Metal Marvels: Revolutionizing Endodontic Restoration With a Novel Endocrown Approach.

This case report explores the innovative application of the endocrown technique for restoring a severely damaged mandibular molar (tooth #46) in a 28-year-old male patient. With a recent root canal treatment history, the patient presented with a dislodged prosthesis. Due to financial constraints, a base metal alloy was chosen for the endocrown restoration. The unique preparation process involved reducing the occlusal surface by 2 mm, creating a shoulder cervical margin, and preserving enamel walls. The endocrown, crafted from a base metal alloy, demonstrated a semi-conservative approach, providing cost-effectiveness and minimal tooth preparation. The case adheres to the 2013 CAse REport (CARE) guidelines. The discussion highlights the biomechanical benefits of the endocrown, emphasizing stress resistance, stability, and superior performance compared to traditional treatments. Materials like ceramic, resin nanoceramic, and polyetheretherketone are briefly discussed, focusing on the promising success rates of endocrowns, mainly through computer-aided designing/computer-aided manufacturing systems. The report provides valuable insights for clinicians considering this endocrown technique in reconstructing severely damaged molars and premolars.

Isoprenyl diphosphate synthases of terpenoid biosynthesis in rose-scented geranium (Pelargonium graveolens).

The essential oil of Pelargonium graveolens (rose-scented geranium), an important aromatic plant, comprising mainly mono- and sesqui-terpenes, has applications in food and cosmetic industries. This study reports the characterization of isoprenyl disphosphate synthases (IDSs) involved in P. graveolens terpene biosynthesis. The six identified PgIDSs belonged to different classes of IDSs, comprising homomeric geranyl diphosphate synthases (GPPSs; PgGPPS1 and PgGPPS2), the large subunit of heteromeric GPPS or geranylgeranyl diphosphate synthases (GGPPSs; PgGGPPS), the small subunit of heteromeric GPPS (PgGPPS.SSUI and PgGPPS.SSUII), and farnesyl diphosphate synthases (FPPS; PgFPPS).All IDSs exhibited maximal expression in glandular trichomes (GTs), the site of aroma formation, and their expression except PgGPPS.SSUII was induced upon treatment with MeJA. Functional characterization of recombinant proteins revealed that PgGPPS1, PgGGPPS and PgFPPS were active enzymes producing GPP, GGPP/GPP, and FPP respectively, whereas both PgGPPS.SSUs and PgGPPS2 were inactive. Co-expression of PgGGPPS (that exhibited bifunctional G(G)PPS activity) with PgGPPS.SSUs in bacterial expression system showed lack of interaction between the two proteins, however, PgGGPPS interacted with a phylogenetically distant Antirrhinum majus GPPS.SSU. Further, transient expression of AmGPPS.SSU in P. graveolens leaf led to a significant increase in monoterpene levels. These findings provide insight into the types of IDSs and their role in providing precursors for different terpenoid components of P. graveolens essential oil.

Living will: Todays thoughts and actions.

Introduction: The word "Euthanasia" relates to two different words from the Greek language "Eu which indicates good and Thanatosis which indicates death", suggesting a "satisfactory Death" or "easy and painless Death" The phrase "mercy killing" has become associated with this meaning. It comprises inflicting painless death on a person suffering from an incurable and dreadful illness. It's the practice of terminating a person's life by administering a lethal injection or ceasing medical treatment. Informed and shared decision-making between the patient and the health professional caring for him or her is crucial for the quality of care and its outcomes. Living wills are nothing more than a tangible representation of this truth. As a result of their legal approval, patients' autonomy has been recognized. However, there are some differences in the regulations that have been adopted, and the health practice linked with these documents raises a number of practical and ethical questions that should be considered. Materials and Methods: PUBMED and COCHRANE databases were searched, with no language constraints, up to July 2021. Trial registration studies, hand searching, and bibliographic references of pertinent literature were also checked. Individual authors were responsible for data collection and analysis. The studies were evaluated independently by three review authors. Conclusion: A thorough assessment of the current accessible literature on living will be conducted, just to focus on the knowledge of euthanasia in detail. Most importantly, the social impact of the concept of euthanasia needs to be understood by the society. Moreover, it must be considered that euthanasia is different from suicide. Few communities may show the interference of their religion with euthanasia. So it is essential to enlighten the idea of euthanasia in legal ways for different countries.

