Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.

BACKGROUND: The present review aimed to investigate the association between salivary biomarkers and temporomandibular disorders (TMD). TMD is a multifactorial condition characterised by pain and dysfunction in the temporomandibular joint (TMJ) and surrounding structures. Salivary biomarkers have emerged as potential diagnostic tools due to their non-invasiveness and easy accessibility. However, the literature on salivary biomarkers in relation to TMD is limited and inconsistent. METHODS: Electronic databases of Pubmed, Embase, Web of Science, Scopus, Cochrane Library, PsychINFO, CINAHL and Medline were searched using specific search terms and Boolean operators. The search was limited to articles published in English that assessed salivary biomarkers in individuals diagnosed with TMD. Two reviewers independently screened the articles and extracted data. ROB-2 was used to assess the risk of bias. RESULTS: Eleven clinical papers met the inclusion criteria and were included in the review. The findings provided consistent evidence of a clear association between salivary biomarkers and TMD. Various biomarkers, including cortisol, IL-1, glutamate and several others, were assessed. Some studies reported higher levels of cortisol and IL-1 in TMD patients, indicating potential involvement in stress and inflammation. Glutamate levels were found to be elevated, suggesting a role in pain modulation. Other biomarkers also showed alterations in TMD patients compared to controls: CONCLUSION: The findings from the included studies suggest that salivary biomarkers may play a role in TMD pathophysiology. Though a definitive conclusion can be drawn regarding the specific salivary biomarkers and their association with TMD, the results must be interpreted with caution considering the heterogeneity of the biomarkers assessed. Further research with larger sample sizes, standardised methodology and rigorous study designs is needed to elucidate the role of salivary biomarkers in TMD.

SPECT/CT and PET/CT, related radiopharmaceuticals, and areas of application and comparison.

The paper begins by identifying the key historical elements in the development of nuclear medicine imaging, focusing on the Anger camera and single photon emission computed tomography (SPECT) technologies. In this context, key reference is made to the physics of detection in Anger camera systems, especially key components such as the sodium iodide crystal, the function and performance of photomultiplier tubes, and the collimator design. It is discovered that within each component of technology, there are fundamental physical relationships that govern the performance of each component, and that overall image quality is the result of the complex interaction of all such elements. The increasing use of SPECT/CT imaging is described and illustrated with a range of typical clinical applications, which include brain, spinal, cardiac, and cancer studies. The use of CT imaging functionality allows for SPECT image correction based on compensation for absorption within tissue. Reference is also made to the basics of positron emission tomography (PET) imaging and, in particular, to the integration of PET/CT systems where the anatomy profile of the CT image is used to provide correction for photon absorption. A summary is provided of the radionuclides and radiopharmaceuticals commonly used in PET/CT imaging and a range of image studies referenced includes those of nasopharyngeal carcinoma, lung cancer investigation, brain investigation (cancer detection and dementia) and cardiac function. Reference is made to the development of "time of flight" (TOF) technology for improving of image resolution in PET/CT systems. Furthermore, SPECT/CT and PET/CT imaging systems are compared, where a key factor identified is the significantly higher number of photons detected with PET/CT technology and improved image resolution.

Enhancement of Mammographic Images Using Histogram-Based Techniques for Their Classification Using CNN.

