Three-dimensional Finite Element Stress Pattern Analysis in Bone around Implant-supported Abutment with Different Angulations under Axial and Oblique Load.

AIM: The goal of this research was to compare the stress distribution in the bone adjacent to the implant where three different angled abutments were loaded in both the axial and oblique directions. MATERIALS AND METHODS: The premaxilla region was digitally recreated in 3-dimension (3D) using a finite element model, with a solid 4.2 mm by 13 mm implant and abutments at 0°, 15°, and 25° of rotation. Axial load (100 N) and oblique load were also applied to the abutments (178 N). Six models were made and used with a fixed bases. The coefficient of friction was set at a constant value of 0.02. The CITIA program was used for the stress analysis. In this investigation, we employed linear static analysis. Each abutment and crown in the model has subjected to an arbitrary vertical load as well as the oblique load. RESULTS: The cortical bone around the implant with a 25° angled abutment experienced a maximum von Mises stress of 187.692 Mpa under oblique load. This stress was increased with the degree of abutment angulation. CONCLUSION: As abutment angulation was increased, axial and oblique burdens were also increased. In both cases, we were able to identify the source of the observed growth. When we looked at the effect of stress on angulation, we found that the peaks were seen in the area of abutment and cortical bone. Since it was difficult to predict the stress distribution around implants with varying abutment angles in a clinical setting, finite element analysis (FEA) was chosen for this investigation as a more cutting-edge approach. CLINICAL SIGNIFICANCE: It is a herculean task calculating the prompted forces clinically, FEA has opted for this study as it's a progressively wielded tool to prognosticate the stress allocation in the region of the implants with different angled abutments.

Amphiphilic ionic liquid induced fusion of phospholipid liposomes.

We have investigated the impact of increasing concentration of imidazolium-based ionic liquids ([CnMIM]+[Br]-) on the structural integrity of large unilamellar vesicles (LUVs) made of pure phosphatidylcholine (PC) and phosphatidylglycerol (PG) lipids. Calcein based dye leakage assays were used to monitor the permeability of LUVs in the presence of ionic liquids. As the ionic liquid concentration approaches the critical micelle value, vesicle fusion occurs resulting in unexpected quenching which is accompanied by rapid dye leakage due to the formation of transiently lived fusion-holes. Vesicle fusion is confirmed using dynamic light scattering based size measurements and fluorescence based lipid mixing assays. 1H-1H NOESY measurements using solid-state NMR spectroscopy were performed to obtain insights into the fusion mechanism. While POPC LUVs are more prone to membrane fusion, the overall extent of fusion is higher in POPG LUVs. Ionic liquid induced splaying of phospholipid chains is crucial for overcoming the hydration barrier between the merging bilayers.

Sonication tailored enhance cytotoxicity of naringenin nanoparticle in pancreatic cancer: design, optimization, and in vitro studies.

Objective: In vitro, optimization, characterization, and cytotoxic studies of NAR nanoparticles (NPs) to against pancreatic cancer.Method: The sonication tailored Naringenin (NARG)-loaded poly (lactide-co-glycolic acid) (PLGA) NPs was fabricated for potential cytotoxic effect against pancreatic cancer. NARG NPs were prepared by emulsion-diffusion evaporation technique applying BoxBehnken experimental design based on three-level and three-factors. The effect of independent variables surfactant concentration (X1), polymer concentration (X2), and sonication time (X3) were studied on responses particle size (Y1), and drug release % (Y2). NPs characterized for particles size and size distribution, polydispersity index (PDI), zeta potential, transmission electron microscope (TEM), scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FT-IR), Differential scanning calorimeter (DSC), and X-ray diffraction (XRD) studies. Further, the studies was fitted to various drug release kinetic model and cytotoxicity evaluated in vitro.Results: The nanosized particles were spherical, uniform with an average size of 150.45 ± 12.45 nm, PDI value 0.132 ± 0.026, zeta potential -20.5 ± 2.5 mV, and cumulative percentage release 85.67 ± 6.23%. In vitro release of NARG from nanoparticle evaluated initially burst followed by sustained release behavior. The Higuchi was best fitted model to drug release from NARG NPs. The cytotoxicity study of NARG NPs apparently showed higher cytotoxic effect over free NARG (p < 0.05). The stability study of optimized formulation revealed no significant physico-chemical changes during 3 months.Conclusions: Thus, NARG-loaded NPs gave ameliorated anticancer effect over plain NARG.

