pacifier use was reported by the parents and categorized as "never used", "used up to 24 months" and "used more than 24 months". Perceived parental positive attitude was measured by two self-reported questions "I have enough energy to do what has to be done" and "I have self-discipline". Socioeconomic variables were collected. Children were examined by two examiners to the diagnosis of AOB according to Forster and Hamilton criteria. Adjusted logistic and multinomial regressions were performed (p<0.05). Results: Children who used pacifiers more than 24 months were 6.21 times more likely to have AOB than those who did not use pacifier (95% CL 2.98–12.92). Children who discontinued pacifier use within 24 months had parents with higher energy than those who keep the habit for more than 24 months (OR: 1.22; 95% CL 1.01–1.47). Parents from children who never used or used pacifier for less than 24 months were more self-disciplined than those who used for more than 24 months (OR 1.18; 95% CL 1.01–1.37; OR 1.29; 95% CL 1.06–1.56). Conclusion: High energy and self-discipline of parents were active factors in the discontinuation of pacifier sucking habit in less than 24 months.

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ABSTRACT Objective: To determine the prevalence of possible sleep and awake bruxism and its related risk factors in children with Congenital Zika Virus Syndrome. Material and Methods: The case group consists of 20 children with congenital Zika, age range from S to 6 years old, and the control group consists of 120 regular children of the same age group. A questionnaire was used to assess bruxism and associate possible risk factors such as medications, systemic disorders, and sleep relationships, and a validated Oral Behaviors Checklist (OBC) was applied. Absolute and percentage frequencies of each outcome variable and mean and standard deviation of each item of the OBC questionnaire were calculated, respectively, compared between case and control groups using Fisher’s exact or Pearson’s chi-square and Mann-Whitney tests. Results: Only 25% of the children with microcephaly do not present swallowing difficulty, significantly lower compared to the 95.8% of the children in the control group who do not (p<0.001). The occurrence of bruxism was significantly higher in the case group (47.4%) compared to the control group (10.2%). In addition, 89.8% of children did not grind their teeth in the control group, compared to only 52.6% in the case group. There was a statistically significant difference between the case and control group (p<0.001). Conclusion: Dysphagia, feeding routes, and reflux in children with cerebral palsy are risk factors for possible awake bruxism, and children with congenital Zika virus syndrome showed a prevalence for possible bruxism compared to regular children.

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ABSTRACT Objective: To determine the association between oral health-related symptoms and oral health-related quality of life (OHRQoL) among diabetic patients. Material and Methods: This cross-sectional study involved 202 diabetic patients. The Malay version of the Short Oral Health Impact Profile [S-OHIP(M)] questionnaire was used to assess OHRQoL. A higher S-OHIP(M) score indicates greater oral impact and worse OHRQoL. The prevalence of oral impact was determined by the percentage of participants who reported experiencing one or more impacts ‘very often’ or ‘fairly often’. An additional self-administered questionnaire was used to obtain perceived oral health symptoms. Data were analyzed using descriptive analysis, independent t-test, and ANOVA. Results: 45.6% of respondents reported at least one oral health symptom. The most common symptoms were bad breath (30.2%), cavities (29.7%), and toothache (16.8%). The prevalence of oral impact was 33.7%, and the total mean S-OHIP(M) score was 6.15 (SD=6.09). The mean of the S-OHIP(M) score was significantly higher in participants with toothache, cavities, sore gums, swollen gums, bleeding gums, mobile teeth, and bad breath. Conclusion: Oral health symptoms are significantly associated with poorer OHRQoL among diabetic patients. Preventive care and timely treatment of oral health issues are critical to improving the overall quality of life and well-being of this population.

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ABSTRACT Objective: To determine the clinical characteristics and treatment outcomes in patients with trigeminal neuralgia in a tertiary care setting. Material and Methods: The data of patients diagnosed with trigeminal neuralgia over a nine-year period in this tertiary care center from the archives of the Medical Records Department were included. Two observers documented the clinical data and treatment outcomes in a specially designed proforma. A p-value of <0.0S was considered statistically significant. A comparison of categorical variables was done using the Chi-square/Fisher exact test. A comparison of continuous variables was done using the Mann-Whitney U test. Results: There were 34 males and 24 females with a mean age of onset of neuralgia at S2.02 years. The estimated prevalence of trigeminal neuralgia from this tertiary care center in Karnataka, India, is 0.007%. There was a female dominance regarding the reported symptoms that triggered pain (p=0.031), with talking and chewing being the most common triggers. Primary and classical variants were the most common types. Medical management was the sole treatment of choice for nine participants; surgery was performed for 49 and 14 participants underwent a combination therapy. Conclusion: No single best treatment option has been established for this disorder. Further clinical trials with promising pain management regimens need to be conducted to strengthen the existing evidence for improving the quality of life of these individuals.