In the world, one in eight women will develop breast cancer. Men can also develop it, but less frequently. This condition starts with uncontrolled cell division brought on by a change in the genes that regulate cell division and growth, which leads to the development of a nodule or tumour. These tumours can be either benign, which poses no health risk, or malignant, also known as cancerous, which puts patients' lives in jeopardy and has the potential to spread. The most common way to diagnose this problem is via mammograms. This kind of examination enables the detection of abnormalities in breast tissue, such as masses and microcalcifications, which are thought to be indicators of the presence of disease. This study aims to determine how histogram-based image enhancement methods affect the classification of mammograms into five groups: benign calcifications, benign masses, malignant calcifications, malignant masses, and healthy tissue, as determined by a CAD system of automatic mammography classification using convolutional neural networks. Both Contrast-limited Adaptive Histogram Equalization (CAHE) and Histogram Intensity Windowing (HIW) will be used (CLAHE). By improving the contrast between the image's background, fibrous tissue, dense tissue, and sick tissue, which includes microcalcifications and masses, the mammography histogram is modified using these procedures. In order to help neural networks, learn, the contrast has been increased to make it easier to distinguish between various types of tissue. The proportion of correctly classified images could rise with this technique. Using Deep Convolutional Neural Networks, a model was developed that allows classifying different types of lesions. The model achieved an accuracy of 62%, based on mini-MIAS data. The final goal of the project is the creation of an update algorithm that will be incorporated into the CAD system and will enhance the automatic identification and categorization of microcalcifications and masses. As a result, it would be possible to increase the possibility of early disease identification, which is important because early discovery increases the likelihood of a cure to almost 100%.

Efficacy of Antibiotic Versus Probiotics As Adjuncts to Mechanical Debridement for the Treatment of Peri-Implant Mucositis.

The objective was to compare the efficiency of probiotic therapy (PT) vs antibiotic therapy (AT) as adjuvants to nonsurgical-mechanical debridement (NSMD) for the treatment of peri-implant mucositis (Pi-M). Volunteers with Pi-M were encompassed. Therapeutically, patients were randomly divided into 3 groups: (a) Group 1: NSMD + PT; (b) Group 2: NSMD + AT; and (c) Group 3: NSMD alone. Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD), and crestal bone loss (CBL) were recorded at baseline and at 3 and 6 months follow-up. P < .05 was selected as the indicator of statistical significance. Forty-two male individuals (14, 14, and 14 in Groups 1, 2, and 3, respectively) were included. At 3 and 6 months of follow-up, PI (P < .01), BOP (P < .01), and PD (P < .01) were higher in Group 2 than Group 1. At 3 months of follow-up, PI (P < .01), BOP (P < .01), and PD (P < .01) were higher in Group 3 than Group 2. At 6 months of follow-up, PI, BOP, and PD were comparable in Groups 2 and 3. In Group 3, PI, BOP, and PD were comparable with the respective baseline values at 6 months of follow-up. The CBL in all groups remained unchanged up to 6 months of follow-up. The NSMD with adjuvant PT is more effective than adjunct AT for the treatment of Pi-M for up to 3 months.

Role of Probiotics for the Treatment of Peri-Implant Mucositis in Patients With and Without Type 2 Diabetes Mellitus.

This study hypothesized that probiotic therapy (PT) does not offer additional benefits to mechanical debridement (MD) for the treatment of diabetic subjects with peri-implant mucositis (PM). This study compared the influence of PT as an adjunct to MD for the treatment of PM in type 2 diabetic and nondiabetic patients over a 12-month follow-up period. Patients with and without type 2 diabetes were included. PM patients were categorized into 2 groups based on the treatment procedure: (1) nonsurgical + PT and (2) nonsurgical MD alone. Demographics and education statuses were recorded. Gingival index (GI) and plaque index (PI), crestal bone loss (CBL), and probing depth (PD) were measured at baseline and after 6 and 12 months. Significant differences were detected with P < .01. The hemoglobin A1c level was significantly higher in patients with diabetes at all time durations than in patients without type 2 diabetes (P < .001). Baseline GI, PI, PD, and CBL were comparable in all groups. In patients with type 2 diabetes, there was no difference in PI, GI, PD, and CBL at 6- and 12-month follow-up. In patients without type 2 diabetes, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01) at 6-month and 1-year follow-up as compared with baseline. In patients without type 2 diabetes, MD with or without adjunct PT reduced soft-tissue inflammatory parameters in patients with PM.

Implant Treatment for a Patient With Large Condensing Osteitis: Case Report.