A 3-D Finite Element Analysis of Stress Distribution on Implant-supported Fixed Prosthesis with Four Different Commercially Available Implant Systems.

AIM: To investigate by the finite element analysis comparison of stress distribution on the cortical and cancellous bone in an implant-supported yttrium tetragonal zirconia polycrystals (Y-TZP FPD) in four different widely used implant systems under different loading conditions. MATERIALS AND METHODS: Four 3-D finite element analysis (FEA) models of mandible having different implant systems with dimensions 8.0 mm × 5 mm in the second premolar and molar region were developed. In these models, abutment was tightened and 3-unit implant-supported Y-TZP FPD were cemented. A lateral force component of 100 N at 30° to the occlusal plane and a vertical intrusive force component of 250 N were applied to the central fossa of the FDP and the stress on bone around the implant was analyzed by FEA. RESULTS: In the four implant systems, the maximum stress values on the crestal bone differ for the different implant systems for the two loading conditions applied. In both cases, the maximum stress values on the cortical bone were in ADIN Touareg Closefit WP implants and the maximum stress on the cancellous bone was observed in the Nobel Speedy Groovy implants. CONCLUSION: The ADIN Touareg Closefit WP implant system induced maximum stress on the crestal bone in both axial and buccolingual loading. Nobel Speedy Groovy implant system favored more equitable load distribution to the peri-implant crestal bone when compared to the other three implant systems. CLINICAL SIGNIFICANCE: From this study, it was found that out of all the implants used for the study, the Nobel Speedy Groovy implant system favored more equitable load distribution due to the platform switch design contrary to the other systems and at the cancellous bone the least load was transferred by the Nobel Active implants due to the reverse buttress thread design and larger thread pitch.

Comparative Analysis of Marginal Accuracy of Complete Crowns Fabricated by Using Ringless and Metal Ring Investment Systems: An In Vitro Study.

AIM: To compare the vertical margin accuracy of lost wax castings produced by the conventional casting technique with all metal (WIRONIUM®) and PFM alloy (WIRON®99) using a metal ring and ringless system. MATERIALS AND METHODS: A brass die assembly was used to fabricate standardized wax pattern crowns. A total of 100 wax patterns were made with both ringless and metal ring investment systems. Wax patterns were readapted and refined on the master die and divided into two groups, namely, group I and group II with 50 wax patterns in each group. Group I (ringless system) and group II (metal ring system) were further divided into subgroups having a sample size of 25 in each group. Each coping was invested and cast individually. The marginal discrepancy between the metal die and the castings were measured by a stereomicroscope and AutoCAD software 2013. Measurement was made on the facial area of the metal die. RESULTS: The resultant casts obtained from different casting systems show statistically significant difference found between the marginal discrepancies using metal ring and ringless castings system, and statistically nonsignificant difference was found between the marginal discrepancies using all metal alloy (WIRONIUM®) and PFM alloy (WIRON®99) within the same group. CONCLUSION: The marginal discrepancy for castings made with ringless casting system was less when compared to metal ring casting system, and there was no difference in marginal discrepancy when compared to all metal alloy (WIRONIUM®) and PFM alloy (WIRON®99) within the same group. CLINICAL SIGNIFICANCE: Marginal fit is influenced by several factors including type of crown, tooth preparation geometry, dimensional accuracy of impression materials, factors related to dental casting, type of cement, luting pressure, duration of cementation, and use of occlusal vents or die spacers.

A Comparative Radiographic Evaluation of Occlusal Plane in Dentulous and Edentulous Subjects: A Clinical Study.

