Fine-mapping the immunodominant antibody epitopes on consensus sequence-based HIV-1 envelope trimer vaccine candidates.

The HIV-1 envelope glycoprotein (Env) trimer is the key target for vaccines aimed at inducing neutralizing antibodies (NAbs) against HIV-1. The clinical candidate immunogen ConM SOSIP.v7 is a stabilized native-like HIV-1 Env trimer based on an artificial consensus sequence of all HIV-1 isolates in group M. In preclinical studies ConM SOSIP.v7 trimers induced strong autologous NAb responses in non-human primates (NHPs). To fine-map these responses, we isolated monoclonal antibodies (mAbs) from six cynomolgus macaques that were immunized three times with ConM SOSIP.v7 protein and boosted twice with the closely related ConSOSL.UFO.664 immunogen. A total of 40 ConM and/or ConS-specific mAbs were isolated, of which 18 were retrieved after the three ConM SOSIP.v7 immunizations and 22 after the two immunizations with ConSOSL.UFO.664. 22 mAbs (55%) neutralized the ConM and/or ConS virus. Cross-neutralization of ConS virus by approximately one-third of the mAbs was seen prior to ConSOSL.UFO.664 immunization, albeit with modest potency. Neutralizing antibodies predominantly targeted the V1 and V2 regions of the immunogens, with an apparent extension towards the V3 region. Thus, the V1V2V3 region is immunodominant in the potent NAb response elicited by two consensus sequence native-like HIV-1 Env immunogens. Immunization with these soluble consensus Env proteins also elicited non-neutralizing mAbs targeting the trimer base. These results inform the use and improvement of consensus-based trimer immunogens in combinatorial vaccine strategies.

Fluoride Concentration in Saliva following Professional Topical Application of 2% Sodium Fluoride Solution.

BACKGROUND: Topical fluoride application in moderate and high-risk individuals and in those living in low-fluoride communities has been a common practice by dental professionals. OBJECTIVES: The objective of this study was to assess fluoride concentration available in saliva after a professional 2% sodium fluoride solution application (9000 ppm), and the duration of its availability to have an evidence-based practice for application. MATERIALS AND METHODS: Two percent sodium fluoride application was carried out in 45 participants residing in a boarding school. The participants were non tea drinkers and nonfluoride users. Water fluoride of the area ranged from 0.34 ppm to 0.38 ppm. Whole mixed saliva samples were collected at baseline and various time intervals postapplication of 2% sodium fluoride solution. Fluoride in saliva was estimated using the fluoride combination electrode (Orion model 94-09, 96-09) coupled to an ionanalyzer. RESULTS: IBM SPSS statistics version 23.0 was used for the analysis. Normality of the data was assessed using the Kolmogorov-Smirnov test and box plot, and it was found to be nonnormal. Wilcoxon signed-rank test was used to compare all time intervals with baseline, and statistically significant differences were observed (P = 0.0001). Salivary fluoride according to this study showed a biphasic clearance pattern with a peak at 15 min and a rapid fall in 60 min followed by a slow, consistent decline over a 20-h period. The fluoride concentration in saliva remained elevated above baseline from 0.03 ppm to 0.076 ppm even 3 months after application. CONCLUSION: Findings of this study show that, in this population, the frequency of application should be between 2 and 3 months (four applications per year).

Guiding the Child's Teeth with Class III Dental Malocclusion into Correct Occlusion: A Clinician's Parenting.

Pediatric dentists are often the first ones to be consulted for the presence of an anterior cross bite in the primary dentition. The condition requires an early interception to avoid progressive dentoalveolar and skeletal changes. The management, however, poses unique challenges in terms of young age of the child, correct choice of appliance and unpredictability of the response to treatment due to inability to ascertain the inherent growth potential. It is very important therefore for the specialist, to be able to recognize the early signs of a developing class III malocclusion tendency and also know the basic details of successful management of such cases. The following article describes the appropriateness of appliance choice for a case of incisor cross bite in primary dentition using different appliances based on their varied clinical presentations.