Chronic endodontic infections are associated with osseous changes in the peri-apical regions. Dental implants are often placed after the extraction of hopeless teeth with periapical infections. This clinical report describes a patient with a radiopaque mass attached to the root apex of the mandibular right second premolar tooth (No. 45). The differential diagnoses of the radiopaque mass were bone- and tissue-borne diseases. Based on the clinical and radiologic findings (bone density and trabeculation of the bone), the definitive diagnosis of the osseous mass was condensing osteitis. The osseous tumor associated with tooth 45 was atraumatically extracted under local anesthesia. Guided bone regeneration was performed immediately after extraction of tooth 45, and a dental implant was placed in the site after 6 months of healing.

Effect of Different Implant-Abutment Connection Materials on the Fracture Resistance of Zirconia Abutments.

The aim of the present in vitro study was to assess the modes of failures under static load among titanium (Ti) and 1- and 2-piece zirconia abutments. The 1- and 2-piece zirconia abutment specimens were fabricated from prescanned Ti abutments. Twenty-one implant abutments and 21 implant replicas were equally divided into 3 groups as follows: (a) Group 1 (Titanium group); (b) Group 2 (1-piece zirconia abutment group); and (c) Group 3: 2-piece zirconia abutment group). A 250 000-cycle linear fatigue load ranging between 10 N and 210 N was applied to all specimens using an all-electric dynamic test instrument. The specimens were loaded until they fractured. In all groups, assessment of mode of fracture was done on visual assessment by a trained and calibrated investigator. Prior sample-size estimation was performed; and sample distribution was assessed using the Kolmogorov and Shapiro tests. Screw fracture (n = 7) and abutment bending at the apical part (n = 7) occurred in the Ti group. In the 1-piece zirconia group, screw and abutment fractures occurred in 7 and 7 cases, respectively. In the 2-piece zirconia screw fracture (n = 7) above the Ti zirconia junction (transgingival segment) and abutment fracture (n = 7) were determined as the failure modes. In vitro, the 1-piece zirconia abutments are more fracture resistant than titanium and 2-piece zirconia abutments. From a clinical perspective, further studies are needed to determine the minimum static load value required to induce fracture of the 1- and 2-piece zirconia abutments.

Efficacy of Nonsurgical Mechanical Debridement With and Without Adjunct Low-Level Laser Therapy in the Treatment of Peri-Implantitis: A Randomized Controlled Trial.

We hypothesized that in the long term (6-month follow-up), nonsurgical mechanical debridement (NSMD) with adjunct low-level laser therapy (LLLT) is more effective for the treatment of peri-implantitis than NSMD alone. The aim of the present 6-month follow-up convenience-sample cohort study was to assess the efficacy of LLLT as an adjunct to NSMD in the treatment of peri-implantitis. A questionnaire was used to collect demographic information. Patients with peri-implantitis in the test and control groups underwent NSMD with and without adjunct LLLT, respectively. Randomization was done by tossing a coin. In the test group, the laser was applied perpendicular to the periodontal pocket for 20 seconds at a constant distance of 15 mm and with a continuous wavelength (3.41 J/cm2 delivery with a 1.76 cm2 spot and average output of 0.3 W). In both groups, peri-implant probing depth, bleeding upon probing, and crestal bone resorption were assessed at baseline and at the 3-month and 6-month follow-up. Group comparisons were performed, and P < .05 was considered statistically significant. Sixty-seven individuals with peri-implantitis were included. The mean age of participants who underwent NSMD with adjunct LLLT and NSMD alone was 46.5 ± 3.4 and 45.3 ± 1.1 years, respectively. At the 3- and 6-month follow-up, peri-implant (P < .05), bleeding upon probing (P < .05), and probing depth (P < .05) were significantly higher among patients who underwent NSMD alone compared with patients who underwent NSMD with adjunct LLLT. There was no significant difference in crestal bone resorption in all patients up to the 6-month follow-up. In the short term, NSMD with adjunct LLLT was a useful treatment protocol for the treatment of peri-implant soft-tissue inflammation.

"Religious Belief": An Undervalued Ethical Inclusion Criterion for Clinical Trials on Bone Grafting Procedures.