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ABSTRACT Objective: To evaluate the frequency, diameter, location and path of canalis sinuosus (CS) on CBCT scans of patients candidate for dental implant treatment. Material and Methods: In this cross-sectional study, 200 CBCT images of the maxilla were evaluated and parameters were assessed: age, gender, the canal presence and diameter, the distance between the CS and the nasal cavity floor (NC), the buccal cortical bone (BC) and the most prominent point of the alveolar ridge crest (RC). Quantitative variables were analyzed with an independent t-test, and qualititative variables were analyzed with chi-squared and McNemer tests (p<0.05). Results: CS was detected on 100 CBCT images in the present study. There were significant relationships between the CS frequency and age and gender; however, there was no significant relationship between CS and the maxillary side. The means of BC, RC, NC and the canal diameter were 9.2±2.19, 15.15±3.13, 8.14±2.43, and 0.99±0.26 mm, respectively. There were significant relationships between the canal diameter, NC and BC with gender. However, there was no significant relationship between RC and gender. Conclusion: Canalis sinuosus was detected, with an approximate diameter of 1 mm, in 50% of the subjects in the incisor-canine area. The use of CBCT for accurate diagnosis of canalis sinuosus is suggested before surgical procedures in the palatal aspect of the anterior maxilla.

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ABSTRACT Objective: To assess the pharmacological strategies of a group of Brazilian endodontists regarding endodontic pain. Material and Methods: Specialists answered a questionnaire with two main themes: 1) Pharmacological prescription patterns and 2) Endodontic procedures and risk of postoperative pain. The collective data were presented as descriptive statistics. Results: Almost all endodontists reported using drugs for pain management, mainly for apical abscess (65.8%) and irreversible pulpitis (61%), as well as more after (59.6%) than before (23.3%) endodontic procedure. Dipyrone (72.6%) and ibuprofen (56.8%) were the most prescribed systemic drugs. The most used local anesthetics were mepivacaine (58.2%) and articaine (57.5%). When necessary, 74.7% of specialists use supplementary anesthesia with an additional technique. Extravasation of filling materials (81.5%), limit of apical obturation (71.2%), and instrumentation (66.4%) 1 mm beyond were the main endodontic procedures to increase the risk of postoperative pain. Conclusion: While most strategies employed by Brazilian Society of Endodontics members are evidence-based, divergences in responses highlight the need for further research. This underscores the importance of more profound insights and potential standardization in pain management strategies among professionals.

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ABSTRACT Objective: To determine the prevalence of self-reported halitosis among patients attending the dental clinic of a university in southern Brazil and identify associated factors. Material and Methods: The sample of this cross-sectional study included 269 individuals over 18 who attended the clinic for six months. A questionnaire was used to collect data on self-reported halitosis, sociodemographic characteristics, oral hygiene habits, medication use, systemic diseases, smoking and drinking habits, and self-perception of oral health. The relative and absolute frequencies of the variables were analyzed, and multivariate binary logistic regression analysis was performed to obtain odds ratios (OR) and respective 95% confidence intervals (95%CI) at p < 0.05. Results: The mean age of the sample was 44.86 (±16.55), and 65% were female. The study found a self-reported prevalence of halitosis of 27.9%. Individuals who reported xerostomia were more likely to have self-reported halitosis (OR=2.15; 95% CI: 1.22-3.78). Furthermore, those who visited the dentist more than a year ago were more likely to have self-reported halitosis compared to those who visited no more than six months ago (OR=1.93; 95% CI: 1.09-3.41). Conclusion: The study showed a high prevalence of self-reported halitosis among patients and revealed an association with individuals who reported having xerostomia and who have been attending dental appointments for a longer time.

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ABSTRACT Objective: To investigate the association between genetic polymorphisms in DRD2, ANKK1, COMT, and 5HTT genes and dental fluorosis (DF). Material and Methods: 256 adolescents were examined, and dental fluorosis was diagnosed using the modified Dean index. Genomic DNA was collected, and seven single nucleotide polymorphisms (SNPs), two in the DRD2 (rs6275 and rs6276), one in the ANKK1 (rs1800497), two in the COMT (rs6269 and rs4818), and two in the 5HTT (rs3813034 and rs1042173) were selected. Allele, haplotype, and diplotype frequency comparisons were performed. Multifactorial Dimensionality Reduction investigated SNP-SNP interactions. Allele and haplotype frequency comparisons were performed by PLINK version 1.06. The Fisher exact test performed genotypic analysis, and Poisson Regression was adjusted by gender. Results: In the allelic frequency analysis, rs6275 was associated with DF (p=0.040), and rs6276 was borderline (p=0.07), being confirmed in the haplotype (p<0.05) and diplotype (p=0.007) analysis. Conclusion: The data suggest that DRD2, ANKK1, COMT, and 5HTT genes synergistically interact to increase the dental fluorosis risk.

