Periodontal disease is one of the most common health care problems. The type of treatment of periodontal disease depends on the diagnosis. The treatment plan should also focus on managing the risk factors and modifying factors which affect the periodontal disease and treatment. The evidence-based advancements have given a success predictability level to the periodontal diagnosis and treatment plan. The level of specialty education is limited in the curriculum for undergraduates. Patients should receive the same quality of treatment whether administered by a specialist or general practitioner. Therefore, general dentists need to be well informed about how to make timely and appropriate referrals to periodontists when necessary. An online literature search was done through PubMed, PMC, and open access journals to understand the referral process. Articles pertaining to referral process were selected. Based on the search, it was found that knowledge of elements of the referral process, conditions (general and periodontal) requiring referral, and selection of periodontist are important aspects of the referral process. This short communication will help the general dentist to understand the referral process that will enable them to provide the timely periodontal referral and treatment to the patients.

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Teeth have been used as tools and weapons since the advent of time. Bite marks inflicted by them during violent interactions, form the basis for one of the most intriguing, broad and sometimes controversial encounters in forensic dentistry. Bite mark evidence validates the involvement of the alleged biter in the crime, assuming that the person who made the bite was the one who committed the crime. Forensic odontologist has to determine that the pattern injury is a bite mark record and it represents a human bite and has to make a decision as to its evidentiary value. This recognition and examination of the bite marks and their subsequent comparison with suspects, may lead to criminal identification thereby resolving the crime. This article aims at providing complete review on formation, collection and identification of bitemarks.

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Aim: This in vitro study was carried out to compare of the effect of 17% ethylenediamine tetra-acetic acid (EDTA), 2% chlorhexidine (CHX), 18% etidronic acid (HEBP), and 4% propolis as an irrigant on the microhardness of root dentin. Materials and Methods: The sample size for the study was 100. Each specimen consisted of a longitudinally sectioned half of a root of a single-rooted tooth which was embedded in acrylic resin. The prepared specimens were divided randomly into five groups of twenty specimens each. Each group was treated with the irrigants to be tested. Group I was the control - the specimens were treated with distilled water. The specimens in Group II were treated with sodium hypochlorite (NaOCl) followed by EDTA. Specimens in Group III were treated with NaOCl followed by CHX. Specimens in Group IV were treated with NaOCl followed by HEBP, and specimens in Group V were treated with NaOCl followed by propolis. Following this, all the specimens were placed on the Vickers hardness tester and three readings were taken for each specimen. An average reading was obtained for each group. The results were tabulated and statistically analyzed to determine which of the irrigant solutions had the least effect on the microhardness of root dentin. Results: Eighteen percent HEBP had the least effect on the root dentin microhardness, followed by 4% propolis and 2% CHX. Seventeen percent EDTA showed maximum effect on the microhardness of the dentin. Conclusion: Under the limitations of this study, 18% HEBP and 4% propolis show promise for use as irrigants because of less detrimental effect on the hardness of root dentin. More studies are needed on demineralization depth and the sealability of resin sealers in the radicular dentin after the use of propolis and HEBP.

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Misuse of antibiotics has led to an exponential increase in cases related to antibiotic resistance. This alarming situation calls for antibiotic substitutes to restore sound health. The answer to this is "PROBIOTICS." Considered inimical to pathogens, probiotics help the commensal microflora residing in the host's body to combat diseases. It increases the number of good microorganisms to fight the bad ones. Traditionally considered beneficial against gastrointestinal problems, probiotics in recent times has showcased its ability to take down oral pathogens as well. The aim of this article is to review the literature till date to (1) understand the evolution of probiotics, (2) assess its impact on potential oral pathogens, and (3) analyze its significance in establishing good oral health.

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Introduction: The color of gingiva influences the smile of person and affects esthetics, the present study was conducted to evaluate the effect of gingival depigmentation by scalpel and electrosurgery. Materials and Methods: A total number of 18 patients, 16 males and two females, aged between 18 and 30 years, reported to the clinic, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, complaining of "grayish-blackish gums" which affected the esthetics of their smile. The treatment done in this study was scalpel surgical technique and electrocautery as they could be easily done and were less time consuming. Healing and recurrence of pigmentation were postoperatively evaluated. Intraoral pictures were taken at every follow-up visit to compare the progress and also to access the occurrence of any repigmentation. One-way ANOVA and unpaired t-test were used for statistical analysis. Results: There was statistically significant reduction seen for both the study techniques after 6 months postoperatively as compared to baseline with no complications leading to pain, infection, bleeding, or scarring postoperatively. During the 6 ^th month follow-up, there were no signs of repigmentation in both the treatment modalities. Cases were followed up for any reoccurrences of pigmentation longitudinally. Conclusion: Satisfactory results were obtained with both the surgical and electrocautery procedures for gingival depigmentation. Hence, the surgical technique still serves as the simplest and effective depigmentation technique. During the follow-up period, no recurrence of gingival hyperpigmentation was found with both the techniques employed in this study.

