Establishing legal threshold of 18-years based on the assessment of mandibular molars using three different methods - An observational study.

BACKGROUND: The study evaluates the feasibility of employing the radiographic visibility of the root pulp and periodontal ligament in mandibular molars for age estimation, particularly focusing on the 18 years of age threshold. This study additionally investigates the potential of root canal width reduction in mandibular molars, as a reliable method for forensic age estimation in living individuals. MATERIALS AND METHODS: A cross-sectional study was conducted to assess the radiographic visibility of the root pulp (RPV) and the root canal width (RCW) of mandibular first, second, and third molars along with the radiographic visibility of the periodontal ligament (PLV) of mandibular third molars, in a sample of 403 individuals aged 16-25 years (220 males and 183 females). Data regarding age for different stages of RPV and PLV and various types of RCW were recorded and observed for sex-based differences. Results obtained were tabulated and descriptive statistics were applied to summarise the findings. RESULTS: Individuals over 18 years old were classified with higher accuracy using stage 3 of the RPV scoring system in all mandibular molars (first, second, and third) compared to stage 2, which was also effective for the second and third molars. This result held regardless of sex and side examined. Additionally, root canal width (RCW) assessment demonstrated that individuals with RCW types A, B, and C were more likely to be under 18 years old in both sexes. Conversely, individuals with RCW type U on the right side for males and the left side for females exhibited a higher likelihood of being above 18 years old. CONCLUSION: The study suggests that the assessment of mandibular molars could potentially serve as an auxiliary tool in age estimation methods, particularly for approximating individuals around the 18 years of age threshold. Further investigation is warranted to explore the potential application of root canal width measurements in forensic age estimation.

Correlation of spheno-occipital synchondrosis and mandibular condylar cortication with chronological age using computed tomography in Indian population- A cross-sectional study.

BACKGROUND: Forensic age estimation is a procedure which utilises many methods to estimate the age of both living and deceased individuals, including those who have died in natural disasters or man-made catastrophes. The pattern and closure of spheno-occipital synchondrosis (SOS) fusion, along with subchondral ossification of the mandibular condyle, can be used to estimate age. AIM AND OBJECTIVES: This study aims to estimate age using computed tomographic (CT) images of spheno-occipital synchondrosis fusion (SOS) and mandibular condylar cortication (MCC), and to correlate these findings with chronological age. MATERIALS AND METHODS: The present study included 435 CT images of individuals aged 10-25 years. SOS fusion was assessed using a four-stage system, and MCC was assessed bilaterally using a three-stage system on the sagittal plane. Data on fusion stages and cortication types were entered along with chronological age, and then statistically analysed. RESULTS: SOS fusion stage 2 occurred at similar age in males (19.82 ± 2.67 years) and females (19.23 ± 2.93 years). Earlier fusion of other stages was observed in females by a mean age of 2 years. MCC was completed 1 year earlier in females, with statistically significant differences (p ≤ 0.001). When comparing cortication types and different fusion stages, only type II cortication showed statistically significant differences compared to different fusion stages (p ≤ 0.001). CONCLUSION: Mandibular condylar cortication (MCC) and spheno-occipital synchondrosis (SOS) fusion were positively correlated with chronological age, suggesting that these parameters can be used as an adjunct method for age estimation.

Elevating pyrrole derivative synthesis: a three-component revolution.

Pyrrole is an essential chemical with considerable relevance as a pharmaceutical framework for many biologically necessary medications. The growing demand for biologically active compounds calls for a simple one-pot method for generating novel pyrrole derivatives. Nots surprisingly, several multicomponent reactions (MCRs) aim to synthesize pyrrole derivatives. However, this review presents the three-component synthesis of pyrrole derivatives, highlighting the significance of multicomponent reaction in synthesizing eclectic multi-functionalised pyrrole covering the selected literature on the three-component synthesis of substituted pyrrole from 2016 to late 2023. Furthermore, this article classifies the reactions based on the starting material with functional groups involved in the pyrrole ring formation.

