Dental pain perception and emotional changes: on the relationship between dental anxiety and olfaction.

BACKGROUND: The purpose of the study was to determine to what extent olfactory aromatherapy reduces the intensity of dental pain and the level of dental anxiety. It also attempted to corelate between olfactory aromatherapy, stages of dental visits, and various dental procedures. METHODS: Female patients were enrolled in a randomized controlled study. Olfactory aromatherapy was performed using lavender oils. Patients were randomly assigned to one of two groups: the lavender group, in which patients inhaled 2% lavender vapors, and the control group, in which patients inhaled water vapors. Pain score, anxiety score, and changes in vital signs were among the predictable variables. Anxiety and pain were assessed using the Modified Dental Anxiety Scale (MDAS), Speilberger State-Trait Anxiety Inventory (STAI), and visual analog scales (VAS). The vital signs were systolic (SBP) and diastolic (DBP), heart rate (HR), respiratory rate (RR), and oxygen saturation (Spo2). Variables were evaluated before inhalations, 20 min after inhalations, at the end of settings, and on the following day. RESULTS: Each group had 175 participants. Pain and anxiety scores were significantly reduced, and all vital signs improved, except for DBP. The MDAS, STAI, and pain scores are reduced by 3.4, 4.2, and 2.4 times, respectively, compared to the control group. Olfactory aromatherapy had the greatest impact during the phase of waiting rooms. CONCLUSION: When compared to the control group, olfactory aromatherapy reduces anxiety scores three to four times more. Pain perception is reduced by twice as much as in the control group. It also significantly reduces the anxiety associated with minor to moderately stressful dental procedures.

A Comparative Study on Alvogyl and a Mixture of Black Seed Oil and Powder for Alveolar Osteitis: A Randomized Double-Blind Controlled Clinical Trial.

Introduction: Alveolar osteitis (AO) is the most common complication faced by exodontia patients and is usually seen 24-74 hours after tooth extraction, heralded by severe throbbing pain. Nigella sativa is commonly known as black seed known to have anti-inflammatory and antibacterial properties along with other reparative properties that enhance bone formation. This study aimed to evaluate and compare the effects of Alvogyl and a mixture of Nigella sativa powder and oil in the treatment of dry sockets. Materials and Methods: Sixty patients above the age of 18 and below 70 years, from both genders, who underwent extraction of teeth and were clinically diagnosed with a dry socket at the clinic of the College of Dentistry, Jouf University, Saudi Arabia, were included in this study. Pain scores were assessed after placement of the dressing at the following intervals: 5 minutes, 30 minutes, 60 minutes, 2nd day, 4th day, and 7th day. Patients were randomly allocated to three groups, namely, Group 1 (Alvogyl), Group 2 (mixture of Nigella sativa's powder and oil), and Group 3 (control). Pain relief and healing of the socket were compared between the three groups. The collected data were subjected to statistical analysis through Spearman's correlation test, independent t-test, ANOVA, and post hoc test. Results: A mixture of Nigella sativa powder and oil showed a statistically significant difference in relieving pain compared to the Alvogyl group. A mixture of Nigella sativa's powder and oil required fewer dressings when compared to the Alvogyl group. Conclusion: A mixture of Nigella sativa powder and oil is the more efficacious dressing material for the management of dry sockets compared to Alvogyl. It provides immediate and complete pain relief and fewer numbers of repeated visits.

The Treatment Efficiency and Microbiota Analysis of Sapindus mukorossi Seed Oil on the Ligature-Induced Periodontitis Rat Model.

Periodontitis is a common oral disease mainly caused by bacterial infection and inflammation of the gingiva. In the prevention or treatment of periodontitis, anti-bacterial agents are used to inhibit pathogen growth, despite increasing levels of bacterial resistance. Sapindus mukorossi Gaertn (SM) seed oil has proven anti-bacterial and anti-inflammation properties. However, the possibility of using this plant to prevent or treat periodontitis has not been reported previously. The aim of this study was to evaluate the effects of SM oil on experimental periodontitis in rats by using micro-CT and microbiota analysis. The distance between cementoenamel junction (CEJ) and alveolar bone crest (ABC) on the sagittal micro-CT slide showed that total bone loss (TBL) was significantly lower in CEJ-ABC distances between SM oil and SM oil-free groups on Day 14. Histology data also showed less alveolar bone resorption, a result consistent result with micro-CT imaging. The microbiota analyzed at phylum and class levels were compared between the SM oil and SM oil-free groups on Day 7 and Day 14. At the phylum level, Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria were the dominant bacterium. Firmicutes in box plot analysis was significantly less in the SM oil group than in the SM oil-free group on Day 7. At the class level, Bacteroidia, Gammaproteobacteria, Bacilli, Clostridia, and Erysipelotrichia were the dominant bacteria. The bacteria composition proportion of Bacilli, Clostridiay, and Erysipelotrichia could be seen in the SM oil group significantly less than in t SM oil-free group on Day 7. Overall, the present results show that topical application of SM oil can reduce bone resorption and change bacteria composition in the ligature-induced periodontitis model. According to these results, it is reasonable to suggest SM oil as a potential material for preventing oral disease.

