An exploratory study to understand the relationship between diabetes and various pulpal conditions: An Indian perspective.

Aim: Diabetes mellitus (DM) affects an estimated 100 million Indians, ranking second globally in diabetic prevalence. Despite this, the correlation between DM and specific pulpal diagnoses remains underexplored. This study compares pulpal conditions in DM patients and nondiabetic controls. Designs: The study was started after taking ethical approval. Subjects and Methods: Two thousand and five hundred and sixty teeth were examined over 4 months at the institute, evenly distributed between diabetic and nondiabetic cases, we assessed diagnoses - normal pulp, reversible pulpitis (RP), symptomatic irreversible pulpitis, asymptomatic irreversible pulpitis, pulp necrosis (PN), missing teeth (MT), and root canal-treated teeth (RCT). Statistical analysis used the Chi-square test. Results: PN and MT prevalence in DM patients significantly exceeded the control group. Conversely, the control group showed higher RP prevalence in the older subgroup. Conclusions: PN prevalence was higher in diabetics, suggesting reduced pulp sensitivity in individuals over 60 years. This diminished sensitivity might lead to delayed dental treatment, increasing PN prevalence.

Evaluation and Comparison of Fracture Strength and Fluoride Releasing Properties of New Alkasite Materials with Conventional Restorative Material, Bulk Fill Composite and Glass Ionomer Cement: An In-Vitro Study.

Aim: This study aimed to evaluate and compare fluoride ion release by Cention-N (self-cure and light-cure) and conventional glass-ionomer cement (GIC) at different pH levels and time intervals. Methodology: For fluoride release assessment, 240 samples (10 mm diameter, 2 mm height) of Cention-N and conventional glass-ionomer cement were created using rubber rings. Samples were stored in deionized water, and the cumulative fluoride ion release and change in pH were assessed using a spectrophotometer and pH meter, respectively, at the end of 7 days, 14 days, and 21 days. The obtained data were subjected to statistical analysis. Results: All three samples exhibited very high fluoride release in an acidic medium compared to the neutral medium. Although GIC demonstrated superior fluoride release, Cention-N displayed adequate fluoride release over a longer duration. Conclusions: Within the limitations of this study, it can be concluded that both Glass ionomer cement and Cention-N showed an initial fluoride burst.

Revisiting Premolars Using Cone-Beam Computed Tomography Analysis and Classifying Their Roots and Root Canal Morphology Using Newer Classification.

OBJECTIVE: The objective is to compare the internal morphology of premolars while applying the Vertucci and recent classification system for root canal variations in the Gujarat population using CBCT. MATERIALS AND METHODOLOGY:  A sample size of 537 CBCT images collected from various diagnostic centers in Gujarat was analyzed. The root canal morphology was then classified by using two methods - Ahmed et al. and Vertucci classification system. Fisher's exact test and Chi-square test were used for statistical analysis. RESULTS: All the premolars revealed a varied canal configuration. More than half of maxillary first and 42% of maxillary second premolars were double rooted. Vertucci type IV classification was the most common in first maxillary premolars and Type I and type IV were commonly seen in second premolars. According to the new system, the code 2N B1 P1 was commonly seen for first maxillary premolars. The majority of mandibular premolars were single rooted. Classification wise type I Vertucci and 1 N1  were the most common types observed. CONCLUSION:  Premolars - both maxillary and mandibular - in this subpopulation had a wide range of root canal anatomical variations. Clinicians should be aware of this for a successful treatment outcome. The new system for classifying canal morphology describes the root and canal configurations in a more accurate and practical manner compared to the Vertucci classification and hence can be used routinely.

Influence of the Type of Topical Fluoride Delivery at Various Restoration Time Points on the Micro-Shear Bond Strength of a Resin-Based Composite on Bleached Tooth Enamel.