Cost effectiveness of patellofemoral versus total knee arthroplasty in younger patients.

AIMS: Patellofemoral arthroplasty (PFA) has experienced significant improvements in implant survivorship with second generation designs. This has renewed interest in PFA as an alternative to total knee arthroplasty (TKA) for younger active patients with isolated patellofemoral osteoarthritis (PF OA). We analysed the cost-effectiveness of PFA versus TKA for the management of isolated PF OA in the United States-based population. PATIENTS AND METHODS: We used a Markov transition state model to compare cost-effectiveness between PFA and TKA. Simulated patients were aged 60 (base case) and 50 years. Lifetime costs (2015 United States dollars), quality-adjusted life year (QALY) gains and incremental cost-effectiveness ratio (ICER) were calculated from a healthcare payer perspective. Annual rates of revision were derived from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. Deterministic and probabilistic sensitivity analysis was performed for all parameters against a $50 000/QALY willingness to pay. RESULTS: PFA was more expensive ($49 811 versus $46 632) but more effective (14.3 QALYs versus 13.3 QALYs) over a lifetime horizon. The ICER associated with the additional effectiveness of PFA was $3097. The model was mainly sensitive to utility values, with PFA remaining cost-effective when its utility exceeded that of TKA by at least 1.0%. PFA provided incremental benefits at no increased cost when annual rates of revision decreased by 24.5%. CONCLUSIONS: Recent improvements in rates of implant of survival have made PFA an economically beneficial joint-preserving procedure in younger patients, delaying TKA until implant failure or tibiofemoral OA progression. The present study quantified the minimum required marginal benefit for PFA to be cost-effective compared with TKA and identified survivorship targets for PFA to become both less expensive and more effective. These benchmarks might be used to assess clinical outcomes of PFA from an economic standpoint within the United States healthcare system. Cite this article: Bone Joint J 2017;99-B:1028-36.

Survivorship and functional outcomes of patellofemoral arthroplasty: a systematic review.

PURPOSE: Historically poor results of survivorship and functional outcomes of patellofemoral arthroplasty (PFA) have been reported in the setting of isolated patellofemoral osteoarthritis. More recently, however, fairly good results of PFA were reported, but the current status of PFA outcomes is unknown. Therefore, a systematic review was performed to assess overall PFA survivorship and functional outcomes. METHODS: A search was performed using PubMed, Embase and Cochrane systems, and the registries were searched. Twenty-three cohort studies and one registry reported survivorship using Kaplan-Meier curve, while 51 cohort studies reported functional outcomes of PFA. RESULTS: Twelve studies were level II studies, while 45 studies were level III or IV studies. Heterogeneity was mainly seen in type of prosthesis and year the cohort started. Nine hundred revisions in 9619 PFAs were reported yielding 5-, 10-, 15- and 20-year PFA survivorships of 91.7, 83.3, 74.9 and 66.6 %, respectively, and an annual revision rate of 2.18. Functional outcomes were reported in 2587 PFAs with an overall score of 82.2 % of the maximum score. KSS and Knee Function Score were 87.5 and 81.6 %, respectively. CONCLUSION: This systematic review showed that fairly good results of PFA survivorship and functional outcomes were reported at short- and midterm follow-up in the setting of isolated patellofemoral osteoarthritis. Heterogeneity existed mainly in prosthesis design and year the cohort started. CLINICAL RELEVANCE: These results provide a clear overview of the current status of PFA in the setting of isolated patellofemoral osteoarthritis. LEVEL OF EVIDENCE: IV.

Early functional outcome after lateral UKA is sensitive to postoperative lower limb alignment.