AIM: The aim of this study is to establish a proportion between the inferior border of mandible and lower edge of the mental foramen and inferior border of mandible to occlusal plane for dentulous subjects and to evaluate the validity of this proportion in orienting the occlusal plane for edentulous subjects. MATERIALS AND METHODS: The occlusal plane was evaluated in the selected 50 dentulous and edentulous subjects for its relation to the mental foramen and inferior border of the mandible. The orthopantograms obtained were traced with the markings and the measurements were tabulated under different headings. After measuring the distances, the proportion between the distances was determined. The mean proportions of dentulous, edentulous, male, and female subjects were evaluated. Then the proportion of male subjects was compared with that of female subjects and dentulous subjects with that of edentulous subjects. Comparison of proportion between the different groups was done by using unpaired t test. The mean and standard deviation (SD) were determined for each group separately and were compared within each group. From the calculated "t" value, "p" the probability for error was found out. RESULTS: In dentulous subjects, the proportion ranged from 1:3.53 to 1:4.40. The mean was 1:3.90. In edentulous subjects, the proportion ranged from 1:3.50 to 1:4.15. The mean was 1:3.84. On comparison, the difference between both the groups was 0.06. The difference was statistically insignificant (p = 0.14). In the comparison of dentulous male and female subjects, the difference obtained was 0.02. The difference was statistically insignificant (p = 0.77). The comparison of edentulous male and female subjects and the difference obtained was 0.03. The difference was statistically insignificant (p = 0.51). CONCLUSION: The derived proportion of 1:4 between the inferior border of mandible and mental foramen and inferior border of mandible and occlusal plane in edentulous patients as measured on an orthopantogram may yield a plane of occlusion similar to that existing in the dentulous state. CLINICAL SIGNIFICANCE: The above-drawn proportion between the inferior border of the mandible to the lower edge of the mental foramen and between the inferior border of the mandible and the occlusal plane in edentulous patients may yield a plane of occlusion which is oriented similar to that existing in the dentulous state. The proportions derived radiographically in this study can serve as a basis for future studies to establish the occlusal plane for edentulous subjects.

Human health risk assessment: Study of a population exposed to fluoride through groundwater of Agra city, India.

Fluoride (F-), a harmful compound if present in high concentration, is typically found in groundwater. It is important to investigate the F- concentrations in groundwaters of areas where individuals use groundwater for drinking purposes. The objectives of this study were: (a) to estimate the F- exposure, and (b) to assess the non-carcinogenic risk through consumption of groundwater among urban population (different age groups) of Agra city. A total of 28 groundwater samples were collected from Agra city in May 2016, which comprised 22 samples from hand pump and 6 samples from tube wells from shallow aquifers at different sites. The F- concentrations varied from 0.90 to 4.12 mg/L with an average value of 1.88 mg/L. The results obtained reveal that about 64% of the samples exceeded the F- permissible limit of 1.5 mg/L. Nevertheless, 32% of the samples were well within the WHO drinking water guidelines and 3.5% of the samples from the groundwater were below the 1.0 mg/L threshold. The maximum estimated exposure doses were 0.69, 0.31 and 0.12 mg/kg/day for infants, children and adults, respectively. A dental fluorosis becomes evident when the results obtained are compared with an oral reference dose of 0.06 mg/kg/day. The hazard quotient (HQ) was found to be more than 1 for infants and children in all the studied areas which indicates that young consumers are more vulnerable to non-carcinogenic risk due to exposure of F-. On the other hand, the adults at about 71% of the sampled sites may be victims of non-carcinogenic risk. From the results obtained in this study, it is recommended that there be implementation of the appropriate remediation for defluoridation of water to circumvent the population from the probable health risks of F-.

Fluoride contamination, health problems and remediation methods in Asian groundwater: A comprehensive review.

