Radio frequency plasma assisted surface modification of Fe3O4 nanoparticles using polyaniline/polypyrrole for bioimaging and magnetic hyperthermia applications.

Surface modification of superparamagnetic Fe3O4 nanoparticles using polymers (polyaniline/polypyrrole) was done by radio frequency (r.f.) plasma polymerization technique and characterized by XRD, TEM, TG/DTA and VSM. Surface-passivated Fe3O4 nanoparticles with polymers were having spherical/rod-shaped structures with superparamagnetic properties. Broad visible photoluminescence emission bands were observed at 445 and 580 nm for polyaniline-coated Fe3O4 and at 488 nm for polypyrrole-coated Fe3O4. These samples exhibit good fluorescence emissions with L929 cellular assay and were non-toxic. Magnetic hyperthermia response of Fe3O4 and polymer (polyaniline/polypyrrole)-coated Fe3O4 was evaluated and all the samples exhibit hyperthermia activity in the range of 42-45 °C. Specific loss power (SLP) values of polyaniline and polypyrrole-coated Fe3O4 nanoparticles (5 and 10 mg/ml) exhibit a controlled heat generation with an increase in the magnetic field.

Combinational delivery of anticancer drugs for osteosarcoma treatment using electrosprayed core shell nanocarriers.

In bone cancer treatment, local delivery of chemotherapeutic agents is preferred compared to other routes of administration. Delivery of multiple drugs using biodegradable carriers improves the treatment efficiency and overcomes drug resistance and toxicity. With this approach, we have developed multilayer biodegradable core shell nanoparticles (NPs) using the electro-spraying technique to deliver methotrexate (MTX) and doxorubicin (DOX) for the treatment of osteosarcoma. These core-shell NPs with a mean particle size of 212 ± 41 nm consist of hydroxyapatite (HA) and DOX as core with the outer shell made of chitosan (CH) followed by polycaprolactone (PCL) with MTX. The encapsulation efficiency of MTX was around 85% and DOX was 38%. In vitro drug release studies were performed in phosphate buffered saline (PBS) at pH 5 and pH 7.4 for 8 days. Different release profiles were observed in both acidic and alkaline pH. The sequential release of MTX followed by DOX was observed in both pH in sustained manner. Human osteosarcoma MG 63 (OMG-63) cells lines were used to test the cytotoxicity of drug loaded NPs. Multi-drug encapsulated bioresorbable and biodegradable electro-sprayed core shell NPs will be promising as a bone substitute for the treatment of osteosarcoma.

Ceramic core with polymer corona hybrid nanocarrier for the treatment of osteosarcoma with co-delivery of protein and anti-cancer drug.

For the treatment of metastatic bone cancer, local delivery of therapeutic agents is preferred compared to systemic administration. Delivery of an anti-cancer drug and a protein that helps in bone regeneration simultaneously is a challenging approach. In this study, a nanoparticulate carrier which delivers a protein and an anti-cancer drug is reported. Bovine serum albumin (BSA) as a model protein was loaded into hydroxyapatite (HA) nanoparticles (NPs) and methotrexate (MTX) conjugated to poly(vinyl alcohol) was coated onto BSA-loaded HA NPs. Coating efficiency was in the range of 10-17 wt%. In vitro drug release showed that there was a steady increase in the release of both BSA and MTX with 76% of BSA and 88% of MTX being released in 13 days. Cytotoxicity studies of the NPs performed using human osteosarcoma (OMG-63) cell line showed the NPs were highly biocompatible and exhibited anti-proliferative activity in a concentration-dependent manner.

Unusual foreign body in the nasal cavity of an adult with repaired cleft lip and palate.

Intranasal foreign bodies arising from dental clinical practice, especially in patients with cleft lip and palate (CLP) occur rarely and are very scarce in the literature. This article reports an unusual case of a dental impression material presenting as a foreign body in the nasal cavity of an adult with repaired CLP who presented for dental prosthetic rehabilitation. To our knowledge, this is only the second report presenting nasal foreign body in a cleft patient arising due to a dental impression procedure.

Effect of Early Orthodontic Treatment on Long-Term Stability of Class II Malocclusions.