Confocal Raman Spectroscopic Imaging for Evaluation of Distribution of Nano-Formulated Hydrophobic Active Cosmetic Ingredients in Hydrophilic Films.

Film-forming systems are highly relevant to the topical administration of active ingredients (AI) to the body. Enhanced contact with the skin can increase the efficacy of delivery and penetration during prolonged exposure. However, after the evaporation of volatile solvents to form a thin film, the distribution of the ingredient should remain homogenous in order to ensure the effectiveness of the formula. This is especially critical for the use of hydrophobic molecules that have poor solubility in hydrophilic films. In order to address this concern, hydroxyphenethyl esters (PHE) of Punica granatum seed oil were prepared as a nanosuspension stabilised by poloxamers (NanoPHE). NanoPHE was then added to a formulation containing polyvinyl alcohol (PVA) as a film forming agent, Glycerol as a plasticiser and an antimicrobial agent, SepicideTM HB. Despite their reliability, reference methods such as high-performance liquid chromatography are increasingly challenged due to the need for consumables and solvents, which is contrary to current concerns about green industry in the cosmetics field. Moreover, such methods fail to provide spatially resolved chemical information. In order to investigate the distribution of ingredients in the dried film, Confocal Raman imaging (CRI) coupled to Non-negatively Constrained Least Squares (NCLS) analysis was used. The reconstructed heat maps from a range of films containing systematically varying PHE concentrations highlighted the changes in spectral contribution from each of the ingredients. First, using NCLS scores it was demonstrated that the distributions of PVA, Glycerol, SepicideTM HB and PHE were homogenous, with respective relative standard deviations (RSD) of 3.33%, 2.48%, 2.72% and 6.27%. Second, the respective relationships between ingredient concentrations in the films and their Raman responses, and the spectral abundance were established. Finally, a model for absolute quantification for PHE was be constructed using the percentage of spectral abundance. The prepared %w/w concentrations regressed against predicted %w/w concentrations, displaying high correlation (R2 = 0.995), while the Root Mean Squared Error (0.0869% w/w PHE) confirmed the precision of the analysis. The mean percent relative error of 3.75% indicates the accuracy to which the concentration in dried films could be determined, further supporting the suitability of CRI for analysis of composite solid film matrix. Ultimately, it was demonstrated that nanoformulation of hydrophobic PHE provides homogenous distribution in PVA based film-forming systems independent of the concentration of NanoPHE used in the formula.

Can lavender oil inhalation help to overcome dental anxiety and pain in children? A randomized clinical trial.

Aromatherapy with essential oils can be used to relieve children. The aim of this study was to evaluate the correlations between psychological and physiologic findings after lavender oil inhalation among children assigned to undergo tooth extraction. A total of 126 children aged between 6 and 12 years were enrolled in the study. The groups were randomly divided into control and lavender groups. The lavender group inhaled 100% lavender oil for 3 min before the interventions, the control group received no prior application. Psychological assessments were made using face image scale (FIS), Face, Legs, Activity, Cry, Consolability (FLACC) and Wong-Baker pain rating scale (WBS). Physiologic changes were assessed using vital signs evaluations. All parameters were noted prior to applications, after inhalation, anesthesia injection, and tooth extraction. The lavender group showed significant lower anxiety and pain scores after tooth extraction (p < 0.05). Significantly lower levels of blood pressures and a significant pulse rate drop were found after inhalation in the lavender group. A statistically significant increase in heart rate was observed after anesthesia injection and tooth extraction in the control group (p < 0.05).Conclusion: Lavender oil can be preferred as a treatment of choice in routine pediatric dentistry.Trial registration number: NCT04115891 (Lavender Oil Inhalation Help to Overcome Dental Anxiety Among Children)What is Known:• Dental anxiety is the most common factor that causes children to have difficulty with the dentist and their parents during treatment.• Aromatherapy with essential oils can be used to relieve children.What is New:• Aromatherapy with lavender oil relieves the child by reducing the level of anxiety and facilitates dental treatment.• During surgical procedures such as local anesthesia and tooth extraction, lavender oil inhalation decreases pain levels of children.