PURPOSE: The predictive role of patient-specific characteristics and radiographic parameters on medial unicompartmental knee arthroplasty (UKA) outcomes is well known, but knowledge of these predictors is lacking in lateral UKA. Therefore, purpose of this study was to assess the predictive role of these parameters on short-term functional outcomes of lateral UKA. METHODS: In this retrospective cohort study, Western Ontario and McMaster Universities Arthritis Index scores were collected at 2-year follow-up (median 2.2 years, range 2.0-4.0 years) in 39 patients who underwent lateral UKA. Patient-specific characteristics included age, BMI and gender, while radiographic parameters included osteoarthritis severity of all three compartments and both preoperative and postoperative hip-knee-ankle alignment. RESULTS: BMI, gender, age and preoperative valgus alignment were not correlated with functional outcomes, while postoperative valgus alignment was correlated with functional outcomes (0.561; p = 0.001). Postoperative valgus of 3°-7° was correlated with better outcomes than more neutral (-2° to 3° valgus) alignment (96.7 vs. 85.6; p = 0.011). Postoperative alignment was a predictor when corrected for patient-specific characteristics (regression coefficient 4.1; p < 0.001) and radiological parameters (regression coefficient 3.8; p = 0.002). CONCLUSIONS: Postoperative valgus alignment of 3°-7° was correlated with the best short-term functional outcomes in lateral UKA surgery, while patient-specific parameters and preoperative alignment were not correlated with functional outcomes. Based on these findings, a surgeon should aim for valgus alignment of 3°-7° when performing lateral UKA surgery for optimal functional outcomes. LEVEL OF EVIDENCE: Prognostic study, Level II.

Why do patellofemoral arthroplasties fail today? A systematic review.

BACKGROUND: Historically poor results of patellofemoral arthroplasty (PFA) were reported in the setting of isolated patellofemoral osteoarthritis (OA). In order to lower PFA failure rates, it is important to identify failure modes using a standardized method. In this systematic review, PFA failure modes were assessed and compared in early vs. late failures and older vs. recent studies. METHODS: Databases of PubMed, Embase and Cochrane and annual registries were searched for studies reporting PFA failures. Failure modes in studies with mean follow-up <5years were classified as early failures while >5years were classified late failures. Cohorts started before 2000 were classified as older studies and started after 2000 as recent studies. RESULTS: Thirty-nine cohort studies (10 level II and 29 level III or IV studies) and three registries were included with overall low quality of studies (GRADE criteria). A total of 938 PFA failures were included and were caused by OA progression (38%), pain (16%), aseptic loosening (14%) and patellar maltracking (10%). Pain was responsible for most early failures (31%), while OA progression was most common in late failures (46%). In older studies, OA progression was more commonly reported as failure mode than in more recent studies (53% vs. 39%, p=0.005). CONCLUSION: This level IV systematic review with low quality of studies identified OA progression and pain as major failure modes. Reviewing these studies, appropriate patient selection could prevent PFA failures in select cases. Future studies assessing the role of PFA in isolated patellofemoral OA are necessary.

Patients with isolated lateral osteoarthritis: Unicompartmental or total knee arthroplasty?

BACKGROUND: Lateral unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) are both reliable treatment options for patients with isolated lateral osteoarthritis (OA). However, studies comparing both procedures are scarce. Aims of this study were to (I) compare short-term functional outcomes following lateral UKA and TKA and (II) assess the role of patient characteristics on outcomes as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). METHODS: In this retrospective cohort study, 82 patients (48 undergoing lateral UKA and 34 undergoing TKA) were identified that presented with lateral OA and completed the WOMAC. Independent t-tests were used to compare outcomes following lateral UKA and TKA. RESULTS: Mean follow-up was 2.8 years (range: 2.0 - 5.0 years). Preoperatively, no differences between lateral UKA and TKA were seen (50.1±13.5 and 53.3±17.1, respectively, p=0.551). Postoperatively, lateral UKA patients reported better overall outcomes than TKA (90.5±11.7 vs. 81.8±17.9, p=0.017). Subgroup analysis showed better outcomes following lateral UKA than TKA in patients younger than 75 years (92.1±9.9 vs. 81.3±19.6, p=0.014) and in females (91.6±9.9 vs. 81.0±18.2, p=0.014). CONCLUSION: These findings indicate that lateral UKA has superior short-term functional outcomes compared to TKA in patients with isolated lateral OA. Better outcomes were especially seen in younger patients and females. These findings may help orthopedic surgeons choose treatment for patients presenting with lateral OA and optimize treatment for individual patients.