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ABSTRACT Objective: To evaluate the effect of photobiomodulation of diode laser on the healing of gingiva following gingivectomy. Material and Methods: 15 patients with inflammatory gingival enlargement in the age group 18-65 years were enrolled for the study according to the inclusion and exclusion criteria and were divided into two groups, i.e., control and test, with a total of 30 sites. Gingivectomy was performed with a scalpel, and the test site was irradiated with a diode laser, which was repeated after 7 days, finally, the patients were recalled after 21 days for re-evaluation. Soft tissue parameters were recorded at baseline and 21 days, and visual analog scale was recorded at 7 days. Also, tissue was excised and sent for histological analysis both at baseline and 21 days, and the data was subjected to statistical analysis. Results: A clinically significant improvement was observed in patient response to pain in the test group compared to the control group (p=0.001). There was an observable improvement in tissue color in the soft tissue analysis (p=0.001) and a significant reduction in the inflammatory component in the histological analysis in the test group as compared to the control group (p=0.001). Conclusion: Diode laser has a photobiomodulation effect on wound healing after gingivectomy, thus enhancing the rate of healing and decreasing post-operative pain.

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ABSTRACT Objective: To evaluate the bibliometric characteristics of clinical studies about the non-instrumental technique with antibiotic paste. Material and Methods: The Web of Science database 'Core-Collection' was searched by two researchers. The following bibliometric parameters were examined: number of citations, authorship, institution, country, journal title and impact factor, study design, year of publication, and keywords. Scopus and Google Scholar databases were used to compare the number of article citations. The VoSviewer software was used to generate collaboration networks. Results: 452 articles were recovered with the search key, and 18 articles were included. The number of citations ranged from 0 to 80, and the number of authors ranged from 2 to 7. Japan had the highest number of citations (n=80). Clinical trials were the most common study design (n= 6). The journals that published the most articles were Pediatric Dentistry (22.2%), Journal of Clinical Pediatric Dentistry (16.6%), Contemporary Clinical Dentistry (11.2%), and International Journal of Pediatric Dentistry (11.2%). Most papers originated from Brazil, the United States of America, and India. Conclusion: The study showed increased publications with a clinical focus in the last decade on the LSTR/NIPT technique, with Brazil leading in the number of relevant publications. It also provided clinicians and researchers with articles on an alternative technique for pulp therapy in deciduous teeth with pulp necrosis.

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ABSTRACT Objective: To investigate macro-regional disparities in specialized outpatient dental care for children in the Brazilian Unified Health System (SUS). Material and Methods: An ecological study was conducted using a longitudinal, retrospective, and quantitative approach. The number of outpatient dental procedures (ODPs) performed by Pediatric Dentists in the SUS was retrieved by the Outpatient Information System (SIA/SUS), considering the period between 2008 and 2022, as well as the five macro-regions of Brazil. Statistical analysis was based on descriptive and analytical approaches. The significance level was adjusted to 5%. Results: More than 29 million outpatient dental procedures were performed in the last 15 years by Pediatric Dentists in the SUS. The incidence rate of ODPs was significantly lower in the Northeast macro-region compared to the other macro-regions and the national estimate (p<0.05). The north was the only macro-region that showed a decreasing temporal trend over the last 15 years (p=0.026), while the others were stationary (p>0.05). However, when the COVID-19 pandemic years were removed, testing from 2008 to 2019, the trend was also stationary (p=0.351). In addition, the North macro-region was the only one not correlated with the national estimate (p=0.478), showing a distinct pattern in the incidence rate of ODPs over the last 15 years. Nonetheless, The variability of this particular variable was striking across all macro-regions, but it was especially pronounced in the north. Conclusion: There are macro-regional disparities in specialized dental care for children in the Brazilian Unified Health System.

