Botanicals as promising antimicrobial agents for enhancing oral health: a comprehensive review.

The mouth houses the second largest diversity of microorganisms in the body, harboring more than 700 bacterial species colonizing the soft mucosa and hard tooth surfaces. Microbes are the cause of several health-related problems, such as dental carries, gingivitis, periodontitis, etc., in the mouth across different age groups and socioeconomic/demographic groups. Oral infections are major health problems that affect the standard of living. Compromised oral health is related to chronic conditions and systemic disorders. Microbes responsible for dental caries are acid-producing and aciduric Gram-positive bacteria (Streptococci, Lactobacilli). Gram-negative bacteria (Porphyromonas, Prevotella, Actinobacillus, and Fusobacterium) capable of growing in anaerobic environments are responsible for periodontal diseases. Due to the high prevalence of oral diseases, negative effects associated with the use of antimicrobial agents and increased antibiotic resistance in oral pathogens, suitable alternative methods (effective, economical and safe) to suppress microbes disturbing oral health need to be adopted. Side effects associated with the chemical antimicrobial agents are vomiting, diarrhea and tooth staining. Several researchers have studied the antimicrobial properties of plant extracts and phytochemicals and have used them as indigenous practices to control several infections. Therefore, phytochemicals extracted from plants can be suitable alternatives. This review focuses on the various phytochemical/plant extracts suppressing the growth of oral pathogens either by preventing their attachment to the surfaces or by preventing biofilm formation or other mechanisms.

Toll-like receptor expression profile of stem/progenitor cells from human exfoliated deciduous teeth.

BACKGROUND: Stem/progenitor cells from human exfoliated deciduous teeth (SHED) show remarkable pluripotent, regenerative, and immunological capacities. During in vivo regenerative processes, there could be the presence of SHED in the surrounding inflammatory microenvironment, through toll-like receptors (TLRs). AIM: The aim of this paper was to present a characteristic TLR expression profile on SHED for the first time. DESIGN: Cells were harvested from extracted primary teeth (n = 10), anti-STRO-1 immunomagnetically sorted and cultivated, through colony-forming units (CFUs). SHED were examined for mesenchymal stem/progenitor cell traits, including the expression of clusters of differentiation (CDs) 14, 34, 45, 73, 90, 105, and 146, and their multilineage differentiation aptitude. TLRs 1-10 expression was investigated for SHED in uninflamed and inflamed (25 ng/mL IL-1ß, 103 U/mL IFN-γ, 50 ng/mL TNF-α, and 3 × 103 U/mL IFN-α; SHED-i) microenvironmental conditions. RESULTS: SHED were negative for CDs 14, 34, and 45, but were positive for CDs 73, 90, 105, and 146, and demonstrated characteristic multilineage differentiation. In an uninflamed microenvironment, SHED expressed TLRs 1, 2, 3, 4, 6, 8, 9, and 10. The inflammatory microenvironment downregulated TLR7 significantly on gene level and upregulated TLR8 on gene and protein levels (p < .05; Wilcoxon signed-rank test). CONCLUSION: There appears to be a unique TLR expression profile on SHED, which could modulate their immunological and regenerative abilities in oral tissue engineering approaches.

Pain perception following computer-controlled versus conventional dental anesthesia: randomized controlled trial.

BACKGROUND: The administration of local anesthesia (LA) in dental practice requires an injection which is the leading cause of patients' fear and anxiety. Computer-controlled local anesthetic injector, designed to reduce the pain of performing local anesthesia by controlling the speed of injection. This single-blind randomised control trial aimed to compare the pain perception after computer-controlled local anesthesia (CCLA) and conventional LA. METHODS: Dental students were both test and operator group versus an experienced dentist as additional operator of the LA. Data were collected regarding gender, age, medical condition, smoking habits. Additionally, operator feedback about the handling, pain at insertion and during infiltration, excitement (Dental Anxiety Scale), and complications were assessed. RESULTS: Out of the 60 included participants, the majority were females (n = 41; 68.3%), medically healthy (n = 54; 90%), and did not receive medications (n = 54; 90%). While the participating students administered 62 (51.7%) injections, the experienced dentist administered 58 (48.3%) injections. The difference in pain perception on puncture between CCLA and conventional injections was not statistically significant (Sig. = 0.285); however, pain perception during injection was significantly different (Sig. = 0.029) between CCLA (1.65 ± 1.93) and conventional injections (2.49 ± 2.31). CONCLUSION: The professional experience influenced the pain perception while applying the LA. CCLA did not reduce pain on puncture significantly; however, pain perception during the injection was significantly reduced in the case of using CCLA devices compared to the conventional syringe.

