Methodological quality of umbrella reviews in endodontics: A cross-sectional study.

INTRODUCTION: In endodontics, the number of umbrella reviews has increased significantly over the last few years, but there is no evidence that they were methodologically sound. The aim of the current study was to appraise the methodological quality of umbrella reviews in endodontics, and to identify possible predictive factors associated with methodological quality. METHODS: Umbrella reviews published in the discipline of endodontics until December 2023 were included. The methodological quality of the reviews was evaluated using a checklist consisting of 11 items. Each item in the checklist was evaluated by two independent assessors who assigned a score of '1' if it was fully addressed, '0.5' if it was partially ddressed, and '0' if it was not addressed. Bootstrapped multiple linear regression analysis was used to examine the association between the total scores awarded and five predictor variables (a priori protocol registration, year of publication, number of authors, journal impact factor (IF) and continent of the corresponding author). The statistical significance level was set as 5%. RESULTS: A total of 27 reviews were included. Ninety-six per cent of the reviews adequately reported: eligibility criteria for selecting the reviews, details of the reviews, techniques for assessing the risk of bias or methodological quality of the individual systematic reviews they included. Only 30% of the reviews adequately managed overlapping primary studies within individual systematic reviews. Among the five predictors analysed, a priori protocol registration and journals with IFs were associated with significantly greater total methodological quality scores. DISCUSSION: Several methodological shortcomings in the umbrella reviews published within the field of endodontics were revealed. Umbrella reviews published in journals with IFs and those with protocols registered a priori had significantly superior methodological quality scores. CONCLUSION: In endodontics, authors intending to publish umbrella reviews should consider the limitations revealed in this study and follow the appropriate rules to ensure their reviews comply with the highest standards and provide accurate and dependable information and conclusions.

Evaluation of salivary placental growth factor in Health and Periodontitis.

BACKGROUND: Various immune mediators have a role in the progression of periodontitis. Placental Growth Factor (PLGF) is important during pregnancy and also is involved in the pathology of several diseases. Hence, this study aimed to evaluate salivary PLGF in health and periodontitis that seemingly has not been reported earlier. METHODS: Fifty participants were grouped as healthy and periodontitis patients. Clinical history, periodontal parameters [Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BoP)] were recorded; saliva was collected and PLGF was estimated using a commercially available ELISA kit. The data were statistically analyzed using Shapiro-Wilk's test, Kruskal-Wallis test, Dunn's post hoc test with Bonferroni correction, and Spearman's rank-order correlation coefficient. The significance level was set at p ≤ 0.05 for all tests. RESULTS: Salivary PLGF levels comparison between the two groups showed no significant difference between both groups. Quantitatively, females had higher salivary PLGF levels than males. No significant association was observed between salivary PLGF levels and the severity of periodontitis. The periodontitis group showed statistically significant correlations between salivary PLGF levels, BoP(p = 0.005) and PPD(p = 0.005), and significant correlations of PLGF with PPD (p = 0.035) for both groups. CONCLUSIONS: PLGF can be detected and measured in the saliva of healthy individuals and periodontitis patients. However, the role of PLGF in periodontal pathology needs to be further confirmed based on their salivary levels.

Evaluation of salivary Thy-1 in health, periodontitis, and obesity.

OBJECTIVES: Thy-1 (CD90) is a glycosylphosphatidyl-anchored protein belonging to the immunoglobulin family and is known to control mesenchymal stromal cells differentiation into osteoblasts or adipocytes. The study aimed to investigate the salivary levels of Thy-1 in health, periodontitis, obesity, and any potential association. MATERIALS AND METHODS: Seventy-one participants were divided into four groups: healthy (H), subjects with periodontitis (P), obese individuals (O), and obese individuals having periodontitis (PO). Unstimulated whole saliva was collected from participants who were evaluated for periodontal parameters. The levels of Thy-1 were measured with a commercially available ELISA kit. The data were statistically analyzed. RESULTS: A significant difference in salivary Thy-1 levels among different groups was observed. Periodontitis patients had the maximum, and obese individuals had the minimum Thy-1 levels. Significant differences between H and P, H and PO, P and O, and O and PO were observed. Overall correlations between Thy-1 and periodontal parameters and a positive correlation with pocket depth in group PO were noted. CONCLUSION: Thy-1 could be detected in the saliva of all study participants. It is implied that a local inflammatory condition like periodontitis elevates the salivary levels of Thy-1 with, and without obesity.