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ABSTRACT Objective: To evaluate knowledge, attitude and practice of deep margin elevation (DME) amongst dental practitioners in India, thereby increasing awareness. Material and Methods: A cross-sectional study was carried out among academicians, private practitioners, and post-graduate students, comprising 266 participants. Twenty-three close-ended web-based questionnaires were circulated through Google Forms. Data was analyzed using the Chi-square test, and descriptive analysis was performed using the Statistical Package for the Social Sciences software. Results: Although most respondents were aware of DME, only 27.4% claimed to have used this approach in daily practice. 60.4% reasoned out that DME was a technique-sensitive procedure. However, 50% of participants prefer to use DME as a substitute for surgical crown lengthening. There was a significant association between awareness regarding the term DME, knowledge of the procedure, and the study participants' cadre (p=0.024 and p=0.214, respectively). Conclusion: Knowledge, attitude, and practice of DME among dental practitioners in India are adequate. However, few dentists use this method to treat extensive subgingival decay in clinical practice. This can be attributed to the lack of literature on the subject and the perceived difficulties of the procedure. There is a need for more clinical research to understand the long-term prognosis of teeth restored using this technique and to encourage its usage in practice.

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ABSTRACT Objective: To describe and compare children and adolescents' vertical and sagittal cephalometric characteristics with and without a gummy smile (GS). Material and Methods: From a population of 204 patients (7-17 years old) and after applying the selection criteria, a sample of 156 subjects were included: 37 cases (GS) and 119 controls (no GS [NGS]), in a proportion of 1:3. An operator calibrated performed linear and angular measurements on standardized digital lateral radiographs, and the skeletal, dental and soft tissue structures were then analyzed. Results: The mean age of the patients was 9.97 ± 2.12. There were differences in maxillary size and position (p<0.05), mandibular size and rotation (p<0.05), and anterior vertical proportions between SG and NSG patients. The logistic regression model (R2=0.63) showed that increased occlusal plane/palatal plane (OP/PP) and occlusal plane/mandibular plane (OP/MP) angles increase the possibility for GS, with an OR of 2.05 (95% CI: 1.30-3.22) and an OR of 2.32 (95% CI: 1.42-3.75), respectively. No statistically significant differences were found in sex or habits between the GS and NGS patients. Conclusion: Class II skeletal malocclusion with maxillary prognathism and mandibular retrognathism, the hyperdivergent growth pattern, and increased values for OP/PP and OP/PM were associated with GS in children and adolescents. This relationship was established in childhood and adolescence.

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ABSTRACT Objective: To evaluate the frequency and association between anxiety disorders (AD), sleep disorders (SD), and the circadian cycle (CC) with possible sleep bruxism (SB) in children/adolescents. Material and Methods: The clinical records of children/adolescents, between 7-11 years, who were treated at the pediatric dentistry clinic/UFRJ (January/2018 to March/2020), were evaluated. SCARED and CIRENS questionnaires and, SD were analyzed. The chi-square test, t-test, and Cohen’s D were applied. Results: Of 85 clinical records were evaluated, 41 (48.2%) were from girls and 44 (51.8%) from boys of 7 (3.5%), 8 (5.9%), 9 (25.9%), 10 (24.9%) and 11 (40%) years old. There were identified in 40 (47.1%) participants with AD, while SB was identified in 28 (32.9%). The most prevalent CC was "neither morning nor night" (75.3%), followed by "morning type" (20%). No association was found between CC and SB (p>0.05). Likewise, no association was found between AD and SB, SD and AD (p>0.05). However, an association was identified between SD and SB (p<0.05). In addition, the shorter the sleep duration, the greater the likelihood of bruxism (p<0.01). For effect size Cohen’s d was 0.955, considered large. Conclusion: It was not possible to identify an association between the CC and psychological factors, such as anxiety, with the presence of SB. However, sleep disorders and sleep duration demonstrated a relationship with sleep bruxism.

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ABSTRACT Objective: To investigate the pain-relieving property of consuming sweet-tasting solution before dental injections. Material and Methods: In this single-blinded split-mouth study, fifty-two 5-year-old children who needed bilateral mandibular deciduous molars pulpotomies participated. The effect of drinking a cool liquid snack containing 10 milliliters of 12% sucrose solution (study group) or cool tap water (control group) with a straw before inferior alveolar nerve block injection was assessed regarding pain perception. The degree of discomfort was recorded after dental injections using the Wong-Baker Faces Pain Scale (WBFPS). Data were analyzed using SPSS version 26 and the Independent Sample Test. The statistical significance level was set at p<0.05. Results: Significantly lower WBFPS scores were reported for the test group (2.9231) compared to the study group (5.0000) (p<0.001). Conclusion: Drinking a cool sucrose solution with a straw before dental injections can aid in reducing the associated discomfort, resulting in better interaction with the child during dental sessions.

