Enhancement of Odontoblastic Differentiation of Stem Cells from Exfoliated Deciduous Tooth Using N-acetylcysteine-An In Vitro Study.

AIM AND OBJECTIVE: The study was conducted to evaluate the effects of N-acetylcysteine (NAC) on the propagation and differentiation of stem cells from human exfoliated deciduous teeth(SHED). MATERIALS AND METHODS: SHEDs were isolated by explant culture method and characterized for stem cell properties using flow cytometry method. MTT assay and Cell Counting Kit-8 (CCK-8) assay were used to examine the viability and proliferation of the SHEDs. The effects of NAC-induced osteo/odontoblastic differentiation of SHEDs were determined by functional staining for mineralization, and the gene expression of osteo/odontoblastic transcription factors and proteins was evaluated by real-time quantitative reverse transcription-polymerase chain reaction(qRT-PCR) analyses. Protein levels of collagen type 1 (COL1), dentin sialophosphoprotein (DSPP), and dentin matrix acidic phosphoprotein 1(DMP-1) were calculated by the Western blot method to assess the osteo/odontogenic differentiation. RESULTS: SHEDs presented mesenchymal stem cell (MSC)-like characteristics on flow cytometric analysis. The cell viability and metabolic activity of SHEDs were increased with an increase in the concentrations of NAC from 0.5 to 10 nM. However, the concentrations of NAC from 0.5 to 2.5 mM did not affect cell proliferation. NAC incorporated at a concentration of 2.5 mM showed higher mineralization and considerably increased gene expression levels of runt-related transcription factor 2 (RUNX2), COL1A1, DSPP, and DMP-1. It significantly increased the protein expression of odontoblast-related matrix proteins like COL1, DSPP, and DMP-1. CONCLUSION: NAC regulates the healthy propagation of dental stem cells in vitro. Its effects on the differentiation of dental pulp SHEDs remain unidentified. This study explores that NAC can encourage the mineralization of SHEDs and differentiate them into the odontoblastic lineage. CLINICAL SIGNIFICANCE: The results propose that NAC could have a significant pharmacological role in activating and enhancing odontogenic differentiation of dental stem cells and possibly a prospect in regenerative dentistry.

Virtual Reality Distraction: A Novel Behaviour Management Technique.

Virtual reality distraction (VRD) is developing technologies for behavior management that can assist a child in adjusting to the dental setting and provide high-quality dental care. The purpose of this literature is to shed light on VRD and its application to the treatment of pediatric dental patients.

Comparing Patient Outcomes for Teeth Treated with Traditional Root Canal Therapy Versus Pulpotomy: A Randomized Controlled Trial.

Background: Root canal therapy (RCT) and pulpotomy are two common treatment modalities for managing dental pulp infections, but their comparative effectiveness in terms of patient outcomes remains unclear. This root canal therapy (RCT) aimed to assess and compare patient outcomes between teeth treated with traditional RCT and pulpotomy. Materials and Methods: In this single-center RCT, a total of 120 patients presenting with symptomatic dental pulp infections were randomly assigned to either the RCT group or the pulpotomy group. The RCT group received conventional root canal treatment, which involved complete removal of infected pulp and obturation of the root canals. The pulpotomy group underwent a procedure where only the coronal pulp tissue was removed, followed by the placement of a medicament. Pain levels, infection resolution, and tooth survival were assessed at 6 months and 1 year posttreatment. Results: At the 6-month follow-up, patients in the RCT group reported significantly lower pain scores (2.5 ± 0.8) compared with the pulpotomy group (4.3 ± 1.2, P < 0.001). Infection resolution was also higher in the RCT group (92%) compared with the pulpotomy group (78%) at 6 months. Tooth survival rates at 1 year were significantly higher in the RCT group (95%) compared with the pulpotomy group (81%, P < 0.05). Conclusion: This RCT demonstrates that traditional RCT is superior to pulpotomy in terms of pain reduction, infection resolution, and tooth survival. Patients who underwent RCT experienced less pain, faster infection resolution, and better tooth survival rates compared with those who received pulpotomy. These findings support the use of RCT as the preferred treatment modality for dental pulp infections.

Efficacy of Chewable Brush Compared to Manual Brush in School Going Children of Age Group 10-12 Years.