Enhanced anti-psoriatic efficacy and regulation of oxidative stress of a novel topical babchi oil (Psoralea corylifolia) cyclodextrin-based nanogel in a mouse tail model.

Psoriasis is a proliferative inflammatory skin disorder with relapsing episodes. Herein, the efficacy of babchi oil (BO) loaded nanostructure gel was evaluated for antipsoriatic activity and oxidative stress biomarkers assessment using mouse tail model. BO was entrapped into cyclodextrin-based nanocarriers (360.9 ± 19.55 nm), followed by incorporation into Carbopol gel and characterised for viscosity, spreadability, and texture analysis. The gels were topically applied on mouse-tails once daily for fourteen days. Evaluation of antipsoriatic activity as determined by histopathological observations of orthokeratotic epidermis revealed two times higher efficacy of BO nanogel in comparison to the native BO gel. Further, significantly enhanced superoxide dismutase (SOD) and reduced glutathione (GSH) levels, and diminished malondialdehyde (MDA) and nitrite (NO) levels revealed that prepared nanogels played a major role in the management of reactive oxygen species (ROS) associated in psoriasis pathogenesis. Hence, this study provides strong evidence for use of cyclodextrin-based nanogels as a safe and better delivery carrier of BO for management of psoriasis.

Optimization of Curcuma Oil/Quinine-Loaded Nanocapsules for Malaria Treatment.

Quinine, a treatment used in chloroquine-resistant falciparum malaria, was loaded into poly(ɛ-caprolactone) or Eudragit® RS100 nanocapsules using Curcuma oil as the oil-based core. Until now, the effect of cationic nanocapsules on malaria has not been reported. A 24 factorial design was adopted using, as independent variables, the concentration of Curcuma oil, presence of quinine, type of polymer, and aqueous surfactant. Diameter, zeta potential, and pH were the responses studied. The formulations were also evaluated for drug content, encapsulation efficiency, photostability, and antimalarial activity against Plasmodium berghei-infected mice. The type of polymer influenced all of the responses studied. Quinine-loaded Eudragit® RS100 (F13) and PCL nanocapsules (F9), both with polysorbate 80 coating, showed nanometric particle size, positive zeta potential, neutral pH, high drug content, and quinine photoprotection ability; thus, these nanocapsules were selected for in vivo tests. Both formulations showed lower levels of parasitemia from the beginning of the experiment (5.78 ± 3.60 and 4.76 ± 3.46% for F9 and F13, respectively) and highest survival mean time (15.3 ± 2.0 and 14.9 ± 5.6 days for F9 and F13, respectively). F9 and F13 showed significant survival curve compared to saline, thus demonstrating that nanoencapsulation improved bioefficacy of QN and co-encapsulated curcuminoids, regardless of the surface charge.

Interventions for cutaneous molluscum contagiosum.