Comparative Evaluation of the Effectiveness of Triphala and Chlorhexidine in Full-mouth Disinfection Treatment of Periodontitis in Type 2 Diabetes Patients.

AIM: To evaluate and compare the efficacy of triphala and chlorhexidine (CHX) in the treatment of stages II and III periodontitis with one-stage complete mouth disinfection in type 2 diabetes mellitus (DM) patients. MATERIALS AND METHODS: A total of 24 type 2 diabetic subjects with either stage II or stage III periodontitis were randomly divided into test and control groups with 12 patients in each group. For control group, full-mouth disinfection (FMD) was done using CHX and for test group, FMD was done using triphala. Clinical parameters were evaluated at baseline and at 6 months which comprised of probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), papillary bleeding index (PBI). The primary outcomes considered were a reduction in PPD and a gain in CAL. The data were recorded, tabulated, and statistically analyzed. RESULTS: The PPD reduction for the test group was 3.38 ± 0.75 mm and for the control group was 3.39 ± 0.76 mm. The CAL gain for the test group was 3.39 ± 0.76 mm and for the control group was 3.18 ± 0.74 mm. Although there was a statistically significant PPD reduction, statistically not significant CAL gain was observed. CONCLUSION: Both the groups with the FMD protocol showed beneficial results in terms of PPD reduction and CAL gain but the test group showed slightly better results. CLINICAL RELEVANCE: Clinically, there is more PPD reduction and CAL gain from baseline to 6 months in the test group compared to the control group. Clinically, the test group has more favorable results compared to the control group.

Wilckodontics: A Multidisciplinary Approach for Orthodontic Treatment.

Wilckodontics is the periodontally accelerated orthodontic treatment, which is a clinical procedure that combines orthodontic tooth movement with corticotomy and bone grafting. Corticotomy is the surgical procedure that involves cutting the bone, perforating the bone and mechanically altering it. This procedure makes tooth movement easy and rapid with the help of orthodontic force application. This procedure is based on the regional acceleratory phenomenon that increases the bone width, shortens the treatment time from years to months and increases the treatment stability. This procedure also reduces the need for extraction and also increases bone support for teeth and soft tissues. This review article describes the surgical procedure, advantages, disadvantages, indications, and contraindications of Wilckodontics and the current advances in this technique.

Evaluation of PRF and PLA-PGA Membrane Along with Hydroxyapatite Crystal Collagen Fibers Bone Graft in the Treatment of Infrabony Defects.

AIM: The present study was carried out to compare the effectiveness of leukocyte platelet-rich fibrin (L-PRF) membrane and polylactic acid-polyglycolic acid (PLA-PGA) membrane along with hydroxyapatite crystal collagen fibers bone graft in the treatment of human infrabony defects using cone beam computed tomography. MATERIALS AND METHODS: A total of 28 systemically healthy patients was chosen which were found appropriate after initial therapy. Each group comprises of 14 defects, according to randomized parallel design. The group A was managed by hydroxyapatite crystal collagen fibers bone graft in conjunction with L-PRF membrane, while group B was treated by hydroxyapatite crystal collagen fibers bone graft in conjunction with PLA-PGA membrane. Clinical and radiographic measurements were recorded at baseline and 6 months postoperatively. RESULTS: Statically significant difference was seen in mean probing pocket depth (PPD), mean R-CAL, and DD from baseline to 6 months in group A and group B but there was no statically significant difference in mean PPD reduction (0.35 ± 1.90 mm), mean R-CAL gain (0.28 ± 1.85 mm) and DD reduction (0.12 ± 1.42 mm) seen at 6 months when compared between both the groups. CONCLUSION: At 6 months post-surgery both treatment modalities demonstrated statistically significant improvements with regards to CAL gains, PPD reduction, and reduction in radiographic defect depth. CLINICAL SIGNIFICANCE: Platelet-rich fibrin (PRF) membrane and PLA-PGA membrane along with hydroxyapatite crystal collagen fibers bone graft are useful in the treatment of infrabony defect. Platelet-rich fibrin membrane with hydroxyapatite crystal collagen fibers bone graft have shown to be better in regeneration of bony defect as PRF membrane has growth factors which help in bone regeneration.

Participatory assessment of management and biosecurity practices of smallholder pig farms in North East India.