Aim: Chewable toothbrushes were compared to traditional manual toothbrushes in terms of their ability to remove plaque and their impact on salivary pH in a sample of school-aged children. Materials and Methods: The sample size for this research was 200 youngsters aged 10-12. Saliva was collected by spitting into a clean container, and the pH levels were measured using color-coded pH strips to determine where the person was starting from. The plaque score was measured using the OHI-S index after the application of the disclosing agent. The pH and plaque scores were also recalculated after brushing to see how they had changed after surgery. Results: Results indicated that both manual and chewable brushes significantly improved post-brushing pH ratings (P = 0.001), and that plaque scores decreased (P = 0.001). When compared to conventional manual toothbrushes, the chewable brush was much more successful in reducing plaque and elevating salivary pH (P = 0.001). Conclusion: As a result, parents may offer their kids a chewable toothbrush to help them maintain good oral hygiene after lunch and on lengthy car trips, when they would not have time to wash their teeth properly.

Incidence and Intensity of Pain Following Endodontic Treatment by Different Instrumentation Techniques in Teeth With Periapical Lesion.

AIM AND OBJECTIVES:  This study was carried out to compare the effectiveness of hand and rotary instrumentation techniques on postoperative pain in asymptomatic necrotic premolars with periapical lesions and instrumented by a modified step-back technique using a K file, crown down by continuous rotary motion technique using ProTaper Universal (Dentsply Mailefer, Ballaigues, Switzerland), and with the reciprocation technique using WaveOne (Dentsply Sirona, Charlotte, NC, USA). MATERIALS AND METHODS:  For this study, 66 premolars with single roots and canals were chosen. The procedure was completed in a single visit. Following access opening, the working length was initially determined using an apex locator and then confirmed after inserting K file #10 by radiograph. The canal was cleaned and shaped using a grouping system. After the master apical preparation, the canal was dried by paper point and obturated with gutta-percha and AH plus sealer, an epoxide-amine resin pulp canal sealer. In order to confirm the obturation, a radiograph was taken. After that, a permanent restoration material was used to seal the access cavity. Following that, patients to whom the visual analog scale (VAS) had already been explained were contacted by phone at six, 12, 24, and 48 hours. RESULTS:  In this study, compared to a stainless steel instrumentation technique, WaveOne instrumentation caused more noticeable pain. The results of the current study showed that, on average, postoperative pain scores decreased over the course of the 12 to 48-hour period, reaching a minimum or a maximum at 48 hours (p<0.01). CONCLUSION:  Postoperative pain was produced by all instrumentation methods used in the study. In comparison to ProTaper and WaveOne, instrumentation using the modified step-back technique with K files caused less pain, especially over the course of a 24-hour period.

An In-Vitro Analysis of Root Fracture Strength Using Single File Systems.

Aim Root canal obturation during endodontic therapy supports the root canal space and helps the extra tooth structure resist fracture. Some believe endodontic-treated teeth are more likely to break than natural teeth. The most common causes of tooth decay are endodontic treatment's extensive tooth structure loss and coronal and radicular dentin drying. Materials and methods Two hundred removed human permanent mandibular first molars were allowed to be stored in isotonic saline solution for a maximum of 72 hours. The collection, storing, sterilizing, and handling of the samples were done per the Occupational Safety and Health Administration (OSHA) and Centers for Disease Control and Prevention (CDC) guidelines. Out of a total of 200 newly removed mandibular first molars, 120 teeth were finally gathered, sterilized, and kept in 1% thymol in normal saline at 30 degrees Celsius. The access cavity was prepared, and the pulp chamber was cleaned and debrided using an ultrasonic scaler tip while being irrigated with regular saline. A digital radiograph was taken after a 6# K file was placed to the working length in the mesiobuccal canal. Based on their weights, the samples were dispersed equally across the six groups (n=20). They looked inside them to ensure that the root morphology was normal and that the canal was open and free of any abnormalities, damage, or fillings. They looked at the curvature of the mesial root and chose samples with a curvature of 20-35 degrees. The mesial roots were dissected, labeled, and put in a different location. Results Overall, the experimental group's incidence of buccolingual fractures was 55%, making it the most prevalent fracture type. The mesiodistal type of fracture had a 35% incidence rate, which was the second most prevalent. We found that comminuted and transverse fractures occurred in only 15% and 5% of patients, respectively, of all fractures. Both the test and the control groups had a disproportionately high number of buccolingual fractures. When comparing the root fracture loads of the two experimental groups, there was no significant difference (p>0.05) Conclusion Within this study's restrictions and standardization techniques, it can be concluded that the single file system-prepared roots' resistance to fracture was comparable to that of the control group. It is recommended to conduct additional research on these single file systems using different metrics and to assess them in a clinical setting.

