Effect of serum vitamin D, calcium, and phosphorus on mandibular residual ridge resorption in completely edentulous participants: A clinical study.

STATEMENT OF PROBLEM: Published data regarding association between edentulous mandibular residual ridge resorption and nutritional status of geriatric patients is limited. PURPOSE: The purpose of this clinical study was to evaluate the degree of mandibular residual ridge resorption in completely edentulous participants and to investigate the role of dietary nutrients in the resorption process. MATERIAL AND METHODS: Three hundred (55% men and 45% women; aged between 35 and 85 years) completely edentulous participants with specific inclusion and exclusion criteria were enrolled for the study. A standardized panoramic radiograph was made, measurements were made digitally, and the amount of resorption was calculated using the Wical and Swoope method. The blood plasma levels of vitamin D3 were analyzed by using the direct competitive chemiluminescence immunoassay (CLIA) method, whereas the total calcium and phosphorus were determined by using spectrophotometer method. Statistical data of serum nutrient levels (calcium, phosphorus, and vitamin D3), age, sex, and residual ridge resorption were subjected to the Mann-Whitney U test, the Spearman correlation test, and a stepwise multiple linear regression analysis (α=.05). RESULTS: Calcium (P=.003) and phosphorus (P<.001) levels were significantly increased in the female participants as compared with the male participants. Vitamin D3 levels were similar in all the participants. Moreover, metabolic levels of calcium (rho=-0.09), phosphorus (rho=-0.10), and vitamin D3 (rho=-0.02) were found to be reduced with increasing age. However, male participants had increased mandibular residual ridge resorption (P<.001) with positive correlation (rho=0.06) when compared with female participants. Mandibular ridge resorption was increased with a decrease in levels of serum nutrients. CONCLUSIONS: Increased levels of mandibular residual ridge resorption were observed in participants with decreased levels of systemic biochemical parameters, including calcium, phosphorus, and vitamin D3. Moreover, male participants showed increased residual ridge resorption when compared with female participants, who showed a significantly higher level of serum nutrient levels. Serum nutrient levels decreased, whereas mandibular residual ridge resorption increased with age.

Comparative Evaluation of Mechanical and Microleakage Properties of Cention-N, Composite, and Glass Ionomer Cement Restorative Materials.

AIM: The longevity of restorative materials depends on the resistance to masticatory forces. The present study was undertaken to evaluate the mechanical and microleakage properties of Cention-N with glass ionomer cement (GIC) and composite restorative materials. MATERIALS AND METHODS: A total of 45 specimen blocks were prepared with 15 samples of each type of restorative material, namely Cention-N, GIC, and hybrid composite. Samples were subjected to load at crosshead speed of 0.75 ± 0.25 mm/min till the fracture of sample. Class V cavities were prepared on the buccal surface of orthodontically extracted premolars followed by restoration of each test material. All the surfaces of the tooth were coated with clear nail varnish except 1 mm around the margins of the restorations. These samples were immersed in 0.5% basic fuchsine dye and longitudinally sectioned and observed under stereomicroscope to check microleakage. The obtained data were statistically evaluated. RESULTS: We found the highest mean compressive and flexural strength for hybrid composite followed by Cention-N and least for GIC which is statistically significant (p < 0.001). CONCLUSION: Mean microleakage was least for Cention-N. Cention-N is a newer restorative material having higher mechanical properties with lesser microleakage. CLINICAL SIGNIFICANCE: Cention-N is a newer restorative material having promising properties. This material can be used as an alternative restorative material.

Alginate based biomaterials for hemostatic applications: Innovations and developments.

Development of the efficient hemostatic materials is an essential requirement for the management of hemorrhage caused by the emergency situations to avert most of the casualties. Such injuries require the use of external hemostats to facilitate the immediate blood clotting. A variety of commercially available hemostats are present in the market but most of them are associated with limitations such as exothermic reactions, low biocompatibility, and painful removal. Thus, fabrication of an ideal hemostatic composition for rapid blood clot formation, biocompatibility, and antimicrobial nature presents a real challenge to the bioengineers. Benefiting from their tunable fabrication properties, alginate-based hemostats are gaining importance due to their excellent biocompatibility, with >85 % cell viability, high absorption capacity exceeding 500 %, and cost-effectiveness. Furthermore, studies have estimated that wounds treated with sodium alginate exhibited a blood loss of 0.40 ± 0.05 mL, compared to the control group with 1.15 ± 0.13 mL, indicating its inherent hemostatic activity. This serves as a solid foundation for designing future hemostatic materials. Nevertheless, various combinations have been explored to further enhance the hemostatic potential of sodium alginate. In this review, we have discussed the possible role of alginate based composite hemostats incorporated with different hemostatic agents, such as inorganic materials, polymers, biological agents, herbal agents, and synthetic drugs. This article outlines the challenges which need to be addressed before the clinical trials and give an overview of the future research directions.

