Mines of cytokine: A treasure trove in pulpal and periapical diseases.

Pulpitis is a special disease of dental pulp. It causes localized inflammation, due to various inflammatory mediators such as cytokines and chemokines. These inflammatory mediators are responsible for various reparative and resorptive processes in the dental pulp. The balance between these processes ultimately determines the viability of the tooth. Due to the important properties of various inflammatory markers, the correlation of cytokinin gene expression in various stages of inflammation becomes necessary to focus on. Several studies in the past have focused on the importance of such correlation to help in diagnostic applications. The nature of these inflammatory mediators can help us in diagnostic evaluation. Several attempts have been made to focus on these associations so that it can assist in making clinical decisions effectively. The data available are vast but are the most neglected topic. This review article briefly outlines and summarizes the importance of various inflammatory mediators such as cytokinin and chemokines in various pathways of pulpal and periapical inflammation in explanatory and diagrammatic forms. Knowledge gained about pulpal inflammatory response may aid in understanding the molecular level of inflammatory pulpal and periapical diseases, which shall modify our future diagnostic modalities. Several medicaments are used in the treatment of minimal to advanced dental caries which leads to periapical infections. Thorough understanding of these medicaments can resolve secondary infection and can improve the prognosis of the treated tooth.

Single visit rehabilitation of 12-day neonate with cleft palate using modified feeding spoon impression technique: A case report.

The rehabilitation of the cleft requires a multidisciplinary approach involving a pediatrician, surgeon, otolaryngologist, speech therapist, orthodontist, prosthodontist, and psychologist. The present case report illustrates the rehabilitation of a 12-day-old neonate with a cleft palate. Since the palatal arch of the neonate was very small, a feeding spoon was innovatively modified to obtain the impression. The obturator was fabricated on the same day and delivered in one appointment.

Comparative evaluation of antimicrobial efficacy of calcium hydroxide, triple antibiotic paste and bromelain against Enterococcus faecalis: An In Vitro study.

Context: Considering the effectiveness and safety concerns of synthetic intracanal medicaments (ICM), alternative usage of herbal ingredients in the root canal treatment may prove to be beneficial. Hence, the naturally available potent proteolytic, anti-inflammatory, and antimicrobial pineapple extract Bromelain as an ICMs needs to be studied. Aim: The aim of this study is to evaluate and compare the antimicrobial efficacy of calcium hydroxide (CaOH) and triple antibiotic paste (TAP) with Bromelain against Enterococcus faecalis bacteria using the turbidity method. Materials and Methods: Forty-four freshly extracted single-rooted teeth were collected and 6 mm sections were prepared. These samples were infected with E. faecalis bacteria (ATCC 29212), randomly divided into four groups. Negative control, CaOH paste, TAP, and Bromelain paste. After the removal of medicament, the optical density (OD) of the dentinal shavings was measured using a spectrophotometer. Statistical Analysis: The Chi-square and Kruskal - Wallis ANOVA test were used. The confidence interval was set to 95% at 5% significance level. Results: TAP showed less OD than CaOH2 paste which is statistically significant. (P = 0.0022). The OD reading of Bromelain paste was less than CaOH2 with P = 0.007. The OD of Bromelain and TAP were statistically insignificant (P = 0.095), indicating their comparable antibacterial efficacy. Conclusions: The antimicrobial efficiency of Bromelain was found to be more effective than Ca (OH) 2 paste and comparable to TAP against E. faecalis.

Oral Tissue Involvement and Probable Factors in Post-COVID-19 Mucormycosis Patients: A Cross-Sectional Study.

The primary goal of this study was to assess the prevalence of oral involvement and, secondarily, the likely variables in patients with confirmed COVID-19 accompanied by mucormycosis infection. The study design was a cross-sectional descriptive sort that was performed at a tertiary centre. The non-probability convenience sampling approach was used to determine the sample size. Between May 2021 and July 2021, all patients who presented to our tertiary care centre with suspected mucormycosis were considered for the investigation. The research only included individuals with proven mucormycosis after COVID-19. The features of the patients, the frequency of intraoral signs/symptoms, and the possible variables were all noted. Of the 333 COVID-19-infected patients, 47 (14%) were diagnosed with confirmed mucormycosis. The mean (SD) age of the patients was 59.7 (11.9) years. Of the 47 patients with confirmed mucormycosis, 34% showed sudden tooth mobility, 34% expressed toothache, 8.5% reported palatal eschar, 34% presented with jaw pain, 8.5% had tongue discoloration, and 17% had temporomandibular pain. About 53% of the patients were known cases of type 2 diabetes mellitus, 89% of patients had a history of hospitalization due to COVID-19 infection, 89.3% underwent oxygen support therapy, and 89.3% were administered intravenous steroids during hospitalization due to COVID-19 infection. About 14% of the suspected cases attending the mucormycosis out-patient department (OPD) had been confirmed with definite mucormycosis. Oral involvement was seen in 45% of cases of CAM (COVID-associated mucormycosis). The most frequent oral symptoms presented in CAM were sudden tooth mobility and toothache. Diabetes and steroids were the likely contributing factors associated with CAM.