BACKGROUND: Molluscum contagiosum is a common skin infection that is caused by a pox virus and occurs mainly in children. The infection usually resolves within months in people without immune deficiency, but treatment may be preferred for social and cosmetic reasons or to avoid spreading the infection. A clear evidence base supporting the various treatments is lacking.This is an update of a Cochrane Review first published in 2006, and updated previously in 2009. OBJECTIVES: To assess the effects of specific treatments and management strategies, including waiting for natural resolution, for cutaneous, non-genital molluscum contagiosum in people without immune deficiency. SEARCH METHODS: We updated our searches of the following databases to July 2016: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We searched six trial registers and checked the reference lists of included studies and review articles for further references to relevant randomised controlled trials. We contacted pharmaceutical companies and experts in the field to identify further relevant randomised controlled trials. SELECTION CRITERIA: Randomised controlled trials of any treatment of molluscum contagiosum in people without immune deficiency. We excluded trials on sexually transmitted molluscum contagiosum and in people with immune deficiency (including those with HIV infection). DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed methodological quality, and extracted data from selected studies. We obtained missing data from study authors where possible. MAIN RESULTS: We found 11 new studies for this update, resulting in 22 included studies with a total of 1650 participants. The studies examined the effects of topical (20 studies) and systemic interventions (2 studies).Among the new included studies were the full trial reports of three large unpublished studies, brought to our attention by an expert in the field. They all provided moderate-quality evidence for a lack of effect of 5% imiquimod compared to vehicle (placebo) on short-term clinical cure (4 studies, 850 participants, 12 weeks after start of treatment, risk ratio (RR) 1.33, 95% confidence interval (CI) 0.92 to 1.93), medium-term clinical cure (2 studies, 702 participants, 18 weeks after start of treatment, RR 0.88, 95% CI 0.67 to 1.14), and long-term clinical cure (2 studies, 702 participants, 28 weeks after start of treatment, RR 0.97, 95% CI 0.79 to 1.17). We found similar but more certain results for short-term improvement (4 studies, 850 participants, 12 weeks after start of treatment, RR 1.14, 95% CI 0.89 to 1.47; high-quality evidence). For the outcome 'any adverse effect', we found high-quality evidence for little or no difference between topical 5% imiquimod and vehicle (3 studies, 827 participants, RR 0.97, 95% CI 0.88 to 1.07), but application site reactions were more frequent in the groups treated with imiquimod (moderate-quality evidence): any application site reaction (3 studies, 827 participants, RR 1.41, 95% CI 1.13 to 1.77, the number needed to treat for an additional harmful outcome (NNTH) was 11); severe application site reaction (3 studies, 827 participants, RR 4.33, 95% CI 1.16 to 16.19, NNTH over 40).For the following 11 comparisons, there was limited evidence to show which treatment was superior in achieving short-term clinical cure (low-quality evidence): 5% imiquimod less effective than cryospray (1 study, 74 participants, RR 0.60, 95% CI 0.46 to 0.78) and 10% potassium hydroxide (2 studies, 67 participants, RR 0.65, 95% CI 0.46 to 0.93); 10% Australian lemon myrtle oil more effective than olive oil (1 study, 31 participants, RR 17.88, 95% CI 1.13 to 282.72); 10% benzoyl peroxide cream more effective than 0.05% tretinoin (1 study, 30 participants, RR 2.20, 95% CI 1.01 to 4.79); 5% sodium nitrite co-applied with 5% salicylic acid more effective than 5% salicylic acid alone (1 study, 30 participants, RR 3.50, 95% CI 1.23 to 9.92); and iodine plus tea tree oil more effective than tea tree oil (1 study, 37 participants, RR 0.20, 95% CI 0.07 to 0.57) or iodine alone (1 study, 37 participants, RR 0.07, 95% CI 0.01 to 0.50). Although there is some uncertainty, 10% potassium hydroxide appears to be more effective than saline (1 study, 20 participants, RR 3.50, 95% CI 0.95 to 12.90); homeopathic calcarea carbonica appears to be more effective than placebo (1 study, 20 participants, RR 5.57, 95% CI 0.93 to 33.54); 2.5% appears to be less effective than 5% solution of potassium hydroxide (1 study, 25 participants, RR 0.35, 95% CI 0.12 to 1.01); and 10% povidone iodine solution plus 50% salicylic acid plaster appears to be more effective than salicylic acid plaster alone (1 study, 30 participants, RR 1.43, 95% CI 0.95 to 2.16).We found no statistically significant differences for other comparisons (most of which addressed two different topical treatments). We found no randomised controlled trial evidence for expressing lesions or topical hydrogen peroxide.Study limitations included no blinding, many dropouts, and no intention-to-treat analysis. Except for the severe application site reactions of imiquimod, none of the evaluated treatments described above were associated with serious adverse effects (low-quality evidence). Among the most common adverse events were pain during application, erythema, and itching. Included studies of the following comparisons did not report adverse effects: calcarea carbonica versus placebo, 10% povidone iodine plus 50% salicylic acid plaster versus salicylic acid plaster, and 10% benzoyl peroxide versus 0.05% tretinoin.We were unable to judge the risk of bias in most studies due to insufficient information, especially regarding concealment of allocation and possible selective reporting. We considered five studies to be at low risk of bias. AUTHORS' CONCLUSIONS: No single intervention has been shown to be convincingly effective in the treatment of molluscum contagiosum. We found moderate-quality evidence that topical 5% imiquimod was no more effective than vehicle in terms of clinical cure, but led to more application site reactions, and high-quality evidence that there was no difference between the treatments in terms of short-term improvement. However, high-quality evidence showed a similar number of general side effects in both groups. As the evidence found did not favour any one treatment, the natural resolution of molluscum contagiosum remains a strong method for dealing with the condition.

Effect of incorporating seed oils on the antifungal property, surface roughness, wettability, weight change, and glucose sorption of a soft liner.