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Objective: To assess the clinical performance of four adhesive strategies; 3-step etch-and-rinse Adper Scotchbond Multi-Purpose (SM), 2-step etch-and-rinse (Adper Single Bond-2 [S2]), 2-step self-etch Adper Scotchbond SE (SE) and 1-step self-etch (Adper Single Bond Universal [SU]). Materials and Methods: Eighty cervical cavities exhibiting dentin carious lesions were used. Four adhesives from the same manufacturer (3M ESPE, St. Paul, MN, USA) representing different bonding strategies were used; SM (3-step etch-and-rinse), Adper S2 (2-step etch-and-rinse), SE (2-step self-etch) and SU (1-step self-etch). Cavities were restored with a nanohybrid composite resin (Z-350XT - 3M ESPE, St. Paul, MN, USA), and clinically followed up for 24 months using the modified United States Public Health Service criteria. Results: The outcome of Wilcoxon signed rank test showed no significant difference among the groups for each adhesive material at different evaluation periods (P > 0.05). Furthermore, the Friedman test revealed that there was no significant difference between all materials in all evaluation criteria, except for marginal discoloration at 24-month evaluation period. At 24-month evaluation period, teeth restored with self-etch adhesives showed more marginal staining. Conclusions: The four bonding strategies used in the current study showed an acceptable 2-year clinical performance.

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Aim: To investigate and compare the vertical marginal discrepancy and spread of excess cement after cementation with modified cementation technique and conventional technique. Materials and Methods: Ten implant analogs with prefabricated standard abutments of similar dimensions were mounted individually in self-cure acrylic blocks subcrestally. Forty ideal metal coping specimens were prepared by conventional lost wax technique. Measurement of the marginal discrepancy at the implant-crown interface was done using a stereomicroscope before cementation. Abutment replicas (ARs) were prepared for twenty specimens using cast copings and pattern resin. All forty copings were cemented according to the following cementation techniques and cement types, with ten specimens in each group. (1) Group 1: Half filling (HF) cementation technique using provisional cement. (2) Group 2: HF cementation technique using permanent cement. (3) Group 3: AR technique using provisional cement. (4) Group 4: AR technique using permanent cement. Specimens were subjected to measurement of marginal discrepancy and spread of excess cement using stereomicroscope after cementation procedure. Data were analyzed using paired t-test and unpaired t-test. Results: AR technique showed significantly less marginal discrepancy (P = 0.000) and apical spread of excess cement (P = 0.002) than conventional HF technique. Provisional cement showed significantly more marginal discrepancy (HF-P = 0.000 and AR-P = 0.001) and less apical spread of excess cement (HF-P = 0.023 and AR-P = 0.002) and among both technique. Statistical Analysis: Unpaired t-test. Conclusion: An alternative technique of using AR is effective technique to prevent peri-implant diseases.

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Introduction: Demand for orthodontic treatment is increasing in Saudi Arabia. An observational study was planned to assess the incisor crowding in maxillary and mandibular arch among Saudi males and females reporting to different dental clinics in Abha city, Kingdom of Saudi Arabia (KSA). Materials and Methods: A cross-sectional study was conducted. Five hundred and thirty-two study casts of males and females aged between 16 and 35 years without a previous history of extraction of permanent teeth were included in the study. Labiolingual linear displacement of anatomic contact points of each maxillary and mandibular incisor from the adjacent tooth was measured. Right canine mesial aspect to the left canine mesial aspect was examined for five displacements. Results: There was a high prevalence of incisor crowding observed in the study population. Sixty-four percent (342 out of 532) casts showed bi-maxillary crowding, 14% (75 out of 352) showed mandibular, and 8.1% (43 out of 532) showed maxillary crowding. About 13.6% (72 out of 532) of the study population had well-aligned maxillary and mandibular incisors while 86.4% (460 out of 532) had some degree of incisor crowding. Females had more incisor crowding (48.5%-258 out of 532) than males (37.9%-202 out of 532). Conclusion: High prevalence of incisor crowding in Abha region reported in this study necessitates long-term planning and preventive measures for the adolescent population and treatment of the adult population of the Abha city, KSA.

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