TLR3 ligation affects differentiation and stemness properties of gingival mesenchymal stem/progenitor cells.

AIM: Toll-like receptors are key players in mesenchymal stem/progenitor cells' micro-environmental crosstalk, endorsing various biological reactions. For the first time, this study investigates the effects of TLR3-ligation on gingival mesenchymal stem/progenitor cells (G-MSCs) stemness and differentiation properties. MATERIAL AND METHODS: G-MSCs (n = 5) were isolated, sorted using anti-STRO-1 antibodies,and sowed on culture dishes to generate colony-forming units (CFUs), and their stem/progenitor cells' features and TLR3 expression were characterized. Subsequently, TLR3 activation of G-MSCs via Poly (I:C) was done, followed by an analysis of the expression of pluripotency-related factors, mesenchymal stemness-associated surface markers, and the ability to form CFUs and multilineage differentiation, using qualitative and quantitative histochemistry and RT-PCR. RESULTS: G-MSCs demonstrated all predefined stem/progenitor cells' characteristics and TLR3 expression. TLR3-activated G-MSCs showed a significantly reduced ability to form CFUs and pluripotency transcriptional factors expression. Mesenchymal stem/progenitor cell-associated surface markers and multilinear differentiation potential were significantly higher following TLR3 ligation (p < .05, Wilcoxon signed rank test). CONCLUSIONS: TLR3-mediated activation maintains the mesenchymal stem/progenitor cells phenotype and drives G-MSCs' differentiation and commitment, with a shift away from an undifferentiated pluripotent cellular phenotype. This distinctive modulation could influence potential therapeutic applications of G-MSCs.

TLR-induced immunomodulatory cytokine expression by human gingival stem/progenitor cells.

During therapeutic application, mesenchymal stem cells (MSCs) may interact with their environment via their expressed toll-like-receptors (TLRs) leading to pro- or anti-inflammatory immune responses. The present study aimed to describe the gingival margin-derived stem/progenitor cells' (G-MSCs) TLR-induced immune regulatory response to specific TLR agonists. Gingival cells were obtained, immunomagnetically sorted via anti-STRO-1 antibodies and seeded out to achieve colony forming units (CFUs). G-MSCs were investigated for stem cell characteristics and TLR expression. Specific TLR agonists were applied and m-RNA expression of pro- and anti-inflammatory factors was analyzed via real-time polymerase chain reaction. G-MSCs showed all characteristics of stem/progenitor cells. All TLR agonists induced pro-inflammatory cytokines, except for the TLR3 agonist, which significantly promoted the anti-inflammatory response. (p⩽0.05, Wilcoxon-Signed-Ranks-Test). TLR-induced immunomodulation by G-MSCs could impact their therapeutic potential in vivo. Two distinctive pro-inflammatory and an anti-inflammatory TLR-induced phenotypes of G-MSCs become noticeable in this study.

TlR expression profile of human gingival margin-derived stem progenitor cells.

BACKGROUND: Gingival margin-derived stem/progenitor cells (G-MSCs) show remarkable periodontal regenerative potential in vivo. During regeneration, G-MSCs may interact with their inflammatory environment via toll-like-receptors (TLRs). The present study aimed to depict the G-MSCs TLRs expression profile. MATERIAL AND METHODS: Cells were isolated from free gingival margins, STRO-1-immunomagnetically sorted and seeded to obtain single colony forming units (CFUs). G-MSCs were characterized for CD14, CD34, CD45, CD73, CD90, CD105, CD146 and STRO-1 expression, and for multilineage differentiation potential. Following G-MSCs' incubation in basic or inflammatory medium (IL-1ß, IFN-γ, IFN-α, TNF-α) a TLR expression profile was generated. RESULTS: G-MSCs showed all stem/progenitor cells' characteristics. In basic medium G-MSCs expressed TLRs 1, 2, 3, 4, 5, 6, 7, and 10. The inflammatory medium significantly up-regulated TLRs 1, 2, 4, 5, 7 and 10 and diminished TLR 6 (p≤0.05, Wilcoxon-Signed-Ranks-Test). CONCLUSIONS: The current study describes for the first time the distinctive TLRs expression profile of G-MSCs under uninflamed and inflamed conditions.