In low concentration, fluoride is considered a necessary compound for human health. Exposure to high concentrations of fluoride is the reason for a serious disease called fluorosis. Fluorosis is categorized as Skeletal and Dental fluorosis. Several Asian countries, such as India, face contamination of water resources with fluoride. In this study, a comprehensive overview on fluoride contamination in Asian water resources has been presented. Since water contamination with fluoride in India is higher than other Asian countries, a separate section was dedicated to review published articles on fluoride contamination in this country. The status of health effects in Asian countries was another topic that was reviewed in this study. The effects of fluoride on human organs/systems such as urinary, renal, endocrine, gastrointestinal, cardiovascular, brain, and reproductive systems were another topic that was reviewed in this study. Different methods to remove fluoride from water such as reverse osmosis, electrocoagulation, nanofiltration, adsorption, ion-exchange and precipitation/coagulation were introduced in this study. Although several studies have been carried out on contamination of water resources with fluoride, the situation of water contamination with fluoride and newly developed technology to remove fluoride from water in Asian countries has not been reviewed. Therefore, this review is focused on these issues: 1) The status of fluoride contamination in Asian countries, 2) health effects of fluoride contamination in drinking water in Asia, and 3) the existing current technologies for defluoridation in Asia.

A Radiographic Evaluation of Peri-implant Bone Level in Immediate and Conventionally Loaded Implants Using Flap and Flapless Techniques.

AIM: The purpose of this research is to compare peri-implant bone level in immediate and conventionally loaded implants using flap and flapless techniques. MATERIALS AND METHODS: Forty patients were selected and were subjected into four groups. Group A: 10 patients with immediate loading (IL) by raising the flap. Group B: 10 patients with IL without raising the flap. Group C: 10 patients with conventional loading by raising the flap. Group D: 10 patients with conventional loading without raising the flap. RESULTS: It was observed that for most of the flapless techniques with IL cases, the bone loss settled at first thread or just below the implant collar after 6 months. CONCLUSION: It was seen that the crestal bone height was reduced in both flap and flapless techniques by immediate and conventional loading, respectively. On comparing the bone loss, the flapless approach by IL showed statistically significant lesser reduction as determined by radiovisiography. CLINICAL SIGNIFICANCE: Postoperative pain was less in the flapless technique as compared to the traditional flap technique. IL minimizes invasiveness, complexity, and also improves acceptance by patients.

Evaluation of Shear Bond Strength of Three Different Acrylic Resin and Artificial Denture Teeth with and without Monomer Application.

AIM: To compare and evaluate the shear bond strength of the tooth-denture base junction when three different commercially available acrylic resin base bonded to acrylic teeth with and without application of methyl methacrylate monomer on ridge lap area. MATERIALS AND METHODS: A three-stepped cylindrical shaped die was customized. Sixty samples were fabricated with heat cure and self-cure acrylic resin with and without monomer application. A total of 60 samples were divided into three groups and six subgroups. • Group A-Twenty samples of Trevlon-HI heat-activated acrylic resin. • Subgroup A1-Ten samples of acrylic teeth bonded with Trevlon-HI heat-activated acrylic resin with the application of monomer on ridge lap area. • Subgroup A2-Ten samples of acrylic teeth bonded with Trevlon-HI heat-activated acrylic resin without application of monomer on ridge lap area. • Group B-Twenty samples of Trevalon heat-activated acrylic resin. • Subgroup B1-Ten samples of acrylic teeth bonded with Trevlon heat-activated acrylic resin with the application of monomer on ridge lap area. • Subgroup B2-Ten samples of acrylic teeth bonded with Trevlon heat-activated acrylic resin without application of monomer on ridge lap area. • Group C-Twenty samples of Trevlon-RR self-activated acrylic resin. • Subgroup C1-Ten samples of acrylic teeth bonded with Trevlon-RR self-activated acrylic resin with the application of monomer on ridge lap area. • Subgroup C2-Ten samples of acrylic teeth bonded with Trevlon-RR self-activated acrylic resin without monomer application on ridge lap area. RESULTS: Samples obtained from high impact heat cure acrylic resin with monomer application shows higher bond strength when tested under the universal testing machine. CONCLUSION: With and without monomer application on high impact polymethylmethacrylate (PMMA) resin and Heat cured resin it was found that high impact shows better bond strength. Trevlon HI monomer shows a greater increase in strength due to the presence of cross-linking agents. CLINICAL SIGNIFICANCE: The incorporation of mechanical surface treatments followed by monomer application significantly influences the bonding between denture teeth and denture base resin.

