Background and Aim: Gingival hyperpigmentation is an esthetic problem. The aim of the present study was to identify most effective treatment modality for managing generalized physiological gingival pigmentation. Materials and Methods: A systematic review and meta-analysis were done (1919 to October 2018) using PubMed, CINHAL, Dental and Oral Science, and manual searches. Twenty-five articles were finally reviewed. Only human clinical trials were considered with physiological gingival pigmentation treated with different depigmentation methods and compared with surgical stripping. The outcome was the achievement of gingival depigmentation and its recurrence. RevMan software was used for data analysis. Results: Of 26,132 articles, 25 met the inclusion criteria. Seventeen were randomized control trials and 8 were nonrandomized control trials. Most of the studies were on laser. The control group was scalpel surgery. Majority of studies showed no difference in compared treatment modality. A meta-analysis compared laser ablation with surgical stripping revealed a nonsignificance difference regarding recurrence ( P = 0.75) and depigmentation ( P = 0.23) and a statistically significant difference regarding postoperative pain favoring laser ablation ( P ≤ 0.05). Conclusions: Surgical stripping has been the conventional treatment of choice, but our review showed that new techniques are equally effective or even better. Laser especially diode laser was the most frequently used technique and showed better esthetic outcomes, less pain, faster healing, and patients' preference and satisfaction after treatment. However, laser showed more regimentation at 6-month evaluation. More good quality randomized controlled trials with different depigmentation methods are needed to draw strong conclusions.

The objective of the present systematic review is to evaluate the success of pulpotomy in mature permanent teeth presented with irreversible pulpitis. The following databases were searched: PubMed, Oral and Dentistry Database, Cochrane, and CINAHL plus. We included studies published in the English language only. However, narrative reviews and case reports/series were excluded. The first electronic and hand search yielded a total of 2851 articles. After going through extensive screening and eligibility process, only six articles were finally selected for the review. The follow-up period ranged from 1 to 10 years. Randomized controlled trial compared pulpotomy with the root canal treatment and reported comparable and even better success of the pulpotomy (78% success). All the other studies have also shown better clinical and radiographic success of pulpotomy (68%–100%). Pulpotomy can be considered an alternative option for mature permanent teeth with irreversible pulpitis.

Objective:To determine the accuracy of extra oral periapical radiography in obtaining root length by comparing it with the radiographs obtained from standard intraoral approach and extended distance intraoral approach.Materials and Methods:It was an in vitro, comparative study conducted at the dental clinics of Aga Khan University Hospital. ERC exemption was obtained for this work, ref number 3407Sur-ERC-14. We included premolars and molars of a standard phantom head mounted with metal and radiopaque teeth. Radiation was exposed using three radiographic approaches: Standard intraoral, extended length intraoral and extraoral. Since, the unit of analysis was individual root, thus, we had a total of 24 images. The images were stored in VixWin software. The length of the roots was determined using the scale function of the measuring tool inbuilt in the software. Data were analyzed using SPSS version 19.0 and GraphPad software. Pearson correlation coefficient and Bland–Altman test was applied to determine whether the tooth length readings obtained from three different approaches were correlated. P = 0.05 was taken as statistically significant.Results:The correlation between standard intraoral and extended intraoral was 0.97; the correlation between standard intraoral and extraoral method was 0.82 while the correlation between extended intraoral and extraoral was 0.76. The results of Bland–Altman test showed that the average discrepancy between these methods is not large enough to be considered as significant.Conclusions:It appears that the extraoral radiographic method can be used in root length determination in subjects where intraoral radiography is not possible.