Periodontal regeneration employing gingival margin-derived stem/progenitor cells in conjunction with IL-1ra-hydrogel synthetic extracellular matrix.

AIM: This study investigated the periodontal regenerative potential of gingival margin-derived stem/progenitor cells (G-MSCs) in conjunction with IL-1ra-releasing hyaluronic acid synthetic extracellular matrix (HA-sECM). MATERIALS AND METHODS: Periodontal defects were induced at four sites in eight miniature pigs in the premolar/molar area (-4 weeks). Autologus G-MSCs were isolated from the free gingival margin and magnetically sorted, using anti-STRO-1 antibodies. Colony formation and multilineage differentiation potential were tested. The G-MSCs were expanded and incorporated into IL-1ra-loaded/unloaded HA-sECM. Within every miniature pig, four periodontal defects were randomly treated with IL-1ra/G-MSCs/HA-sECM (test group), G-MSCs/HA-sECM (positive-control), scaling and root planing (SRP; negative control-1) or left untreated (no-treatment group; negative control 2). Differences in clinical attachment level (ΔCAL), probing depth (ΔPD), gingival recession (ΔGR), radiographic defect volume (ΔRDV), and changes in bleeding on probing (BOP) between baseline and 16 weeks post-transplantation, as well as periodontal attachment level (PAL), junctional epithelium length (JE), connective tissue adhesion (CTA), cementum regeneration (CR) and bone regeneration (BR) at 16 weeks post-transplantation were evaluated. RESULTS: Isolated G-MSCs showed stem/progenitor cell characteristics. IL-1ra loaded and unloaded G-MSCs/HA-sECM showed higher ΔCAL, ΔPD, ΔGR, PAL, CR and BR as well as a lower JE compared to their negative controls and improved BOP. CONCLUSION: G-MSCs in conjunction with IL-1ra-loaded/unloaded HA-sECM show a significant periodontal regenerative potential.

Beneath the rind: A review on the remarkable health benefits and applications of the wood apple fruit.

Limonia acidissima Groff, commonly referred to as the Wood apple, is a tropical fruit belonging to Rutaceae family. Indigenous to Sri Lanka, India, and Myanmar, it is extensively cultivated throughout Southeast Asia. This fruit holds a profound historical significance in traditional medicine due to its exceptional nutritional and therapeutic attributes. Wood apple pulp is significantly abundant in ß-carotene, a precursor to vitamin A, and contains a substantial amount of vitamin B, including riboflavin and thiamine, as well as trace amounts of ascorbic acid (vitamin C). Moreover health-benefitting properties associated with L. acidissima, such as, antioxidant, hepatoprotective, antimicrobial, neuroprotective, antidiabetic, anti-inflammatory, anti-spermatogenic, analgesic, antiulcer, and antihyperlipidemic properties, are attributed to a diverse range of phytochemicals. These encompass polyphenolic compounds, saponins, phytosterols, tannins, triterpenoids, coumarins, amino acids, tyramine derivatives, and vitamins. From the findings of the various studies, it was observed that wood apple fruit shows significant anticancer activity by inhibiting the proliferation of cancer. Furthermore, wood apple finds wide-ranging commercial applications in the formulation of ready-to-serve beverages, syrups, jellies, chutneys, and various other food products. In summary, this review highlights the nutritional and phytochemical constituents of wood apple, depicts its antioxidant, anti-inflammatory, and anti-diabetic capabilities, and explores its potential in value-added product development. Nevertheless, it is crucial to acknowledge that the molecular mechanisms supporting these properties remain an underexplored domain. To ensure the safe integration of wood apple fruit into the realms of the food, cosmetics, and pharmaceutical sectors, rigorous clinical trials, including toxicity assessments, are required. These endeavors hold the potential to promote innovation and contribute significantly to both research and industrial sectors.