The present study was aimed at describing the pig production system, farm management, pig movement, and existing biosecurity level of smallholders' pig production system in North East India. A cross-sectional survey of 1,000 pig producers in four districts (two urban and two rural) in core pig-producing regions of India, where ASF occurrence had been reported, was conducted. The mean pig population was significantly (p < 0.05) higher in urban districts. In urban districts, most of the pig houses were isolated but located on the roadside, while in rural districts, commune pig houses along the roadside were more common. The majority of the respondent purchased (91%) or sold (60%) the pigs during the past 12 months. Swill feeding was common in the entire study area. The majority of the respondent (80%) in rural districts were unaware of ASF. Significant pig trade of live pigs and pork products was observed in the urban district. In the case of on-farm biosecurity measures, only 6.9% of respondents had fencing for the pig farm, 99.3% did not have provision for a footbath, and only 17.2% of the respondents restricted visitors' access to the pig farm. The study revealed that the pig production system is dominated by smallholding units with a frequent introduction or exit of pigs along with poor on-farm biosecurity measures. With the current level of farm management and biosecurity practices, smallholder pig farmers are at an increased risk of ASF and other contagious diseases.

The potentialities of omics resources for millet improvement.

Millets are nutrient-rich (nutri-rich) cereals with climate resilience attributes. However, its full productive potential is not realized due to the lack of a focused yield improvement approach, as evidenced by the available literature. Also, the lack of well-characterized genomic resources significantly limits millet improvement. But the recent availability of genomic data and advancement in omics tools has shown its enormous potential to enhance the efficiency and precision faced by conventional breeding in millet improvement. The development of high throughput genotyping platforms based on next-generation sequencing (NGS) has provided a low-cost method for genomic information, specifically for neglected nutri-rich cereals with the availability of a limited number of reference genome sequences. NGS has created new avenues for millet biotechnological interventions such as mutation-based study, GWAS, GS, and other omics technologies. The simultaneous discovery of high-throughput markers and multiplexed genotyping platform has aggressively aided marker-assisted breeding for millet improvement. Therefore, omics technology offers excellent opportunities to explore and combine useful variations for targeted traits that could impart high nutritional value to high-yielding cultivars under changing climatic conditions. In millet improvement, an in-depth account of NGS, integrating genomics data with different biotechnology tools, is reviewed in this context.

Evaluation of PRF Membrane with Coronally Advanced Flap with and without Vertical Releasing Incisions for the Treatment of Gingival Recessions.

AIM: The aim of the current study was to compare the esthetic results for subjects with Miller Class I and II gingival recession (GR) abnormalities using platelet-rich fibrin (PRF) membrane with coronal advanced flaps (CAFs) with and without vertical releasing incisions (VRIs; the envelope-type flap and the flap with VRIs). MATERIALS AND METHODS: Seven defects from each of the test and control groups made up of fourteen defects total. In the test group, PRF + CAF was performed without VRI, while in the control group, VRI was used. Gain in root coverage was the main result, with secondary results including papillary bleeding index (PBI), plaque index (PI), relative gingival margin level, relative attachment level, probing pocket depth, recession depth, width of keratinized gingiva (WKG), and gingival thickness. After 3 months of therapy, a clinical evaluation was conducted. RESULTS: No significant difference was observed between the two groups in terms of recession reduction (2.08 ± 0.5 vs 1.91 ± 0.66 mm), clinical attachment level (CAL) gain (2.08 ± 0.5 vs 1.91 ± 0.66 mm), and increase in WKG (2.66 ± 0.88 vs 2.58 ± 0.51 mm) for test and control groups, respectively. CONCLUSION: For the treatment of GR, both groups are efficient. However, the CAF + PRF without VRI group showed higher patient compliance and lower postoperative morbidity. CLINICAL RELEVANCE: The PRF membrane with CAF with or without VRI provide effective treatment option for GR. CAF + PRF without VRI is easy to perform and has less postoperative complications.

Clinical Implications of Probiotics in Oral and Periodontal Health: A Comprehensive Review.