Evaluation of Salivary Butylated Hydroxytoluene and Ascorbic Acid Levels in Type 2 Diabetes Mellitus Patients.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a global health concern associated with systemic as well as oral complications. The preventive antioxidants found in saliva naturally reduce the damaging effects of reactive oxygen molecules. Any disruption to the regular functioning of these antioxidants may lead to oxidative stress, which could boost an individual's vulnerability to oral diseases. Diabetes patients are vulnerable to various dental complications, such as oral mucosal disorders, dental caries, dry mouth, and periodontal disease. AIM: This study aimed to assess the salivary butylated hydroxytoluene (BHT) and ascorbic acid (AA) levels in patients with controlled and uncontrolled type 2 diabetes mellitus. MATERIALS AND METHODS: The present study included samples from patients aged 45-65. Group I consisted of 20 controlled diabetic patients, and Group II consisted of 20 uncontrolled diabetic patients. Unstimulated whole saliva samples were collected from both groups, and laboratory analysis was done. Salivary BHT and AA levels were quantified using enzyme-linked immunosorbent assay (ELISA) and spectrophotometric assay. RESULTS: Salivary butylated hydroxytoluene levels were found to be higher in the uncontrolled diabetic group than in the controlled diabetic group, and salivary AA levels were found to be higher in the controlled diabetic group than in the uncontrolled diabetic group. The mean ± standard deviation (SD) values of butylated hydroxytoluene among controlled and uncontrolled diabetic patients were 2.98 ± 0.12 and 2.99 ± 0.11 absorbance units, respectively. The mean ± SD value of AA in the controlled group was found to be 2.99 ± 0.15 absorbance units, and the mean ± SD value of AA in the uncontrolled group was 2.64 ± 0.96 absorbance units. However, it has been found that there is no statistically significant difference between salivary BHT and AA levels among controlled and uncontrolled diabetics, with p-values of 0.867 and 0.419, respectively. CONCLUSION: Values of salivary biochemical markers were distinctly different between controlled and uncontrolled diabetic groups. However, to establish a definite role of salivary BHT and AA levels as biomarkers in managing and monitoring type 2 diabetes, future studies are required, even though the trends exhibit possible alterations in biomarkers.

Artificial Intelligence: A Reliable Tool to Detect the Elongation of the Styloid Process.

Background Eagle's syndrome is characterized by the anomalous elongation of the styloid process. This condition is usually identified through the manual evaluation of orthopantomogram (OPG) images, which is time-consuming and can have interobserver variability. The application of Artificial intelligence (AI) in radiology is gaining importance and interest in recent years. The application of AI in detecting styloid process elongation is less explored, advocating for research in the same arena. Aim and objectives The study aimed to evaluate the accuracy of artificial intelligence in detecting styloid process elongation in digital OPGs and to compare the performance of the three different AI algorithms with that of the manual radiographic evaluation by the radiologist. Materials and methods A total of 400 digital OPGs were screened, and linear measurements of the styloid process length (ImageJ software (National Institute of Health, Maryland, USA)) were done for the identification of styloid process elongation by a single calibrated observer to finally include a processed image dataset including 169 images of the elongated styloid process and 200 images of the normal styloid process. A machine learning approach was used to detect the styloid process elongation using the three different AI models: logistic regression, neural network, and Naïve Bayes algorithms in Orange software (University of Ljubljana, Slovenia). Performance evaluation was done using the accuracy, sensitivity, specificity, precision, recall, F1 score, and AUC-ROC (area under the receiver operating characteristic) curve. Results Logistic regression and neural network algorithms depicted the highest accuracy of 100% with no false positives or false negatives, securing a score of 1.000 for all the metrics. However, the Naïve Bayes model demonstrated a fairly considerable accuracy, classifying 49 false positive images and 59 false negative images with an AUC (area under the curve) score of 78 %. Nevertheless, it performed better than random guessing. Conclusion Logistic regression and neural network algorithms accurately detected styloid process elongation similar to that of manual radiographic evaluation. The Naïve Bayes algorithm did not perform an accurate classification yet performed better than random guessing. AI holds a promising scope for its application in automatically detecting styloid process elongation in digital OPGs.

Effectiveness of various irrigant activation techniques on the penetration of sodium hypochlorite into lateral canals of mature permanent teeth: A systematic review and meta-analysis.

Objective: This review aimed to systematically review the effectiveness of various irrigant activation techniques (IATs) on the penetration of sodium hypochlorite (NaOCl) into the lateral canals of mature permanent teeth. Methods: Electronic databases including MEDLINE (via PubMed), Scopus, ProQuest, and Cochrane Library were searched to identify laboratory studies evaluating the penetration of NaOCl into lateral canals following the use of apical negative pressure irrigation (ANP), passive ultrasonic irrigation (PUI), sonic irrigation (SI), and/or manual dynamic activation (MDA) techniques. Meta-analysis was performed for individual IATs in comparison with CNI into the lateral canals of both straight and curved root canals. On the basis of the previous literature and parameters, the risk of bias of the selected studies was evaluated with the help of a customized tool. Results: Of the 983 records screened, 12 studies were selected to include in the systematic review, and 10 studies were selected for the meta-analysis. The total quality assessment across the included studies indicated a high quality (83.3%). Overall, the meta-analysis demonstrated IATs had significant improvement in the penetration of NaOCl into the lateral canals of straight canals (34.3%) over CNI. The subgroup analysis of individual IATs demonstrated PUI (60.9%) to be superior in the penetration into lateral canals of straight canals. Conclusions: IATs improved the irrigant penetration into lateral canals and therefore their use during routine endodontic practice is recommended. In straight canals, PUI is the most effective IAT followed by ANP, SI, and MDA techniques.

Comparative evaluation of the efficacy of Nigella sativa (75% v/v) cream and clobetasol propionate (0.05% w/w) gel in oral lichen planus-a double-blinded randomized control trial.