Chitosan/alginate nanogel potentiate berberine uptake and enhance oxidative stress mediated apoptotic cell death in HepG2 cells.

Biopolymer-based nanoscale drug delivery systems have become a promising approach to overcome the limitations associated with conventional chemotherapeutics used for cancer treatment. Herein, we reported to develop a hydrophilic nanogel (NG) composed of Chitosan (Chi) and sodium alginate (Alg) using the ion gelation method for delivering Berberine hydrochloride (BBR), an alkaloid obtained from Berberis aristata roots. The use of different nanocarriers for BBR delivery has been reported previously, but the bioavailability of these carriers was limited due to phagocytic uptake and poor systemic delivery. The developed NG showed enhanced stability and efficient entrapment of BBR ∼92 %, resulting in a significant increase in bioavailability. The pH-dependent release behavior demonstrated sustained and effective release of ∼86 %, ∼74 % and, ∼53 % BBR at pH 5.5, 6.6, and 7.4 respectively after 72h, indicating its potential as a drug carrier. Additionally, the cellular uptake of BBR was significantly higher ∼19 % in the BBR-NG (25 µM) than in bulk BBR (100 µM), leading to enhanced ROS generation, mitochondrial depolarisation, and inhibition of cell proliferation and colony formation in HepG2 cells. In summary, the results suggest that the Chi/Alg biopolymer-based nano-formulation could be an effective approach for delivering BBR and enhancing its cellular uptake, efficacy, and cytotoxicity.

Use of Endodontic Procedures in Young Permanent Teeth.

Background: Regenerative endodontic procedures (REPs) have emerged as a promising treatment option for young permanent teeth with pulp necrosis, offering the potential for tissue repair and preservation. Materials and Methods: A retrospective analysis was conducted on a cohort of 30 patients aged 8 to 16 years with pulp necrosis in young permanent teeth. The patients underwent REPs, including disinfection, triple antibiotic paste application, and a coronal barrier. Clinical and radiographic data were collected at baseline and follow-up appointments at 6, 12, and 24 months. Radiographs were analyzed for root lengthening, apical closure, and resolution of periapical lesions. Results: The mean increase in root length after 24 months was 3.42 mm (SD ± 1.12 mm), and 90% of cases demonstrated complete apical closure. The overall success rate, defined as the absence of clinical symptoms and radiographic evidence of pathology, was 80. Conclusion: REPs show promising outcomes in young permanent teeth with pulp necrosis, promoting root development, and apical closure.

Enamel Hypoplasia and Dental Fluorosis in Children With Special Healthcare Needs: An Epidemiological Study.

Background Children with cerebral palsy, intellectual difficulties, or hearing deficiencies may have enamel hypoplasia. Moreover, as the child begins to walk, the fluorosis progresses to bone malformations in the lower limbs, and it fully manifests as the child grows up. Methodology An epidemiological study was conducted to assess the prevalence of dental caries, oral hygiene status, enamel opacities, and oral hygiene habits among children 4-15 years of age from various schools for special healthcare needs including government schools and non-government organizations. Results The study sample comprised 1,047 children with special healthcare needs in the age group of 4-15 years, with 608 males and 439 females. It was seen that 29.79% of vegetarian children were affected with caries, while only 16.14% of children with a mixed diet were affected with caries. Conclusions There is no significant association between enamel hypoplasia and the physical and mental disabilities of children with special healthcare needs.

Using the Caries Assessment Spectrum and Treatment Index to Determine the Caries Incidence in Primary and Permanent Molars Among School Children of Kolkata: A Cross-Sectional Study.