Background: Class II malocclusions are a common orthodontic problem, often requiring comprehensive treatment to achieve proper occlusion and facial harmony. Early orthodontic intervention in the mixed dentition phase has been advocated to address these issues. Materials and Methods: A retrospective analysis was conducted on a cohort of 150 patients with class II malocclusions who underwent early orthodontic treatment between the ages of 7 and 10 years. The treatment included fixed or removable appliances, headgear, and functional appliances, depending on individual needs. Records of their initial malocclusion severity, treatment modalities, and long-term follow-up data (mean follow-up duration of 10 years) were collected and analyzed. Stability was assessed by evaluating overjet and overbite changes from post-treatment to the long-term follow-up. Results: The initial mean overjet and overbite values were 8.5 mm and 4.0 mm, respectively. Following early orthodontic intervention, these values were significantly reduced to 3.0 mm and 1.5 mm, respectively (P < 0.001). At the long-term follow-up, the mean overjet and overbite remained stable at 3.2 mm and 1.6 mm, respectively. Analysis revealed that 85% of patients maintained their corrected class II occlusion within clinically acceptable limits, while 15% experienced minor relapse requiring minimal additional treatment. Conclusion: Early orthodontic treatment in class II malocclusions can lead to significant improvements in overjet and overbite, and these corrections tend to remain stable over the long term.

Acute leukemias: a dentist's perspective.

Oral cavity reflects the health status of an individual. Many systemic diseases have signs and symptoms that manifest in the oral cavity, which in most of the cases precede the systemic manifestations. These array of diseases also include acute leukemias which present as gingival hyperplasia as the most consistent symptom seeking dental consultation that can be easily confused with many other benign conditions that present as gingival enlargements. One such rare case of adult acute lymphoblastic leukemia is presented in this article.

Electroacoustics of particles dispersed in polymer gel.

This study examines the electroacoustics of particles dispersed in polymer hydrogels, with the particle size either less than or greater than the gel mesh size. When the particles are smaller than the gel mesh size, their acoustic vibration is resisted by only the background water medium, and the measured dynamic electrophoretic mobility, µ(d) (obtained in terms of colloid vibration current, CVI), is the same as that in water. For the case of particles larger than the gel mesh size, µ(d) is decreased due to trapping, and the net decrease depends on the viscoelastic properties of the gel. The gel mesh size was varied by varying its cross-link density, with the latter being characterized as the storage modulus, G'. The dependence of mobility on G', for systems of a given particle size, and on particle size, for gels of a given G', are investigated. The measured mobility remains constant as G' is increased (i.e., mesh size is decreased) up to a value of approximately 300 Pa, beyond which it decreases. In the second set of measurements, the trapped particle size was increased in a gel medium of constant mesh size, with G' being approximately 100 Pa. In this case, the measured µ(d) is found to be effectively constant over the particle size range studied (14-120 nm); that is, it is independent of the degree of trapping as expressed by the ratio of the particle size to the mesh size.

Acoustic spectroscopy of colloids dispersed in a polymer gel system.

The technique of acoustic spectroscopy offers some significant advantages over conventional techniques, such as dynamic light scattering and differential sedimentation (centrifugation), for the characterization of colloidal dispersions in that it does not require that the systems be highly dilute and transparent. Another advantage of the method may derived from the fact that in applications, the relative motion between any particle and the medium is very small, at the most being comparable to the particle size. It may thus be suited, within limits, to the study of dispersions in polymer gels, without the additional limitation of conventional methods to transparent media (matching refractive index of polymer and liquid). The present work seeks to probe experimentally the limits of the technique and its current theory for the determination of particle size distributions in gel media. Experiments measuring acoustic attenuation have been conducted on dispersions of silica particles of varying size in aqueous hydroxylpropyl cellulose (HPC) gels of varying cross-link density. The particle size distribution (PSD) was successfully measured by acoustic attenuation theory for dispersions in Newtonian media provided that the hydrodynamic particle diameter was less than the hydrodynamic mesh size of the gel, as given by simple rubber elasticity theory (mesh size/particle size ≳1.5). The same results were obtained at particle loadings of up to 15 wt %. If the particles are larger than the mesh size, then a viscoelastic response from the gel matrix is observed that cannot be interpreted to yield the particle size using the existing theoretical framework.

