This randomized, active-controlled, double-blind, prospective clinical trial evaluated the anesthetic efficacy of 2% lidocaine with 1:200,000 epinephrine versus an admixture of 2% lidocaine with 1:200,000 epinephrine and 1 mL of 4 mg dexamethasone (Twin mix) for inferior alveolar nerve blocks (IANBs) in patients with symptomatic irreversible pulpitis (SIP) of the mandibular molars. Seventy-eight patients with SIP of mandibular molars were randomly allocated to the 2 groups of 39 subjects. All patients were required to have profound lip numbness within 10 minutes of local anesthetic deposition. The efficacy of pulpal anesthesia was confirmed by absence of pain or mild pain (Heft-Parker visual analogue scale ≤54 mm) during access cavity preparation and placement of glide path files. The collected data were subjected to independent t test, chi-square test, and Fisher exact test using SPSS software version 20.0 at a significance level of 0.05. IANB success rates for the lidocaine group and the Twin mix group was 66% and 68% respectively, which was not a statistically significant difference (p > .05). This study demonstrated that the anesthetic efficacy of Twin mix was equivalent to 2% lidocaine for IANBs in teeth with SIP.

A 56-year-old female patient came to the department complaining of pain in the upper right back tooth region. The patient reported a history of paralysis in the right half of the body. There is neither swelling nor inflammation in the gingiva. No sinus tract is present in the vestibular area. There were no noticeable caries lesions. Right first maxillary premolar with significant periodontal pocket and grade 2 mobility on palpation. There is tenderness in the percussion. The patient refused treatment alternatives and had the tooth extracted. The middle third of the root contains a completely detached fragment in the middle third. The root fragment was sent for biopsy for histological analysis. Cementum, dentin, and inflammatory cells were found during histological examination and were suggestive of cemental tear.

A 56-year-old female patient came to the department complaining of pain in the upper right back tooth region. The patient reported a history of paralysis in the right half of the body. There is neither swelling nor inflammation in the gingiva. No sinus tract is present in the vestibular area. There were no noticeable caries lesions. Right first maxillary premolar with significant periodontal pocket and grade 2 mobility on palpation. There is tenderness in the percussion. The patient refused treatment alternatives and had the tooth extracted. The middle third of the root contains a completely detached fragment in the middle third. The root fragment was sent for biopsy for histological analysis. Cementum, dentin, and inflammatory cells were found during histological examination and were suggestive of cemental tear.

Context: Dental caries remains the most widespread oral disease among all age groups. Hormonal fingerprints (second digit: fourth digit ratio or 2D:4D ratio) are biomarkers displaying sexual dimorphism and diverse human phenotypic traits. A person's genetic makeup may influence the occurrence of dental caries. Aim: The present study aimed to evaluate the influence of digit ratio on the incidence of dental caries. Settings and Design: Two hundred patients between 18 and 55 years, reporting for restorations or endodontic therapy, participated in the study. Subjects and Methods: Hormonal fingerprints (2D:4D ratio) were measured with the help of a digital vernier caliper. Caries incidence was recorded using the DMFT index. Statistical Analysis used: Data obtained were tabulated and statistically analyzed using Independent t -test and Chi-square test. Results Males had a less mean 2D:4D ratio than females, which was statistically significant ( p -value = 0.003). Chi-square test was applied, and there was a statistically significant correlation between high digit ratio and caries experience ( p -value = 0.002). Females with a high digit ratio and males with a low digit ratio were in the moderate and low caries risk groups with a p -value of 0.029 and 0.001 in the respective risk groups. Conclusion The present study displayed a correlation between hormonal fingerprints (2D:4D ratio) and dental caries. An indicator of caries risk will help prevent caries by implementing oral hygiene measures, which will reduce its incidence as the most occurring oral disease.

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