Dysbiosis linking periodontal disease and oral squamous cell carcinoma-A brief narrative review.

An association between periodontal disease and oral squamous cell carcinoma (OSCC) has been recognized. However, there is no causal relationship between the two. The polymicrobial etiology of periodontal disease is confirmed, and so are the proven etiological factors for OSCC. Inflammation lies at the core of periodontal pathogenesis induced by the putative microbes. OSCC has inflammatory overtures in its pathobiology. Bacterial species involved in periodontal disease have been extensively documented and validated. The microbial profile in OSCC has been explored with no specific conclusions. The scientific reasoning to link a common microbial signature that connects periodontal disease to OSCC has led to many studies but has not provided conclusive evidence. Therefore, it would be beneficial to know the status of any plausible microbiota having a similarity in periodontal disease and OSCC. This brief review attempted to clarify the existence of a dysbiotic "fingerprint" that may link these two diseases. The review examined the literature with a focused objective of identifying periodontal microbial profiles in OSCC that could provide insights into pathogen commonality. The review concluded that there is great diversity in microbial association, but important bacterial species that correlate with periodontal disease and OSCC are forthcoming.

Hyaluronic acid in Dentoalveolar regeneration: Biological rationale and clinical applications.

Background: Hyaluronic acid (HA) is found in different locations in the periodontium, including mineralized tissues (i.e., cementum and alveolar bone) and non-mineralized tissues (i.e., gingiva and periodontal ligament). In addition, it seems to play an essential part in regulating the underlying mechanisms involved in tissue inflammatory reactions and wound healing. HA has the potential to regulate periodontal tissue regeneration and treat periodontal disease. Aim: The current review of the literature was conducted to assess how HA plays its part in periodontal therapy and examine the contemporary literature's viewpoint on its use in periodontal regeneration. Conclusion: HA has a multifunctional character in periodontal regeneration, and healing and appears to provide promising outcomes in different periodontal regenerative applications.

mGluR7 allosteric modulator AMN082 corrects protein synthesis and pathological phenotypes in FXS.

Fragile X syndrome (FXS) is the leading cause of inherited autism and intellectual disabilities. Aberrant protein synthesis due to the loss of fragile X messenger ribonucleoprotein (FMRP) is the major defect in FXS, leading to a plethora of cellular and behavioral abnormalities. However, no treatments are available to date. In this study, we found that activation of metabotropic glutamate receptor 7 (mGluR7) using a positive allosteric modulator named AMN082 represses protein synthesis through ERK1/2 and eIF4E signaling in an FMRP-independent manner. We further demonstrated that treatment of AMN082 leads to a reduction in neuronal excitability, which in turn ameliorates audiogenic seizure susceptibility in Fmr1 KO mice, the FXS mouse model. When evaluating the animals' behavior, we showed that treatment of AMN082 reduces repetitive behavior and improves learning and memory in Fmr1 KO mice. This study uncovers novel functions of mGluR7 and AMN082 and suggests the activation of mGluR7 as a potential therapeutic approach for treating FXS.

Drug Delivery Systems in Regenerative Medicine: An Updated Review.

Modern drug discovery methods led to evolving new agents with significant therapeutic potential. However, their properties, such as solubility and administration-related challenges, may hinder their benefits. Moreover, advances in biotechnology resulted in the development of a new generation of molecules with a short half-life that necessitates frequent administration. In this context, controlled release systems are required to enhance treatment efficacy and improve patient compliance. Innovative drug delivery systems are promising tools that protect therapeutic proteins and peptides against proteolytic degradation where controlled delivery is achievable. The present review provides an overview of different approaches used for drug delivery.