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ABSTRACT Objective: To describe and analyze the context and decision-making process to deal with a major problem: the high prevalence of dental caries and the great difficulty in moving students from schools to the Basic Health Units of the Unified Health System for carrying out treatments in a metropolis. Material and Methods: To conduct this work, we used the "3-i+E Framework", which can help explore how key factors interact to influence, define, and structure policy choices. The data were collected from different sources using a qualitative exploratory approach. A documentary analysis of the minutes from meetings of a committee of specialists and an analysis of interviews with key informants were carried out. Results: As for institutions, governmental structures, policy networks, the oral health care network implemented at the municipality level were considered fundamental aspects that enabled the development of the strategies. As for ideas, three factors were highlighted: 1) the teaching-service relationship, which was fundamental for the decision to be based on scientific evidence; 2) managers valued scientific evidence, and 3) university was effective in communicating research results. With regard to interests, the decision-making was consolidated from the convergence of interests of public officials, politicians and researchers. Conclusion: The problem and its solutions were addressed at the political agenda by a window of opportunity, and the decision-making process was well-informed.

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ABSTRACT Objective: To evaluate the effect of various types of cigarettes on the color of microhybrid (MH) and nanofilled (NF) resin composites. Material and Methods: Disc-shaped specimens (5 × 2 mm; n = 10) of MH (Filtek Z250, 3M) or NF (Filtek Z350XT, 3M) were exposed or not (control) to cigarette smoke (20 cigarettes daily × 5 days) from four commercial cigarettes with increasing concentrations of tar, nicotine, and carbon monoxide (MSL < MFP < MBI < MR). The cigarettes had an additional filter (MFP) or added flavoring (MBI). The color parameters (L*, a*, b*, ∆Eab, ∆E00) were determined considering baseline versus after exposure to cigarette smoke. Data were submitted to Mann-Whitney, Kruskal-Wallis, and Dunn tests (α=0.05). Results: Significant differences were observed for ∆L* (toward black), ∆a* (toward red), ∆Eab, and ∆E00 of both resin composites compared with the control (p<0.05) regardless of the type of cigarette, with higher values for NF (p<0.05). For the MH, MBI provided higher negative ∆L* variation compared to MSL and MR (p<0.05). For the NF, higher ∆a* values were observed for MR and MSL, with significant differences from MFP and MBI (p<0.05). Regardless of the cigarette, ∆Eab and ∆E00 exceeded the limits of perceptibility and acceptability of color alteration. Conclusion: Color alteration of resin composites was modulated by the cigarette and resin composite type, the NF resin composite being more susceptible to staining.

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ABSTRACT Objective: To evaluate the surface properties and ion release of a glass ionomer cement (GIC) incorporated with nanostructured silver vanadate (AgVO3). Material and Methods: Specimens were obtained with AgVO3 (1%, 2.5%, and 5%) and without nanomaterial. Charge dispersion was assessed by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). The release of silver (Ag+) and vanadium (V4+/V5+) was determined using inductively coupled plasma mass spectrometry (ICP-MS). The release of fluoride was determined using an ion-selective electrode. Data were analyzed by ANOVA and Bonferroni post-test (α=0.05). Results: Photomicrographs and EDS suggested the presence of AgVO3. The 2.5% and 5% groups showed a greater release of Ag+ (p<0.05). A greater release of V4+/V5+ was observed with 5% (p<0.05). There was a greater release of V4+/V5+ than Ag+ in the 2.5% (p=0.006) and 5% (p<0.001) groups. All groups showed a greater fluoride release on day 7 and a progressive decrease (p=0.004). On day 7, groups with 1% (p=0.036) and 2.5% (p=0.004) showed greater release than control. Conclusion: All concentration test altered the surface properties of GIC, with greater release of Ag+ and V4+ /V5+ in the group with 5%. In all groups, there was a greater release of fluoride on day 7 with a subsequent decrease. AgVO3 at concentrations of 1% and 2.5% favored fluoride release on day 7.

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ABSTRACT Objective: To analyze the impact on quality of life-related to the need for endodontic treatment and possible association with sociodemographic variables. Material and Methods: It was carried out through the application of a sociodemographic script and the Oral Health Impact Profile (OHIP-14). The association between variables was verified using Fisher's exact test and the strength of the association between the independent variables and the impact on quality of life was calculated using the odds ratio (OR). Results: The impact on quality of life was declared by 87.8% of the participants, with physical pain (67.3%) and psychological discomfort (76%) being the most impacted domains. In terms of education level, participants who completed high school or more reported an 88.4% impact on the disability dimension, with around 2.4 times greater chances of suffering impact on this dimension. Individuals living alone reported a greater impact on the psychological disability dimension (54.8%). Participants with limited or no access to dental services, especially through the Unified Health System (NHS), reported a greater impact on the psychological disability dimension (61%). Conclusion: The need for endodontic treatment has a significant impact on quality of life, as stated by 87.8% of the participants, especially in the psychological discomfort (76%) and physical pain (67.3%) domains. These findings were associated with the following sociodemographic variables: gender, race/color, marital status, schooling, socioeconomic status and type of access to oral health services.