A comparative assessment of fluoride concentration available in saliva using daily prescribed topical fluoride agents.

OBJECTIVE: To assess the availability of fluoride concentration in saliva following the use of fluoride mouthrinse and dentifrice. MATERIALS AND METHODS: The experiment was carried out in 7-15 year-old school children of Chandigarh (n = 90). The children were nonfluoride users. Baseline saliva samples were collected. The subjects were exposed to two test agents, i.e., fluoride mouthrinse (0.05%, 225 ppm F) and dentifrice (1000 ppm F) for 7 days and on the day 8, saliva samples were collected over a 20 hrs period. Wash out period of 3(1/2) months was there before the subjects were exposed to the second test agent. Fluoride in saliva was estimated using fluoride ion-specific electrode. Written informed consent was taken. STATISTICAL ANALYSIS: Kolmogorov-Smirnov test was applied to test the normality of the variables. Mann-Whitney U-test was used to compare the fluoride concentration available in saliva at respective time intervals subsequent to use of the two test agents. RESULTS: Fluoride concentration was elevated in saliva compared to baseline for both the test agents. Fluoride mouthrinse (0.05% sodium fluoride [NaF]) and dentifrice (1000 ppm monofluorophosphate [MFP]) showed a biphasic clearance. Peak in saliva occurred at 15 mins postuse. Night-time use resulted in higher concentration of fluoride in saliva compared to baseline. There was statistically significantly higher fluoride concentration available in saliva for the dentifrice at 5 hrs, 10 hrs, and 20 hrs postuse (P < 0.05). CONCLUSION: Subsequent to the use of NaF (0.05%) daily mouthrinse and MFP dentifrice (1000 ppm) the fluoride concentration in saliva remained elevated to a level of 0.12 ppm for mouthrinse and 0.14 ppm for dentifrice compared to baseline (0.03 ppm) up to 20 hrs postuse. The therapeutic window though not yet established but suggested is 0.1-1 ppm for prevention of demineralization, indicating that daily use of fluoride mouthrinse and dentifrice provides fluoride concentration in saliva for the prevention of demineralization.

Effect of oral-transmucosal midazolam sedation on anxiety levels of 3-4 years old children during a Class II restorative procedure.

AIM: A double-blind randomized control trial was conducted to assess the effect of oral-transmucosal midazolam sedation on changes in anxiety levels of precooperative children during a Class II amalgam restorative procedure. METHODOLOGY: A sample of 40 healthy, American Society of Anesthesiologists I, children aged 3-4 years having at least one carious primary mandibular molar requiring a Class II amalgam restoration with no previous dental history were randomly divided into experimental and control groups comprising of 20 children each. The children in the experimental group (Group I) received 0.5 mg/kg body weight of midazolam mixed in strawberry syrup and those in the control group (Group II) received the same syrup mixed in saline, 15 min prior to the restorative procedure. Routine nonpharmacological behavior management techniques were used in both groups. The anxiety levels were recorded using Venham's anxiety scale at the start and end of each procedural step. RESULTS: There was a significant (P < 0.001) reduction in the anxiety levels of children in the experimental group on entry into the operatory compared with the control group. Introduction of each fear evoking stimuli showed a somewhat similar increase in anxiety levels in the two groups. In spite of a similar trend, the anxiety levels remained much lower in Group I than in Group II. CONCLUSION: Midazolam in conjunction with behavior management is more helpful in relaxing the child initially than behavior management alone, thus increasing the chances of successful and easy accomplishment of further treatment steps.

