Publications

BACKGROUND: A common form of self-injurious behavior (SIB) involves self-inflicted injury to the lips. The available published literature offers limited noninvasive treatment options that produce predictable and successful outcomes without surgery.

OBJECTIVE: This case report aims to illustrate the conservative management and rehabilitation of a patient exhibiting SIB through lip-biting. The treatment utilized an innovative, removable acrylic splint, named the "Noninvasive intraoral acrylic appliance" (NIINAA).

METHODOLOGY: The NIINAA was custom-built using auto-polymerizing acrylic resin. The patient was instructed on its use, and modifications to the appliance's design were made based on the patient's feedback during subsequent follow-up visits.

RESULTS: Follow-up appointments conducted at one week, 15 days, and 4 weeks showed successful healing, effective rehabilitation, and strong patient compliance. The patient indicated a marked improvement in their primary complaint, as measured by a visual analog scale (VAS). The treatment demonstrated high adherence and tolerance with no significant adverse effects noted.

CONCLUSION: A conservative approach using the NIINAA device successfully established patient rehabilitation without requiring invasive surgical procedures. This method underscores the importance of preserving teeth and surrounding oral structures in patients with SIB through non-surgical interventions. How to cite this article: Waseem A, Suresh NM, Girija D, et al. Effective Therapeutic Approach for Rehabilitation of a Patient with Lip-biting Injury using a Novel Appliance-Noninvasive Intraoral Acrylic Appliance: A Case Report. J Contemp Dent Pract 2025;26(7):716-719.

AIM: This case report aims to highlight the application of a computed tomography (CT)-guided, digitally designed workflow for implant-retained auricular prosthetic rehabilitation in a patient with traumatic ear loss.

BACKGROUND: Implant-retained auricular prostheses require highly precise implant positioning for optimal retention and esthetics. Advances in virtual surgical planning, combined with radiographic imaging and implant planning software, now enable a prosthetically driven, patient-specific approach.

CASE DESCRIPTION: A 45-year-old male with right auricular loss from childhood trauma reported dissatisfaction with an adhesive-retained prosthesis due to poor retention and skin irritation. Clinical evaluation confirmed adequate bone and healthy surrounding tissue, thus planned for implant-retained prosthetic rehabilitation. A CT-guided digital workflow was employed, using a custom 3D-printed surgical guide with intraoral occlusal support and an external auditory canal plug for accurate implant placement in the mastoid region. Peri-implant soft tissue was managed through debulking, split-thickness skin grafting, and a stent-supported healing protocol. A CAD-designed, stereolithography-printed three-piece negative mold was used to fabricate a wax pattern and a color-matched silicone prosthesis secured to a custom metal bar. The patient was instructed on hygiene maintenance to preserve soft tissue health. Patient acceptance of the prosthesis was found to be favorable, with positive feedback regarding both esthetic integration and functional comfort, which further supports the efficacy of implant-supported facial prostheses in restoring quality of life following orofacial rehabilitation.

CONCLUSION: This case highlights the effectiveness of a CT-based digital workflow in improving the precision and clinical outcomes of implant-retained auricular prostheses. The integration of a modified 3D surgical guide and custom negative mold offers a patient-specific, accurate, and reproducible approach for complex auricular rehabilitation, significantly enhancing prosthesis retention, esthetics, and patient satisfaction.

CLINICAL SIGNIFICANCE: This case underscores the value of a CT-based digital workflow and customized 3D-printed tools in achieving precise implant placement and superior prosthetic outcomes in auricular reconstruction. By integrating anatomical references like the external auditory canal into the surgical guide and employing a custom negative mold for prosthesis fabrication, clinicians can enhance retention, soft tissue health, and esthetic results. How to cite this article: Ajay Y, Vijayamohan M, Krishnadas A, et al. Digital Workflow for Implant-retained Auricular Prosthesis Using Modified 3D Surgical Guide and Negative Mold: A Case Report. J Contemp Dent Pract 2025;26(7):710-715.

AIM: To evaluate salivary soluble neuropilin-1 (sNRP-1) levels in patients with stage I-II periodontitis and periodontally healthy patients at baseline and 3 months.