Comparative evaluation of enamel microhardness after using two different remineralizing agents on artificially demineralized human enamel: An in vitro study.

AIM: The purpose of this study was to compare the remineralization outcomes of two agents using the Vickers microhardness test (VMHT) on artificially induced enamel subsurface lesions. MATERIALS AND METHODS: Forty sound extracted premolars were selected as samples for the current study and divided into four groups of 10 teeth each: Clinpro (group 1), Remin Pro (group 2), untreated positive control (group 3), and a demineralized negative control (group 4). All the sample groups were assessed first at baseline then after demineralization and remineralization using DIAGNOdent. After the remineralization process, VMHT was performed on all sample groups to assess surface microhardness (SMH). The results obtained were then compared using a one-way analysis of variance (ANOVA) for the difference in SMH. RESULTS: Vickers microhardness number values were analyzed using one-way ANOVA and samples in the experimental groups 1 and 2 showed a statistically significant difference compared to the control groups (P < 0.05). Remineralization was higher in the Remin Pro group, followed by Clinpro group. CONCLUSIONS: The results of this in vitro study show that both Remin Pro and Clinpro are equally effective as remineralizing agents. Although Remin Pro tended to yield a higher microhardness, no significant differences were observed between the two agents. RELEVANCE FOR PATIENTS: Enamel mineral loss leads to the degradation of the surface and subsurface structures of teeth. Natural remineralization that occurs physiologically is not sufficient to overcome the hurdles of mineral loss a tooth undergoes due to changes in food habits and lifestyle. A thought on remineralization and management such as prescribing remineralizing agents and regular professional topical fluoride applications would definitely render satisfactory results by a strong healthy enamel.

Comparative evaluation of the effect of decontamination protocol on the shear bond strength of eighth generation bonding agent to contaminated dentin: an in vitro study.

INTRODUCTION: This in vitro study aims to evaluate and compare the effect of decontamination protocol - based on sodium hypochlorite - NaOCl, as a decontaminating agent, followed by the application of a collagen cross-linking agent like sodium ascorbate or Proanthocyanidin on the shear bond strength of eighth generation bonding agent to contaminated dentin (saliva, blood and blood followed by hemostatic agent). METHODS: The buccal surfaces of extracted premolars were flattened to expose the dentine. The teeth were then randomly divided into 3 groups based on the contaminant used (saliva, blood and blood followed by hemostatic agent). Decontamination protocol was carried out with sodium hypochlorite followed by application of either of the two collagen cross-linking agents (sodium ascorbate/proanthocyanidin) in each group. FuturaBond DC (eighth generation) bonding agent was used to bond composite to dentin surfaces which was subjected to shear bond strength testing. Data was analyzed by one-way ANOVA and Tukey test. RESULTS: All the groups (contaminated with saliva, blood, or hemostatic agent) showed a decrease in shear bond strength of composite resin to dentin. The shear bond strength of composite resin to dentin was least affected by contamination with saliva followed by contamination with blood and was most affected by contamination with a hemostatic agent.The decontamination protocol carried out showed that the combination of NaOCl and Proanthocyanidin improved the shear bond strength of composite to dentin significantly more than the combination of NaOCl and sodium ascorbate or of sodium hypochlorite used alone.

Prevalence of impacted third molars among orthodontic patients in different malocclusions.

OBJECTIVES: The aim of this retrospective study was to investigate the prevalence and pattern of third molar impaction and missing third molars in patients over 18 years in different anteroposterior skeletal patterns among central Indian populations. MATERIALS AND METHODS: The study reviewed 357 orthopantomograms of patients attending the Government College of Dentistry, Indore, Madhya Pradesh. Patients were evaluated to determine the prevalence of third molar impaction, angulation, and level of eruption in Class I, Class II, and Class III patients using Winter's classification to determine angulation of third molars and Pell and Gregory classification for level of impaction. RESULTS: Out of 357 patients, 187 (52.3%) were present with at least one impacted teeth. The third molar impaction was most commonly present in Class II malocclusion (60.65%). Overall, the most common angulation of impaction in both genders was the mesioangular (39%), and the most common level of impaction in both arches was Level B. In Class I, Class II and Class III malocclusion vertical angulation was the most common finding in the maxillary arch and mesioangular angulation in the mandibular arch. No significant association was observed between different types of malocclusion and third molar impaction (P > 0.4648). CONCLUSION: This study found that almost half of the adult patients above 18 years had at least one impacted third molar. The anteroposterior relationship does not have any significant role for the third molar impaction.