INTRODUCTION: Caries in their early stages cannot be properly classified using the decayed, missing, and filled teeth (DMFT) index because it does not record precavitated lesions. Thus, the caries assessment spectrum and treatment (CAST) index is a good alternative as it is equipped to record the whole range of dental illnesses and count restored teeth as healthy ones. MATERIALS AND METHODS: The participants in this cross-sectional study included 300 children who were seven-to-eight years of age. We used the CAST index to assess the extent of caries in the deciduous and permanent molars of these children. For this, all the permanent and baby teeth, the primary and secondary permanent molars, as well as the first and second deciduous molars were examined to determine the prevalence of each carious stage. The correlation of the distribution of the CAST codes between the first and second molars, the second and first molars, the right and left sides of the dental bend, and the opposing jaws was analyzed using Spearman's rank correlation coefficient, while the cut-off for statistical significance was a p-value of 0.05. The quantitative analysis was conducted using IBM SPSS Experiences Version 20 for Windows. RESULTS: By comparing CAST codes in the right and left molars, we were able to observe how the development of caries in paired teeth might affect one another. The rank correlation value was found to be less than 0.5 only in the primary second molars (55/65 and 85/75), which were found exclusively in the deciduous first molars. Moreover, the r values for the neighboring deciduous and permanent molars were found to be below 0.3, i.e., 65/64 (0.497), 74/75 (0.327), and 84/85 (0.411), which indicated a weak connection between them. When comparing the teeth in different jaws, we found reasonable correlations (r = 0.33-0.49), with only 64/74 outliers (0.501). CONCLUSIONS: We found that, in the examined population, there was a well-established correlation between the stages of caries development in the deciduous molars on the left side of the mouth.

Effect of Root Canal Taper on the Ability of Endodontically Treated Teeth using the TruNatomy and Protaper Next File Systems to Resist Fracture.

Objectives: This research was done to evaluate how the root canal taper affects the Endodontically Treated Teeth (ETT) prepared with the TruNatomy and Protaper Next file systems in terms of fracture resistance. Materials and Method: Forty recently extracted mandibular premolar teeth were used in this research, which was classified into four groups at random. Groups 1a and 1b used TruNatomy 4% and 6%, respectively, while groups 2a and 2b used the Protaper Next 4% and 6% file systems, respectively. The root canals were cleaned, shaped, and sealed using cold lateral compaction. The root canals were then fixed in standardized autopolymerizing acrylic resin blocks and tested for vertical root fracture using a universal testing machine. Newtons were used to measure the forces needed to cause fractures. Data were statistically analyzed. Results: In comparison with other groups, group 1a (TruNatomy 4%) displayed greater fracture resistance (423.322.43 Newtons), and group 2b (Protaper Next 6%) displayed the least fracture resistance (264.512.76 Newtons). Conclusion: Protaper Next file system had lower fracture resistance than TruNatomy file system. With the use of greater taper instruments, a notable decrease in the fracture resistance of ETT was observed.

Comparative Assessment of Enamel Microhardness Using Various Remineralising Agents on Artificially Demineralized Human Enamel.

INTRODUCTION: Various remineralizing agents can be used to remineralize initial carious lesions. AIM: The study aims to compare and evaluate the remineralizing efficiency of Remin Pro (VOCO GmbH, Cuxhaven, Germany), tricalcium phosphate, and HealOzone (CurOzone USA Inc., Ontario, Canada) by measuring the microhardness of enamel. MATERIALS AND METHOD: Forty-five mandibular premolars were collected and divided into three groups (A, B, and C). After sectioning mesiodistally, they were subdivided into the control and test groups. The test group was further subdivided into demineralized (A2a, B2a, and C2a) and remineralized (A2b, B2b, and C2b) groups. All test group samples were demineralized by immersing in demineralizing solutions for 24 hours. Afterwards, A2b, B2b, and C2b samples were remineralized by remineralizing agents (Remin Pro, tricalcium phosphate, and HealOzone) for three minutes (twice a day) for 14 days, and then Vickers microhardness testing (VHN) was performed. RESULT: The microhardness values of the demineralized group were lower compared to the samples of the control groups. In the remineralized group, the mean microhardness values were maximum for HealOzone (293.22 kgmm-2), followed by Remin Pro (287.5660 kgmm-2) and then tricalcium phosphate (282.4660 kgmm-2). CONCLUSION: The application of remineralizing paste proved potent in improving the remineralization in the demineralized enamel surface.

Rhinocerebral mucormycosis: a systematic review of case reports and case series from a global perspective.