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ABSTRACT Objective: To investigate the correlation between dental anxiety and self-esteem in pediatric patients undergoing six months of maxillofacial orthopedic treatment in Portoviejo, Ecuador. Material and Methods: A quasi-experimental study was conducted on 92 children aged 7 to 11 with malocclusions. Participants completed a dental anxiety scale questionnaire and the House-Tree-Person (HTP) psychological graphic test before and after the installation of maxillofacial orthopedics. Confidence interval analyses were performed for qualitative variables, while mean values with standard deviations were calculated for quantitative variables. The relationship between self-esteem and dental anxiety was assessed using a chi-square test. Results: The mean age of participants was 9 years, with 86.96% residing in urban areas. Sociodemographic variables showed statistically significant differences (p<0.05). There were statistically significant differences in dental anxiety between the initial and final periods (p<0.05), with a decrease in anxiety observed after six months of treatment. As measured by the House drawing, self-esteem was significantly higher in the first period evaluated (p<0.05). Conclusion: The study found a decrease in anxiety after six months of maxillofacial orthopedic treatment. Higher self-esteem was associated with better oral health practices, highlighting the importance of the orthodontist's role in evaluating behavior to enhance treatment success and the mental health of pediatric patients.

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ABSTRACT Objective: To analyze the association of dental tissue fracture related to hypomineralization and its association with anthropometric, orthodontic, and dental caries in deciduous teeth. Material and Methods: A cross-sectional study was conducted with 313 children aged 6 to 10. Data were collected through clinical examination based on criteria from the European Academy of Pediatric Dentistry (EAPD) for the diagnosis of hypomineralization. Facial biotype analysis was conducted based on collected data. Orthodontic data were collected in terms of Angle classification and malocclusions. The diagnosis of dental caries was guided by ICDAS II (International Caries Detection and Assessment System) parameters. Statistical analysis involved descriptive analysis, Fisher's exact test, and the chi-squared test. Results: 23.3% of children had hypomineralization in deciduous, and 20.4% had post-eruptive breakdown preceded by hypomineralization (PEBH). The analyses indicated that weight, height, facial biotype, and malocclusions are not significantly associated with PEBH. Dental caries was associated with the presence of hypomineralization (p<0.001) and breakdown in deciduous teeth (p<0.001). Conclusion: An association between dental caries, hypomineralization, and PEBH was found for deciduous teeth. Orthodontic and anthropometric parameters were not associated with post-er uptive breakdown preceded by hypomineralization.

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ABSTRACT Objective: To evaluate the characteristics of artifacts produced by various intraoral dental materials in magnetic resonance imaging sequences and assess their impact on the diagnostic quality of the resultant images. Material and Methods: A clinical examination was conducted on forty-six patients who underwent magnetic resonance imaging for various brain pathologies. Parameters were recorded, including the location, span, and type of intraoral dental material. The impact of these artifacts on the diagnostic quality of the resultant image sequences was assessed. The reliability of the intraand interobserver was calculated, and Fischer's exact test was applied. P-value <0.05 was considered statistically significant. Results: The most common signal intensity artifact observed was hypointense with hyperintense rim artifacts in FLAIR (95.5%). The most common shape of the artifacts observed was circular/void shape (84.4%). There was a statistically significant difference between the various classes of intraoral dental materials and diagnostic acceptability (p=0.017). In the present study, 28% of the study population images were graded diagnostically unacceptable in the sequences evaluated (FLAIR 37.8%, T2 3.3%, SWI 24.4%, DWI 25%). Conclusion: Dental material artifacts interfered with the interpretation of magnetic resonance imaging at varying levels of diagnostic acceptability depending on the indication for which the imaging was performed.