Correlation between mutans streptococci counts of parents and their children residing in Chandigarh, India.

OBJECTIVES: To determine the prevalence of Mutans Streptococci (MS) in children and to evaluate the relationship between the salivary levels of MS in children and their parents. MATERIAL AND METHODS: 100 children aged 3-6 years along with their parents (100 mothers and fathers each) were included in the study. The children were segregated depending upon their age and level of caries experience. The children were examined clinically on an ordinary chair in natural daylight using the Møller's index criteria. Assays for Mutans Streptococci (MS) were done for both the children and their parents using the Dentocult SM strip mutans test. Collected data was assessed using SPSS software. RESULTS: The overall prevalence of MS in the children was 83%. A statistically significant correlation (p<0.05) was observed between salivary MS counts of children and their mothers. No significant correlation was seen with the fathers. CONCLUSIONS: The findings conclude that if primary caregivers harbour high levels of MS in their saliva, it is likely that their children will have the same. Key words:Mutans streptococci, parents, children, dentocult SM kits.

Synthesis and evaluation of novel tetrapropoxycalix[4]arene enones and cinnamates for protection from ultraviolet radiation.

A series of novel calix[4]arene enones (5-7) and cinnamates (12-14) have been synthesized and evaluated for ensuring protection from ultraviolet radiation (UVR). Spectroscopic analyses has revealed that compound 6 absorbs ultraviolet radiations between 280 and 350 nm with an absorption maximum at 312 nm. Its molar absorption coefficient (ε) (>5 × 10(4)M(-1)cm(-1)) and bandwidth are larger than those for the commercially used sun protectants (oxybenzone (OB), 2-ethylhexyl 4-methoxycinnamate (OMC) and avobenzone). The in vitro Sun Protection Factor (SPF) measurement revealed an SPF of 5.2 at 2% concentration of 6 in home made emulsion formulations while combination of 2% each of 6 and OMC gave an SPF of 8.8. Lower sun protection seems to be compensated by significant protection from more harmful UVA radiations (UVA/UVB absorbance ratio of 0.62).

Progressive changes in arch width from primary to early mixed dentition period: a longitudinal study.

OBJECTIVE: The present study was conducted to evaluate, on a longitudinal basis, the changes in intercanine and intermolar widths form the primary to the early mixed dentition periods. MATERIALS AND METHODS: A total of 38 children aged 4-5 years, with normal occlusion without any proximal caries or any dental anomalies, were selected. The impressions were recorded and casts were prepared. Intercanine and intermolar widths were measured on these dental casts with the help of a digital vernier calliper. After 3 years follow-up, the impressions were recorded again and dental casts were prepared. Intercanine and intermolar widths were measured again at this stage and were compared with the baseline data using the paired t-test and the chi square test. RESULTS: There is a significant increase in the intercanine (3.93 + 1.70 mm) and intermolar width (1.49 + 1.77 mm) during the transition period from primary to early mixed dentition in both the arches and both the sexes. The gender-wise comparison showed a greater increase in males than in females, but this was not statistically significant. CONCLUSION: A thorough knowledge of growth changes during various stages of the mixed dentition period are important for a pediatric dentist to make an accurate diagnosis and treatment planning during preventive and interceptive orthodontics.

Natural prevalence of antibody titers to glucosyltransferase of Streptococcus mutans in serum in high and low caries active children.

In this investigation, serum immunoglobulin G (IgG) and immunoglobulin A (IgA) titers, as well as total immunoglobulin concentration (IgG + IgA + IgM), were found to be raised with the increase in the number of dental caries. Only the total serum antibody titer in high dental caries (HDC) group was found to be significantly raised as compared to no dental carries (NDC) group. Although the IgG and IgA titers were raised in blood with the increased number of caries, the results were not statistically significant. However, we could not find any correlation between serum antibodies and dental caries except that there was an increased trend of serum antibodies to GTF with the increased number of carious lesions.