MATERIALS AND METHODS: A total of 48 subjects were recruited for the study, including 24 individuals diagnosed with stage I-II periodontitis (characterized by clinical attachment loss (CAL) of 1-4 mm and probing depth ≤5 mm) and 24 periodontally healthy individuals. Group A, comprising systemically healthy individuals with periodontitis, received scaling and root planing (SRP), whereas group B, consisting of systemically and periodontally healthy controls, underwent scaling at baseline. Oral hygiene instructions were reinforced for both groups during follow-up visits at 1 and 3 months. Clinical parameters were measured at baseline, first, and third months: Plaque index (PI), modified gingival index (MGI), sulcus bleeding index (SBI), probing pocket depth (PPD), and CAL. Saliva was collected at baseline and the end of the third month for evaluating the salivary sNRP-1 levels using enzyme-linked immunosorbent assay (ELISA). Data were collected and analyzed. An independent t-test was used to compare the mean values between the two groups, while the Chi-square test was employed to assess differences in the distribution of categorical variables.

RESULTS: On intergroup comparison of PI, SBI, and MGI do not show significant differences, whereas PPD and CAL show significant differences. The mean score for sNRP-1 levels (pg/mL) at baseline for group A and B were 1182.35 ± 103.3 and 421.84 ± 230.8, and at the end of the study period were 316.13 ± 212.51 and 214.86 ± 101.36, respectively. In comparison to intragroup changes, sNRP1 levels were significantly higher in the diseased group than in the healthy group (p < 0.05).

CONCLUSION: Within the limits of the study, salivary sNRP-1 levels showed significant intragroup changes in both groups; however, intergroup comparison revealed a more pronounced reduction in biomarker levels in the periodontitis group compared to the healthy group. Clinical significance of the study: Evaluating salivary biomarkers such as sNRP-1 provides a non-invasive, early diagnostic tool for detecting periodontal disease activity. Comparing levels in periodontitis patients and healthy individuals helps to identify potential markers of disease severity and progression. This can improve early detection, enable timely interventions, and support personalized periodontal therapy, which can prevent further destruction of the periodontal structures, causing loss of teeth. How to cite this article: Pamei LT, Pandey R, Palwankar P, et al. Evaluation of Soluble Neuropilin-1 Levels in Patients with Periodontitis: A Case-Control Study. J Contemp Dent Pract 2025;26(7):668-673.

AIM: To evaluate dentinal defect development, this study compared three rotary systems used for root canal preparation, namely ProTaper Next (PTN), 2Shape, and Reciproc.

MATERIALS AND METHODS: Sixty first mandibular molars with two separated canals were selected and included in this study. The samples were divided into four groups (n = 15): Control, PTN, 2Shape, and Reciproc. The control group was left unprepared, and the remaining 45 samples were prepared using these three systems. The samples were sectioned perpendicular to the long axis at 3, 6, and 9 mm from the apex. Each slice was examined under a stereomicroscope at 20× magnification to evaluate the presence of dentinal defects. The images were analyzed using ImageJ software, and the data were assessed statistically using the Chi-square and Fisher's exact tests.

RESULTS: No cracks were observed in the control group. ProTaper Next, 2Shape, and Reciproc groups caused cracks development in 24, 11, and 40% of the samples, respectively. Reciproc system caused significantly more cracks at 3 mm level (p < 0.05). No statistically significant difference was observed among groups at the 6 and 9 mm levels (p > 0.05).

CONCLUSION: All three rotary file systems examined produced dentinal cracks, particularly at the apical third. ProTaper Next and 2Shape tend to produce fewer cracks compared to Reciproc.

CLINICAL SIGNIFICANCE: Although all motion kinematics tested in this study caused some degree of dentinal crack formation, the Reciproc system (R25) demonstrated a more destructive effect in the apical third of the root canal. In contrast, the PTN and 2Shape 25/0.06 systems were found to be safer options for root canal preparation in the mesial roots of first mandibular molars. How to cite this article: Nasiri K, Doychinova M, Wrbas KT. Comparative Evaluation of Dentinal Crack Formation Using Three Ni-Ti Rotary Systems after Root Canal Preparation: An In Vitro Study. J Contemp Dent Pract 2025;26(7):663-667.

AIM: This study aims to devise a comprehensive objective rubric to better facilitate radiographic skills assessment for students and enhance the assessment's impact on the performance, competency, and standards of clinical practice.

MATERIALS AND METHODS: The study population will include 10 clinical experts in dental radiography and 50, 4th year Bachelor of Dental Surgery students. Research will be carried out in multiple phases (11) and will include literature review, expert consultation, rubric construction, and pilot testing. The validation of the rubric will be analyzed using the modified Delphi technique and construct validity, inter-rater reliability, and students' acceptability of the rubric. Data will be analyzed using Statistical Package for Social Sciences software with a significance level of less than 5%. The analysis will involve determining the content validity index, the face validity index, exploratory factor analysis for construct validity, Cronbach's alpha for internal consistency, and inter-rater reliability using Cohens' kappa statistic and intraclass correlation coefficient.

