Effect of lateral extent of pulp tissue removal on the outcome of partial pulpotomy for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis: A randomized clinical trial.

AIM: The aim of this study is to compare the outcomes of restricted partial pulpotomy (R-PP) versus extended partial pulpotomy (E-PP) for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis (SIP). METHODOLOGY: This double-arm, parallel designed randomized clinical trial was registered at clinicaltrials.gov (registration number: NCT05406557). Following random allocation, 43 participants of each group received the designated intervention. In the R-PP group, 2-3 mm of superficial pulp tissue was removed only from the exposure site, while chamber was completely de-roofed and 2-3 mm of superficial pulp tissue from entire chamber was removed in the E-PP group. Haemostasis was achieved using 3% sodium hypochlorite-soaked cotton pellets. Upon haemostasis, ProRoot mineral trioxide aggregate (ProRoot MTA) was placed over the pulpal wound, overlaid with a resin-modified glass ionomer liner, and restored with composite resin in the same visit. Outcome measures included clinical and radiographic success evaluation at 6 and 12 months, and pain assessment using the visual analogue scale pre-operatively and daily for 7 post-operative days. Nonparametric tests were used for variables including patient's age, pain intensities, mean analgesic consumption, and haemostasis time. Categorical variables including gender, caries type, analgesic intake, hard tissue barrier formation, clinical and radiographic success, and pulp sensibility responses were assessed using Chi-square or Fisher's exact test. Tooth survival was analysed using Kaplan-Meier analysis. RESULTS: A total of 81 cases were analysed at 12 months follow-up. Comparable success was observed in both groups (97.6% in E-PP & 97.5% in R-PP; p > .05). The R-PP group reported significantly lower pain scores on the 1st and 2nd post-operative days than E-PP (p < .05) and required significantly less analgesic intake (p < .05). Hard tissue barrier formation was significantly lower in the R-PP group (p < .05). No significant differences were observed between groups regarding haemostasis time, pulp sensibility responses, and tooth survival (p > .05). CONCLUSIONS: Both the PP approaches exhibited comparable success for managing cariously exposed mature permanent molars with SIP. Given the conservative nature of R-PP, it may be used as preferred PP approach for managing such cases. Being the first study of this kind, further work is necessary to draw definitive conclusions.

Pain following foraminal enlargement in mandibular molars with necrosis and apical periodontitis: A randomized controlled trial.

AIM: This randomized controlled trial was conducted to evaluate the effect of foraminal enlargement during chemomechanical root canal preparation on postoperative pain. METHODOLOGY: Seventy mandibular first molars with asymptomatic pulp necrosis and chronic apical periodontitis were randomized into two groups - foraminal enlargement (FE) and conventional nonforaminal enlargement (NFE). Canals were prepared according to the respective protocols, and the teeth were restored temporarily. Postoperatively, the patients were prescribed ibuprofen 400 mg, to be taken if required. Pain experience and analgesic intake were recorded for 7 days following chemomechanical preparation. The data were analysed using Mann-Whitney U-test and chi-square tests. RESULTS: Pain experience was higher with foraminal enlargement than when using a conventional technique. A significant difference was observed in postoperative pain during the first 4 days and the sixth day (P < 0.05), with greater pain in the FE as compared to the NFE group. There was no significant difference in prevalence of analgesic intake and number of doses between the experimental groups (P > 0.05). CONCLUSION: Enlargement of the apical foramen during root canal treatment increased the incidence and intensity of postoperative pain.

Nutritional composition of ginger powder prepared using various drying methods.

A study was undertaken to prepare ginger powder using various drying methods and their nutritional evaluation was carried out. Ginger (Zingiber officinale) was dried using shade, solar, oven and microwave drying methods. All the samples were ground in grinder to make fine powder. Sensory analysis indicated that acceptability of all types of ginger powders were in the range of 'liked very much' to 'liked moderately' by the panelists. The mean score obtained for colour was higher in shade dried ginger powder i.e., 8.20 as compared to oven dried (7.60), solar dried (7.70) and microwave dried ginger powder (7.80). Moisture content ranged from 3.55 % in solar dried ginger powder to 3.78 % in shade dried ginger powder. Slightly higher moisture content was found in shade dried ginger powder. Protein, crude fiber, fat and ash contents ranged from 5.02 to 5.82, 4.97 to 5.61, 0.76 to 0.90 and 3.38 to 3.66 %, respectively. ß-carotene and ascorbic acid content was found maximum in shade dried ginger powder i.e., 0.81 mg/100 g and 3.83 mg/100 g, respectively. Polyphenol content was almost similar in all the samples whereas calcium was slightly higher in the shade dried ginger powder i.e., 69.21 mg/100 g. Results have shown that ginger powder prepared from various drying methods had good sensory and nutritional profile.

Tertiary dentinogenesis with calcium hydroxide: a review of proposed mechanisms.