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ABSTRACT Objective: To verify the accuracy of deep learning models in detecting cellular alterations in histological images of oral mucosa. Material and Methods: The study compares three convolutional neural network (CNN) architectures for classifying histological images: EfficientNet-B3, MobileNet-V2, and VGG16. Efficient and focused on computer vision, each has specific advantages. A Kaggle database with 5192 images was used, divided into training (70%), validation (15%), and test (15%) sets. The CNNs were implemented using the Keras library, trained with pre-trained ImageNet weights, and evaluated using accuracy and AUC metrics. Results: The findings indicate that EfficientNet-B3 achieved the lowest training and validation losses at epoch 30, with the highest accuracy and stability during training. Evaluation metrics showed EfficientNet-B3 with 98% accuracy and 99% sensitivity for oral squamous cell carcinoma (OSCC) images, outperforming MobileNet-V2 and VGG16. MobileNet-V2 achieved 97% accuracy and 96% sensitivity, while VGG16 reached 94% accuracy and 93% sensitivity for OSCC images. All models exhibited high sensitivity and specificity in differentiating between normal and OSCC images, as demonstrated by ROC curves. EfficientNet-B3 had the highest AUC (0.982), followed by MobileNet-V2 (AUC=0.967) and VGG16 (AUC=0.937). These findings underscore the effectiveness of EfficientNet-B3 for accurately detecting cellular alterations in histological images of oral mucosa. Conclusion: Our study reveals the superior performance of CNNs, particularly EfficientNet-B3, in classifying histological images of OSCC.

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ABSTRACT Objective: To analyze the internal morphology of root canals in hypomineralized molars and compare them with healthy teeth and different lesion discolorations using cone-beam computed tomography (CBCT). Material and Methods: CBCT scans of Nineteen teeth were collected: five hypomineralized teeth with a creamy-white color (maxilla=2; mandible=3); eight hypomineralized teeth with a brownish-yellow color (maxilla=3; mandible=5); six healthy teeth (maxilla=4; mandible=2). Parameters such as the number of canals, foramina, accessory canals, relevant distances, and linear measurements were evaluated. The Kruskal-Wallis test and descriptive analysis were performed to assess differences between the groups, with a 5% margin of error. Results: The number of major foramina was higher in hypomineralized teeth with yellow-brown discoloration in the lower arch (p=0.029) compared to the other groups. Hypomineralized teeth exhibited smaller linear measurements when compared to healthy teeth. Conclusion: Hypomineralized teeth tended to have more complex root canal systems when compared to healthy teeth. Further research should be conducted to evaluate these parameters in larger samples.

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ABSTRACT Objective: Describe baseline maternal and newborn variables in a birth cohort study. Material and Methods: A birth cohort study was conducted in Canoas, Brazil. Sociodemographic, behavioral, anthropometric, and clinical baseline variables from mothers and newborns were collected cross-sectionally at the University Hospital's maternity. Maternal data included age, level of education, family structure, smoking, number of prenatal appointments, type of delivery, gestational age, and any comorbidity. Child data included sex, birth weight, length, head circumference, and breastfeeding in the first hour of life. Data were described as absolute and relative frequency, central tendency, and dispersion measures. Results: The baseline sample comprised 1181 mother-child pairs. Average maternal education (SD) was 9.7 (2.3) years, with 28.3% of mothers not reaching secondary education while 12% were adolescents; number of prenatal appointments was at least 6 in 85.3%, while 58.8% of mothers had comorbidities. Cesarean delivery represented 43.2% of births, with 27.7% of pregnancies not reaching 37 weeks. The prevalence of low birth weight was 6.3%, and 77.1% of children breastfed in the first hour of life. Conclusion: Baseline data present indicators that should be the subject of public policies and health services programs, with emphasis on a reasonable proportion of mothers with low levels of education and smokers and a high proportion of maternal comorbidities and cesarean deliveries.

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ABSTRACT Objective: To investigate the inclusion of pediatric dentistry in the curricular matrix of dental courses in the state of Rio Grande do Sul, Brazil. Material and Methods: A descriptive exploratory study was conducted. Searches were conducted from the e-MEC systems in December of 2023. The variables of interest were the categorization of the course (public or private), total course load, structuring of the teaching of pediatric dentistry (curricular, elective/optative or extension), course load of pediatric dentistry, number of semesters and nomenclature. Results: There are 28 dental courses in the state (three public and 25 private). Total course load ranged from 4,000 to 4,700 hours and 80% of the courses had ten semesters. Pediatric dentistry is curricular and normally available between the seventh and ninth semesters, with a total hourly load between 120 and 420 hours, generally in two consecutive semesters. Conclusion: The state of Rio Grande do Sul, Brazil, underwent an exponential expansion of dental courses, especially in the form of private schools. The courses follow the national curricular guidelines (NCGs), and pediatric dentistry is a curricular discipline normally offered in the last semesters of the course. Considerable divergence, however, was found in the course load for pediatric dentistry. There is an evident need for the definition of theoretical content and minimum clinical training to enable students to develop skills for treating children.