CONCLUSION: This study explores rubric use in dental radiography education, aiming to standardize assessment, enhance feedback, improve student skills, and guide future research for better education and patient care outcomes.

CLINICAL SIGNIFICANCE: The need for this study arises from the lack of a standardized, objective, and comprehensive tool to assess dental radiography skills in undergraduate students. Current assessment methods are inconsistent and subjective, leading to variability in evaluating student competence. This study aims to establish a standardized, objective rubric to enhance accuracy and consistency in assessing dental radiography skills, ultimately improving student competence, feedback quality, and patient care outcomes. How to cite this article: Gondivkar SM, Panchbhai A, Gadbail AR, et al. Development of a Comprehensive Rubric for Assessing Dental Radiography Skills in Undergraduate Dental Students: Study Protocol. J Contemp Dent Pract 2025;26(7):658-662.

AIM: To evaluate and compare the shear bond strength (SBS) and adhesive remnant index (ARI) scores of four different orthodontic bracket system bonded to fluorosed enamel surfaces using two color-changing adhesive materials.

MATERIALS AND METHODOLOGY: The sample consisted of 48 extracted human premolar teeth with fluorosis, intended for orthodontic purposes. These were divided into two groups: group I and group II, each comprising 24 samples. Group I samples were bonded with Ormco Grengloo, while group II samples were bonded with 3M Transbond XT Plus. Each group was further subdivided into four subgroups of six samples each, based on the type of brackets used: subgroup A - metal conventional brackets (CBs), subgroup B - metal self-ligating brackets (SLBs), subgroup C - ceramic CBs, and subgroup D - ceramic SLBs. Prior to bonding, all teeth were thermocycled 500 times. The brackets were then debonded using a universal testing machine at a crosshead speed of 1 mm/min. The debonding force was applied in the occlusogingival direction and recorded in Newtons. Statistical comparison of the bond strengths among subgroups was carried out using the ANOVA test.

RESULTS: The analysis revealed a material- and bracket-type-dependent variations in SBS. In group I, subgroup B exhibited the highest SBS, while subgroup C showed the lowest. In group II, subgroup D demonstrated the highest SBS, whereas subgroup A had the lowest. These differences were statistically analyzed using ANOVA, confirming significant variation based on both adhesive type and bracket configuration.

CONCLUSION: These findings suggest that SLBs, both metal and ceramic, generally provide stronger bonds compared to CBs, regardless of the adhesive used. Ormco Grengloo adhesive appears to be more effective for bonding metal CBs and metal SLBs, while Transbond XT Plus excels in bonding ceramic CBs and ceramic SLBs.

CLINICAL SIGNIFICANCE: This study helps orthodontists choose the best bracket-adhesive combinations for fluorosed teeth, improving bond strength, reducing treatment delays, and making bonding easier with color-changing adhesives. It supports personalized treatment, better bracket retention, and fewer bond failures in patients with enamel fluorosis, making orthodontic care more effective and efficient. How to cite this article: Goswami M, Wadhawan A, Nagar S, et al. Evaluation of Shear Bond Strength of Orthodontic Brackets with Color-changing Adhesives on Fluorosed Teeth: A Randomized Clinical Trial. J Contemp Dent Pract 2025;26(7):652-657.

AIM: This study aimed to evaluate the impact of time/aging on the adhesion of one calcium silicate-based sealers (CSBS) (AH Plus® BC Sealer) compared to another novel sealer (K-Biocer) by comparing their push-out bond strength (POBS).

MATERIALS AND METHODS: Ninety single-rooted human mandibular premolars were instrumented using the R25® instrument (Reciproc, VDW, Munich, Germany) and randomly divided into two main groups, A and B (n = 45) based on the sealers used: AH Plus® BC sealer or K-Biocer. All teeth were obturated with matched-taper single-cone and stored for 7 days at 37°C and 100% humidity. Each group was then subdivided into three subgroups (A1, A2, A3) and (B1, B2, B3) (n = 15). Groups A1 and B1 were controls, while A2/B2 and A3/B3 underwent 5,000 and 10,000 thermocycles, respectively. Root slices (1 mm thick) from the coronal, middle, and apical thirds were subjected to a push-out test using a universal testing machine. Failure mode was evaluated under magnification. Statistical analysis included Chi-squared, Fisher's exact test, Kruskal-Wallis, and three-way ANOVA.

RESULTS: No significant associations were found between failure mode and sealer type or aging. Dislodgement resistance varied significantly across canal levels (p < 0.001), with the highest resistance in the coronal third (mean = 10.5 MPa). The most frequent failure mode was cohesive.

