The removal of resin debris and/or resin cement from the enamel surface without causing iatrogenic is the main objective when removing the orthodontic brackets. Some factors such as the time required for removal, damage to the tooth structure, are essential factors for the clinician at the time of removal. Various techniques are used for the removal of orthodontic brackets after the treatment; it is known that the use of clinical procedures such as the use of diamond burs and some pliers removers can damage the structure of the enamel, often depending on the bond strength that should be taken into consideration at the time of removal. This literature review aims to gather the most relevant studies that can clarify the clinical technique, which may be more suitable for removal of the brackets.

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Enzymes of trace elements are an important part of certain biological and chemical reactions. They work in harmony with proteins and often with certain other co enzymes. They attract substrate molecules and enable their conversion to a specific end product. Some trace elements are involved in redox reactions. Modern day diet, comprising of refined foods is a cause of concern, as it may not have a sufficient amount of these trace elements. Dietary supplements may be of required to combat this shortage. The present paper has thoroughly discussed trace elements, as this area of research has not received the deserved attention. Thus, a comprehensive understanding of these trace elements is essential and significant for disease control and for maintaining optimal health.

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Minor salivary gland carcinomas are rarely reported. Low-grade mucoepidermoid carcinomas (MECs) that are of minor salivary gland origin occurrence in children and adolescents have rarely been reported, little information regarding their clinical features and biologic behavior is available. This case report represents minor salivary gland MECs in an 18-year-old female patient. She presented with swelling in the lower left buccal mucosa, which was noticed 1 year back gradually increased to its present size 1.5 cm × 1.5 cm in its greatest dimension buccally. The color of the lesion was pale pink however on the posterior aspect the swelling, which had a bluish tinge, gave a diagnostic dilemma. In children and adolescents, MECs have a female predilection and occur most commonly on the hard or soft palate or both and rare in buccal mucosa. The surgical excision of the swelling was successful with no recurrence reported.

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Lipoma, also known as universal tumor or ubiquitous tumor, can occur anywhere in the body, its incidence being 0.1-5% of all head and neck neoplasms. They are benign neoplasms composed of mature adipocytes. There are various types of lipoma based on the constituent tissue type and location of the lipoma. Though lipomas are slow growing and seldom invade adjacent tissue, some variants do exhibit infiltrative behavior. Here, a case of infiltrating type of lipoma of the chin region is presented, which had suddenly increased size in the last 1 year, which led the patient to seek surgical treatment.

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Introduction: It is a noted fact that dermatologic diseases have varied oral manifestations. By far, there have been inordinately few studies focusing on the prevalence of a wide spectrum of oral mucosal lesions (OML) in patients with dermatologic diseases. This is significant as oral lesions may be the only or the primary feature of the skin disease, which could be neglected by dentists. This study aimed to estimate the frequency and sociobehavioral correlates of OML in skin disease patients attending outpatient's facility of Subharti Hospital, Dermatology Clinic, Meerut, India. Materials and Methods: This was a cross-sectional hospital-based study conducted in Meerut during the period from August 2013 to October 2013. A total of 500 patients (mean age 37.2 ± 14.11 years, 41.4% females) completed an oral examination and a personal interview. OML were recorded using the World Health Organization criteria. Data were analyzed using the Statistical Package for Social Science (version 15.0.1). Cross tabulation and Chi-square with Fisher's exact test were used. Results: At least one kind of OML was registered in 11.8%, males (58.6%): 60.0% versus females (40.0%): 45.6%, P < 0.01) skin disease patients. Thus, a certain number of patients had more than one type of OML. Aphthae were the most frequently diagnosed OML (3.4%), followed in descending order by oral lichen planus (1.8%) and geographic tongue (1.6%). Conclusion: OML were frequently diagnosed in skin disease patients (11.80%) and varied systematically with the dermatologic disease, age, and gender. The substantial prevalence rates of OML emphasize the importance of routine examination of the oral mucosa in a dermatology clinic.

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Background: Data on oral health experiences among pregnant women in developing countries are lacking. The objective of this study was to assess the oral health awareness and experience among pregnant women attending antenatal clinic at the University of Port Harcourt Teaching Hospital, Rivers State Nigeria. Materials and Methods: This was a cross-sectional study carried out during the period between February and March 2013. Pretested, well-structured, and self-administered questionnaire allowing open and closed responses was used for data collection. Results: The age of the subjects ranged from 18 to 49 years and the age group 28-37 years was significantly more (P < 0.00). Majority, 241 (82.0%) significantly had at least secondary education than 53 (18.0%) who had primary education or less (P < 0.01). Less than 10% of the participants were aware of the effect of pregnancy on oral health and the impact of oral disease on pregnancy outcome. In general, the experienced oral health problems among the pregnant women were tooth decay 21.1%, dental pain 42.2%, pain from the gum 22.8%, swollen gum, 23.5%, gum bleeding 32.7%, and excessive salivation 46.1%. However, only 27.9% had visited the dental clinic most of whom, were those with more than three children (P < 0.01). Excessive salivation was significantly experienced more than other oral health problems and in women with three or less children. Conclusion: Oral health awareness among the subjects was poor and a sizeable number of pregnant women experienced oral health problems during pregnancy. There is a need for the development of guidelines that will promote referral and visit of pregnant women for dental consultation.