Clonidine: An Adjuvant to Adrenaline in Local Anesthesia for Third Molar Surgery.

PURPOSE: The aim of the study is to compare the efficacy of anesthesia and hemodynamic parameters of clonidine and epinephrine in lignocaine for lower third molar surgery. MATERIALS AND METHODS: Thirty healthy controls with impacted mandibular third molar were randomly selected from both sexes between the age group of 20-47 years. Patients were divided equally into two groups: Group I (Adrenaline group) and Group II (Clonidine group). Patients received 2.5 ml of 2% lignocaine with adrenaline (12.5 µg/ml) in Adrenaline group and 2.5 ml of 2% lignocaine with clonidine (15 µg/ml) in Clonidine group. Hemodynamic parameters (heart rate, systolic blood pressure [SBP], diastolic blood pressure [DBP], and mean arterial pressure [MAP]) were recorded preoperatively, intraoperatively, and postoperatively. The onset of anesthesia and duration of anesthesia were recorded using pinprick test for both groups. Postoperatively, patients were evaluated for pain experience by the visual analog scale and verbal rating scale. RESULTS: Lignocaine with clonidine intraoperatively and postoperatively decreases SBP and DBP and MAP compared to lignocaine with adrenaline. There was no significant difference in the onset and duration of anesthesia in both the groups. There was a statistically significant difference seen in the visual analog scale, but no statistically significant difference was seen in the verbal rating scale. CONCLUSION: Clonidine has similar efficacy as that of adrenaline with better hemodynamic parameters and can be used as an alternative to adrenaline for third molar surgeries.

Children's experiences following a CBT intervention to reduce dental anxiety: one year on.

Objective: To investigate children's ongoing experiences of dental care and use of strategies to manage their dental anxiety following cognitive behavioural therapy (CBT). Design: A child self-completed postal questionnaire. Settings: Hospital, community and general dental practice. Subjects: Questionnaires were sent to 44 children, aged 10­17 years who had been referred to specialist services due to their dental anxiety. Intervention: Children had all previously received a guided CBT self-help intervention to reduce their dental anxiety and, on completion of treatment, had been discharged to their referring dentist. Questionnaires were sent out 12­18 months later to ascertain dental attendance patterns and application of any strategies learnt from the previous CBT intervention. Results: 22 responses (50%) were received from 16 girls and six boys. Eighty-two percent had subsequently accessed follow-up care with a general dental practitioner and over half of these had undergone a dental procedure, other than a check-up. Ninety-one percent reported feeling less worried about dental visits, than previously, and described a change in cognition, behaviours, and feelings that allowed them to manage their anxiety better. Conclusions: CBT has positive immediate and longitudinal effects in reducing children's dental anxiety. The challenge of adopting this evidence-based approach within primary care settings remains.

Assessment of digital literacy and use of smart phones among Central Indian dental students.

OBJECTIVES: Education has largely been digitalized. More so, for professional education, keeping updated in this fast paced world has become a necessary requisite and dentistry has not been left untouched. This cross sectional questionnaire based study aimed to assess the digital literacy and smartphone usage amongst the 260 Central Indian dental students including their perspicacity about smartphone/internet usage for learning purposes. The students' attitude for implementation of digital technology in study programs/education system was also evaluated. METHODS: The questionnaire was distributed among total 260 dental students from different dental institutes of Central India. The data was collected and analyzed using SPSS software. RESULTS: Out of 260 students, 250 were internet users, out of which 56% had internet access all time. 94.23% students owned a smartphone. 46.53% (114/245) students had some app related to the dentistry in their smartphone device. The commonest site for surfing related to knowledge seeking was google scholar (72%) followed by Pubmed and others. Nearly 80% dental students believed that social media helps them in their professional course studies. Post graduate students showed statistitically significant difference from undergraduates and interns in terms of knowledge of keywords, dental apps and reading research journals. 89.23% students were keen for implementation of e-learning in their curriculum. CONCLUSION: This study reflects willingness of dental students to adopt digital revolution in dental education which in turn may present an opportunity for educators and policy makers to modify educational methods and thereby advance student's current learning approaches.