STATEMENT OF PROBLEM: The colonization of Candida albicans on soft liners causes the deterioration of material surface properties and denture stomatitis. PURPOSE: The purpose of this in vitro study was to investigate the effect of incorporating seed oil on the antifungal properties, surface roughness, wettability, weight changes, and glucose adsorption/absorption of a soft liner. MATERIAL AND METHODS: Centratherum anthelminticum, Ocimum sanctum Linn, and Linum usitatissimum seed oils were incorporated into a soft liner, and the diameter of the inhibition zone (DIZ) was calculated relative to the growth of C albicans at 24, 48, and 72 hours and 7 days. The effect of incorporating oil on wettability was evaluated with the contact angle analyzer, and effect on surface roughness was evaluated with scanning electron microscopy. Weight changes and absorption/adsorption of glucose to the soft liner were estimated. Data were analyzed by using paired Student t tests and 2-way ANOVA (α=.01). RESULTS: Soft liner with 800 µL each of C anthelminticum and O sanctum oils showed complete inhibition at 72 hours; the DIZ on day 7 were 31.66 ±1.20 mm and 29.66 ±1.46 mm, respectively. The change in weight between time intervals differed significantly between conditions (P<.01). The addition of oils decreased the surface roughness and improved wettability significantly for O sanctum and C anthelminticum specimens (P<.01). At 72 hours, 5.5 mg of glucose was detected in the positive control, whereas no glucose was detected in the oil specimens. CONCLUSIONS: The addition of the seed oils of C anthelminticum and O sanctum to the soft liner significantly reduced the growth of C albicans, improved wettability, reduced surface roughness, and minimized the absorption and adsorption of glucose.

Adjunctive use of essential oils following scaling and root planing -a randomized clinical trial.

BACKGROUND: Hitherto no study has been published on the effect of the adjunctive administration of essential oils following scaling and root planing (SRP). This study describes the effect of a mouthrinse consisting of essential oils (Cymbopogon flexuosus, Thymus zygis and Rosmarinus officinalis) following SRP by clinical and microbiological variables in patients with generalized moderate chronic periodontitis. METHODS: Forty-six patients (aged 40-65 years) with moderate chronic periodontitis were randomized in a double-blind study and rinsed their oral cavity following SRP with an essential oil mouthrinse (n  =  23) or placebo (n  =  23) for 14 days. Probing depth (PD), attachment level (AL), bleeding on probing (BOP) and modified sulcus bleeding index (SBI) were recorded at baseline and after 3 and 6 months. Subgingival plaque was taken for assessment of major bacteria associated with periodontitis. RESULTS: AL, PD, BOP and SBI were significantly improved in both groups after three (p   <   0.001) and 6 months (p   ≤   0.015). AL improved significantly better in the test than in the control group after 3 and 6 months (p < 0.001), so did PD after three months in the tendency (p  =  0.1). BOP improved better in the test group after 3 months (p  =  0.065). Numbers of Treponema denticola (p  =  0.044) and Fusobacterium nucleatum (p  =  0.029) decreased more in the test than in the control group after 3 months, those of Tannerella forsythia after 6 months (p  =  0.039). Prevotella micra (p  <  0.001, p  =  0.035) and Campylobacter rectus (p  =  0.002 , p  =  0.012) decreased significantly in both groups after 3 months. CONCLUSIONS: The adjunctive use of a mouthrinse containing essential oils following SRP has a positive effect on clinical variables and on bacterial levels in the subgingival biofilm. TRIAL REGISTRATION: 332-12-24092012, DRKS 00009387, German Clinical Trials Register, Freiburg i. Br., 16.09.2015.

Co-encapsulation of Nigella sativa oil and plasmid DNA for enhanced gene therapy of Alzheimer's disease.

Alzheimer disease involves genetic and non-genetic factors and hence it is rational to be treated with genetic and non-genetic therapeutic agents. Nigella sativa has multiple therapeutic properties including neuroregeneration. Nigella sativa oil (NSO) was encapsulated in PLGA nanoparticles and pDNA was loaded either by adsorption on chitosan-modified particles or encapsulation within PLGA nanoparticles. The particle size and zeta potential of NSO-pDNA-chitosan-PLGA nanoparticles were highly dependent on the medium and exhibited high burst release. Meanwhile, NSO-pDNA-PLGA nanoparticles were more consistent with lower burst release. The fabricated nanoparticles revealed the expected outcomes of both pDNA and NSO. The pDNA transfected N2a cell while the encapsulated NSO promoted neurite outgrowth that is crucial for neuroregeneration. Results from this study suggest that NSO could be added to the gene delivery carrier to enhance treatment benefits for Alzheimer disease.