Comparative Evaluation of Extrusion of Apical Debris and Irrigant using Three Different Rotary Systems with Conventional Irrigation Methods - An In vitro Study.

Aim: The present study aimed to compare and evaluate debris and irrigant extrusion from curved root canals using different rotary systems. Materials and Methods: 30 single-rooted mandibular canines were used in this study. The crown was decoronated, working length and initial apical diameter were established. A 1.5% agar gel model was used in this study. Samples were assigned randomly into 3 groups (n = 10 teeth per group). Protaper Next, OneShape, and Hanudent files were used according to the manufacturers' instructions for canal instrumentation. Apically extruded debris and irrigant was were computed by deducting the initial weight of the test apparatus without a tooth from its weight after the biomechanical preparation. Comparative analysis of the amount of apically extruded debris and irrigant for each of the instruments and the experimental models was performed. Results: The statistically significant difference was found between the three experimental groups. (P < .05). Among all the groups least extrusion was observed in the Protaper Next group when used in combination with conventional irrigation. Conclusion: All the instruments produced apically extruded debris and irrigant, but the maximum was seen with OneShape among the experimental groups.

Teledentistry: Evaluation of Instagram posts related to bruxism.

BACKGROUND: Instagram statistic has attracted roughly one billion, monthly active users. In 2021, Instagram belonged to the most popular social networks worldwide. It has been considered an effective tool that contributes to the contemporary sharing of information for raising public awareness while providing educational information. The growing presence of Instagram and frequent user engagement has made it a potentially effective platform for patient communication, seeking educational information, product information for consumers, and advertisements in the form of images and videos. OBJECTIVE: To assess and compare the contents of Instagram posts by healthcare professionals (HP) and non-professional healthcare workers (NPHW) on bruxism and to assess public engagement with this content. METHODS: Twelve "hashtag" terms linked to bruxism were searched. HP and NPHW analyzed the content of relevant posts for the presence of domains. Discourse analysis assessed the post quality for themes. We conducted the descriptive and univariate statistical analysis, whereas inter-rater reliability was tested using Cohen's kappa. RESULTS: A total of 1184 posts were retrieved, with the majority uploaded by NPHW (622 posts). The posts by HPs were in text and image(s) format (53%) with the range of 25-1100 Instagram post "Likes." "Mouthguard" (90) % was the most frequently included domain posted by HP, followed by "treatment plan/pain management", and complaints of clicking or locking of TMJ" (84%). Greater number of domains (p= 0.03) were seen in the posts by NPHWs, compared to HP's having more bruxism-related content. The inter-rater reliability method (0.89) was used for the presence of domains. CONCLUSION: NPHW uses Instagram more frequently to post bruxism-related information than HP. HPs must ascertain that the content posted by NPHW is relevant and the concerns addressed in posts are to the purpose.

Chronic inflammation on gingiva-derived mesenchymal stem cells.

The impact of inflammatory response on the biological characteristics of GMSCs has been the subject of studies, with conflicting findings. In order to more fully understand the effects of the localized inflammatory environment, the current study assessed the intensity and differentiating capacity of GMSCs derived from healthy periodontal tissues (H-GMSC) and GMSC derived from inflamed periodontal tissues (I-GMSC) tissues. Cells from every well were taken out and counted using a hemocytometer every three days for a total of 12 days. The findings of the cell proliferation assay, which involved quantifying the cells with the help of a hemocytometer at 0th day, 3rd day, 6th day, and 9th day, are shown. On day nine of culture, there was a considerable (P = 0.02) variation in the rate of multiplication between GMSCs from healthy gingival tissues and GMSCs from gingival tissues having inflammation. Additionally, I-GMSCs had a higher cell concentration on day twelve than that of H-GMSCs. However, there was no significant variance in PDT values comparing GMSCs from healthy gingival tissues and GMSCs from gingival tissues having inflammation (P > 0.05). The mean PDT findings of 66.7 h and 53.4 h have been documented for Healthy-GMSCs and Inflamed-GMSCs, respectively. In addition, compared to GMSCs from healthy gingival tissues, GMSCs from inflammatory tissues had decreased osteogenesis and increased adipogenic potential. To evaluate the efficacy of GMSCs derived from patients suffering periodontitis utilising human models for cell-based treatments, additional study is necessary.