Probiotic therapy represents a novel concept in dentistry. The microbial nature of dental plaque can be altered, or the probiotic strategy can efficiently inhibit oral pathogens. Probiotics are dietary supplements that are vital for boosting immunity as they include beneficial bacteria and yeast. In dentistry and medicine, the interest in probiotics, prebiotics, and synbiotics is increasing. By forming a biofilm and assisting in preventing dental cavities, probiotics play a crucial role in dentistry and significantly impact immunity. Prebiotics are non-digestible dietary supplements that enhance health by increasing the quantity and activity of beneficial bacteria such as Lactobacilli and Bifidobacteria. It has been demonstrated that prebiotics, in addition to probiotics, can help treat oral diseases. They promote the growth and activity of beneficial organisms while inhibiting potentially harmful bacteria's growth and activity. Synbiotics are dietary supplements that combine probiotics and prebiotics, believed to work in tandem through a process known as synergism. Studies have indicated that synbiotics, or a combination of probiotics with a prebiotic, may have greater efficacy than either supplement alone.

Implementation of Low-Level Laser Therapy in Dentistry: A Review.

A type of light therapy known as low-level laser therapy (LLLT) uses only one wavelength of light. Low-level lasers (LLL) do not have a warming effect on the tissues; instead, they have an effect called photobiostimulation. LLL do not evaporate the tissue. The use of LLL to manage a range of illnesses is known as LLLT. Helium-neon lasers are an illustration of an LLLT product. Gallium arsenide, the infrared semiconductor made of gallium aluminum arsenide, is also an example. The performance powers range from 50 to 500 mW with electromagnetic spectrum wavelengths in the red and near-infrared region spanning from 630 to 980 nm and pulsed or continuous-wave emission. In periodontics, LLLT has gained prominence for several applications, including wound healing and pain relief after non-surgical and surgical procedures.

Evaluation of gingival crevicular fluid interleukin-35 as a marker for identification of periodontal disease activity.

BACKGROUND: This study was carried out to evaluate and compare the levels of IL-35 in gingival crevicular fluid (GCF) in periodontally healthy subjects, patients with gingivitis and chronic periodontitis and to assess IL-35 as a marker for identification of periodontal disease activity. METHODS: GCF samples were obtained from periodontally healthy subjects (N.=15), gingivitis patients (N.=15) and patients with chronic periodontitis (N.=15). Clinical measurements like probing pocket depth, clinical attachment loss, bleeding on probing, Papillary Bleeding Index, and Modified Plaque Index were recorded. Enzyme-linked immunosorbent assay was used for the determination of GCF IL-35 levels in samples. RESULTS: The IL-35 levels were significantly higher in the healthy subjects as compared to gingivitis and chronic periodontitis group. There was variation in GCF IL-35 levels in healthy sites in each group and gingivitis sites in gingivitis and chronic periodontitis patients. CONCLUSIONS: The levels of IL-35 were observed to decrease with increase in the inflammatory status, so it might play a role in suppressing gingival inflammation and maintaining periodontal health.

Early lactate measurements for predicting in-hospital mortality in paediatric sepsis.

AIM: We compared the performance of plasma lactate with high-sensitivity C-reactive protein (hs-CRP), and paediatric sepsis-related organ failure assessment (pSOFA) score for predicting mortality in septic children. METHODS: Serial plasma lactate and hs-CRP levels and pSOFA score was assessed during early hospital stay in septic children. RESULTS: Out of 149 participants, 45 died. Plasma lactate at 0 h and 6 h was significantly higher, and lactate clearance was significantly lower in non-survivors. The optimal cut-off of plasma lactate at 6h for identifying mortality was 2.5 mmol/L (sensitivity 85% and specificity 74%). pSOFA score had the best predictive ability for mortality (AUC 0.89) followed by hs-CRP at 0 h (AUC 0.86), hs-CRP at 48 h (AUC 0.83), plasma lactate levels at 6 h (AUC 0.83), and plasma lactate at 0 h (AUC 0.67). CONCLUSION: pSOFA score, hs-CRP and hyperlactemia at 6 h can identify septic children at risk of dying.

Genetic mapping in papillon-lefèvre syndrome: a report of two cases.

Papillon-Lefevre syndrome (PLS) is a rare autosomal recessive heterogeneous trait which is characterized by erythematous palmoplantar hyperkeratosis, early-onset periodontitis, and associated calcification of dura mater. The etiology of PLS is multifactorial with genetic, immunological, and microbial factors playing a role in etiopathogenesis. Recently identified genetic defect in PLS has been mapped to chromosome 11q14-q21, which involves mutations of cathepsin C. This paper presents a report of 2 cases of Papillon-lefevre syndrome in which diagnosis is based on clinical presentation and genetic mapping.