Oral Health Behavior and Factors Influencing the Selection of Oral Hygiene Products among the Adolescent Tobacco Consumers in Jharkhand.

AIM: To identify the oral health behavior and factors influencing the selection of oral hygiene products by the adolescent tobacco consumers in Ranchi district, Jharkhand. This study will also attempt to identify the factors related to the selection of toothbrushes for oral hygiene maintenance. MATERIALS AND METHODS: A total of 800 adolescent tobacco consumers were selected from Ranchi district. A self-administered questionnaire collected information on the oral health behavior and factors influencing the selection of oral cleansing aids. Logistic regression analysis was performed. RESULTS: Toothbrush (83.0%) and toothpaste (78.0%) were the most common oral cleansing aids. Media played an important role in the selection of toothbrushes and toothpaste. The dental visit (15.0%) for preventive dental care was reported to be less. The individuals belonging to upper class (OR = 2.8, p value < 0.001*), of nontribal origin (OR = 3.21, p value < 0.001*, and residing in urban areas (OR = 5.6, p value < 0.0001*) were more likely to use a toothbrush. CONCLUSION: The consumption of tobacco should be discouraged. Promotion of oral cleansing aids and interdental aids should be carried out using support from media. CLINICAL SIGNIFICANCE: The oral health behavior of adolescents needs to be improved. The adolescents should be promoted to quit tobacco, and education and counseling should be provided to them for the oral health promotion. Regular dental check-up for preventive care should be encouraged. How to cite this article: Shahi AK, Chandra S, Kumar S, et al. Oral Health Behavior and Factors Influencing the Selection of Oral Hygiene Products among the Adolescent Tobacco Consumers in Jharkhand. J Contemp Dent Pract 2019;20(10):1200-1205.

Comparison of Dimensional Accuracy of Stone Models Fabricated by Three Different Impression Techniques Using Two Brands of Polyvinyl Siloxane Impression Materials.

AIM: The aim of this study is to check the dimensional precision of stone models made by two different brands of polyvinyl siloxane impression materials using the monophase, one-step, and two-step putty/light-body impression techniques. MATERIALS AND METHODS: A metal model, having two crown preparations, was fabricated. With each technique, 40 impressions were made using two types of polyvinyl siloxane impression materials (Aquasil and Virtual). A total of 240 impressions were made with both the polyvinyl siloxane impression materials. Monophase impressions were made with a medium body using an acrylic custom tray. By simultaneous usage of putty and light-body, one-step impressions were made with a perforated metal stock tray. For two-step impressions, a 25-40 microns thick cellophane sheet spacer was used. The stone casts were obtained from the impressions of the stainless steel model. Three different dimensions (height, diameter, and inter-abutment distance) on these resultant stone casts were compared with the standard die. The accuracy of two different brands of impression materials was also compared. The results were then statistically analyzed. RESULTS: The resultant casts obtained from the different impression techniques had significantly larger dimensions in height and diameter, but smaller dimensions were observed for the inter-abutment distance. Larger deviation in resultant casts was observed in the monophase than one-step impression technique and the least deviation was observed in the two-step impression technique. CONCLUSION: The two-step impression technique produced the most accurate results in terms of the resultant casts. Out of the two different brands, Aquasil produced more fare results. CLINICAL SIGNIFICANCE: Adequate marginal adaptation, proper fit and least distortion of the castings, and the final prosthesis can be achieved by using the adequate impression technique and impression material.

3D Finite Element Analysis to Assess the Stress Distribution Pattern in Mandibular Implant-supported Overdenture with Different Bar Heights.