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Background: The development of fibrosis is pathognomic in the potentially malignant oral disorder, oral submucous fibrosis (OSF). Strong evidence exists to implicate the chewing of areca nut in the pathogenesis of the lesion. The constituents of areca nut activate several pro-fibrotic cytokines, chiefly transforming growth factor beta 1 (TGF-β1), which leads to an increased deposition and decreased degradation of extracellular matrix and collagen. TGF-β1 probably represents the major pathway in the deposition of collagen fibers in this condition. The present study aims to identify and correlate the expressions of TGF-β1 immunohistochemically on paraffin sections of various stages of OSF. Materials and Methods: The expression of TGF-β1 antibody was detected immunohistochemically using the anti-TGF-β1 mouse monoclonal antibodies (8A11-NovusBio USA) on paraffin sections of 58 cases of OSF, 10 cases of normal buccal mucosa tissue and 5 cases of scar tissue. The site, extent, and intensity of expression and quantification of TGF-β1 were noted and a comparative evaluation between various grades of OSF. Scar tissue and normal oral mucosa was made using image analysis software (Jenoptik optical system-ProReg ^® Capture Pro 2.8.8 software [2011]). Results: Cells of spinous layer of the epithelium showed more intense staining in all grades of OSF, Grade II showed the highest percentage of expression, same as that of keloid (17%) but less than that of normal mucosa (12%). Positive staining was seen around blood vessels, muscles, fibers in the submucosa and perimuscle fibers. Highest expression was in the muscle in Grade III (80%) compared with normal oral mucosa (37%). Conclusion: These results suggest that the pathogenesis of OSF and scar/keloid could be linked through the TGF-β1 pathway. Interventions directed at the TGF-beta pathway may hold the key in the future management of this oral potentially malignant condition.

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Introduction: This study was carried out to determine the correlation between the sum of the mandibular permanent incisors and the combined mesiodistal crown diameters of the maxillary and mandibular canine and premolars in a sample of mixed Indian subjects, examine the applicability of the Tanaka and Johnston method of prediction in a mixed Indian population and develop a new prediction method for this specific population. Materials and Methods: The dental models of the dentition of 251 mixed Indian patients below the age of 21 years, who had upper and lower permanent canines and premolars erupted were selected for this study. All the measurements were made by an observer with modified Boley gauge with Vernier caliper. Results: The differences between the predicted widths of the canine and premolars with the Tanaka and Johnston equations and the actual widths were highly statistically significant, as indicated by t-tests. The actual widths of the maxillary canine and premolars showed a significant difference in size (P = 0.0001) from the widths predicted by the Tanaka and Johnston equation, as did the canine and premolars in the mandible (P = 0.0003). Conclusion: The current findings suggest that the accuracy of originally derived Tanaka and Johnston mixed dentition analysis method can be increased using a newly derived regression equations based on a local mixed Indian population.

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Background: Casein phosphopeptides-amorphous calcium phosphate (CPP-ACP) products have gained much importance in restorative dentistry and minimally invasive dentistry. Addition of CPP into glass ionomer cement (GIC) has been shown to interact with fluoride ions to produce an additive anticariogenic effect through the formation of stabilized amorphous calcium fluoride phosphate phase. Aim: The aim of this study was to determine the additive effect of CPP-ACP on the mechanical properties of conventional GIC. Materials and Methods: The control GIC was prepared with self-curing GIC. The GIC containing CPP-ACP was prepared from the same batch, with 1.56% w/w CPP-ACP incorporated. Compressive strength and microtensile bond strength tests were done. Energy dispersive X-ray (EDX) analysis was used to determine the composition of various structural phases. Results: Incorporation of 1.56% w/w CPP-ACP into the GIC resulted in an increase in compressive strength and microtensile bond strength. The representative EDX spectra taken showed enhanced release of calcium, phosphate, and fluoride ions.

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Class III facial pattern is characterized by a negative sagittal lineament and has been one of the greatest challenges in orthodontics. This is due to the poor prognosis of this type of malocclusion. The treatment of this malocclusion, in adulthood, involves orthodontic mechanics combined with orthognathic surgery. In general, the facial aspect is greatly compromised, and this is precisely what encourages the patient to seek treatment in most cases. This study is based on a clinical case whose treatment consisted of two surgical steps: Palatal disjunction followed by procedures in the mandible (osteotomy for bilateral sagittal split and mentoplasty) and maxilla (Le Fort I). In the cases of major maxillomandibular discrepancies, surgical-orthodontic treatment )is indicated, considering that none of specialties alone show functional and aesthetically satisfactory results.

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Aim/Objective: This prospective study had a questionnaire prepared to get the information regarding recurrent apthous stomatitis (RAS) in a group of Libyan patients. Materials and Methods: A questionnaire containing a total of 14 questions giving personal and apthous ulcer details were recorded. All the details of each patient were entered into Microsoft Excel sheet and the details were recoded and interpreted. Results: Among 7500 patients who visit the outpatient department every year 460 (6%) of them who were volunteers and gave a history of RAS were selected in the study group. The age of these patients ranged between 10 and 45 years. Among different types of ulcers, 48 (10%) of them showed major apthous ulcer formation, 404 (88%) of them had minor apthous ulcer formation, whereas 8 (2%) of them had herpetiform ulcers. Among 460 patients with h/o RAS 46 (10%) of them were sufferings from different systemic health problems. Total 120 (26%) of them had triggers before the occurrence of RAS and 325 (70%) patients were without any triggers 15 (4%) of them were not aware of any triggers. When the question was asked about occurrence of RAS whether it is related to stress, 384 (83%) of them correlated it with stress and 76 (17%) of them did not. Different sites with their recurrence and duration of the ulcer were recorded. About 45 (9%) were on different treatment modalities. Among 460 of them, 156 (34%) of them had RAS at the day of examination and 304 of them were free from ulcers 304 (66%). Conclusion: Early detection and management of these patients by finding underlying etiology is essential for better management of these cases.

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