Calcium hydroxide has been used extensively in dentistry for a century. Despite its widespread use as a pulp-capping agent, its mechanisms of action still remain ambiguous. Understanding its modes of action will lead to a broader understanding of the mechanisms associated with induced dentinogenesis and help in optimizing the currently available agents to target specific regenerative processes to obtain the best possible clinical outcomes. A literature search relating to mechanisms of dentinogenesis of calcium hydroxide up to December 2011 was carried out using pubmed and MEDLINE database searches as well as manual searching of cross-references from identified studies. Resulting suggestions regarding dentinogenic mechanisms of calcium hydroxide range from direct irritating action of the material to induction of release of biologically active molecules. The purpose of this article is to discuss various mechanisms through which calcium hydroxide may induce tertiary dentinogenesis in the light of observations made in included studies.

Infectivity rate and transmission potential of Hyalomma anatolicum anatolicum ticks for Babesia equi infection.

The infectivity rate of Babesia equi in the salivary glands of Hyalomma anatolicum anatolicum was assessed. The hungry nymphs were fed on a donkey experimentally infected with B. equi. The engorged dropped-off nymphs were collected at different levels of parasitaemia and kept in BOD incubator. After ecdysis, the hungry adults were prefed on rabbits for different time intervals, thereafter the salivary glands were dissected out and acini were examined after methyl green pyronin (MGP) staining. A total of 134 male and 139 female ticks were dissected out. Average infected acini per tick were found to be significantly higher (p<0.05) in male as compared to the female ticks. Further, maximum infected acini in both male and female ticks were found at 24h of prefeeding on rabbits and overall infected acini per tick increased with rise in parasitaemia. The release of infected ticks on susceptible donkeys resulted in development of clinical babesiosis.

Isolates of Theileria annulata collected from different parts of India show phenotypic and genetic diversity.

Phenotypic and genetic polymorphism was studied amongst four Theileria annulata isolates collected from three different parts of India. Amongst various markers studied for the comparison of growth characteristics of schizont cell lines established from these isolates, viability, non-viability counts and nitric oxide (NO) production showed significant variation. A negative correlation was observed between NO production and mRNA expression for TNF-alpha, a potent proinflammatory cytokine related to the pathogenesis of the disease. Phenotypic polymorphism was also revealed by T. annulata schizont-specific monoclonal antibodies (Mabs), viz. 1C7, 1E11, 2G2 and EU-106, which recognized variable number of cells in indirect fluorescent antibody and indirect immunoperoxidase tests, when tested against the four T. annulata isolates collected from India. Genetic polymorphism was recognized amongst the four isolates by restriction digestion analysis of Tams-1 gene PCR products. These observations revealed that the four isolates of T. annulata are different from each other and might be expressing different antigenic determinants on their cell surface.

Spatial analysis and identification of environmental risk factors affecting the distribution of Indoplanorbis and Lymnaea species in semi-arid and irrigated areas of Haryana, India.

Fasciolosis, amphistomosis and schistosomosis, transmitted by the freshwater snail species Indoplanorbis and Lymnaea, are important snail-borne diseases in India as they affect the entire spectrum of domestic animals causing substantial mortality and economic loss. Identifying any heterogeneity in the spatial distribution of these snail-borne diseases will allow for targeted disease control and efficient use of resources. The objectives of this study were threefold: (i) to describe and explore the spatial distribution of Indoplanorbis and Lymnaea in Rohtak and Jhajjar districts of Haryana, India (ii) to identify factors associated with occurrence of these freshwater snail species and (iii) to produce a map showing the predicted risk of occurrence of Lymnaea and Indoplanorbis spp. in the study area. Snails were collected from water bodies of 99 settlements out of a total of 453 in the study area. Kernel smoothing was used to generate a kernel ratio map while Kulldorff's spatial scan statistic was used to detect clusters of settlements with a high/low risk. Multivariable logistic regression showed that snails were almost ten times more likely to be present in rice-growing areas than in those not growing rice (OR 9.24) and that snails were less likely to be present with each 1 km increase in distance from a canal (OR 0.86). The regression model was used to produce a map illustrating the predicted risk of snail occurrence. Since the distribution of vector snails mirrors the distribution of snail-borne parasitic diseases, such spatial analysis helps to determine the relative risk of snail-infestation as well as snail-borne diseases' distribution and planning of control activities.

Relative role of male and female Hyalomma anatolicum anatolicum ticks in Theileria transmission.

The relative role of male and female Hyalomma anatolicum anatolicum ticks in the epidemiology of Theileria transmission was studied by detecting Theileria sporozoites in the dissected salivary glands of 568 ticks by the methyl green pyronin staining method. Detailed frequency distribution of Theileria-positive acini in the salivary glands of the 264 (46.48%) positive ticks from a field collection in Haryana indicated that the number of infected salivary acini per positive tick was greater in females than in males. This suggests that female ticks have a more important role in Theileria transmission than male ticks. This finding assumes greater significance in the light of the observation that the natural male:female ratio is also in favour of female ticks.