Exploring the Potential of Bee-Derived Antioxidants for Maintaining Oral Hygiene and Dental Health: A Comprehensive Review.

Honey bee products comprise various compounds, including honey, propolis, royal jelly, bee pollen, bee wax and bee venom, which have long been recognized for their pharmacological and health-promoting benefits. Scientists have discovered that periodontal disorders stem from dental biofilm, an inflammatory response to bacterial overgrowth produced by dysbiosis in the oral microbiome. The bee products have been investigated for their role in prevention of oral diseases, which are attributed to a myriad of biologically active compounds including flavonoids (pinocembrin, catechin, caffeic acid phenethyl ester (CAPE) and galangin), phenolic acids (hydroxybenzoic acid, hydroxycinnamic acid, p-coumaric, ellagic, caffeic and ferulic acids) and terpenoids. This review aims to update the current understanding of role of selected bee products, namely, honey, propolis and royal jelly, in preventing oral diseases as well as their potential biological activities and mechanism of action in relation to oral health have been discussed. Furthermore, the safety of incorporation of bee products is also critically discussed. To summarize, bee products could potentially serve as a therapy option for people suffering from a variety of oral disorders.

Thymoquinone-Mediated Modulation of Toll-like Receptors and Pluripotency Factors in Gingival Mesenchymal Stem/Progenitor Cells.

Thymoquinone (TQ), the key active component of Nigella sativa (NS), demonstrates very promising biomedical anti-inflammatory, antioxidant, antimicrobial and anticancer properties. Several investigations have inspected the modulative activities of TQ on different stem/progenitor cell types, but its possible role in the regulation of gingival mesenchymal stem/progenitor cells (G-MSCs) has not yet been characterized. For the first time, this study investigates the effects of TQ on G-MSCs' stemness and Toll-like receptor expression profiles. G-MSCs (n = 5) were isolated, sorted via anti-STRO-1 antibodies and then disseminated on cell culture dishes to create colony-forming units (CFUs), and their stem/progenitor cell attributes were characterized. TQ stimulation of the G-MSCs was performed, followed by an examination of the expression of pluripotency-related factors using RT-PCR and the expression profiles of TLRs 1−10 using flowcytometry, and they were compared to a non-stimulated control group. The G-MSCs presented all the predefined stem/progenitor cells' features. The TQ-activated G-MSCs displayed significantly higher expressions of TLR3 and NANOG with a significantly reduced expression of TLR1 (p < 0.05, Wilcoxon signed-rank test). TQ-mediated stimulation preserves G-MSCs' pluripotency and facilitates a cellular shift into an immunocompetent-differentiating phenotype through increased TLR3 expression. This characteristic modulation might impact the potential therapeutic applications of G-MSCs.

A survey on ethnoveterinary medicines used by the tribal migratory shepherds of Northwestern Himalaya.

ETHNOPHARMACOLOGICAL RELEVANCE: Tribal migratory shepherds (Gaddi) living in the Northwestern Himalayan region are well known for their nomadic lifestyle in which tribal migratory shepherds along with their livestock which mainly include sheep and goat migrate seasonally in the Northwestern Himalayan region from high hills to low hills for the survival of their livestock from cold winters and hot summer. Due to harsh environmental conditions, heavy snowfall, heavy rainfall, wild animal attacks, no medical facilities, no transportation, and no electricity facilities tribal migratory shepherds mostly rely on plant species mentioned for ethnoveterinary use to treat livestock disease. AIM OF STUDY: The aim of our study is to conduct ethnoveterinary survey for the first time to document the contemporary oral ethnoveterinary knowledge of Gaddi shepherds living in Northwestern Himalayan region. METHODOLOGY: The documentation of plant species mentioned for ethnoveterinary use was executed through extensive field surveys from 2017 to 2019. Data were collected through direct interviews by administrating questionnaire among tribal migratory shepherds. RESULTS: A total of 181 plant species mentioned for ethnoveterinary use belonging to the same or different families were documented during the seasonal migration of shepherds from Northwestern Himalayan region. Most frequently occurring family of plant species mentioned for ethnoveterinary was Poaceae, leaves and roots were reported to be the most frequently used plant parts. Most frequently documented plant species for ethnoveterinary use were Cynodon dactylon, Chenopodium album, Zanthoxylum armatum, Aloe vera, Azadirachta indica and Cannabis sativa. Chrysopogon serrulatus, Cynodon dactylon, and Vitex negundo were reported with high use reports. Some of the endemic species of Northwestern Himalayan region such as Elymus himalayanus and Euphorbia pilosa and one endangered species Picrorhiza kurrooa were reported in current study. CONCLUSION: It is observed that there is a need to raise awareness among the tribal migratory shepherds about the sustainable use and conservation of some of the plant species mentioned for ethnoveterinary use. This study provided an inventory of plant species mentioned for ethnoveterinary use having significant ethnoveterinary potential, however there is need of scientific evaluations by in vitro, in vivo and clinical studies.