The aim of the present review was to assess randomized controlled trials (RCTs) on bone grafting procedures that included religious belief as an eligibility criterion. Indexed databases were searched up to and including February 2019 using different search strategies. In strategy 1, the following terms were used: (a) belief; (b) bone graft; (c) faith; (d) inclusion; (e) exclusion; (f) eligibility; (g) criteria; (h) randomized clinical trial; (i) religion; and (j) xenograft. In strategy 2, the following terms were used in addition to those used in strategy 1: Xenografts AND oral surgery OR xenografts AND maxillofacial OR xenografts AND dental implants. These searches were filtered using the terms "Randomized clinical trial" and "human studies". The initial search yielded 3932 studies. Filtration of results using the terms "Randomized clinical trial" and "human studies" showed 0 studies. Evaluation of patients' religious beliefs seems to be undervalued in RCTs related to the placement of xenografts. This is an essential and ethical criterion that should be taken into consideration prior to inclusion of participants and signing the informed consent form for RCTs related to the placement of bone grafts.

Are semi-automated software program designed for adults accurate for the identification of vertebral fractures in children?

OBJECTIVES: To assess whether diagnostic accuracy of morphometric vertebral fracture (VF) diagnosis in children can be improved using AVERT™ (a 33-point semi-automated program developed for VF diagnosis in adults) compared with SpineAnalyzer™ (a 6-point program), which has previously been shown to be of insufficient accuracy. MATERIALS AND METHODS: Lateral spine radiographs (XR) and dual-energy X-ray absorptiometry (DXA) scans of 50 children and young people were analysed by two observers using two different programs (AVERT™ and SpineAnalyzer™). Diagnostic accuracy (sensitivity, specificity, false-negative (FN) and false-positive rates (FP)) was calculated by comparing with a previously established consensus arrived at by three experienced paediatric musculoskeletal radiologists, using a simplified algorithm-based qualitative scoring system. Observer agreement was calculated using Cohen's kappa. RESULTS: For XR, overall sensitivity, specificity, FP and FN rates using AVERT™ were 36%, 95%, 5% and 64% respectively and 26%, 98%, 2% and 75% respectively, using SpineAnalyzer™. For DXA, overall sensitivity, specificity, FP and FN rates using AVERT™ were 41%, 91%, 9% and 59% respectively and 31%, 96%, 4% and 69% respectively, using SpineAnalyzer. Reliability (kappa) ranged from 0.34 to 0.37 (95%CI, 0.26-0.46) for AVERT™ and from 0.26 to 0.31 (95%CI, 0.16-0.44) for SpineAnalyzer™. Inter- and intra-observer agreement ranged from 0.41 to 0.47 for AVERT™ and from 0.50 to 0.79 for SpineAnalyzer™. CONCLUSION: AVERT™ has slightly higher accuracy but lower observer reliability for the representation of vertebral morphometry in children when compared with SpineAnalyzer™. However, neither software program is satisfactorily reliable for VF diagnosis in children. KEY POINTS: • SpineAnalyzer™ and AVERT™ have low diagnostic accuracy and observer agreement when compared to three paediatric radiologists' readings for the diagnosis of vertebral fractures (VF) in children. • Neither AVERT™ nor SpineAnalyzer™ is satisfactorily reliable for VF diagnosis in children. • Development of specific paediatric software and normative values (incorporating age-related physiological variation in children) is required.

Diagnosis of osteoporotic vertebral fractures in children.

Osteoporosis is a generalised disorder of the skeleton with reduced bone density and abnormal bone architecture. It increases bone fragility and renders the individual susceptible to fractures. Fractures of the vertebrae are common osteoporotic fractures. Vertebral fractures may result in scoliosis or kyphosis and, because they may be clinically silent, it is imperative that vertebral fractures are diagnosed in children accurately and at an early stage, so the necessary medical care can be implemented. Traditionally, diagnosis of osteoporotic vertebral fractures has been from lateral spine radiographs; however, a small number of studies have shown that dual energy x-ray absorptiometry is comparable to radiographs for identifying vertebral fractures in children, while allowing reduced radiation exposure. The diagnosis of vertebral fractures from dual energy x-ray absorptiometry is termed vertebral fracture assessment. Existing scoring systems for vertebral fracture assessment in adults have been assessed for use in children, but there is no standardisation and observer reliability is variable. This literature review suggests the need for a semiautomated tool that (compared to the subjective and semiquantitative methods available) will allow more reliable and precise detection of vertebral fractures in children.

