Remineralization Potential of a Combination of Chitosan with Nanohydroxyapatite and a Self-assembling Peptide with Nanohydroxyapatite: An In Vitro Study.

AIM: This study explores the demineralizing potential of the combination of chitosan with nanohydroxyapatite (n-HA) and self-assembling peptides with n-HA. MATERIALS AND METHODS: A total of 66 first premolar teeth of similar dimensions extracted for orthodontic purposes were collected for this study. These were then demineralized and randomly divided into the following three groups (n = 22): (i) Control group, (ii) n-HA + Chitosan (HAC), and (iii) self-assembling peptide + n-HA (SP-HA). The samples in each group were brushed every 24 hours with the respective agent. The specimens were stored in Fusayama Meyer's artificial saliva at room temperature and the solution was replenished daily. Mineral content (Ca, P) and surface morphology of the specimens was analyzed, using scanning electron microscopy and energy dispersion X-ray spectroscopy (SEM-EDAX), before demineralization, at 15 days of remineralization and 30 days of remineralization. A two-way analysis of variance (ANOVA) test followed by Tukey's honest significant difference (HSD) post hoc analysis was used to compare the mean elemental composition of the different groups (p < 0.05). RESULTS: There was no significant difference in the calcium (Ca) and phosphate (P) weight percentage between the different groups at the baseline and after demineralization. The Ca and P weight percentages of all three groups after remineralization for 15 and 30 days showed no significant difference from the baseline or after demineralization. The surface morphology after 15 days of remineralization therapy showed decreased surface porosity and increased mineral deposition in the HAC group than the HP-SA group. Surface morphology after 30 days of remineralization showed a more homogenous and smoother surface in the HAC group than the HP-SA group. CONCLUSION: From the results of this study, it can be concluded that the combination of chitosan with n-HA and self-assembling peptides with n-HA can be considered effective demineralizing agents. CLINICAL SIGNIFICANCE: Considering the non-invasive nature of remineralization therapy understanding the effectiveness of different agents is of utmost importance. The demineralizing properties of chitosan, n-HA and self-assembling peptides make their combinations ideal for studying their effectiveness in treating white spot lesions.

Synergistic Effect of Biphasic Calcium Phosphate and Platelet-Rich Fibrin Attenuate Markers for Inflammation and Osteoclast Differentiation by Suppressing NF-κB/MAPK Signaling Pathway in Chronic Periodontitis.

BACKGROUND: Periodontitis is characterized by excessive osteoclastic activity, which is closely associated with inflammation. It is well established that MAPK/NF-kB axis is a key signaling pathway engaged in osteoclast differentiation. It is stated that that biphasic calcium phosphate (BCP) and platelet-rich fibrin (PRF) have significant antiostoeclastogenic effects in chronic periodontitis. OBJECTIVE: We aimed to elucidate the synergetic effect of PRF/BCP involvement of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) and the mitogen-activated protein kinase (MAPK) signaling pathway in osteoclast differentiation in chronic periodontitis. METHODS: We induced osteoclast differentiation in vitro using peripheral blood mononuclear cells (PBMCs) derived from patients with chronic periodontitis. We assessed osteoclast generation by tartrate-resistant acid phosphatase (TRAP) activity, proinflammatory cytokines were investigated by ELISA and NF-κB, and IKB by immunoblot, respectively. MAPK proteins and osteoclast transcription factors were studied by Western blot analysis and osteoclast transcriptional genes were assessed by RT-PCR. RESULTS: The results showed that the potent inhibitory effect of PRF/BCP on osteoclastogenesis was evidenced by decreased TRAP activity and the expression of transcription factors, NFATc1, c-Fos, and the osteoclast marker genes, TRAP, MMP-9, and cathepsin-K were found to be reduced. Further, the protective effect of PRF/BCP on inflammation-mediated osteoclastogenesis in chronic periodontitis was shown by decreased levels of proinflammatory cytokines, NF-kB, IKB, and MAPK proteins. CONCLUSIONS: PRF/BCP may promote a synergetic combination that could be used as a strong inhibitor of inflammation-induced osteoclastogenesis in chronic periodontitis.

Effect of Root Canal Taper on the Ability of Endodontically Treated Teeth using the TruNatomy and Protaper Next File Systems to Resist Fracture.

Objectives: This research was done to evaluate how the root canal taper affects the Endodontically Treated Teeth (ETT) prepared with the TruNatomy and Protaper Next file systems in terms of fracture resistance. Materials and Method: Forty recently extracted mandibular premolar teeth were used in this research, which was classified into four groups at random. Groups 1a and 1b used TruNatomy 4% and 6%, respectively, while groups 2a and 2b used the Protaper Next 4% and 6% file systems, respectively. The root canals were cleaned, shaped, and sealed using cold lateral compaction. The root canals were then fixed in standardized autopolymerizing acrylic resin blocks and tested for vertical root fracture using a universal testing machine. Newtons were used to measure the forces needed to cause fractures. Data were statistically analyzed. Results: In comparison with other groups, group 1a (TruNatomy 4%) displayed greater fracture resistance (423.322.43 Newtons), and group 2b (Protaper Next 6%) displayed the least fracture resistance (264.512.76 Newtons). Conclusion: Protaper Next file system had lower fracture resistance than TruNatomy file system. With the use of greater taper instruments, a notable decrease in the fracture resistance of ETT was observed.