Antimicrobial efficacy of acacia Nilotica (Babul) extract and its effectiveness in disinfecting gutta percha cones - An in vitro study.

BACKGROUND: Gutta-percha cones used directly from the manufacturer's sealed packs harbour micro-organisms. During clinical use, the chances of contamination of gutta-percha increases. Hence, disinfection of gutta-percha cones before use is essential to prevent canal recontamination. AIM: To evaluate the antimicrobial efficacy of babul against chemical disinfectants, and its effectiveness in disinfecting gutta-percha cones. MATERIALS AND METHODS: The extract of babul was used to assess its antimicrobial activity against E-faecalis, S. aureus and C. albicans using the agar diffusion method. A total of 120 cones acquired from freshly opened manufacturers' pack were cut into three equal parts and divided into group I which was directly placed into a nutrient broth, group II was clinically contaminated with gloves for 30 s and placed into a nutrient broth, and the third part was clinically contaminated with gloves and decontaminated for 5 min using the experimental disinfectants to check for the presence of turbidity. STATISTICAL ANALYSIS: The data were analysed by an Unpaired t-test and Chi-square test at a significance level of P < 0.05 using software SPSS 20. RESULTS: Two percent chlorhexidine showed maximum antibacterial action against E. faecalis and S. aureus followed by babul extract. It was also found more efficacious in decontaminating gutta-percha cones followed by babul and 3% sodium hypochlorite in 5 min. CONCLUSION: Babul herbal extract is indeed effective in decontaminating gutta-percha cones and is a better alternative to chemical disinfectants.

Effect of various single file systems on microcrack formation in root canals: Scanning electron microscope study.

BACKGROUND: The aim of this study was to compare dentinal crack formation in root canal walls following 3 single file systems with continuous rotation under a scanning electron microscope (SEM). MATERIALS AND METHODS: In this SEM study, seventy mandibular premolars were randomly divided into 5 groups. 3 experimental groups (n = 20) and 2 control groups (n = 5) as follows: Group I: Neolix NiTi file system, Group II: OneShape systems, Group III: OneCurve file system, positive control: conventional Hand File system, negative control: unprepared. After root canal preparations, the roots were sectioned at 3, 6, and 9 mm from the apex with water irrigation. The sections were inspected in all directions under SEM at × 100 magnification to determine the presence of cracks. The Chi-square test was used to analyze the data. There is a statistically significant difference in the crack formation between the apical third (P = 0.012) and coronal third (P = 0.002) when comparing all the 5 groups. No significant difference is found in the middle third (P = 0.46). P < 0.05 is considered statistically significant. RESULTS: Maximum cracks in the apical third were seen with One Shape file 11 (55%) and in the coronal third with Neolix NiTi 14 (70%). There is a statistically significant difference in the crack formation only in OneCurve when comparing the apical, middle, and coronal third for the individual group (P = 0.042). CONCLUSION: There was a significant difference in crack formation in apical and coronal third. OneCurve caused the least incidence of cracks when compared to other file systems. OneCurve file system can be a choice for canal preparation over Neolix Niti and OneShape.

Histological evaluation to study the effects of dental amalgam and composite restoration on human dental pulp: an in vivo study.

OBJECTIVE: To study and compare the effects of dental amalgam and composite restorations on human dental pulp. MATERIALS AND METHODS: One hundred sound premolars scheduled for orthodontic extraction were divided equally into two groups: group A, teeth restored with silver amalgam, and group B, teeth restored with composite resin. Each group was equally subdivided into two subgroups [extracted after 24 h (A-1 and B-1) or 7 days (A-2 and B-2)], and the histological changes in the pulp related to the two different materials at the two different intervals were studied. RESULTS: It was found that after 24 h, the inflammatory response of the pulp in teeth restored with amalgam and composite was similar (p = 1.00). However, after 7 days, the severity of the inflammatory response of the pulp in teeth restored with amalgam was less compared to that in teeth restored with composite (p = 0.045). CONCLUSION: This study confirmed that amalgam continues to be the mechanically as well as biologically more competent restorative material. Composite could be a promising restorative material to satisfy esthetic needs for a considerable period of time. However, its biological acceptance is still in doubt.