Recent Advances in Novel Packaging Technologies for Shelf-Life Extension of Guava Fruits for Retaining Health Benefits for Longer Duration.

Guava (Psidium guajava L.) fruit is also known as the apple of tropics, belongs to the family of genus Psidium, and is widely cultivated in tropical zones of the world. Recently, the importance of guava fruit has increased due to its inherent nutritional content, pleasant aroma, excellent flavor, and delicious taste. It is considered an excellent source of nutrients and phytochemicals. Guava is a climacteric fruit that continues to mature or ripen even after harvest, showing an increase in the rate of respiration and metabolic activities within a short period, leading to rapid senescence or spoilage of fruit. It has limitations in terms of commercialization due to short storage life after harvest and sensitivity to diseases and chilling injury during the storage period. Many postharvest technologies such as edible packaging, modified atmosphere packaging (MAP), composite packaging, controlled atmosphere packaging (CAP), antimicrobial/antifungal packaging, and nano packaging have been used to retard the chilling injury and enhance the keeping quality of guava fruits during the storage period to control respiration rate, reduce weight loss, minimize lipid oxidation, and maintain organoleptic properties. However, these packaging technologies have varied effects on the internal and external quality attributes of guava fruits. This review, therefore, discusses the physiology, mechanism of ripening, oxidation, and ethylene production of guava fruits. The review also discusses the packaging technologies and their effect on the postharvest characteristics of guava fruits during the storage period.

Acacia catechu (L.f.) Willd.: A Review on Bioactive Compounds and Their Health Promoting Functionalities.

With the advent of pandemics and infectious diseases, numerous research activities on natural products have been carried out to combat them. Researchers are investigating natural products for the treatment and/or management of various infectious diseases and/or disorders. Acacia catechu (L.f.) Willd. belongs to the family Fabaceae (subfamily Mimosoideae) known as Khair or Cutch tree, possesses diverse pharmacological actions, and has been widely used in Asia and different parts of the world. The purpose of the present study is to highlight the phytochemical profile of different parts of A. catechu, the different biological activities of A. catechu extract, and the utilization of A. catechu as food and beverage. The present work constitutes a review of A. catechu; we performed searches (books, Google, Google Scholar, and Scopus publications) to compile the work/investigations made on A. catechu to the present. From our survey, it was concluded that the main phytochemicals compounds in A. catechu are protocatechuic acid, taxifolin, epicatechin, epigallocatechin, catechin, epicatechin gallate, procyanidin, phloroglucin, aldobiuronic acid, gallic acid, D-galactose, afzelchin gum, L-arabinose, D-rhamnose, and quercetin. The whole plant of A. catechu possesses a comprehensive variety of medicinal potentials such as antimicrobial, antidiarrheal, antinociceptive, antihyperlipidemic, antiulcer, antioxidant, antidiabetic, antiproliferative, haemolytic, and anti-inflammatory properties due to the presence of bioactive compounds like flavonoids, alkaloids, and tannins. However, even though the plant's metabolites were reported to have many different pharmacological uses, there is limited information about their toxicity or clinical trials. Further research on diverse metabolites of A. catechu should be carried out to ensure the safety or utilization of this plant in the pharma or food industries and in the development of potent plant-based drugs.

Onion (Allium cepa L.) peels: A review on bioactive compounds and biomedical activities.