OBJECTIVE: Rhinocerebral mucormycosis (RCM) is the most common variant and the presenting features in the head and neck region are seldom pathognomonic. The aim of this systematic review was to obtain a thorough insight into the predisposing factors, clinical features, disease course, management protocol, outcome, and prognosis. STUDY DESIGN: An electronic search was carried out using MEDLINE by PubMed, Scopus, Google Scholar, Web of Science, and EMBASE databases. Articles in which the clinical findings on the extra- and intraoral features of RCM were included for systematic review. Descriptive statistics was applied to obtain the results. RESULTS: A total of 124 case studies (90 case reports, 34 case series) which yielded 219 patients. Diabetes mellitus (57.40%) was the most common comorbid condition. Neurologic manifestations were noted in 23.3% of the individuals. Maxillary/hard palate involvement was a common occurrence (59.2%). Intra-oral necrotic lesions with eschar were noted in 75/219 patients. Amphotericin B was the commonly used drug for the management, and surgical debridement was performed in majority of the cases. The mortality rate was 18.4%. CONCLUSIONS: The clinical manifestations often mimic odontogenic symptoms, hence a sound knowledge about the pathogenesis and course of the disease will aid in the prompt diagnosis and management.

Bioactive Khadi Cotton Fabric by Functional Designing and Immobilization of Nanosilver Nanogels.

The antimicrobial finishing is the most suitable alternative for designing medical textiles for biomedical applications. The present investigation aims at the preparation of skin-contacting khadi cotton fabric that would prevent microbial infection and offer excellent skin compatibility. A simple approach has been followed for the preparation of bioactive nanogels for antimicrobial finishing of the khadi cotton fabric. Bioactive nanogels were synthesized by using aloe vera (AV) as a reducing agent for silver ions in the presence of polyvinyl alcohol (PVA). PVA stabilizes the growth of silver nanoparticles, which is influenced by the variation in the reaction time and the temperature. Nanogels were characterized by transmission electron microscopy and scanning electron microscopy analyses. The nanogels exhibited strong antimicrobial behavior against both Staphylococcus aureus and Escherichia coli, as confirmed by the colony count method. Almost 100% antibacterial behavior was observed for the nanosilver content of 10 mM. The nanogel-finished khadi fabric showed bactericidal properties against both S. aureus and E. coli. The nanogel-finished fabric exhibited high hydrophilicity allowing complete water droplet penetration within 10 s as compared to 136 s in virgin fabric. Moreover, the skin irritation study of the fabric on male Swiss albino mice did not show any appearance of dermal toxicity. These results demonstrated that the bioactive finished khadi fabric is appropriate as skin contacting material in human health care.

Detection of human papillomavirus infection in oral cancers reported at dental facility: assessing the utility of FFPE tissues.

Incidence of human papillomavirus (HPV)-associated oral cancers is on the rise. However, epidemiological data of this subset of cancers are limited. Dental hospital poses a unique advantage in detection of HPV-positive oral malignancies. We assessed the utility of formalin-fixed paraffin-embedded (FFPE) tissues, which are readily available, for evaluation of high-risk HPV infection in oral cancer. For protocol standardization, we used 20 prospectively collected paired FFPE and fresh tissues of histopathologically confirmed oral cancer cases reported in Oral Medicine department of a dental hospital for comparative study. Only short PCRs (~ 200 bp) of DNA isolated using a modified xylene-free method displayed a concordant HPV result. For HPV analysis, we used additional 30 retrospectively collected FFPE tissues. DNA isolated from these specimens showed an overall 23.4% (11/47) HPV positivity with detection of HPV18. Comparison of HPV positivity from dental hospital FFPE specimens with overall HPV positivity of freshly collected oral cancer specimens (n = 55) from three cancer care hospitals of the same region showed notable difference (12.7%; 7/55). Further, cancer hospital specimens showed HPV16 positivity and displayed a characteristic difference in reported sub-sites and patient spectrum. Overall, using a xylene-free FFPE DNA isolation method clubbed with short amplicon PCR, we showed detection of HPV-positive oral cancer in dental hospitals.

Evaluation of indirect pulp capping using pozzolan-based cement (ENDOCEM-Zr®) and mineral trioxide aggregate - A randomized controlled trial.