K.s. Micro-implant placement guide.

A one of the greatest concerns with orthodontic mini-implants is risk of injury to dental roots during placement is, especially when they are inserted between teeth. Many techniques have been used to facilitate safe placement of interradicular miniscrews. Brass Wires or metallic markers are easy to place in the interproximal spaces, but because their relative positions may be inconsistent in different radio -graphic views, they are not always accurate. K.S. micro implant placement guide suggested in this article is simple design and easy in fabrication, required minimal equipment for fabrication and does not disturb the existing appliance system, clearly located in the radiograph and the mini-screw can be easily inserted through the guide reducing the chance of implant misplacement.

Theileria infectivity of Hyalomma ticks in Haryana, India.

Theileria infection of Hyalomma ticks collected from three districts of Haryana was assessed in whole salivary glands by the methyl-green pyronin staining method. Of 1,662 ticks screened, 546 (32.8%) were found Theileria positive. Infection rate in 935 female ticks (36.9%) was more than that of 727 male ticks (27.6%). Density of Theileria infection (number of infected acini per infected tick) was also higher in female ticks. Theileria infection rate of ticks varied greatly in the three districts viz. only 12.0% in Rohtak, 25.8% in Hisar and 48.3% in Karnal. Per cent infection rate was high (63.7%) in ticks from indigenous cattle and low (18.6%) in those collected from buffaloes. However, the intensity of infection in infected ticks from cross-bred cattle was comparatively much higher. Frequency distribution of Theileria positive acini in infected ticks revealed a low density of infection per infected tick. This points to the largely stable endemic situation prevailing in Haryana. Only a single salivary acinus was found infected in 16.6% of the infected ticks, about 70% had up to 10 infected acini while only about 10% had over 25 infected acini per tick. The masses in acini presumed to be Theileria were confirmed by demonstrating parasitic masses on staining one of a pair of salivary glands and inoculating the suspension of the other half of the gland into two cross-bred cow calves which developed clinical signs and lesions typical of theileriosis.

Immunization of cattle with nymphal Hyalomma anatolicum anatolicum extracts: effects on tick biology.

Antigens derived from partially engorged nymphs of Hyalomma anatolicum anatolicum were used in immunizing crossbred (Bos indicus x Bos taurus) cattle against larval, nymphal and adult H. a. anatolicum and H. dromedarii. The cattle were either infected with Theileria annulata at low parasitaemia or were uninfected. Whole nymphal extract (WNE), nymphal membrane antigens (NMA) and nymphal soluble antigens (NSA) were used for immunization. The group immunized with WNE showed significant and better rejection of H. a. anatolicum ticks as compared to calves immunized with either NMA or NSA. The moulting rates of both engorged larvae and nymphs remained unaffected. Nymphs which engorged on the immunized calves were fully susceptible to infection by T. annulata as indicated by the intensity and abundance of Theileria infections in the resulting adult ticks from immunized and unimmunized Theileria infected cattle. These ticks also transmitted fatal theileriosis to susceptible calves.

Folacin and cyanocobalamin in relation to natural Trypanosoma evansi infection in buffaloes.

The haematological values of haemoglobin (Hb), packed cell volume (PCV) and vitamin levels of folacin (folic acid), cyanocobalamin (vitamin B12) of buffaloes, in a surra endemic area of Eastern Haryana, India, were determined. Surra-positive buffaloes had significantly low levels of Hb, PCV, folic acid and vitamin B12. These low levels of folic acid and vitamin B12 may have enhanced the clinical signs of chronic trypanosomiasis, caused by Trypanosoma evansi.

Seasonal distribution of Theileria in Hyalomma anatolicum anatolicum ticks of an endemic area of Haryana, India.

The effect of season on the capacity of Hyalomma anatolicum anatolicum ticks to transmit Theileria was studied by detecting Theileria sporoblasts in the salivary glands of 647 adult ticks moulted in winter (November 1990 to March 1991) and 677 adult ticks moulted in the summer-rainy season (June to August 1991). The intensity (number of infected acini per infected tick) and abundance (number of infected acini per tick examined) of Theileria sporoblasts were significantly (P < 0.05) higher in winter moulted ticks (10.75 and 2.23 respectively) than the summer-rainy season moulted ticks (7.31 and 1.77 respectively). The prevalence of infected moulted ticks was not significantly higher in the summer-rainy season (24.22%) than in the winter (20.71%). A higher percentage of winter moulted ticks had high numbers of infected acini (> or = 11/infected tick) than the summer-rainy season moulted ticks, while the trend was reversed for low numbers of infected acini(5/infected tick), being 47.76% for winter and 73.78% for the summer-rainy season. It was concluded that the winter of Haryana is more favourable to the developing theilerial stages in the ticks than the summer-rainy season.