AIM: Proper stress distribution on dental implants is necessary in bar-retained implant overlay dentures. The purpose of the study is to comparatively assess the stress distribution pattern on the crestal bone at the bone-implant interface due to different bar heights using finite element models (FEMs). MATERIALS AND METHODS: Eight 3D FEMs were developed from mandibular overdentures with two implants in the canine region separated by a distance of 20 mm. In these models, four different bar heights from the mucosa (0.5, 1, 1.5, and 2 mm) with 12 mm occlusal plane height were analyzed. A unilateral and a bilateral vertical load of 150 N were applied to the central occlusal fossa of the first molar and the stress of bone around the implant was analyzed by finite element analysis (FEA). RESULTS: By increasing the bar height, the maximum stress values around implants on the crestal bone were found to be increased in unilateral and bilateral loading models. In unilateral loading models, the maximum stress was found in a model with a 2 mm bar height (0.46 MPa) on the distal side of the ipsilateral implant, and in bilateral loading cases, the maximum stress was also found in a model with a 2 mm bar height (0.456 MPa). CONCLUSION: As the vertical cantilever increases (here the bar height), the maximum stress on the crestal bone increases. A minimum of 0.5 mm of space is sufficient between the mucosa and the inferior border of the bar to maintain oral hygiene. CLINICAL SIGNIFICANCE: From the present study, it can be concluded that an increase in bar height causes an increase in stress levels on the peri-implant crestal bone.

Biocompatibility and Targeting Efficiency of Encapsulated Quinapyramine Sulfate-Loaded Chitosan-Mannitol Nanoparticles in a Rabbit Model of Surra.

Quinapyramine sulfate (QS) produces trypanocidal effects against the parasite Trypanosoma evansi but is often poorly tolerated and causes serious reactions in animals. The encapsulation of QS in chitosan-mannitol to provide sustained release would improve both the therapeutic effect of QS and the quality of life of animals treated with this formulation. QS was encapsulated into a nanoformulation prepared from chitosan, tripolyphosphate, and mannitol nanomatrix (ChQS-NPs). ChQS-NPs were well ordered in shape, with nanoparticle size, as determined by transmission electron microscopy and atomic force microscopy. Our research revealed dose-dependent effects on biosafety and DNA damage in mammalian cells treated with ChQS-NPs. ChQS-NPs were absolutely risk-free at effective as well as many times higher doses against T. evansi ChQS-NPs were effective in rabbits, as they killed the parasites, relieving the animals from the clinical symptoms of the disease. The extent of this protection was similar to that observed with the conventional drug at higher dosages (5 mg QS/kg of body weight). ChQS-NPs are safe, nontoxic, and more effective than QS and offer a promising alternative to drug delivery against surra in animal models. ChQS-NPs may be useful for the treatment of surra due to reduced dosages and frequency of administration.

Crestal Bone Changes around immediately loaded Single-piece Implants using Flap and Flapless Technique: A Radiographic Study.

AIM: With the trend shifting toward the minimally invasive surgeries in implant surgery, the flapless technique of implant placement is gaining popularity among the implantologists. This study was done to assess the crestal bone loss level in flap and flapless surgery at follow-up periods of 0, 1, and 3 months. MATERIALS AND METHODS: Patients presenting with missing teeth requiring dental implants for rehabilitation were included in the study. Implant placement was done in 10 patients with traditional flap technique, while in other 10 patients, flapless technique was performed after determining the availability of sufficient bone width with ridge mapping. Radiographical follow-up was done for 3 months at 0-, 1-, and 3-month intervals. RESULTS: It was observed that for most of the flapless cases, the bone loss settled at 1st thread or just below the implant collar after 3 months. CONCLUSION: It was seen that crestal bone height was reduced in both flap and flapless techniques. On comparing the bone loss, the flapless approach showed statistically significant lesser reduction as determined by radiovisiography. CLINICAL SIGNIFICANCE: The study has been done to evaluate crestal bone level using flap and flapless technique. It was seen that reduction of crestal bone height was seen in both flapless and with flap techniques. However, on comparison, less bone resorption was observed in flapless technique.