Ion selective electrode for cesium based on 5-(4'-nitrophenylazo)25,27-bis(2-propyloxy)26,28-dihydroxycalix[4]arene.

A polyvinylchloride (PVC) based liquid membrane ion selective electrode (ISE) for cesium was fabricated with 5-(4'-nitrophenylazo)25,27-bis(2-propyloxy)26,28-dihydroxycalix[4]arene as ionophore. Different membrane constituents were investigated to realise optimum performance of the ISE developed. Of the four plasticizers and two ion additives studied, the best response was observed with membrane having 2-nitro phenyl octyl ether (oNPOE) as plasticizer and potassium tetrakis (perchloro phenyl) borate (KTpClPB) as ion additive. Linear response over concentration range of 10(-5)-10(-1)M CsCl was obtained. The Nernstian slope of the response was 56 mV per decade for Cs with a response time less than 20s. Matched potential method has been applied to find out the selectivity for Cs over several ions like Rb(+), K(+), Na(+), NH(4)(+), Sr(2+), Ba(2+), Ca(2+), Mg(2+), Cu(2+), Pb(2+), Zn(2+), Ni(2+) and Ce(3+). The response of ISE for Cs(+) was fairly constant over the pH range of 3-11. The lifetime of the electrode is 9 months which is the longest life for any membrane-based Cs-ISE so far developed. The concentration of cesium in two simulated high level active waste streams was determined and results agreed well with those obtained independently employing atomic absorption spectrometry.

A study of influence of sugars on the modulations of dental plaque pH in children with rampant caries, moderate caries and no caries.

The present study is undertaken to find out the pH of resting plaque in children with no caries, moderate caries and rampant caries and to determine the modulations of plaque pH with different sugar solution rinses viz: sucrose, glucose and fructose. The study was carried out on forty five children, in the age group of 3-10 years (25 males and 20 females). The child was given 10 ml of test solution and was asked to rinse and swish it in the mouth for a period of 30 sec. Plaque samples were taken from 20 different spots after 5, 10, 20 and 30 min of the rinse and pH values of all the samples were determined. Results show that there was a statistically significant (P<0.05) difference between the pH values of plaque at different intervals of time with sucrose, fructose and glucose solution rinse in children with moderate caries, rampant caries as compared to the caries free group. Sucrose was found to be highly cariogenic in all the children with a greater potentiating effect in moderate and rampant caries. Glucose also appeared to have a cariogenic role while fructose had the least of it all.

In vivo remineralization of artificial enamel carious lesions using a mineral-enriched mouthrinse and a fluoride dentifrice: a polarized light microscopic comparative evaluation.

BACKGROUND: Remineralization process is accelerated by the presence of fluoride ions in the oral environment, but this mechanism of caries reversal will be further enhanced if the concentration of calcium, phosphate and fluoride ions is supersaturated with respect to that of oral fluids. AIM: This in vivo study was carried out to evaluate and compare the remineralizing efficacy of a urea-based mineral-enriched mouthrinse and a fluoridated dentifrice using an in vivo intraoral appliance model and polarized light microscopic evaluation technique. MATERIALS AND METHODS: The specimens were prepared from sound teeth and artificial caries was produced using an artificial caries medium in vitro and enamel specimens were inserted in removable orthodontic appliances that were to be worn by 14 children of 10-15 years of age. They were divided into three groups - nonfluoridated dentifrice, fluoridated dentifrice and mineral-enriched mouthrinse groups. After the 6-month experimental period, during which the enamel specimens inserted in the intraoral appliance were subjected to one of the agents (either fluoride, nonfluoride dentifrice or mouthrinse) in vivo, the specimens were retrieved from the patients and were evaluated using the polarized light microscopic technique. OBSERVATIONS AND RESULTS: On analysis, mineral gain occurred in all groups, viz. nonfluoride dentifrice group, fluoride dentifrice and mineral-enriched mouthrinse group. However, it was found to be complete in the mouthrinse group, i.e. both at the surface and at the subsurface (67%), while in the fluoridated dentifrice group, 43% of the samples showed mineral gain in both zones. In the nonfluoridated dentifrice group also, remineralization occurred but was limited either to the surface or the subsurface zone. CONCLUSIONS: Urea-based mineral-enriched mouthrinse was shown to be more efficacious in the process of remineralization of artificial carious lesions.