BACKGROUND: Pulp capping should always be considered as the primary treatment of choice for teeth without irreversible pulpitis in lesions approaching dental pulp. The predictability of vital pulp therapy has improved with the introduction of newer bioceramic materials. AIM: The purpose of this randomized controlled trial was to compare the outcomes of mineral trioxide aggregate (MTA) (Angelus, Londrina, Brazil) and a pozzolan-based cement (ENDOCEM-Zr® [Maruchi, Wonju, Korea]) as an indirect pulp capping (IPC) material. MATERIALS AND METHODS: IPC was performed in forty patients who were randomly divided into ENDOCEM-Zr® and MTA groups. The outcome was assessed using clinical and radiographic tests at different time intervals. The prognostic factors on the outcome of IPC were also evaluated. RESULTS AND CONCLUSIONS: The success rate of ENDOCEM-Zr® and MTA groups was 94.7% and 89.4%, respectively. The results were not statistically significant. Binary logical regression showed that the age of the patient and the status of the pulp before treatment were deciding variables for the outcome of the study. Therefore, it was concluded from the study that the evaluated pozzolan-based cement could be used as an alternative to MTA because of its faster setting time and lower discoloration potential. In addition, pulp capping should be performed with caution in individuals above 40 years and in teeth with reversible pulpitis.

Stealth recombinant human serum albumin nanoparticles conjugating 5-fluorouracil augmented drug delivery and cytotoxicity in human colon cancer, HT-29 cells.

BACKGROUND AND OBJECTIVE: 5-Fluorouracil (5-FU) is a first-line chemotherapeutic drug in colorectal cancer. However, intravenous administration of 5-FU at the dose of 7-12mg/kg exhibits curbs like short half-life (20min) and toxic side-effects on bone marrow cells. Therefore, in present investigation, 5-FU was conjugated to poly (ethylene glycol) anchored recombinant human serum albumin nanoparticles (5-FU-rHSA-PEG-NPs) to improve the pharmacokinetic and therapeutic profiles. METHODS AND RESULTS: The mean particle size of 5-FU-rHSA-NPs was measured to be 44.3±5.8-nm, significantly (P<0.05) lesser than 65.7±7.2-nm of 5-FU-rHSA-PEG-NPs. In addition, zeta-potential of 5-FU-rHSA-NPs was estimated to be -10.2±2.6-mV significantly (P<0.05) lower than -25.8±3.5-mV of 5-FU-rHSA-PEG-NPs. Moreover, both 5-FU-rHSA-NPs and 5-FU-rHSA-PEG-NPs were smooth, spherical and regular in shape. In-vitro drug release analysis indicated that 5-FU-rHSA-NPs and 5-FU-rHSA-PEG-NPs separately released 10.9% and 9.23% of 5-FU in PBS (pH∼7.4) with no significant difference (P>0.05) up to 48h. However, addition of 20% v/v serum to PBS (pH∼7.4) boosted the drug release. 5-FU-rHSA-NPs and 5-FU-rHSA-PEG-NPs released 78.26% and 48.9% of the 5-FU up to 48h in presence of PBS (pH∼7.4 and 20% serum) with significant difference (P<0.05). Furthermore, 5-FU-rHSA-PEG-NPs displayed the IC50 of 3.7-µM significantly (P<0.05) lower than 6.8-µM and 11.2-µM of 5-FU-rHSA-NPs and 5-FU solution, respectively. One compartmental pharmacokinetic elements indicated that 5-FU-rHSA-PEG-NPs demonstrated the half-life (t1/2) of 5.33±0.15-h significantly (P<0.001) higher than 1.50±0.08-h and 0.30±0.09-h of 5-FU-rHSA-NPs and 5-FU solution, respectively. CONCLUSION: 5-FU-rHSA-PEG-NPs tendered improved cytotoxicity and pharmacokinetic profile. Hence, 5-FU-rHSA-PEG-NPs must be further tested under stringent milieu for translating in to a clinical product.

Nanogel--an advanced drug delivery tool: Current and future.

Nanogels are robust nanoparticles that could be used to deliver active drug compounds in controlled drug delivery applications. Nanogels drug delivery system is more effective and safer for both hydrophilic and hydrophobic drugs due to their chemical composition and formulations that are inappropriate for other formulations. Nanogels have enabled enlargement of functionalized nanoparticles, which act as a drug carriers that can be loaded with drugs and other active material to be released in a controlled manner at specific site. This review aims at providing general introduction on nanogels, recent synthesis methodology and their novel application in different fields.