Evaluating the Effect of Different Impression Techniques and Splinting Methods on the Dimensional Accuracy of Multiple Implant Impressions: An in vitro Study.

AIM: This study was done to determine more accurate impression technique and splinting method for multiple implant impressions in edentulous patients. MATERIALS AND METHODS: A prefabricated maxillary reference model was taken on which four implants were placed parallel to each other using vertical milling machine. Forty custom trays having different tray designs were fabricated using autopolymeri-zing acrylic resin on the stone cast obtained from the reference model. A total of 40 samples (n = 40) were divided into five groups, in which group I included casts obtained from impressions made with closed-tray technique, group II: open-tray impression technique, group III: open-tray impressions splinted with acrylic, group IV: open-tray impressions splinted with light cure material, and group V acted as a control group (reference model). Casts obtained were poured with dental stone. The interimplant distances were checked using coordinate measuring machine to evaluate the three-dimensional (3D) positional accuracy in X, Y, and Z axes. RESULTS: Casts obtained from impressions made with closed-tray technique showed highest mean deviation from the reference model while those obtained from open-tray splinted with light cure showed the least deviation. The casts obtained from open-tray nonsplinted and open-tray acrylic splinted showed intermediate mean deviations. CONCLUSION: The casts obtained from open-tray impression technique were more accurate as compared with the closed-tray technique. Among splinting, the impressions obtained from light cure splinting showed more accuracy than the impressions obtained from acrylic splinting. CLINICAL SIGNIFICANCE: The accuracy of the multiple implant impression is influenced by the type of impression material used which ultimately leads to an accurate cast on which precisely fitting prosthesis is fabricated. Several factors including material accuracy, time span before the impression is poured, and extent of intraoral undercuts are to be kept in mind while choosing an impression material.

Influence of Lifestyle Factors on Oral Health-Related Quality of Life in Pregnant Women in Indore City.

BACKGROUND: Lifestyle factors affect the periodontal and oral hygiene status and, thus, may affect the Oral Health-Related Quality of Life (OHRQoL) in pregnant women. Thus, the aim of the study was to assess the OHRQoL and determine its relationship with lifestyle and other factors in pregnant women in Indore city. METHODS: This cross-sectional study was carried out on 400 pregnant women who were selected using stratified random sampling technique from eight private maternity centers located in Indore city. A questionnaire collected information on socio-demographic characteristics, oral hygiene practices, previous dental visit and past medical history. OHRQOL was assessed using Oral Health Impact Profile-14 questionnaire. Lifestyle factors were assessed using the Health practice Index. RESULTS: The lifestyle factors were the strongest predictor for poor OHRQOL. The pregnant women (OR = 3.22, P-value < 0.0001*) with poor lifestyle had significantly poor OHRQOL. Logistic regression analysis showed that poor socio-economic status (OR = 2.63, P-value = 0.025*), brushing frequency of less than or equal to once daily (OR = 2.02, P-value = 0.025*), and suffering from systemic diseases (OR = 2.11, P-value = 0.017*) were other important predictors for poor OHRQOL in pregnant women. CONCLUSIONS: Our findings showed that lifestyle factors significantly impact OHRQOL in pregnant women. Thus, it is recommended that effective policies should be drafted to improve lifestyle factors and OHRQOL in pregnant women.

Coordinated protein co-expression in plants by harnessing the synergy between an intein and a viral 2A peptide.