Open flap debridement in combination with acellular dermal matrix allograft for the prevention of postsurgical gingival recession: a case series.

Open flap debridement with flap repositioning may result in significant gingival recession. Patients with chronic periodontitis were treated with open flap debridement followed by placement of an acellular dermal matrix allograft (ADMA) underneath the flap to minimize the occurrence of postsurgical gingival recession. Ten patients (total, 60 teeth) with periodontal pockets in the anterior dentition underwent open flap debridement combined with ADMA. Probing pocket depth, relative attachment level, and relative gingival margin level were recorded at baseline and 6 months postsurgery. The mean probing pocket depth at baseline and 6 months was 4.4 and 1.7 mm, respectively (P < .05); the mean relative attachment level at baseline and 6 months was 12.9 and 10.7 mm, respectively (P < .05); and the mean relative gingival margin level at baseline and 6 months was 8.4 and 9.0 mm, respectively. ADMA underneath the flap when combined with open flap debridement effectively minimizes postsurgical gingival recession.

Periodontal regeneration using platelet-derived growth factor in infrabony defects: a series of three cases.

The periodontal researchers and clinicians, in an effort to develop effective regenerative therapies, have sought to understand key events involved in the regeneration of periodontium. Polypeptide growth factors are a class of natural biological mediators which regulate key cellular events in tissue repair. Platelet-derived growth factor (PDGF) is the most thoroughly studied growth factor in periodontal regeneration. The present case series evaluate the effectiveness of platelet-derived growth factor (rh-PDGF-BB) in combination with beta-tricalcium phosphate ( ß -TCP) to achieve periodontal regeneration in 3 infrabony defects.

Interimplant papilla reconstruction by using demineralized freeze dried bone allograft block fixed by titanium screw: a case report.

Dental implants are now considered as a predictable treatment modality for the oral rehabilitation of partially or fully edentulous patients. Recently emphasis has changed towards achieving a predictable esthetic success. Creating aesthetically successful implant-supported restoration in the anterior region of oral cavity depends on the presence of interimplant papilla when multiple implants are used. The present paper reports a case of interimplant papilla reconstruction in esthetic zone of maxilla during one stage early loading multiple implant procedure using demineralized freeze dried bone allograft block fixed by titanium screw.

Surgical reconstruction of interdental papilla using subepithelial connective tissue graft (SCTG) with a coronally advanced flap: a clinical evaluation of five cases.

AIM: The aim of these case reports was to evaluate the effectiveness of a subepithelial connective tissue graft with a coronally advanced flap to reconstruct an interdental papilla. BACKGROUND: In the last decade, esthetics has become a major concern in periodontal therapy. One of the most difficult and elusive goals for the periodontist in the esthetic aspect of periodontal therapy is the reconstruction of the interdental papilla. Consequently, the absence or loss of the interdental papilla for a variety of reasons may create significant esthetic, functional, and phonetic challenges for the patient. CASE DESCRIPTION: Five systemically healthy patients between the ages of 23 and 52 years with absence of the periodontal pocket were selected. Loss of interdental papillary height was classified using the Nordland and Tarnow classification system as class 1 to 4. All five patients received a subepithelial connective tissue graft (SCTG) with a coronally advanced flap (CAF). Four parameters were measured at baseline and at six months post-surgery: (1) vertical distance from contact point to gingival margin, (2) soft tissue (papilla) height in the interdental area, (3) horizontal distance at the gingival margin, and (4) width of keratinized gingiva. The changes noted at six months post-surgery were (1) the vertical distance decreased from 3.2±0.44 mm to 0.4±0.54 mm, (2) the mean gain in soft tissue (papilla) height increased from 3.2±0.44 mm to 5.8±0.44 mm, (3) the horizontal distance at the gingival margin was reduced from 2.6±0.54 mm to 0.4±0.54 mm and the width of the keratinized gingiva increased 1.4±0.89 mm. CONCLUSION: The periodontal surgical technique used for the five reported cases successfully reconstructed the interdental papilla in just one type of papilla loss, the class I situation. Therefore, it should not be concluded that the technique shown would be equally as successful for every type of papilla loss. Furthermore, the postoperative time interval was short, at only six months. CLINICAL SIGNIFICANCE: A subepithelial connective tissue graft supported by a coronally advanced flap should be considered to surgically correct the loss of an interdental papilla in class I cases.