In vivo inhibition of epileptiform afterdischarges in rat hippocampus by light-activated chloride channel, stGtACR2.

AIMS: The blue light-sensitive chloride-conducting opsin, stGtACR2, provides potent optogenetic silencing of neurons. The present study investigated whether activation of stGtACR2 in granule cells of the dentate gyrus (DG) inhibits epileptic afterdischarges in a rat model. METHODS: Rats were bilaterally injected with 0.9 µl of AAV2/7-CaMKIIα-stGtACR2-fusionred in the DG. Three weeks later, afterdischarges were recorded from the DG by placing an optrode at the injection site and a stimulation electrode in the perforant path (PP). Afterdischarges were evoked every 10 min by unilateral electrical stimulation of the PP (20 Hz, 10 s). During every other afterdischarge, the DG was illuminated for 5 or 30 s, first ipsilaterally and then bilaterally to the PP stimulation. The line length metric of the afterdischarges was compared between illumination conditions. RESULTS: Ipsilateral stGtACR2 activation during afterdischarges decreased the local field potential line length only during illumination and specifically at the illuminated site but did not reduce afterdischarge duration. Bilateral illumination did not terminate the afterdischarges. CONCLUSION: Optogenetic inhibition of excitatory neurons using the blue-light sensitive chloride channel stGtACR2 reduced the amplitude of electrically induced afterdischarges in the DG at the site of illumination, but this local inhibitory effect was insufficient to reduce the duration of the afterdischarge.

Efficacy of calcium sodium phosphosilicate in managing dentinal hypersensitivity.

A large number of home use products have been tested and used for managing dentinal hypersensitivity. This eight-week clinical trial compared the temporal efficacy of a commercially available toothpaste containing calcium sodium phosphosilicate to that of a toothpaste containing potassium nitrate. For this study, 20 subjects (age 18 - 65) were screened using a visual analog scale (VAS) for sensitivity to a cold stimulus. Baseline VAS sensitivity scores to tactile stimulus were recorded for a minimum of two teeth per patient. Dentifrices were prescribed for all patients and sensitivity scores were re-evaluated at two, four, and eight weeks. Though both groups showed significant reductions in sensitivity scores, only at eight weeks was there a marginally significant difference (p = 0.0551) in sensitivity scores between the test group and the positive control group.

Periodontal disease and anemias associated with Crohn's disease. A case report.

Crohn's disease (CD) is an inflammatory bowel disease with oral findings, including periodontal manifestations. Anemias, such as iron deficiency and anemia of chronic disease (ACD), are the most common hematologic complications of CD. Periodontitis has systemic effects, and may tend toward anemia, which can be explained by depressed erythropoiesis. In the report presented here, the authors review a case of Crohn's disease diagnosed 10 years previous to the patient presenting with a changing anemic profile and periodontal disease. A discussion of patient and disease management is included.

Platelet-rich plasma. A review.

Platelet-rich plasma has been used in periodontal therapy because of its biologic characteristics in promoting wound healing and regeneration. Platelet-rich plasma, growth factors in platelet-rich plasma, their mechanism of action, probable role in wound healing, preparation of platelet-rich plasma and its activation are reviewed to provide insights into the role of this entity in wound healing and regeneration.

A short term comparative evaluation of the efficacy of diode laser with desensitizing toothpastes and mouthwashes in the treatment of dentinal hypersensitivity.