Background This study aimed to evaluate the micro-shear bond strength (mSBS) of an adhesive applied to bleached enamel to determine the effects of fluoride supply and restoration time on the mSBS. Methodology In this study, we bleached 130 samples of enamel and split them into the following three groups of 40 each: group MI: McInnes bleaching solution; group MIF: McInnes bleaching solution + topical acidulated phosphate fluoride gel; group FMI: 2% fluoridated McInnes bleaching solution. Non-bleaching or fluoridation was performed on a group of 10. Subgroups were created for each group (except for the control) to be restored for seven, 14, or 21 days. The mSBS test was performed on a universal testing machine after Tygon tubes were filled with composite resin and put on enamel surfaces. Tukey's post-hoc test (p = 0.05) and two-way analysis of variance were employed to analyze the data. Results The mSBS values obtained for all groups immediately and after seven days were lower, while at 14 and 21 days were similar to the control group. According to the data, group FMI had greater mSBS levels than groups MI and MIF, both immediately and seven days later. Conclusions When in-office bleaching was employed, only the fluoride McInnes solution was successful in quickly correcting the adverse effects of low mSBS.

Multifarious Targets and Recent Developments in the Therapeutics for the Management of Bone Cancer Pain.

Bone cancer pain (BCP) is a distinct pain state showing characteristics of both neuropathic and inflammatory pain. On average, almost 46% of cancer patients exhibit BCP with numbers flaring up to as high as 76% for terminally ill patients. Patients suffering from BCP experience a compromised quality of life, and the unavailability of effective therapeutics makes this a more devastating condition. In every individual cancer patient, the pain is driven by different mechanisms at different sites. The mechanisms behind the manifestation of BCP are very complex and poorly understood, which creates a substantial barrier to drug development. Nevertheless, some of the key mechanisms involved have been identified and are being explored further to develop targeted molecules. Developing a multitarget approach might be beneficial in this case as the underlying mechanism is not fixed and usually a number of these pathways are simultaneously dysregulated. In this review, we have discussed the role of recently identified novel modulators and mechanisms involved in the development of BCP. They include ion channels and receptors involved in sensing alteration of temperature and acidic microenvironment, immune system activation, sodium channels, endothelins, protease-activated receptors, neurotrophins, motor proteins mediated trafficking of glutamate receptor, and some bone-specific mechanisms. Apart from this, we have also discussed some of the novel approaches under preclinical and clinical development for the treatment of bone cancer pain.

Comparing Bacterial Leakage of Three Intraorifice Barrier Sealing Materials against Enterococcus faecalis and Proteus vulgaris.

AIM: The purpose of this in vitro study was to evaluate the intraorifice sealing ability of light-cured glass-ionomer cement (LC-GIC), Tetric N-Flow, and ProRoot mineral trioxide aggregate (MTA) against Enterococcus faecalis and Proteus vulgaris. MATERIALS AND METHODS: Crowns of the eighty human mandibular teeth were decapitated. Working length determination was performed, after which cleaning and shaping were carried out. A uniform orifice diameter of 1.3 mm, at its widest point, was made. Once instrumentation was completed, the canals were irrigated and then obturated. A heat carrier was used to remove gutta-percha to the depth of 3.5 mm. Samples were then divided into a control group (Group 1) with no barrier, and three groups, namely, Group 2, Group 3, and Group 4, were restored with the LC-GIC, Tetric N-Flow, and ProRoot MTA, respectively. The groups were further subdivided into Subgroup A for checking bacterial leakage against E. faecalis and Subgroup B, against P. vulgaris. All samples were subjected to the bacterial leakage test and observed daily for the appearance of turbidity after which statistical analysis was performed. RESULTS: Group 1 showed leakage in, as early as, 3 days. The longest time for the turbidity to appear was shown by Group 4 with an average of 31 days. The mean number of days for turbidity to appear in Group 2 and Group 3 was 23 and 24 days, respectively. Group 4 showed the best intraorifice sealing ability with a significant difference. CONCLUSION: The teeth with an intraorifice coronal seal had better protection against microbial leakage. Among all materials used, the ProRoot MTA showed the best intraorifice sealing ability. CLINICAL SIGNIFICANCE: Use of the ProRoot MTA promises long-term results in the endodontically treated teeth as compared with other materials.