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ABSTRACT Objective: To evaluate the effect of repeated usage of Reciproc and Reciproc Blue on their shaping ability and to determine the maximum number of artificial canals that they can prepare until fracture. Material and Methods: The two file systems, Reciproc and Reciproc Blue, were used to instrument a total of 436 resin blocks. The blocks simulated standardized root canals with a 35° angle of curvature. The rotary systems were divided into two groups (n=21). All canals were prepared to an apical size of 25 according to the manufacturer's instructions. A computer imaging program was then used to analyze canal straightening after preand post-instrumentation digital photography was superimposed. Results: Both Reciproc and Reciproc Blue instruments respected the original canal curvature. There were no significant differences between the instruments in terms of maintaining canal curvatures. Moreover, there were no significant differences in preparation time and the number of canals prepared before failure between the two instruments. Conclusion: Reciproc and Reciproc Blue were safe to use under the conditions of this study. Reciprocal motion files with or without heat treatment had comparable preparation time, shaping abilities, and the ability to maintain root canal curvatures.

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ABSTRACT Objective: To reveal the capabilities of the Teleinterconsulting application in Stomatology, shedding light on how this tool operates within our own experience. Material and Methods: This observational and cross-sectional study was carried out using data obtained from the pilot study of the Teleinterconsulta application in Stomatology in Paraíba, Brazil, from April 2021 to October 2023. A descriptive analysis of the data was carried out, including an analysis of the experiences of the situation. Results: This study involved the participation of 22 dentists who acted as consultants in the application, which already has more than 400 registered dentists who participate in the healthcare network. Conclusion: Teleconsultation in Stomatology can be a powerful tool that can contribute to the early diagnosis of potentially malignant diseases. We anticipate that this brief communication will inspire professionals to adopt and integrate technologies that allow teleconsultation, promoting greater openness to e-health practices.

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ABSTRACT Objective: To assess the clinical outcomes of regenerative endodontic procedures using autologous platelet concentrate. Both regeneration and apexification procedures were examined and compared with each other. Material and Methods: The PRISMA 2020 Checklist has been utilized to carry out the systematic review and meta-analysis for the present study. PubMed, Scopus, Web of Science, EBSCO, Embase, and ISI Web of Knowledge have been reviewed for systematic literature until May 2023. A fixed-effect model and a Mantel-Haenszel methodology have been used to measure the risk ratio’s 95% confidence interval. Then, Metaanalyses were carried out utilizing Stata/MP version 17. Results: Duplicate studies were eliminated from the first review, 849 studies’ abstracts were reviewed, two authors reviewed 103 papers’ full texts, and finally, 20 articles were selected. The survival rate in regenerative endodontic procedures between apexification and regenerative endodontic procedures was −0.01 (RR: −0.01, 95% CI: −0.05, 0.02; p=0.35). Conclusion: Throughout the present meta-analysis, regenerative endodontic therapy is an effective intervention with a high survival and success rate in managing immature necrotic permanent teeth.

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ABSTRACT Objective: To assess the frequency of the BRAF V600E mutation in odontogenic keratocyst, correlating the methods of evaluation and detection of the mutated protein. Material and Methods: This systematic review was conducted following the PRISMA guidelines and registered in PROSPERO (CRD 42022379570). An electronic search was performed up to January 20th, 2024, in the databases of Medline, Scopus, Embase, and gray literature (Google Scholar, BDTD). One hundred and sixty-six cases in seven studies were included. The methodological quality of the studies was performed according to the Joanna Briggs Institute. Results: Only two of the seven studies reported positivity for the BRAF V600E mutation, both by molecular methods. In the remaining five studies, the BRAF V600E mutation was not present, one evaluated by RT-PCR, three by DNA sequencing, and one by IHC. Conclusion: Through analysis of the articles, the BRAF V600E gene mutation alone does not play a significant role in the pathogenesis of OKC. Further research and new studies are necessary.

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ABSTRACT Objective: To provide comprehensive information about barriers to using dental services in India. Material and Methods: Original research articles published on factors and(or) barriers to dental and oral health care services utilization were extracted from four electronic databases such as Scopus, PubMed, Web of Science, and EMBASE. The selection process involved looking for English-language articles published between 2005 and 2023 that addressed one or more areas of dental and oral health care barriers in India. Selected articles were analysed using thematic analysis. Results: 188 original studies were retrieved from the four databases, and 23 were extracted. The barriers to dental and oral health care service utilization were classified into three major themes: sociodemographic factors, dental care access, and individual factors. The findings of the selected articles showed that the high cost of dental care, educational level, fear of dental treatment, poor perception about teeth, and(or) lack of felt need and lack of time were the most frequently reported barriers. Conclusion: Appropriate utilization of dental and oral health care services was one of the key principles in achieving "Health for All."Dental care delivery systems should address the barriers to its utilization by incorporating policies to overcome the utilization barriers and community-based oral health awareness programs.