Background: Treatment of dentinal hypersensitivity (DH) has always been challenging with a wide variety of therapeutic options, in-office and home care. The study objective was to compare the clinical efficacy of diode laser [DL] with four commercially available desensitizing agents (two toothpastes and two mouthwashes) in the treatment of DH. Material and Methods: This study involved 75 participants (25-45 years) who were categorized as Group 1 (n=15) treated with DL, and Groups 2, 3,4 and 5 (n=15 in each) who were prescribed 3% potassium nitrate mouth rinse, a herbal mouth rinse, potassium nitrate tooth paste and a herbal tooth paste, respectively. DH was assessed by air blast stimulation using air blast syringe, and evaluation of DH was done based on the patient's subjective response using the Visual Analog Scale (VAS) at baseline, 1 week and 1 month. Results: DL and the desensitizing agents showed significant reduction in DH at 1 month when compared with baseline, except potassium nitrate mouth wash. However, DL showed more percentage reduction in DH when compared with potassium nitrate tooth paste, herbal mouth wash and paste. Conclusions: The study implies that even though all five groups showed improvement in terms of DH reduction, DL showed the best results among all the groups. Key words:Dentinal Hypersensitivity, Diode Laser, Potassium Nitrate, Herbal, Visual analog scale.

Photodynamic Therapy for Peri-Implant Diseases.

Peri-implant diseases are frequently presented in patients with dental implants. This category of inflammatory infections includes peri-implant mucositis and peri-implantitis that are primarily caused by the oral bacteria that colonize the implant and the supporting soft and hard tissues. Other factors also contribute to the pathogenesis of peri-implant diseases. Based on established microbial etiology, mechanical debridement has been the standard management approach for peri-implant diseases. To enhance the improvement of therapeutic outcomes, adjunctive treatment in the form of antibiotics, probiotics, lasers, etc. have been reported in the literature. Recently, the use of photodynamic therapy (PDT)/antimicrobial photodynamic therapy (aPDT) centered on the premise that a photoactive substance offers benefits in the resolution of peri-implant diseases has gained attention. Herein, the reported role of PDT in peri-implant diseases, as well as existing observations and opinions regarding PDT, are discussed.

An evaluation of platelet-rich plasma without thrombin activation with or without anorganic bone mineral in the treatment of human periodontal intrabony defects.

The efficacy of platelet-rich plasma (PRP) in periodontal regeneration is not well understood and the definite clinical viability of blood derived platelets lacks clarity. Also, the use of thrombin for platelet activation is disputed. Hence, the purpose of this study was to evaluate the efficacy of blood derived platelets without thrombin activation, alone or in combination with bovine anorganic bone mineral (ABM), in the treatment of human periodontal intrabony defects. PRP was prepared using a simple tabletop centrifuge and activated using calcium chloride without the addition of thrombin. This PRP was used alone (in Group A) and in combination with bovine ABM (in Group B) in the treatment of human periodontal angular defects. Both the control and the test groups showed definite improvement in clinical parameters. On comparison, however, there was a statistically significant improvement in the probing pocket depths and relative attachment level in Group B over Group A at 3 and 6 months intervals, whereas at the end of 9 months this difference was not statistically significant. There was no statistically significant difference between the groups with respect to the relative defect depth. Within the limitations of this study and the type of PRP used, i.e. without thrombin mediated activation, it can be concluded that both PRP and PRP combined with bovine ABM results in significant clinical improvement. Albeit statistically insignificant, there is a preponderance of better clinical results with the addition of ABM to PRP. Further studies need to be carried out on a larger sample size to confirm the results of the present study.

Attenuation of Hippocampal Evoked Potentials in vivo by Activation of GtACR2, an Optogenetic Chloride Channel.