Antimicrobial effect of lemongrass oil against oral malodour micro-organisms and the pilot study of safety and efficacy of lemongrass mouthrinse on oral malodour.

AIMS: Lemongrass oil (LG) has been reported as being effective against bacteria embedded within the biofilm. The aims of this study were to investigate antimicrobial activity against common odourigenic micro-organisms, the safety and efficacy of LG mouthrinse on oral malodour in healthy volunteers. METHODS AND RESULTS: Antimicrobial activity of LG mouthrinse was examined against common odourigenic micro-organisms using broth microdilution assay and the disc diffusion method. A randomised double-blind clinical study was performed in 20 healthy volunteers. Volatile sulphur compounds (VSCs) level was measured using a Halimeter on day 0 and day 8 in each volunteer. The results showed that LG mouthrinse was effective against Aggregatibacter actinomycetemcomitans ATCC43718 and Porphyromonas gingivalis W50 but less effective against Streptococcus mutans ATCC 25175. In addition, the mouthrinse significantly reduced VSCs on day 8. CONCLUSIONS: LG mouthrinse was able to reduce oral malodour and appeared to be safe. The overall satisfaction of the mouthrinse was acceptable. However, the spiciness and taste of the mouthrinse need to be improved. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrated that the LG mouthrinse significantly reduced oral malodour. This mouthrinse would be another alternative mouthrinse choice for prevention of malodour, plaque and gingivitis.

Histological Evaluation of Allium sativum Oil as a New Medicament for Pulp Treatment of Permanent Teeth.

OBJECTIVE: The objective of this study was to evaluate the histo pathology effects of two medicaments Allium sativum oil and formocresol on the remaining pulp tissue of the permanent teething children. MATERIALS AND METHODS: A total of 18 premolars were included in this study. Two sound premolars were extracted and subjected to histological examination to show the normal pulp tissue. Pulpo tomy procedure was performed in the rest of the remaining 16 premolars; half of them using Allium sativum oil and the rest of the tested premolars were medicated using formocresol and all were sealed with suitable restoration. Then, premolars extracted at variable intervals (48 hours, 2 weeks, 1 month, 2 months), stained using hemotoxylin and eosin etain (H&E) and prepared for histopathology examination. RESULTS: Histological evaluation seemed far more promising for Allium sativum oil than formocresol. Histological evaluation revealed that teeth treated with Allium sativa oil showed infammatory changes that had been resolved in the end of the study. On the contrary, the severe chronic infammation of pulp tissue accompanied with formocresol eventually produced pulp necrosis with or without fibrosis. In addition, pulp calcification was evidenced in certain cases. CONCLUSION: Allium sativum oil is a biocompatible material that is compatible with vital human pulp tissue. It offers a good healing potential, leaving the remaining pulp tissue healthy and functioning.

Can ambient orange fragrance reduce patient anxiety during surgical removal of impacted mandibular third molars?

PURPOSE: To investigate whether ambient orange fragrance, compared with no fragrance, can reduce patient anxiety before and during surgical removal of an impacted mandibular third molar. MATERIALS AND METHODS: In the present randomized clinical trial, the patients who required extraction of an impacted mandibular third molar and fulfilled the predetermined criteria were included. A dental anxiety scale (DAS) questionnaire was used to determine the anxiety level of the patients before surgery. Only patients with moderate and high anxiety levels (DAS scale ≥ 9 to ≤ 14) were included. The predictor variable was fragrance exposure. The fragrance group was exposed to orange fragrance, and the control group was exposed to no fragrance. The outcome variables were physiologic measures related to anxiety, including the mean blood pressure, respiratory rate, and pulse rate. The physiologic vital changes were determined before and during the surgical procedure. The data were analyzed using the independent t test, χ(2) test, and Mann-Whitney U test (Statistical Package for Social Sciences, version 16; α = 0.05). RESULTS: A total of 56 patients fulfilled the inclusion criteria (fragrance group, 19 males and 9 females; no-fragrance group, 12 males and 16 females). Before entering the waiting room, the patients' vital signs were recorded twice. No significant differences were found between the 2 groups. The mean blood pressure, pulse rate, and respiratory rate were significantly lower in the fragrance group during surgery (from sitting in the dental chair to the end of surgery; P < .05). CONCLUSIONS: The results of our study have shown that orange fragrance is effective in reducing the anxiety related to surgical removal of an impacted mandibular third molar.

Activity of chitosan-encapsulated Eucalyptus staigeriana essential oil on Haemonchus contortus.