Development and Testing of a Cognitive Behavioral Therapy Resource for Children's Dental Anxiety.

Cognitive Behavioral Therapy (CBT) is an evidence-based treatment for dental anxiety; however, access to therapy is limited. The current study aimed to develop a self-help CBT resource for reducing dental anxiety in children, and to assess the feasibility of conducting a trial to evaluate the treatment efficacy and cost-effectiveness of such an intervention. A mixed methods design was employed. Within phase 1, a qualitative "person-based" approach informed the development of the self-help CBT resource. This also employed guidelines for the development and evaluation of complex interventions. Within phase 2, children, aged between 9 and 16 y, who had elevated self-reported dental anxiety and were attending a community dental service or dental hospital, were invited to use the CBT resource. Children completed questionnaires, which assessed their dental anxiety and health-related quality of life (HRQoL) prior to and following their use of the resource. Recruitment and completion rates were recorded. Acceptability of the CBT resource was explored using interviews and focus groups with children, parents/carers and dental professionals. For this analysis, the authors adhered to the Mixed Methods Appraisal Tool criteria. There were 24 families and 25 dental professionals participating in the development and qualitative evaluation of the CBT resource for children with dental anxiety. A total of 56 children agreed to trial the CBT resource (66% response rate) and 48 of these children completed the study (86% completion rate). There was a significant reduction in dental anxiety (mean score difference = 7.7, t = 7.9, df = 45, P < 0.001, Cohen's d ES = 1.2) and an increase in HRQoL following the use of the CBT resource (mean score difference = -0.03, t = 2.14, df = 46, P < 0.05, Cohen's d ES = 0.3). The self-help approach had high levels of acceptability to stakeholders. These findings provide preliminary evidence for the effectiveness and acceptability of the resource in reducing dental anxiety in children and support the further evaluation of this approach in a randomized control trial. Knowledge Transfer Statement: This study details the development of a guided self-help Cognitive Behavioral Therapy resource for the management of dental anxiety in children and provides preliminary evidence for the feasibility and acceptability of this approach with children aged between 9 and 16 y. The results of this study will inform the design of a definitive trial to examine the treatment- and cost-effectiveness of the resource for reducing dental anxiety in children.

Thrombocytopenia in HIV infection: impairment of platelet formation and loss correlates with increased c-Mpl and ligand thrombopoietin expression.

Thrombocytopenia is a common hematologic disorder in patients infected with the human immunodeficiency virus (HIV) and represents a risk for bleeding which is further deleterious during surgery. The major causes of the thrombocytopenia include accelerated peripheral platelet destruction by antiplatelet antibodies and insufficient production of platelets from the infected megakaryocytes. Additionally, at an earlier stage of platelet development, HIV may inhibit megakaryopoiesis at multiple stages of pluripotent CD34+ progenitor stem cell differentiation possibly contributing to decreased levels of platelets in circulation. In HIV infected patients, both the serum thrombopoietin (TPO) levels and theTPO-c-Mpl complexes on the platelet surface were significantly elevated. Therapeutic infusion of HIV infected patients with pegylated recombinant human megakaryocyte growth development factor (PEG-rHu-MGDF) restores platelet counts to normal levels and reduces the c-Mpl expression per platelet. In vitro aggregation of platelets treated with TPO and agonist, adenosine diphosphate (ADP), decrease the dose of ADP that is required for half-maximum aggregation. In vivo dosing does not effect platelet aggregation showing that the metabolism of TPO following its internalization through TPO-c-Mpl complex is rapid and that dosing within the therapeutic range does not constitute increased risk of thrombotic disease.

Temporomandibular pain.

Temporomandibular joint pain has various medical and dental etiological factors. The etiology of the temporomandibular joint pain is enigmatic, no single etiological factor is regarded as the cause. Its distribution is also not confined to a single area. This article presents the basic etiologic factors, its epidemiology, distribution of pain, classification of patients and the psychosocial behavior of patients suffering with temporomandibular pain. As overwhelming majority of medical and dental conditions/issues related to etiology of temporomandibular pain in patients have traditionally been presented and interpreted from the clinician's point of view.