AIM: GtACR2, a light-activated chloride channel, is an attractive tool for neural inhibition as it can shunt membrane depolarizations. In this study, we assessed the effect of activating GtACR2 on in vivo hippocampal CA1 activity evoked by Schaffer collateral (SC) stimulation. METHODS: Adult male Wistar rats were unilaterally injected with 0.5 µL of adeno associated viral vector for induction of GtACR2-mCherry (n = 10, GtACR2 group) or mCherry (n = 4, Sham group) expression in CA1 pyramidal neurons of the hippocampus. Three weeks later, evoked potentials (EPs) were recorded from the CA1 subfield placing an optrode (bipolar recording electrode attached to an optic fiber) at the injection site and a stimulation electrode targeting SCs. Effects of illumination parameters required to activate GtACR2 such as light power densities (LPDs), illumination delays, and light-pulse durations were tested on CA1 EP parameters [population spike (PS) amplitude and field excitatory postsynaptic potential (fEPSP) slope]. RESULTS: In the GtACR2 group, delivery of a 10 ms light-pulse induced a negative deflection in the local field potential which increased with increasing LPD. When combined with electrical stimulation of the SCs, light-induced activation of GtACR2 had potent inhibitory effects on CA1 EPs. An LPD of 160 mW/mm2 was sufficient to obtain maximal inhibition CA1 EPs. To quantify the duration of the inhibitory effect, a 10 ms light-pulse of 160 mW/mm2 was delivered at increasing delays before the CA1 EPs. Inhibition of EPs was found to last up to 9 ms after the cessation of the light-pulse. Increasing light-pulse durations beyond 10 ms did not result in larger inhibitory effects. CONCLUSION: Precisely timed activation of GtACR2 potently blocks evoked activity of CA1 neurons. The strength of inhibition depends on LPD, lasts up to 9 ms after a light-pulse of 10 ms, and is independent of the duration of the light-pulse given.

In vivoblue light illumination for optogenetic inhibition: effect on local temperature and excitability of the rat hippocampus.

Objective.The blue light-activated inhibitory opsin, stGtACR2, is gaining prominence as a neuromodulatory tool due its ability to shunt-inhibit neurons and is being frequently used inin vivoexperimentation. However, experiments involving stGtACR2 use longer durations of blue light pulses, which inadvertently heat up the local brain tissue and confound experimental results. Therefore, the heating effects of illumination parameters used forin vivooptogenetic inhibition must be evaluated.Approach.To assess blue light (473 nm)-induced heating of the brain, we used a computational model as well as direct temperature measurements using a fiber Bragg grating (FBG). The effects of different light power densities (LPDs) and pulse durations on evoked potentials (EP) recorded from dentate gyrus were assessed. For opsin-negative rats, LPDs between 127 and 636 mW mm-2and pulse durations between 20 and 5120 ms were tested while for stGtACR2 expressing rats, LPD of 127 mW mm-2and pulse durations between 20 and 640 ms were tested.Main results.Increasing LPDs and pulse durations logarithmically increased the peak temperature and significantly decreased the population spike (PS) amplitude and latencies of EPs. For a pulse duration of 5120 ms, the tissue temperature increased by 0.6 °C-3.4 °C. All tested LPDs decreased the PS amplitude in opsin-negative rats, but 127 mW mm-2had comparatively minimal effects and a significant effect of increasing light pulse duration was seen from 320 ms and beyond. This corresponded with an average temperature increase of 0.2 °C-1.1 °C at the recorded site. Compared to opsin-negative rats, illumination in stGtACR2-expressing rats resulted in much greater inhibition of EPs.Significance.Our study demonstrates that light-induced heating of the brain can be accurately measuredin vivousing FBG sensors. Such light-induced heating alone can affect neuronal excitability. Useful neuromodulation by the activation of stGtACR2 is still possible while minimizing thermal effects.

Hyaluronan-containing mouthwash as an adjunctive plaque-control agent.