Influence of Different Luting Cements on the Shear Bond Strength of Pretreated Lithium Disilicate Materials.

AIMS: The aim of the study was to examine the shear bond strength of different luting cements bonding to pre-treated lithium disilicate materials. MATERIALS AND METHODS: Sixty A2 shade lithium disilicate discs were subjected to either micro-etch with aluminum trioxide and etching by 10% hydrofluoric acid (micro-etch group; n = 30); or etching with 10% hydrofluoric acid (acid-etch group; n = 30) before cementation. Three dual-cure Variolink Esthetic (VDC), RelyX Ultimate (RUT), and RelyX Unicem (RUC) and three light-cure Variolink Veneer (VV), Variolink Esthetic (VLE), RelyX Veneer (RV) resin cements were used for cementation. The specimens from each group were tested for shear bond strength (SBS). The data were analyzed using two-way ANOVA; p < 0.05 is considered statistically significant. RESULTS: For all resin cements tested with different surface treatments, there was a statistically significant difference within resin cements per surface treatment (p < 0.05). The SBS in the micro-etch group was significantly higher across all the cements tested when compared to the acid-etch group (p < 0.05), thus suggesting that surface treatment affects the SBS largely irrespective of the resin cement. Their interaction between cement and the surface treatment was significantly different across groups (p < 0.001). CONCLUSION: Under the limitations of the present study, it can be concluded that surface treatment influences the bond strength irrespective of the resin cement (light/dual-cure) used for indirect restorations' cementation. The shear bond strength in the sand blast/acid etch group was significantly higher across all the cements tested when compared to the acid-etch alone. CLINICAL SIGNIFICANCE: The surface treatment of porcelain veneer hugely influence the SBS, which will directly affect the veneer clinical success rate. The micro-etching recorded a higher shear bond strength when compared to those with acid-etch only.

The Effect of in vitro Aging and Fatigue on the Flexural Strength of Monolithic High-translucency Zirconia Restorations.

AIM: The aim of this in vitro study was to evaluate the effect of accelerated artificial aging (AAA) and fatigue on the biaxial flexural strength (BFS) of three types of monolithic high-translucency zirconia restorations compared with conventional low-translucency zirconia restorations. MATERIALS AND METHODS: Four groups of 20 disc-shaped specimens (10 × 1.2 mm) were made from the following computer-aided design and computer-aided manufacturing (CAD/CAM) zirconia blocks: Low-translucency zirconia (Ceramill ZI-LT) as a control, and three brands of high-translucent zirconia (Lava Plus, Ceramill Zolid White, and Copran Monolithic HT). Ten discs from each group were subjected to the BFS test using the universal testing machine. The other 10 discs from each group were subjected to AAA (thermocycling, 3,500 cycles) and fatigue (250,000 cycles) before the fracture test. The definitive fracture load was recorded, and the BFS was calculated in accordance with International Organization for Standardization (ISO) 6872. The data were analyzed with one-way analysis of variance (ANOVA), Scheffe post hoc, and Mann-Whitney U test. Data analyses were evaluated at a significance level of p < 0.05. RESULTS: Significant differences were detected in the BFS among the four groups before AAA and fatigue. The mean BFS was highest with Ceramill ZI (935.3 ± 47.1 MPa), and least in Ceramill Zolid White (685.7 ± 32.6 MPa). After AAA and fatigue, significant differences were reported where the mean of BFS was highest with Copran Zr-i Monolithic HT (777.5 ± 21.2 MPa), and least in Ceramill Zolid White (576.0 ± 36.3 MPa). Furthermore, Mann-Whitney U test showed that AAA and fatigue significantly affect the BFS of each material individually. CONCLUSION: The AAA and fatigue significantly affected the BFS of the monolithic high-translucency zirconia restorations. CLINICAL SIGNIFICANCE: Although monolithic high-translucency zirconia had significantly lower BFS than conventional zirconia tested in this study, they still have sufficient strength for clinical use.