Need for In Vivo Triggering of Homeostasis to Repair Irreversible Tissue Degeneration by Stem Cells through Innate and Invasive Regeneration Processes.

The regeneration patterns are innate, inherited and evolutionarily conserved mechanisms. In every individual there are certain cells and signaling networks which work together to proliferate the desired tissue lineages to replace the dead, lost and injured counter parts. This homeostasis mechanism keeps functioning of the organ system intact. There are some tissues such as skin, gut, blood, respiratory tract, uterine endometrium, testis must perpetually renew the majority of cells. As the aging advances the turnover potentials decreases under normal circumstances, some of these respond inefficiently to regenerative pressures (eg: brain and heart) while other respond quite well. Therefore creating an optimized micro environment using external means through non-invasive or invasive procedures preferably minimally by utilizing appropriately subjected stem cells/stem cell secretome to induce regeneration at the target sites where it does not take place spontaneously.Stem cell biology is one of the most attractive areas of biomedical research, as emerges for the execution of biotechnology towards the regenerative medicine continues to expand. The presumed potential of the stem cell populations with clonogenic capabilities are harnessed for the therapeutic applications. Advancements in the research technology and the idea of inducing innate regeneration by stem cell based approaches can generate the potential cure for many degenerative disorders, age related disabilities and accidental tissue damages.

Root coverage using subepithelial connective tissue graft with platelet-rich plasma in the treatment of gingival recession: A clinical study.

INTRODUCTION: The presence of gingival recession associated with an insufficient amount of keratinized tissue may indicate gingival augmentation procedure. It is a multifaceted problem for which several treatment options are available. The most predictable technique used for gingival augmentation is the subepithelial connective tissue graft (SCTG). Platelet-rich plasma (PRP) is an enhanced source of growth factors and helps in accelerated periodontal repair and regeneration. AIMS: The aim of this study was to evaluate the efficacy of SCTG along with PRP in the treatment of Miller's class I and II gingival recessions. MATERIALS AND METHODS: Eleven subjects with Miller's class I and II gingival recessions were treated using SCTG with PRP. Clinical variables, including plaque index, gingival index, recession depth (RD), Recession width (RW), width of the keratinized gingiva, probing pocket depth (PD) and clinical attachment level (CAL) were recorded. Patients were recalled at baseline, 3 months, 6 months and 1-year after surgery and clinical recordings were taken. Root coverage percentage (%) was measured at the end of 1-year. RESULTS: The clinical parameters were analyzed during the follow-up period by repeated measures ANOVA test. Twelve months follow-up results showed significant improvements in all the clinical parameters. Reduction of recession resulted in a significant decrease in CAL, PD, RW and RD at the end of 12 months. A statistically significant gain in width of keratinized gingiva and a mean root coverage of 84.72 ± 19.10 was obtained at the end of 12 months. CONCLUSION: From the results of this study, it may be concluded that SCTG with PRP is an effective and predictable method to treat miller's class I and II gingival recession.

Oral health status and awareness among tuberculosis patients in an Indian population.

BACKGROUND: Knowledge and awareness regarding oral health problems of tuberculosis patients are lacking among patients, physicians, as well as dental practitioners. AIM: This study aimed to assess the oral health status and awareness among the tuberculosis patients in an Indian population. METHODS: Study sample comprised of 210 tuberculosis patients and 210 nontuberculosis subjects. The tuberculosis patients were categorized into new patients (group A), previously treated (group B), and drug-resistant tuberculosis patients (group C). History of present problem and awareness about oral health was noted. Periodontal health status was ascertained using Community Periodontal Index (CPI). Other oral findings were also recorded. RESULTS: The results were analyzed statistically. 62.9% of total tuberculosis patients had one or more oral problems. Most common problem was tooth pain (34%). CPI score was significantly higher (p<0.05) for tuberculosis patients (2.94) than in control group (1.34). Mean CPI score for groups A, B, and C patients was 2.83, 2.91, and 3.09, respectively. CONCLUSION: This study suggests awareness of oral health status and oral manifestations of tuberculosis among physicians and dental professionals.