Evaluation of obturation techniques in primary teeth among Indians.

Evaluation of four distinct obturating methods namely endodontic pressure syringe (n=40), reamers (n=40), Lentulo spirals driven through slow-speed handpiece (n=40) and incremental filling technique (n=4) using zinc oxide eugenol (ZOE) paste as obturating material in deciduous teeth is of interest to dentist. Hence, we are interested determining the effective obturation methodology using CBCT. Handpiece driven lentuspirals helped in optimum obturation in high percentage of root canals. Low percentage of optimally filled root canals was observed in reamers technique. Moreover, under filled root canals was low in lentuspirals technique of obturation. Thus, overfilled root canals were high in endodontic pressure syringe and reamers obturation technique.

Manual and Powered Toothbrushing Effectiveness on Autistic Children's Oral Hygiene Status.

Background: Autistic children want a lot of help cleaning their teeth and they have a higher risk of periodontal disorder and less caries than the general public. The study's purpose is to see how helpful manual and powered toothbrushing are for autistic kids aged 6-12 years. Materials and Methods: A total of 40 autistic children aged 6-12 years were chosen at random from Mangalore city schools. The simplified oral hygiene index was used to determine the baseline oral health (OHI-S). Children were split into two classes during an oral review. Children in Group 1 received a manual toothbrush, and those in Group 2 received a powered toothbrush. Many of the children were given Colgate fluoride-free toothpaste. Under the guidance of care professionals, children were taught to brush for 3 min. They were taught to count from 1 to 20 when brushing each buccal and lingual section. The index was rechecked at the conclusion of the 1st month (30th day) and the next month (3rd month) (90th day). On the 60th day, the recently learned techniques were reinforced (end of the 2nd month). Result: In Group 1, a statistically significant reduction in mean OHI-S scores was observed in baseline versus 30 days and baseline versus 90 days, while in Group 2, a statistically highly significant reduction in baseline versus 30 days, baseline versus 90 days, and 30 days versus 90 days was observed. Conclusion: Furthermore, in autism children, powered teeth brushing shows potential. Long-term follow-up and greater sample size are, however, needed.

Efficacy of Ozone to Eliminate Endopathogenic Microorganism in Rootcanal Biofilm.

Objective: The researchers wanted to see whether ozonated water with ultrasonication and sodium hypochlorite can destroy Enterococcus faecalis bacteria in root canals. Materials and Methods: A total of 40 single-rooted human teeth were used. A total of 100 roots were harvested and mechanically prepared. The root canals were randomly divided into four classes (n = 10) after being infected with E. faecalis for 24 h. Each sample's MTT value was calculated. Conclusions: NaOCl and aqueous ozone provide antibacterial effects in in-vitro conditions in root canals.

Diode Laser Approach for Excision of Solitary Mucocele.

Oral mucoceles or mucoceles are communal minor salivary gland lesions, and they are clinically categorized by the presence of single or multiple, spherical-shaped fluctuant nodules which are asymptomatic and pain free. Application of diode laser for removal of mucosal lesions in the oral cavity is relatively new and viably better alternative to its precedent methods. The added advantage of using a laser includes lesser bleeding, improved or reduced healing time, and its affinity to melatonin that prevents further or recurrent pigmentation.

Evaluation of Class II Restoration Microleakage with Various Restorative Materials: A Comparative In vitro Study.