Phytotherapy has been described as an alternative method for the control of gastrointestinal nematodes in small ruminants. Goal of the encapsulation of essential oils in biopolymer matrices is to optimize the biological effects of these oils. The aim of the present study was to evaluate the in vitro and in vivo anthelmintic activity of encapsulated Eucalyptus staigeriana essential oil (EncEs) on the eggs and larvae of Haemonchus contortus. Therefore, the egg hatching test (EHT), larval development test (LDT) and worm load evaluation were performed to evaluate Meriones unguiculatus experimentally infected with H. contortus. The chemical constituents of E. staigeriana essential oil (EsEO) and the in vitro oil release profile from the chitosan matrix at a pH of 1.2 and 7.0 were also characterized. EncEs and EsEO inhibited larval hatching by 97.19% and 99.96% at doses of 1.5 and 1.0 mg ml(-1), respectively. In the LDT, EncEs and EsEO induced a larvicidal effect greater than 95% at concentrations of 5.8 and 8 mg ml(-1), respectively. EncEs and EsEO decreased H. contortus load in M. unguiculatus by 40.51% and 46.44%, respectively. The major chemical constituents of EsEO were (+)-Limonene (72.9%), 1,8-Cineole (9.5%) and o-Cimene (4.6%). The release profile of EsEO was 30% in acid and 25% at neutral pH. The similar efficacy of EncEs and EsEO demonstrates that there was no optimization of anthelmintic action following the encapsulation process. Therefore, the use of new encapsulation matrices with controlled release in the pH of the abomasum should be investigated.

Lipids in preventive dentistry.

OBJECTIVES: There is still a great demand for the improvement of oral prophylaxis methods. One repeatedly described approach is rinsing with edible oils. The aim of the present review paper was to analyze the role of lipids in bioadhesion and preventive dentistry. MATERIALS AND METHODS: Despite limited sound scientific data, extensive literature search was performed to illustrate possible effects of lipids in the oral cavity. RESULTS: It is to be assumed that lipophilic components modulate the process of bioadhesion to the oral hard tissues as well as the composition and ultrastructure of the initial oral biofilm or the pellicle, respectively. Thereby, lipids could add hydrophobic characteristics to the tooth surface hampering bacterial colonization and eventually decreasing caries susceptibility. Also, a lipid-enriched pellicle might be more resistant in case of acid exposure and could therefore reduce the erosive mineral loss. Furthermore, anti-inflammatory effects on the oral soft tissues were described. However, there is only limited evidence for these beneficial impacts. Neither the lipid composition of saliva and pellicle nor the interactions of lipids with the initial oral biofilm and the pellicle layer have been investigated adequately until now. CONCLUSION: Edible oils might qualify as mild supplements to conventional strategies for the prevention of caries, erosion, and periodontal diseases but further research is necessary. CLINICAL RELEVANCE: Against the background of current scientific and empirical knowledge, edible oils might be used as oral hygiene supplements but a decisive benefit for the oral health status is questionable.

Evaluating the antimicrobial activity of commercially available herbal toothpastes on microorganisms associated with diabetes mellitus.

AIM: The present study was conducted to evaluate the effcacy of commercially available herbal toothpastes against the different periodontopathogens. MATERIALS AND METHODS: Six herbal toothpastes that were commonly commercially available were included in the study. Colgate herbal, Babool, Meswak, Neem active, Dabur red toothpastes were tested for the study whereas sterile normal saline was used as control. Antimicrobial effcacies of dentifrices were evaluated against Streptococcus mutans and Actinobacillus actinomycetemcomitans. The antimicrobial properties of dentifrices were tested by measuring the maximum zone of inhibition at 24 hours on the Mueller Hinton Agar media inoculated with microbial strain using disk diffusion method. Each dentifrice was tested at 100% concentration (full strength). RESULTS: The study showed that all dentifrices selected for the study were effective against the entire test organism but to varying degree. Neem active tooth paste gave a reading of 25.4 mm as the zone of inhibition which was highest amongst all of the test dentifrices. Colgate Herbal and Meswak dentifrices recorded a larger maximum zone of inhibition, measuring 23 and 22.6 mm respectively, compared to other toothpastes. All other dentifrices showed the zone of inhibition to be between 17 and 19 mm respectively. CONCLUSION: The antibacterial properties of six dentifrices were studied in vitro and concluded that almost all of the dentifrices available commercially had antibacterial properties to some extent to beneft dental health or antiplaque action.

Evaluation of ozonated olive oil with or without adjunctive application of calcium sodium phosphosilicate on post-surgical root dentin hypersensitivity: a randomized, double-blinded, controlled, clinical trial.