Comparison of validity of DIAGNOdent with conventional methods for detection of occlusal caries in primary molars using the histological gold standard: an in vivo study.

AIM: This study was conducted to compare the in vivo effectiveness of DIAGNOdent with other conventional methods (visual, tactile and bitewing radiographs) for the detection of occlusal caries in primary molars. Another objective of the study was to calculate new cut-off limits for the detection of caries by DIAGNOdent in primary teeth. MATERIALS AND METHODS: Eighty-four primary molars in 52 children (aged 8-12 years), which were indicated for extraction, were selected and evaluated for dental caries using DIAGNOdent, visual and tactile examination and bitewing radiographs. Histological examination of the sections, prepared subsequent to extraction of the teeth, served as the gold standard for comparison of the above-mentioned methods. RESULTS: When considering enamel caries, values obtained for sensitivity, specificity and accuracy were 48.15, 100 and 49.40% for visual examination, 48.15, 100.00 and 49.40% for tactile examination, 49.38, 50.00 and 49.40% for bitewing radiographs, 85.19, 50.00 and 84.34% for DIAGNOdent scores interpreted according to manufacturer's cut-off limits and 81.48, 100.00 and 81.93% for DIAGNOdent scores interpreted according to newly formulated cut-off limits, respectively. At dentin caries cut-off levels, the values of sensitivity, specificity and accuracy for visual examination were 52.78, 89.36 and 73.49%; 50.00, 91.49 and 73.49% for tactile examination; 30.56, 82.98 and 60.24% for bitewing radiographs; 72.22, 76.60 and 74.70% for DIAGNOdent scores when interpreted according to manufacturer's cut-off limits and 77.48, 74.47 and 75.90%, respectively, for the DIAGNOdent scores when interpreted according to the newly formulated cut-off limits. CONCLUSIONS: DIAGNOdent showed higher sensitivity and accuracy as compared with other conventional methods for detection of enamel caries, whereas for detection of dentinal caries, even though the sensitivity was high, accuracy of the DIAGNOdent device was similar to other conventional caries diagnostic methods.

Natural prevalence of antibody titres to GTF of S. mutans in saliva in high and low caries active children.

The present study was conducted to find out the role of natural immunity against dental caries. Whole stimulated saliva of various caries from active children was collected. Antigen glucosyltransferase (GTF) was prepared from Streptococcus mutans serotype C and the antibody titre was estimated using ELISA. Salivary IgG, s-IgA and total immunoglobulins (IgG + s-IgA+ IgM) concentration were assayed. The result showed an increased level of salivary IgG concentration with the increased number of dental caries, which was not statistically significant. But there were significant decrease of s-IgA titre as well as total immunoglobulin concentration in saliva with the increased number of dental caries. This study showed that because of lack of local immunity the children are more prone to dental caries.

Orthodontic management of faciolingual horizontally impacted maxillary central incisor.

This paper describes the successful alignment of a horizontally impacted maxillary central incisor positioned high in the vestibule, in a 15-year-old girl, by purely orthodontic means. A unique and innovative technique for traction was employed so as to cause minimal injury to the neighboring soft tissue. The article is a step forward in establishing the predictability of orthodontic alignment in management of such cases, which may become the method of choice over extractions or surgical repositionings.