BACKGROUND AND OBJECTIVES: The quest for a suitable esthetic material for tooth restoration has resulted in significant advancements in both material properties and application technique. Composites and acid-etch procedures are two significant advancements in esthetic restorative dentistry. Further research has strengthened composites' overall wear resistance and strength, but the problem of polymerization shrinkage has persisted. To reduce polymerization shrinkage and microleakage, a variety of techniques and material modifications have been suggested. The marginal leakage of amalgam, packable composite, flowable composite with packable composite, and high-viscosity traditional glass ionomer cement (GIC) was compared in this analysis to test the mentioned hypothesis. MATERIALS AND METHODS: We chose 60 freshly extracted teeth and divided them into four classes of 15 teeth each. Class II cavities were prepared in a standardized manner. Group I was treated with amalgam, Group II with packable composite (GC G-aenial Posterior), Group III with flowable composite (G-aenial Universal Flo) as a liner and then restored with packable composite (GC G-aenial Posterior), and Group IV with high-viscosity traditional GIC (EQUI FORTE FILL). After that, the restorations were put through a thermocycling process. The specimens were soaked in 0.5% methylene blue dye before being cut into mesiodistal sections to assess microleakage at the gingival margin. After that, the parts were examined under a stereomicroscope. The degree of dye penetration was used to determine the score. RESULTS: There was no microleakage in the control group, and the gap between the control and experimental groups was statistically significant (P = 0.017). CONCLUSION: The glass hybrid restorative device had less gingival microleakage than the resin-based restorative material, indicating that it has a better sealing capacity. Clinical acceptability of glass hybrid restorative systems, on the other hand, must be confirmed with a larger sample size and in vivo trials.

Glucose and Serum Deprivation Led to Altered Proliferation, Differentiation Potential and AMPK Activation in Stem Cells from Human Deciduous Tooth.

Stem cell therapy is an evolving treatment strategy in regenerative medicine. Recent studies report stem cells from human exfoliated deciduous teeth could complement the traditional mesenchymal stem cell sources. Stem cells from human exfoliated deciduous teeth exhibit mesenchymal characteristics with multilineage differentiation potential. Mesenchymal stem cells are widely investigated for cell therapy and disease modeling. Although many research are being conducted to address the challenges of mesenchymal stem cell therapy in clinics, most of the studies are still in infancy. Host cell microenvironment is one of the major factors affecting the homing of transplanted stem cell and understanding the factors affecting the fate of stem cells of prime important. In this study we aimed to understand the effects of serum deprivation in stem cells derived from human deciduous tooth. Our study aimed to understand the morphological, transcriptional, cell cycle and stemness based changes of stem cells in nutrient deprived medium. Our results suggest that stem cells in nutrient deprived media undergo low proliferation, high apoptosis and changed the differentiation potential of the stem cells. Serum deprived mesenchymal stem cells exhibited enhanced chondrogenic differentiation potential and reduced osteogenic differentiation potential. Moreover, the activation of key metabolic sensor AMP-activated kinase (AMPK) leads to activation of transcription factors such as FOXO3, which leads to an S phase quiescence. Serum deprivation also enhanced the expression of stemness related genes Sox2 and c-Myc.

Effectiveness of licorice in preventing dental caries in children: A systematic review.

BACKGROUND: Dental caries is one of the most prevailing oral health diseases in children. Recent times have focused on herbal products, because they have minimum or no side effects and are effective in prevention. Licorice is one such product belonging to Glycyrrhiza family used in the form of dentifrice, chewing gums, lollipop, gels, etc., Literature reports about the activity of licorice root extract on the biofilm thereby reducing Streptococcus mutans (SM) count and preventing dental caries in children. OBJECTIVES: The objective is to assess the effectiveness of licorice in reducing SM count and preventing dental caries in children. METHODOLOGY: PubMed and Google scholar were searched with search strategies for studies reporting licorice as intervention in children among 3-15 years for preventing dental caries. Only those studies with study design of randomized controlled trials, clinical trials, and comparative studies published between January 1, 2000, and October 31, 2019 were included. Cross references and hand searching for the relevant articles were also conducted. RESULTS: A preliminary search yielded a total of 31 studies through PubMed and Google scholar. From 31 studies, nine studies were excluded based on the screening through titles. From the remaining 22 articles, six duplicates, four without parameters, six as reviews and case reports and were excluded. Finally, six articles giving ten estimates were included for qualitative synthesis. CONCLUSION: Licorice extracts proves to be effective as an antimicrobial agent by reducing the count of SM in children. Its action on biofilm limits the fall of pH thereby preventing acidic environment that increases the risk of dental caries. Moreover, licorice in lollipop form is well accepted by children.