ASSOCIATION OF PULP CALCIFICATIONS AND CARDIOVASCULAR DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS.

INTRODUCTION: This systematic review and meta-analysis was performed to evaluate the association between pulp calcifications (PC) and cardiovascular disease (CVD). METHOD: Five databases (PubMed, Scopus, Embase, Web of Science and ProQuest) were searched to identify articles. Quality assessment of the selected articles was done using Joanna Briggs Institute critical appraisal tool and the inter-examiner agreement was calculated using the Cohen-Kappa test. The random-effects maximum likelihood model was used to evaluate the association between the conditions. Trim-and-fill funnel plot was used to evaluate the presence of publication bias. The level of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS: A total of 2487 articles were identified from the initial search. Ten articles were included in this review of which 7 were cross-sectional and 3 were case-control studies. Eight articles had a low risk of bias (RoB), one article each had a moderate and high RoB. Inter-examiner reliability score was 0.8592. Seven articles reported a statistically significant positive association between CVD patients and PC. Two articles reported a non-significant positive association and one article reported no association between the same. A significant difference was observed in favor of CVD patients to possess more PC in comparison to non-CVD patients with an OR of 4.30 (95% confidence interval (CI): 2.19, 8.46; p = .000). Asymmetry in the Trim-and-fill funnel Plot suggested the presence of publication bias. GRADE analysis demonstrated low certainty of the evidence for the overall sample. CONCLUSION: There exists a low level of evidence to show that CVD patients are more prone to have PC in comparison to non-CVD patients.

Comparative evaluation of the antimicrobial efficacy of nanoparticle-mediated photodynamic therapy versus photodynamic therapy and conventional disinfection in endodontics: A systematic review and meta-analysis.

Introduction: The aim of this systematic review was to assess the antimicrobial activity of nanoparticle-mediated photodynamic therapy (N-PDT) on Enterococcus faecalis biofilms in the presence of dentin substrate when compared to photodynamic therapy (PDT) and conventional disinfection protocols. Materials and Methods: This systematic review was registered in Open Science Framework (10.17605/OSF.IO/GBR3F). Six databases, namely PubMed, Embase, Web of Science, Scopus, Medline, and Google Scholar, were searched for English language articles until June 2022. Laboratory studies assessing the antimicrobial activity of N-PDT against E. faecalis biofilm in human or bovine teeth were included. The risk of bias (RoB) was evaluated using the Joanna Briggs Institute tool for quasi-experimental studies. Meta-analysis was performed using the random-effects maximum likelihood model. Results: The search revealed 2804 articles, out of which 9 studies were included in the final review. Seven articles had low RoB and two had moderate RoB. Chitosan and diode laser at 810 nm were the most commonly used nanoparticle and light source, respectively. The meta-analysis of bacterial reduction log and percentage reduction revealed that N-PDT had better antimicrobial efficacy than the control group. When the bacterial reduction log of N-PDT was compared with PDT, PDT performed better N-PDT, and for percentage reduction, there was no difference. Conclusion: The currently available evidence is low and inconclusive with regard to the superior efficacy of N-PDT. The type of nanoparticle, incubation time, light source, and exposure time were found to be covariates that influence the antimicrobial efficacy of N-PDT.

Mandibular second molar exhibiting a unique "Y-" and "J-" "shaped" root canal anatomy diagnosed using cone-beam computed tomographic scanning: A case report.

This article aims to report a unique case with aberrant root canal anatomy exhibiting "Y-" and "J"-shaped canal pattern in a mandibular second molar. Anatomic complexities may pose challenges for endodontic treatment. Before performing endodontic treatment, the clinician should be aware of the internal anatomy of the tooth being treated and should recognize anatomic aberrations if present. Presence of unusual anatomy may call for modifications in treatment planning. This report describes in detail about a mandibular second molar tooth associated with two paramolar tubercles having a peculiar "Y-" and "J-"shaped canal anatomy detected with the aid of cone beam computed tomography, which has never been reported in the dental literature. The proposed treatment protocol for the endodontic management of the same has also been discussed.