AIM: This study was conducted to evaluate the efficacy of ozonated olive oil with or without adjunctive application of mineral wash containing calcium sodium phosphosilicate on the reversal of post-surgical root dentin hypersensitivity. METHODS: A double-blinded, randomized controlled clinical trial was conducted on 51 participants with root dentin hypersensitivity (RDH). Participants were randomLy assigned to 4 groups: Group A, ozonated olive oil (OZO): Group B, ozonated olive oil and mineral wash: Group C, placebo olive oil (PPO) and mineral wash: Group D, placebo olive oil only. Active treatment was carried out in-clinic and followed by at-home care with a remineralising paste. The response to various pain stimuli was periodically assessed with a visual analogue scale. Additionally, scanning electron microscopic study assessed the dentinal tubule occlusion and change in tubular surface area after treatment. RESULTS: The group B participants showed a significant decrease in tooth level and global sensitivity over the period (P<0.001). Moreover, the intergroup comparison also revealed a significant result (P<0.001). Similarly, participants of group C also showed a significant reduction in sensitivity over the period (P<0.001). Whereas, no significant (P>0.05) difference was detected between group A and group D for tooth level and global sensitivity analysis. The SEM study result showed a significantly (P<0.001) enhanced tubule occlusion and decreased tubular surface area in group B specimens compared to other group specimens. CONCLUSION: OZO, as a mono-therapy is not efficient in reducing post-surgical RDH. However, the adjunctive application of mineral wash containing calcium sodium phosphosilicate has positive impact on the reversal of post-surgical root dentin hypersensitivity.

Comparing the effect of different mouthrinses on de novo plaque formation.

PURPOSE: Several antiplaque agents are being available in the market in spite of vast development of modern medical science, satisfactory treatment of 'oral diseases' by newer drugs is not fully achieved, rather the chemical compounds has exposed the patients to it is different ill effects, therefore, there is interest to find out effective remedy of any disease by harmless herbal drugs thus the aim of this study was to compare plaque formation at 24 hours after the use of Triphala, Hi ora, Chlorhexidine and Colgate Plax mouth washes. METHODS: A controlled, randomized, double-blind, crossover clinical trial was designed. Thirty subjects underwent four consecutive experimental phases with four treatments: Triphala, Hi Ora, Chlorhexidine and Colgate Plax. On the day of study, the subjects discontinued all other oral hygiene habits and were randomly assigned for treatment with the experimental mouthwash. Each experimental phase was preceded by a 28-day washout period. Plaque formation was recorded after one undisturbed day. RESULTS: Triphala, Hi Ora and Chlorhexidine reduced de novo plaque formation to a greater extent than the colgate plax mouthwash (p < 0.05). CONCLUSION: Triphala and Hi Ora presents an anti-plaque efficacy similar to that of chlorhexdine, and was more effective at inhibiting plaque formation than the Colgate Plax mouth wash.

Requirements for Translation in Clinical Trials of Aromatherapy: The Case of the Essential Oil of Bergamot (BEO) for Management of Agitation in Severe Dementia.

Due to the tight link between undertreated pain and agitation in dementia patients, aromatherapy can be a useful approach if an essential oil (EO) with powerful analgesic activity is used. The methodological difficulties of most aromatherapy trials have not allowed any definitive conclusion about the effectiveness of aromatherapy in dementia. The objective of the present perspective is to illustrate the long rigorous process leading from preclinical research to clinical translation of the EO of bergamot (BEO) for the management of agitation in dementia. A nanotechnology-based delivery system consisting of odorless alpha-tocopheryl stearate solid lipid nanoparticles (SLN) loaded with BEO (NanoBEO), has been proven active in acute and neuropathic pain models confirming the strong antinociceptive and anti-allodynic efficacy reported for BEO in preclinical studies. In particular, prolonged physicochemical stability of NanoBEO and titration in its main components are remarkable advantages allowing reproducible antinociceptive and anti-itch responses to be measured. Furthermore, the possibility to perform double-blind clinical trials made impossible so far because of the strong smell of essential oils used in aromatherapy. Demented patients receive limited treatment for chronic pain, particularly neuropathic. The BRAINAID (NCT04321889) trial will assess the effectiveness of NanoBEO on agitation and pain in severely demented patients to offer a safe tool able to provide relief to this fragile population. This double-blind clinical trial will be the first to assess the efficacy and safety of an engineered essential oil and will provide the rationale for the safer treatment of neuropsychiatric symptoms of dementia and pain in clinic.