OBJECTIVES: The a im of this study is to evaluate and compare the efficacy of Nigella sativa (75% v/v) cream and clobetasol propionate (0.05% w/w) gel for the management of oral lichen planus (OLP). STUDY DESIGN: Sixty clinically diagnosed cases of OLP were stratified into moderate cases or severe cases based on burning sensation before getting allocated to group I receiving Nigella sativa cream and group II receiving clobetasol propionate gel, two times a day for 45 days. Patients were examined every 15 days for a change in burning sensation and size of the lesion using the numeric pain rating scale (NRS) and a standard Vernier caliper, respectively. Statistical tests including Mann-Whitney U, Wilcoxon signed-rank, Friedman's, Dunn's post hoc, unpaired t, paired t, one-way repeated measures ANOVA, and Bonferroni's post hoc were applied. RESULTS: There was a statistically significant reduction in the burning sensation as well as the size of the lesion in both groups (P ≤ 0.05). There was an 87.8% (moderate cases) and 85.7% (severe cases) reduction in the mean NRS scores on the 45th day in group I when compared to the 96.5% (moderate cases) and 93.48% (severe cases) in group II. There was a 92.9% (moderate cases) and 90.7% (severe cases) reduction in the size of the lesion in group I when compared to the 92.6% (moderate cases) and 93.1% (severe cases) in group II. CONCLUSION: The topical application of Nigella sativa cream was effective and comparable to clobetasol propionate 0.05% gel in the management of OLP, without any side effects. Hence, this study recommends the use of topical Nigella sativa cream therapy in the management of OLP. CLINICAL RELEVANCE: The current mainstay of treatment for OLP is the administration of topical or systemic corticosteroids, which are known to cause side effects, demanding a search for an alternative. Nigella sativa oil cream could be a safe, promising, cost-effective, adjunctive, or alternative modality. Clinical trial registration number: CTRI/2020/07/026745 (India).

Efficacy of topical tulsi (Ocimum sanctum) paste for the management of oral submucous fibrosis - A clinical study.

Context: Oral submucous fibrosis (OSMF) is a chronic insidious oral potentially malignant disorder characterized by increased collagen deposition and reduced collagen degradation causing burning sensation and difficulty in mouth opening. Aim: To assess the efficacy of topical Tulsi (Ocimum sanctum) paste for the management of OSMF. Settings and Design: Institution-based clinical trial. Materials and Methods: The study included a total of 60 OSMF patients categorized into three Groups A, B and C (20 in each) depending on the severity according to Lai DR et al. classification. The patients were advised for topical Tulsi paste application and were evaluated for the reduction in the burning sensation and improvement in mouth opening every month for 3 subsequent months using the numeric pain rating scale (NRS) and a Vernier calliper, respectively. Statistical Analysis: The baseline and 3-month recordings were subjected to inter- and intra-group statistical analysis using Kruskal-Wallis analysis of variance (ANOVA), Mann-Whitney U, one-way ANOVA, Tukey's multiple post-hoc and Wilcoxon matched-pairs tests. Results: There was a reduction in the burning sensation and improvement in the mouth opening in all three groups. The reduction in the burning sensation was statistically significant among all the groups (P < 0.05) and the NRS scores after 3 months among the three groups were not statistically significant (P > 0.05). There was a statistically significant difference (P < 0.05) in the improvement of mouth opening between Group A and B; A and C; but not between B and C. Conclusion: Tulsi paste showed a significant reduction in the burning sensation and improvement of the mouth opening thereby proving to be a safe and promising medicament for OSMF.

Comparative efficacy of topical coconut cream and clobetasol propionate ointment for the management of oral lichen planus: A double-blinded randomized control trial.

CONTEXT: Oral lichen planus (OLP) is a quite common chronic inflammatory mucocutaneous disorder affecting the oral cavity and skin. The current treatment relies on systemic or topical corticosteroids but is known to cause side effects thereby demanding a search for an alternative. AIM: This study aims to assess and to compare the efficacy of topical Coconut (Cocos nucifera) 50% cream and Clobetasol propionate 0.05% ointment for the management of OLP. SETTINGS AND DESIGN: An institution-based double-blinded randomized control trial. MATERIALS AND METHODS: Sixty clinically diagnosed OLP patients were allotted to two groups (30 in each): Group I (Coconut cream-50%) and Group II (Clobetasol Propionate ointment-0.05%). Patients were examined every 15 days until two months for a change in the lesion size and reduction in the burning sensation. The measurement of lesion size and burning sensation was done using Adobe Photoshop software (version CS3) and Numeric Pain Rating scale (NPS), respectively. STATISTICAL ANALYSIS USED: The recordings were subjected to the statistical analysis using Wilcoxon matched-pairs and Mann-Whitney U tests for intra-group and inter-group comparisons, respectively. RESULTS: There was an 85% regression in the size of the lesion in Group I whereas Group II had it to be 95%, and a 100% reduction in the NPS score in Group I whereas Group II had it to be 95%. CONCLUSION: The Coconut cream showed a significant decrease in the size of the lesion and the burning sensation with no side effects neither any signs of toxicity reported during the treatment or follow-up, thereby proving to be a safe and promising medication for OLP.