Evaluation of Interactions of Surface Fluorides on Nickel-chromium and Casted Titanium Alloys: An In Vitro Study.

AIM: The present study was conducted to assess the effects of topical fluoride on casted Titanium and nickel chromium using Scanning Electron Microscope. MATERIALS AND METHODS: This in vitro study comprised of 45 specimens of Titanium and 45 specimens of nickel-chromium of same dimensions. They were divided into three groups of 15 each. GroupI specimens were immersed in 2% neutral sodium fluoride (NaF) solution for 16 minutes. Group II specimens were placed in 1.23% acidulated phosphate fluoride (APF) gel for eight minutes. Group III specimens were placed in distilled water for 8 minutes. All specimens were evaluated for surface roughness using a scanning electron microscope. RESULTS: Data thus obtained were subjected to statistical analysis including post-hoc test and analysis variance (ANOVA). There was no significant increase in surface roughness of nickel- chromium specimens in group I, II and III (p > 0.05) whereas Titanium specimens in group II showed a substantial increase in surface roughness (p < 0.05). There was surface corrosion of Titanium specimens and slight pitting of nickel-chromium specimens in group II. CONCLUSION: The studied preparation (1.23%) of acidulated phosphate fluoride has shown to affect the surface roughness of Titanium and nickel-chromium specimens whereas 2% neutral sodium fluoride and distilled water has no noticeable effect, therefore, providing some logical clinical correlations. CLINICAL SIGNIFICANCE: Clinicians must be well known about the logical usages of topical fluorides in dentistry. Different fluoride concentrations and preparations are capable of producing prosthesis's surface roughness of various degrees. Surface roughness is acting as potent areas of bacterial adhesion, plaque retention, calculus retention and microcrack formation with poor esthetics and therefore it significantly affect long-term prosthesis success. Thus, the operator must be very critically monitoring and managing the harmful effects of acidic fluoridated on prosthesis made up of casted Titanium and nickel-chromium.

Effect of newly Developed Resin Cements and Thermocycling on the Strength of Porcelain Laminate Veneers.

AIM: The aim of this study was to determine the effect of different luting cements and accelerated artificial aging (AAA) in the fracture resistance of porcelain laminate veneers (PLVs). MATERIALS AND METHODS: A total of 80 disc-shaped specimens were prepared using computer-aided design/computer-aided milling technology from lithium disilicate glass-ceramic blocks. Specimens (0.5 mm thick, 10 mm diameter) were divided into eight groups of 10 specimens per group. The control groups consisted of specimens without cement and not subjected to AAA (CN group) and specimens prepared without cement but subjected to AAA (CW group). The experimental groups were subjected to AAA and cemented with Variolink Veneer, Variolink Esthetic LC, Variolink Esthetic DC, RelyX Unicem, RelyX Veneer, or RelyX Ultimate. Specimens were individually tested for biaxial flexure on a universal testing machine. One-way analysis of variance and the Tukey's post hoc test were used to compare the groups' significance statistically (α = 0.05). RESULTS: The loads to fracture (LTF) values in the CN group were higher than those in the CW and experimental groups. The lowest LTF value was in the CW group (31.5 ± 9.5 N) and the highest LTF value in the CN group (56.7 ± 10.6 N). Tukey's post hoc test demonstrated a statistically significant (p < 0.01) difference between the CN group and the other groups. CONCLUSION: Artificial aging had a significant effect on the LTF value of the tested specimens compared with the resin cements used. Cohesive failure within the PLVs was the most common mode of failure. CLINICAL SIGNIFICANCE: Fatigue strength of dental ceramics and moisture was shown to affect the mechanical properties of all-ceramic restorations. All-ceramic material is extremely sensitive to humidity and thermocycling.