Huge quantities of byproducts/wastes generated in onion processing are usually discarded, but they are excellent sources of bioactive compounds and phytochemicals. However, with growing interest in the sustainable use of resources and the circular economy to reduce adverse impacts on the environment, food processing wastes such as onion peel/skin can be extracted and employed as inputs in developing or reformulating nutrient supplements, and pharmacological drugs. This review highlights major bioactive components, especially total phenolics, total flavonoid, quercetin and its derivatives present in onion peel/skin and their therapeutic applications as cardioprotective, neuroprotective, antiobesity, antidiabetic, anticancer and antimicrobial agents. The present review emphasized that onion peel is one of the important agricultural by-products which is rich in bioactive compounds and can be utilized as health promoting ingredient especially in pharmacological and biomedical fields. Thus, with increasing burden of life style disorders/non-communicable diseases, finding suitable natural alternative for their treatment is one major concern of the researchers and onion peel and its extract can be exploited as a prime ingredient.

Guava (Psidium guajava L.) seed: A low-volume, high-value byproduct for human health and the food industry.

Guava processing industries generate peel and seeds as primary waste fractions. Guava seeds obtained after fruit processing possess untapped potential in the field of food science due to the presence of a diversity of nutritional and bioactive compounds. Along with offering a detailed understanding of the nutritional attributes of guava seeds, the present review comprehensively elaborates on the therapeutic activities of their bioactive compounds, their techno-functional properties, and their other edible and nonedible applications. The limited molecular and biochemical mechanistic studies outlining the antioxidant, immunomodulatory, anticancer, antimicrobial, neuroprotective and antidiabetic activities of guava seeds available in the literature are also extensively discussed in this review. The use of guava seed constituents as food additives and food functional and structural modulators, primarily as fat reducers, emulsifiers, water and oil holding agents, is also conceptually explained. Additional human intervention and molecular mechanistic studies deciphering the effects of guava seeds on various diseases and human health are warranted.

Apitherapy and Periodontal Disease: Insights into In Vitro, In Vivo, and Clinical Studies.

Periodontal diseases are caused mainly by inflammation of the gums and bones surrounding the teeth or by dysbiosis of the oral microbiome, and the Global Burden of Disease study (2019) reported that periodontal disease affects 20-50% of the global population. In recent years, more preference has been given to natural therapies compared to synthetic drugs in the treatment of periodontal disease, and several oral care products, such as toothpaste, mouthwash, and dentifrices, have been developed comprising honeybee products, such as propolis, honey, royal jelly, and purified bee venom. In this study, we systematically reviewed the literature on the treatment of periodontitis using honeybee products. A literature search was performed using various databases, including PubMed, Web of Science, ScienceDirect, Scopus, clinicaltrials.gov, and Google Scholar. A total of 31 studies were reviewed using eligibility criteria published between January 2016 and December 2021. In vitro, in vivo, and clinical studies (randomized clinical trials) were included. Based on the results of these studies, honeybee products, such as propolis and purified bee venom, were concluded to be effective and safe for use in the treatment of periodontitis mainly due to their antimicrobial and anti-inflammatory activities. However, to obtain reliable results from randomized clinical trials assessing the effectiveness of honeybee products in periodontal treatment with long-term follow-up, a broader sample size and assessment of various clinical parameters are needed.

Carica papaya L. Leaves: Deciphering Its Antioxidant Bioactives, Biological Activities, Innovative Products, and Safety Aspects.

The prevalence of viral infections, cancer, and diabetes is increasing at an alarming rate around the world, and these diseases are now considered to be the most serious risks to human well-being in the modern period. There is a widespread practice in Asian countries of using papaya leaves (C. papaya L.) as herbal medicine, either alone or in combination with prescribed medications, to treat a variety of ailments. The importance of conducting the necessary descriptive studies in order to determine the safety of papaya leaf consumption is also emphasized in the context of their application in the healthcare sector. Electronic databases such as Google Scholar, Scopus, and PubMed were used to gather information on papaya leaves, their therapeutic potential, and clinical evidence-based studies. The literature was gathered from publications on papaya leaves, their therapeutic potential, and clinical evidence-based studies. The antidengue, anticancer, antidiabetic, neuroprotective, and anti-inflammatory effects of papaya leaves discussed in this article are supported by evidence from preclinical, in vivo, in vitro, and clinical trial studies, as well as from other sources. Leaves have been investigated for their mechanism of action as well as their potential to be used in the development of novel herbal products for the health business. According to the reports gathered, only a small number of research demonstrated that leaf extract at high concentrations was hazardous to certain organs. The collective literature reviewed in this review provides insights into the use of papaya leaves as a cure for epidemic diseases, highlighting the phytochemical composition and pharmacological attributes of papaya leaves, as well as the results of various preclinical and clinical studies that have been conducted so far on the subject. The review clearly demonstrates the successful medical evidence for the use of papaya leaf extracts in the healthcare system as a supplemental herbal medication in a variety of clinical settings.