CONCLUSION: Thermal aging did not significantly affect the dislodgement resistance of either sealer. Both materials maintained stable adhesion over time, suggesting resistance to degradation.

CLINICAL SIGNIFICANCE: The clinical interest of this study is to assess the adhesion of CSBS to dentinal walls and to better understand the mechanical properties of these sealers. AH Plus® BC Sealer and K-Biocer demonstrated comparable and durable adhesion, unaffected by aging. How to cite this article: Assaf Y, El Hachem R, Kaloustian M-K, et al. Impact of Aging on the Push-out Bond Strength of Two Endodontic Sealers: A Comparative In Vitro Study. J Contemp Dent Pract 2025;26(7):645-651.

AIM: To evaluate the solubility of bioceramic-coated and conventional gutta-percha (GP) in various organic and traditional solvents at two time intervals.

MATERIALS AND METHODS: This in vitro study used 200 ISO-standardized size 35, taper 6% GP cones (100 bioceramic-coated, 100 conventional), divided into five solvent groups: xylene, orange oil, castor oil, peppermint oil, and distilled water (control). Cones were immersed for 5 and 10 minutes. Pre- and postimmersion weights were measured using a digital weighing balance at two different time intervals, and the difference was used to assess solubility.

RESULTS: Xylene demonstrated the highest solubility for both GP types. Orange oil was moderately effective on bioceramic-coated cones, while castor and peppermint oils showed minimal effect. For conventional GP, solvent efficacy followed the order: orange oil > peppermint oil > castor oil.

CONCLUSION: Xylene remains the most effective solvent, though its toxicity raises concerns. Organic solvents, particularly orange oil, offer safer alternatives, but their effectiveness varies with the type of GP.

CLINICAL SIGNIFICANCE: Solubility differences between bioceramic-coated and conventional GP impact retreatment efficiency. While xylene remains most effective, orange oil provides a biocompatible alternative, particularly effective against conventional GP, supporting safer and more targeted solvent selection in clinical practice. How to cite this article: Arora T, Dahiya S, Khandelwal S, et al. Decoding Dissolution-Solubility Comparison of Bioceramic-coated and Conventional Gutta-percha Cones across Solvents and Two Different Time Intervals: An In Vitro Study. J Contemp Dent Pract 2025;26(7):639-644.

Ultimately, human behavior needs to be understood in the context of natural everyday tasks. Over the last two decades, a number of observations of natural visually guided behavior have accumulated. These observations help define the functional demands placed on the visual system in a variety of tasks, but progress has been limited by the diversity of natural behavior and by the lack of unified theoretical structures to guide understanding of the underlying processes. In this article, we summarize some recent attempts that might provide a template for a more formal approach. This is possible because it has become clear that natural behavior has many regularities reflecting the underlying sensorimotor decisions. We first summarize these regularities and then show how simple visually guided behaviors can be well described by partially observable Markov decision processes. We give examples of how laboratory experiments can be designed to elicit the common elements of natural behavior and how such experiments afford control of the statistical structure of tasks, thereby allowing formal modeling. Finally, we suggest that a new exciting avenue using recently introduced inverse models may lead the way forward, as it recovers the intrinsic properties of human perception, cognition, and action, which are intertwined in natural behavior.

Binocular integration and interocular suppression are fundamental processes underlying binocular vision, giving rise to stereopsis and binocular rivalry, respectively. To investigate how the visual system dynamically coordinates these processes to form a unified percept, we conducted four psychophysical experiments examining the temporal interactions between binocular rivalry and stereopsis. In Experiment 1a, binocular rivalry, especially with high-contrast stimuli, impaired subsequent stereopsis, significantly elevating average stereo detection thresholds from 60.5 to 111.8 arcsec. Experiment 1b revealed no effect on contrast detection, confirming that the suppression was specific to stereopsis rather than due to general attentional distraction. Experiment 2a revealed that preceding stereopsis rebalanced subsequent rivalry dynamics by reducing ocular dominance asymmetry and increasing mixed percepts, without affecting alternation rate. Experiment 2b further demonstrated that anti-correlated stereograms, which do not elicit stable stereopsis, exerted no effect on subsequent rivalry dynamics. These findings underscore a dynamic interplay between binocular integration and suppression in resolving perceptual ambiguity and achieving unified visual perception. Crucially, our results reinforce that stereopsis is not merely a passive consequence of binocular integration, but actively contributes to rebalancing ocular dominance, thus offering insights for interventions aimed at restoring binocular function.