Salivary α-amylase as a stress biomarker in mentally and physically disabled individuals during COVID-19 times.

Background: Stress is faced by every individual in their day-to-day life activities. During pandemic, most people have experienced multiple episodes of depression, anxiety, and insomnia. Several medical and dental problems are reported with stress and the fastest and easiest way to study and investigate is through body fluids, mainly saliva. Hence, we aim to study salivary α amylase in disabled individuals and hypothesize that salivary α amylase could be a reliable stress biomarker in disabled individuals. Materials and Methods: Cross-sectional study was conducted including 200 individuals grouped into controls (100) and disabled individuals (100). Disabled individuals were further grouped into physically (50) and mentally (50) disabled. Stimulated and unstimulated saliva was collected from all the participants and were investigated for salivary α-amylase by direct substrate method. The enzyme activity was analyzed using a spectrophotometer and the obtained were analyzed statistically. Result: Salivary α-amylase showed significant difference between controls and disabled group (p = 0.000). Salivary α-amylase was least in the mentally disabled group compared to physically disabled group. Age related comparison of salivary α-amylase was higher in physically disabled whereas gender related comparison showed females in physically disabled group to be more affected than controls. Conclusion: Saliva, the easy and most researched fluid, is rich in salivary α-amylase. Salivary α-amylase is a potential biomarker to assess stress. Further diagnostic studies are required to know the salivary changes and their influence on individual general health status.

Life span of Neoendo Flex and ProTaper Next rotary files with reciprocating motion in single-rooted teeth.

Background: Cleaning and shaping represent a vital step in the endodontic procedure. In routine endodontic therapy, the fracture of nickel-titanium (NiTi) instruments is a procedural problem creating a major obstacle to therapy. Aim: This study examines the life span of one Neoendo Flex and ProTaper Next (PTN) rotary file using reciprocating motion and compares the time required by both file systems for canal preparation. Materials and Methods: One hundred maxillary permanent central incisors were selected. In that, fifty teeth are utilized in a reciprocating motion (RM) with the PTN file (n = 25) and Neoendo Flex file (n = 25). To check fractured resistance and the overall root canal preparation time, fifty more teeth are employed in continuous motion (CM) with canals prepared using PTN (n = 25) and Neoendo Flex (n = 25). All canals are prepared following the sequence of respective files. Later, the fracture mechanism of the files was inspected using a scanning electron microscope. Results: In an RM motion, both PTN and Neoendo Flex files can be used in a minimum of 25 canals in single-rooted teeth. Statistical analysis using the Mann-Whitney U-test showed no significant difference in total time taken by PTN and Neoendo Flex in both motions. Conclusion: Within the limitation of this study, the RM was found to be better than CM with less incidence of instrument fracture.

Assessment of various endodontic instrumentation systems on the amount of apically extruded bacteria - An in vitro study.

AIM: The objective of this in vitro study was to assess the effect of different endodontic instrumentation systems on the amount of apically extruded bacteria. MATERIALS AND METHODS: One hundred and twenty freshly extracted human mandibular premolars with single canal were collected. Endodontic access cavities were prepared and then contaminated with an Enterococcus faecalis suspension (ATCC 29212). After incubation at 37°C for 24 h, the root canals were instrumented with K flare files, F360 Single file system, K3XF files, Heroshaper files, Protaper Next files, and Hyflex EDM Single file system. During instrumentation, apically extruded bacteria were collected in the vials containing 0.9% NaCl. Samples were taken from the vials and incubated in brain-heart infusion agar medium for 24 h. STATISTICAL ANALYSIS: The number of colony-forming units was determined, and data were statistically analyzed using one-way analysis of variance and post hoc Tukey test. CONCLUSIONS: Both rotary and hand instrumentation systems extruded intracanal bacteria through the apical foramen, Group 1 (Hand K Flare files) showed maximum, whereas, Group 5 (Protaper Next) and Group 6 (Hyflex EDM) showed the least extrusion.