Evaluation of the Physicochemical and Antimicrobial Properties of Nanoemulsion-Based Polyherbal Mouthwash.

A nanoemulsion-based polyherbal mouthwash (PHFX) of Curcuma longa hydroalcoholic extract was developed and evaluated for its antibacterial effects against a variety of Gram-positive and Gram-negative oral pathogens in comparison to standard chlorhexidine acetate (CHD-A) (positive control). Various nanoemulsion-based mouthwashes of C. longa extract were produced using an aqueous phase titration approach via construction of pseudoternary phase diagrams. The developed nanoemulsion-based PHFX was studied for thermodynamic stability tests. Selected formulations (PHFX1-PHFX5) were characterized physicochemically for droplet diameter, polydispersity index (PDI), refractive index (RI), transmittance, and pH. The drug release studies were performed using the dialysis method. Based on the minimum droplet diameter (26.34 nm), least PDI (0.132), optimal RI (1.337), maximum %T (99.13), optimal pH (6.45), and maximum cumulative drug release (98.2%), formulation PHFX1 (containing 0.5% w/w of C. longa extract, 1.5% w/w of clove oil, 7.0% w/w of Tween-80, 7.0% w/w of Transcutol-HP, and 84.0% w/w of water) was selected for antimicrobial studies in comparison to standard CHD-A. The antibacterial effects and minimum inhibitory concentration were studied against various Gram-positive oral pathogens such as Streptococcus mutans, Staphylococcus aureus, Streptococcus pneumoniae, and Bacillus subtilis and Gram-negative oral pathogens such as Escherichia coli and Klebsiella pneumoniae. The antibacterial effects of PHFX1 were found to be significant over standard CHD-A against most Gram-positive and Gram-negative oral pathogens. The antimicrobial studies showed that the formulation PHFX1 was effective against all oral pathogens even at 3- to 4-fold lower working concentrations. These findings indicated the potential of nanoemulsion-based mouthwash in the treatment of a variety of oral pathogen infections.

Use of Collagen Membrane in the Treatment of Periodontal Defects Distal to Mandibular Second Molars Following Surgical Removal of Impacted Mandibular Third Molars: A Comparative Clinical Study.

The study aims to assess the efficacy of using collagen membrane in the treatment of distal periodontal defects of mandibular second molars following the removal of mesioangularly or horizontally impacted mandibular third molars surgically. Forty sites in twenty patients with bilaterally impacted mandibular third molars (mesioangular or horizontal) were considered for the study. In 20 test sites (Group A), after surgical removal of the mandibular third molar, a resorbable collagen membrane barrier was placed on the distal aspect of the mandibular second molar to cover the post-surgical bone defect. In the other control 20 sites (Group B), the same surgical procedure was repeated without placing any membrane barrier. The clinical parameters recorded were Oral Hygiene Index Simplified (OHI-S), Probing pocket depth (PPD), Clinical attachment level (CAL), and radiographic assessment of alveolar bone level (ABL). OHI-S score of most of the patients was observed to be satisfactory. Group A was observed to achieve a statistically significant reduction in PPD, CAL, and ABL gain compared to Group B. The improvements indicated that the use of collagen membrane facilitates early wound stabilization and promotes primary closure of the defect. This recovery is achieved through its unique property to assist fibrinogenesis over osteoconduction. Further longitudinal studies are needed to confirm the present findings.

Conventional versus digital approach for measuring dentin translucency in forensic age estimation.

BACKGROUND: Root dentine translucency remains the method of choice providing the most accurate results for age estimation. Conventionally, translucency is measured using calipers. In recent times, computer-based methods are proposed, which require the use of custom-built software programs. AIMS AND OBJECTIVES: The aim was to use a digital method to measure dentinal translucency on sectioned teeth and to compare digital measurements to conventionally obtained translucency measurements. MATERIALS AND METHODS: A total of 200 extracted permanent teeth were collected and were sectioned to a thickness of 250 µm. Translucency measurements were obtained using the digital method and compared with those obtained using a caliper. RESULTS: Correlation coefficients of translucency measurements to age were statistically significant for both methods (P < 0.001), although marginally higher correlation was observed for the conventional method (r = 0.612). Application of derived linear regression equations on an independent sample (n = 25) suggested that conventional approach is marginally better in estimating age to within 5 years of the actual age, both the methods are similar in assessing age within 5-10 years of the actual age, and digital approach is marginally better in estimating age beyond 10 years of actual age. CONCLUSION: The translucency measurements obtained by the two methods were identical, with no clear superiority of one method over the other.