Intricate Assessment and Evaluation of Long-term Implant Success as affected by Clinicomicrobial and Salivary Diagnostics in Type II Diabetic Patients: A Longitudinal Study.

INTRODUCTION: Replacement of missing teeth by dental implants is one of the most common methods employed these days. Because of significant advancement in the design of implants and modifications in the procedure of dental implant surgery, the survival rate of the dental implants has reached up to approximately 95%. Osseointegration is one of the important factors affecting the survival of dental implants. Apart from these, the body's physiologic alterations can also predispose the dental implants for failure. Diabetes is one such metabolic disease characterized by abnormal or delayed wound healing. Hence, we assessed the clinicomicrobial and salivary profile of diabetic patients undergoing rehabilitation by dental implants. MATERIALS AND METHODS: This study included diabetic patients who underwent dental implant surgeries for prosthetic rehabilitation. Follow-up records of the patients' up to 1 year were maintained. Various clinicoradiographic and periodontal parameters were measured at various time intervals during follow-up time; 25 mL of salivary and blood sample was taken from all the subjects and was sent to the laboratories for assessment of various salivary biomarkers. All the results were analyzed by Statistical Package for the Social Sciences software. RESULTS: The mean level of interleukin-p at baseline time was found to be 2.38 and 2.21 in diabetic group and control group respectively. While comparing the levels of osteoprotegerin in both study groups, a significant correlation was obtained. In diabetic and control group, 62 and 61 years was the mean age of the patients respectively. No significant correlation was obtained while comparing the microbial flora of diabetic and control group. CONCLUSION: In both diabetic and nondiabetic patients, similar microbial, salivary marker, and clinicoradiological patterns were seen. CLINICAL SIGNIFICANCE: Diabetic patients who maintain their body's metabolic rate show similar success rate of dental implants as seen in nondiabetic patients.

In vitro Assessment of Clasps of Cobalt-Chromium and Nickel-titanium Alloys in Removable Prosthesis.

BACKGROUND: It has been since a long time that the use of base-metal alloys has significantly increased in the area of prosthetic science. One of the factors contributing for the increasing use of base-metal alloys is the increasing and high cost factor of noble metals. Although numerous materials have been tried since the recent past, Cobalt-Chromium (CoCr) alloys still form the most commonly used ones because of the numerous advantages they offer. Titanium alloys are also significantly being used in this field because of their high resistance strength and high corrosion resistance. Therefore, we aimed to evaluate the flexure strength and fatigue resistance of clasps made up of CoCr alloys and Nickel-titanium (NiTi) alloys. MATERIALS AND METHODS: We evaluated the retentive forces of CoCr and NiTi clasps two different sizes engaging retentive undercuts of different depths (0.25 and 0.50 mm). Mandibluar second premolar was prepared to frame the prosthesis for missing mandibular first and second molar. A total of 50 clasps were included in the study out of which 30 were NiTi clasps and 30 CoCr clasps. We evaluated the loading of the force at the rate of half Newton(N)/second at the central part of the specimen until fracturing of the specimen occurred and finally measurement of the modulus of elasticity was also done. Statistical analysis was carried out; unpaired "t" test was used for evaluating the level of significance. RESULTS: The mean load needed for CoCr clasps was 0.7450 and for NiTi clasp was 0.6140 Kgf for producing a deflection of 0.25 mm. As far as flexibility is concerned, more value was seen in NiTi group than CoCr group. For deflecting the clasp up to 0.50 mm, the mean load needed for CoCr clasps was 1.4102 and for NiTi clasp was 0.8260 Kgf. The results were statistically significant. While measuring the flexibility, more value (p < 0.05) was seen in NiTi group than in CoCr group. NiTi alloy clasps had mean flexural strength of 1640 MPa and modulus of elasticity of 32 GPa. CONCLUSION: For producing deflection of 0.25 and 0.50 mm, the mean loading force was higher for NiTi alloys. Although being increasingly used these days, NiTi alloys have limited use as compared with CoCr alloys due to high cost of titanium and certain other limitations.