Botanicals and Oral Stem Cell Mediated Regeneration: A Paradigm Shift from Artificial to Biological Replacement.

Stem cells are a well-known autologous pluripotent cell source, having excellent potential to develop into specialized cells, such as brain, skin, and bone marrow cells. The oral cavity is reported to be a rich source of multiple types of oral stem cells, including the dental pulp, mucosal soft tissues, periodontal ligament, and apical papilla. Oral stem cells were useful for both the regeneration of soft tissue components in the dental pulp and mineralized structure regeneration, such as bone or dentin, and can be a viable substitute for traditionally used bone marrow stem cells. In recent years, several studies have reported that plant extracts or compounds promoted the proliferation, differentiation, and survival of different oral stem cells. This review is carried out by following the PRISMA guidelines and focusing mainly on the effects of bioactive compounds on oral stem cell-mediated dental, bone, and neural regeneration. It is observed that in recent years studies were mainly focused on the utilization of oral stem cell-mediated regeneration of bone or dental mesenchymal cells, however, the utility of bioactive compounds on oral stem cell-mediated regeneration requires additional assessment beyond in vitro and in vivo studies, and requires more randomized clinical trials and case studies.

Dental Students in Germany throughout the COVID-19 Pandemic: A Psychological Assessment and Cross-Sectional Survey.

Multiple investigations have reported high psychological distress among students since the coronavirus (COVID-19) outbreak started. This survey examined the associations between psychological features, and several demographic and social factors among dental students in German universities. Dental students registered in German universities nationwide were asked to join this survey via a self-directed online questionnaire, from July 2020 to January 2021. This study assembled data on demographic statistics, the depression anxiety stress scales (DASS-21), and the impact of events scale-revised (IES-R) instrument. The relationships between demographic-related variables and mental consequences of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were inspected. Two hundred and eleven students contributed to the questionnaire and conveyed overall normal or mild outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal. In addition, female gender, cardiovascular diseases, smoking habits, and seeing the COVID-19 outbreak as a financial risk were stated as significant related factors (p < 0.05), with increased IES-R and DASS-21 scores. These results highlight the features that should be considered to better protect dental students' mental health in German universities during the crisis.

The Psychological Impact of the COVID-19 Pandemic on Dentists in Germany.

Since the announcement of the coronavirus 2019 (COVID-19) outbreak as a pandemic, several studies reported increased psychological distress among healthcare workers. In this investigation, we examined the association between psychological outcomes and various factors among German dentists. Dentists from all German federal states were invited to participate in this study through a self-administered online questionnaire between July and November 2020. This questionnaire collected information on demographics, Depression Anxiety Stress Scales (DASS-21), and the Impact of Events Scale-Revised (IES-R) instrument. The associations displayed between demographic and psychological outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were evaluated. Seven-hundred-and-thirty-two dentists participated in the survey and reported overall scores of (4.88 ± 4.85), (2.88 ± 3.57), (7.08 ± 5.04), (9.12 ± 8.44), (10.68 ± 8.88) and (10.35 ± 8.68) for depression, anxiety, stress, intrusion, avoidance, and hyperarousal, respectively. For females, being between 50-59 years of age, being immune deficient or chronically ill, working at a dental practice, and considering the COVID-19 pandemic a financial hazard were reported as significant associated factors (p < 0.05) with higher DASS-21 and IES-R scores. These findings underline the aspects which need to be taken into attention to protect the mental wellbeing of dentists in Germany during the crisis.