A novel approach is developed for coordinated expression of multiple proteins from a single transgene in plants. An Ssp DnaE mini-intein variant engineered for hyper-N-terminal autocleavage is covalently linked to the foot-and-mouth disease virus 2A (F2A) peptide with unique ribosome skipping property, via a peptide linker, to create an 'IntF2A' self-excising fusion protein domain. This IntF2A domain acts, in cis, to direct highly effective release of its flanking proteins of interest (POIs) from a 'polyprotein' precursor in plants. This is successfully demonstrated in stably transformed cultured tobacco cells as well as in different organs of transgenic tobacco plants. Highly efficient polyprotein processing mediated by the IntF2A domain was also demonstrated in lettuce and Nicotiana benthamiana based on transient expression. Protein constituents released from the polyprotein precursor displayed proper function and accumulated at similar levels inside the cells. Importantly, no C-terminal F2A extension remains on the released POIs. We demonstrated co-expression of as many as three proteins in plants without compromising expression levels when compared with those using single-protein vectors. Accurate differential cellular targeting of released POIs is also achieved. In addition, we succeeded in expressing a fully assembled and functional chimeric anti-His Tag antibody in N. benthamiana leaves. The IntF2A-based polyprotein transgene system overcomes key impediments of existing strategies for multiprotein co-expression in plants, which is particularly important for gene/trait stacking.

Risk of Stroke-Associated Pneumonia and Oral Hygiene.

BACKGROUND: Pneumonia is a major complication of stroke, but effective prevention strategies are lacking. Since aspiration of oropharyngeal secretions is the primary mechanism for development of stroke-associated pneumonia, strategies that decrease oral colonization with pathogenic bacteria may help curtail pneumonia risk. We therefore hypothesized that systematic oral care protocols can help decrease pneumonia risk in hospitalized stroke patients. In this study, we investigated the impact of a systematic oral hygiene care (OHC) program in reducing hospital-acquired pneumonia in patients with acute-subacute stroke. METHODS: This study compared the proportion of pneumonia cases in hospitalized stroke patients before and after implementation of a systematic OHC intervention. All patients hospitalized with acute ischemic stroke or intracerebral hemorrhage admitted to a large, urban academic medical center in Boston, Mass., USA from May 31, 2008, to June 1, 2010 (epoch prior to implementation of OHC), and from January 1, 2012, to December 31, 2013 (epoch after full implementation of OHC), who were 18 years of age and hospitalized for ≥ 2 days were eligible for inclusion. The cohort in the first epoch constituted the control group whereas the cohort in the second epoch formed the intervention group. Multivariate logistic regression was used to control for confounders. The main outcome measure was hospital-acquired pneumonia, defined via International Classification of Diseases, Ninth Revision, Clinical Modification codes. RESULTS: The cohort comprised 1,656 admissions (707 formed historical controls; 949 were in the intervention group). The unadjusted incidence of hospital-acquired pneumonia was lower in the group assigned to OHC compared to controls (14 vs. 10.33%; p = 0.022) with an unadjusted OR of 0.68 (95% CI 0.48-0.95; p = 0.022). After adjustment for influential confounders, the OR of hospital-acquired pneumonia in the intervention group remained significantly lower at 0.71 (95% CI 0.51-0.98; p = 0.041). CONCLUSION: In this large hospital-based cohort of patients admitted with acute stroke, systematic OHC use was associated with decreased odds of hospital-acquired pneumonia.

Knowledge,attitude and anxiety towards pandemic flu a potential bio weapon among health professionals in Indore City.

BACKGROUND: Flu is one of the oldest medical concerns, causing high mortality rates among humans. Swine flu has not only emerged as a fatal disease omong Indian population but has also created havoc among various sections of society. OBJECTIVE: To determine Knowledge, Attitude and Anxiety towards pandemic flu a potential bioweapon among health care professionals in Indore City. METHOD: The study design used was a cross sectional descriptive study was carried out between February-March 2015 during the outbreak of Swine Flu. The survey was administered to a sample of 271 health professionals. Participants comprised of 148 medical professionals and 123 dental professionals practicing in Sri Aurobindo Institute of Medical Science. The data collection tools comprised of a questionnaire on demographic characteristics, knowledge and attitude. Beck Anxiety Inventory was used to assess the anxiety among professionals. RESULTS: The medical professionals (95.9%) had significantly higher (p value=0.007) knowledge about available vaccines against Swine Flu. The dental professionals (33.3%) were more hesistant in treating patients suffering from Swine Flu compared to medical. CONCLUSION: The results of the present study suggest that the health care professionals had good knowledge, showed positive attitude, and demonstrated lower anxiety levels.