Postfatigue fracture resistance of modified prefabricated zirconia implant abutments.

STATEMENT OF PROBLEM: The fracture of zirconia abutments has been reported relative to different amounts of reduction. Data are not available to demonstrate whether the apical vertical reduction of a zirconia abutment at different levels can be achieved while maintaining an acceptable load-to-fracture value. PURPOSE: The purpose of this study was to evaluate in vitro the effect of different levels of preparation of zirconia implant abutments on the fracture load. MATERIAL AND METHODS: Twenty-seven zirconia abutments (NobelProcera Abutment Zirconia) and 27 implant analogs (NobelReplace Implant Replicas) were divided into 3 groups of 9 abutments and 9 implant analogs. The Zu group (n=9) without any modification and with a chamfer margin width of 0.8 mm served as the control. The Zp1 group (n=9) was prepared with a chamfer margin width of 0.8 mm and with a 1-mm step in the labial margin. The Zp2 group (n=9) was prepared with a chamfer margin width of 0.8 mm and with a 1.5-mm step in the labial margin. The zirconia abutment was attached to the implant analog and fixed in a customized steel mounting table. The abutment-implant complex was immersed in saliva substitute to simulate the clinical oral environment. A 250 000 cycle sinusoidal fatigue load that ranged between 10 N and 210 N was applied to the specimens by using a universal testing machine. Subsequently, the specimens were loaded to fracture. One-way ANOVA and the Tukey post hoc test were used to compare the groups statistically (α=.05). RESULTS: The mean (standard deviation) values of the abutment load to fracture were as follows: Zu group = 567.3 ± 35.4 N; Zp1 group = 445.4 ± 41.0 N; Zp2 group = 430.5 ± 39.4 N. The lowest abutment load-to-fracture value was in the Zp2 group (408.6 N), whereas the highest abutment load-to-fracture value was in the Zu group (591.4 N). A significant (P<.05) difference was found between the Zu group and the other groups, but no significant difference was found between the Zp1 group and the Zp2 group. The primary mode of fracture (67%) was at the abutment-analog interface. CONCLUSION: Preparation of prefabricated zirconia abutments had a statistically significant negative effect on the abutment load-to-fracture values.

Full-mouth rehabilitation of severely worn dentition due to soda swishing: a clinical report.

Diagnosis and treatment planning of severely worn dentition are complex and complicated. Erosion is one of the common causes of lost tooth surface. Defining the etiology of the erosion is essential before proceeding with treatment to be able to provide the most predictable treatment outcome. Multiple specialists including psychologists, family medicine practioners, and social workers should be involved in the diagnosis and the prevention of a continuing erosion process. The treatment plan should be based on the severity of the tooth surface lost. It can range from simple direct restorations to a full-mouth rehabilitation. This clinical report is a detailed description of a complex prosthodontic diagnostic index class IV patient based on current evidence-based dentistry.

Effects of COVID-19 on Synaptic and Neuronal Degeneration.

Neurons are the basic building blocks of the human body's neurological system. Atrophy is defined by the disintegration of the connections between cells that enable them to communicate. Peripheral neuropathy and demyelinating disorders, as well as cerebrovascular illnesses and central nervous system (CNS) inflammatory diseases, have all been linked to brain damage, including Parkinson's disease (PD). It turns out that these diseases have a direct impact on brain atrophy. However, it may take some time after the onset of one of these diseases for this atrophy to be clearly diagnosed. With the emergence of the Coronavirus disease 2019 (COVID-19) pandemic, there were several clinical observations of COVID-19 patients. Among those observations is that the virus can cause any of the diseases that can lead to brain atrophy. Here we shed light on the research that tracked the relationship of these diseases to the COVID-19 virus. The importance of this review is that it is the first to link the relationship between the Coronavirus and diseases that cause brain atrophy. It also indicates the indirect role of the virus in dystrophy.