Influence of ThreeDifferent Instrumentation Techniques on the Incidence of Postoperative Pain After Endodontic Treatment

Objective:To evaluatethe influence of threedifferent instrumentation techniques on the incidence of postoperative pain after endodontic treatment.Material and Methods:Ninety permanent single rooted mandibular premolar with sign and symptoms of non-vital teethwere selected. Patients were randomly divided into three different groups according to the type of instrumentation:Group 1=Reciproc; Group 2=Twisted File incontinuousmotion and Group 3=WaveOne. Oburation was done with corresponding guttapercha points using zinc oxide eugenol sealer. The intensity of pain was recorded by the patient using visual analoguescale, after 2hr,6hr,12hr,48hr and 3days of completion of obturation.Data analysis was done using Wilcoxon signed-rankstest. The level of significance was set at 5%.Results:For Group 1 at 12 hours mean was 4.53 + 1.9 and median was 5. The mean value increased from 2 hours to 6 hours upto 12 hours and decreased after 48 hours till 3rd day. For Group 2 at 12 hours mean was 2.80 + 0.71 and median was 3.00. The mean value increased from 2 hours to 6 hours upto 12 hours and decreased after 48 hours till third day. For Group 3 at 12 hours mean was 4.77 + 1.81 and median was 5.00. Mean value increased from 2 hrupto 12 hr and decreased from 12 hours upto third day.At interval from 2-48 hours there is no significant difference seen between 3 groups and at 2 hours-3 days interval significant difference was seen in first group, but no significant results were seen between group 2 and group 3. There was no significant difference seen between all the groups at the interval of 6-12 hours (p>0.05). Conclusion:Pain score was less in case of Twisted File continuous motion technique while it was more in WaveOne and Reciproc technique (AU).

Clinical and radiographic assessment of periapical pathology in single versus multivisit root canal treatment: An in vivo study.

OBJECTIVE: The objective of the study was to compare and evaluate the clinical and radiographic outcome of single- versus multivisit endodontic treatment in teeth with periapical pathology at the end of 1, 3, and 6 months. MATERIALS AND METHODS: Sixty single- and multi-rooted teeth indicated for root canal treatment with periapical pathology were included in the study. The teeth were assigned randomly into two groups Group I and Group II (n = 30 each), which were further subdivided into subgroup IA, subgroup IB and subgroup IIA, subgroup IIB (n = 15 each), respectively. Group I was medicated with ApexCal paste and obturated using the standardized protocol in second visit 7-10 days later, whereas Group II was obturated at the first visit. In subgroup IA and subgroup IIA, obturation was done using Apexit Plus sealer, whereas, in subgroup IB and subgroup IIB, AH Plus sealer was used. Patients were recalled at intervals of 1, 3, and 6 months to evaluate teeth for periapical healing. RESULTS: Kruskal-Wallis and one-way ANOVA test showed no significant difference between Groups I and II, whereas Wilcoxon signed-rank test showed improvement in all the subgroups with highly significant P value (≤0.001). CONCLUSION: Single-visit root canal treatment can be considered as a viable option for treatment of teeth with periapical pathology.

Osteoblastic and osteoclastic metastases in a single vertebra-a rare presentation.

Malignancies may produce bony metastases which may be osteoclastic or osteoblastic. Vertebrae are a common site for bony metastases. Prostatic adenocarcinoma is an important source of vertebral metastases that are mainly osteoblastic in nature. As the osteoblastic metastases are developing there is an ongoing osteoclastic activity which is going on at the microscopic level. Presence of gross osteoblastic and osteoclastic lesions, in the same vertebra, have not been reported at the time of presentation. Here a rare case of vertebral metastases is being presented which shows osteoblastic and osteoclastic gross lesions in the same vertebra.

A Rare Case of Vanishing Lung Syndrome.

Vanishing lung syndrome (VLS) is a rare radiological syndrome in which the lungs appear to be disappearing on X-ray. It is a chronic, progressive condition usually affecting young male smokers and is characterised by giant emphysematous bullae, which commonly develop in the upper lobes. We describe here a rare case of 60-year-old male patient who had a history of chronic smoking for 30 years. He had been admitted in the hospital multiple times due to spontaneous pneumothorax, type 2 respiratory failure and infective exacerbations. He was earlier diagnosed having chronic obstructive pulmonary disease (COPD) with predominant emphysema on the basis of his history and chest X-ray findings. Eventually, his CT chest revealed the diagnosis of giant bullous disease/vanishing lung syndrome. He had been surviving with his little lung tissue for about 10 years. No such case has been reported in the literature so far. He was attended last on 12th October, 2009 in medical outdoor of Christian Medical College and Hospital, Ludhiana by the first three authors. Thereafter, the patient was not traceable.