PURPOSE: Hyaluronan, commonly known as hyaluronic acid, has been shown to have anti-inflammatory action, bacteriostatic effect and antioxidant properties, thus making its use as a long-term anti-plaque and anti-gingivitis agent an appealing proposition. The aim of the present study was to evaluate the efficacy of 0.025% hyaluronan-containing mouthwash in comparison with 0.2% chlorhexidine and a water-based mouthwash and also to evaluate its antibacterial efficacy on isolated strains of periodontopathogens. MATERIALS AND METHODS: Forty-five volunteers in a hospital setting were recruited. A single-blinded, parallel design, randomised controlled trial was carried out and the 4-day plaque re-growth model was used to study the efficacy of the three mouthwashes. Microbiological and clinical evaluation was performed by culturing and using dental indices, respectively. The three mouthwashes used in the present study were commercially available 0.025% sodium hyaluronate, 0.2% chlorhexidine and a water-based rinse (negative control). Effects of the three mouthwashes were tested on the growth of isolated strains of Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa) and Prevotella intermedia (Pi). RESULTS: In vitro, hyaluronan had a distinct effect on the growth of Aa and Pi with no effect on the growth of Pg. In vivo, the differences between the individual rinse solutions and the water-based solution showed significantly less plaque regrowth with respect to both chlorhexidine (P = 0.033) and hyaluronan (P = 0.045) when compared to the negative control. The difference between chlorhexidine and hyaluronan was not statistically significant (P = 0.69). CONCLUSIONS: Hyaluronan (0.025%)-containing mouthwash was comparable to chlorhexidine (0.2%) in inhibiting plaque growth in vivo, and it significantly reduced the growth of Aa and Pi in vitro

Awareness and knowledge regarding maternal periodontal status and associated pregnancy outcomes among the gynecologists of Hubli-Dharwad.

INTRODUCTION: Periodontitis is an inflammatory disease of gingiva and its supporting structures and is known to cause systemic infection which has adverse effect on pregnancy outcomes, such as preterm birth, preeclampsia, or miscarriage, which have been linked to maternal periodontitis. AIM: Thus, this study aimed to evaluate the knowledge and awareness regarding the association of periodontitis and adverse pregnancy outcomes among the gynecologists practicing in Hubli-Dharwad city. MATERIALS AND METHODS: The study involved a survey for 50 practicing gynecologists in Hubli-Dharwad city, a pretested close-ended questionnaire was distributed comprising 10 questions on oral health for expectant mothers, and thus, their knowledge and awareness levels were assessed. RESULTS: The results showed that majority of gynecologists agreed importance of maintaining good general health during pregnancy and supported that providing dental treatment during pregnancy improved the pregnancy outcomes. CONCLUSION: However, practical implementation and referring patients to dentists were less. The gynecologists were aware of the facts but failed to execute at the clinical level. Thus, this bilateral interdisciplinary protocol can thus reduce the incidence of maternal and neonatal complications.

Serum sTWEAK levels in chronic periodontitis and type 2 diabetes mellitus.

AIM: The two-way relationship between diabetes mellitus and periodontitis has been extensively studied with various interconnected biomarkers sharing a link. Soluble Tumour Necrosis Factor-like Weak inducer of apoptosis (sTWEAK) is gaining attention as an important mediator in chronic inflammatory diseases. Thus, the aim of this study was to detect, estimate and compare the levels of sTWEAK in the serum of health, chronic periodontitis (CP), and CP with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Forty-five participants between 18 and 65 years were divided into groups of 15 each as Group 1: healthy, Group 2: CP, and Group 3: CP + T2DM. Clinical periodontal parameters and glycemic status were assessed. sTWEAK in serum was estimated using a commercially available ELISA kit. The data was statistically analyzed. RESULTS: sTWEAK was detected in all participants. Significant differences were observed between the groups for sTWEAK; highest in health, lower in CP and lowest in CP + T2DM. In the diseased groups, the clinical and glycemic parameters correlated positively with each other, whereas sTWEAK correlated negatively with each of the parameters. CONCLUSION: The literature reports lower concentrations of systemic sTWEAK in T2DM which may be comparable to our observations in CP + T2DM when compared to health and its negative correlation with all the parameters suggesting an association with both clinical periodontal parameters and glycemic levels. However, serum sTWEAK levels may not be necessarily elevated in periodontitis as previously reported, and hence has the potential to be studied extensively for clarification with its association with T2DM.