Evaluation of the physical properties of bromelain-modified biodentine for direct pulp capping.

BACKGROUND: This study aims to evaluate the compressive strength, solubility, radiopacity, and flow of Bromelain (BR)-modified Biodentine (BD) for direct pulp capping (DPC). This is suggested to determine the impact of BR on the physical properties of BD. METHODS: Eighty samples were prepared according to the ISO and ADA specifications and evaluated for compressive strength, solubility, radiopacity, and flow. The compressive strength was evaluated at 24 h and 21 days via a universal testing machine. The solubility was determined by weight loss after 24-hours immersion in deionized water. Radiopacity was assessed via X-ray with aluminum step-wedges, and flow was measured by the diameter of the discs under a standard weight. Independent sample t-tests were used to statistically assess the data. A significance level of 5% was considered. RESULTS: The compressive strength was 41.08 ± 1.84 MPa for BD and 40.92 ± 1.80 MPa for BR + BD after 24 h, and 88.93 ± 3.39 MPa for BD and 87.92 ± 3.76 MPa for BR + BD after 21 days, with no significant differences. Solubility was slightly greater in the BR + BD (2.75 ± 0.10%) compared to BD (2.62 ± 0.25%), but not significantly different. The radiopacity was similar between BD (2.82 ± 0.11 mm) and BR + BD (2.73 ± 0.10 mm). BR + BD resulted in significantly greater flow (9.99 ± 0.18 mm) than did BD (9.65 ± 0.27 mm) (p ≤ 0.05). CONCLUSION: BR-modified BD maintains BD's physical properties, with improved flow, making it a promising DPC agent that warrants further study.

NIR-Responsive Deployable and Self-Fitting 4D-Printed Bone Tissue Scaffold.

The treatment of irregular-shaped and critical-sized bone defects poses a clinical challenge. Deployable, self-fitting tissue scaffolds that can be implanted by minimally invasive procedures are a promising solution. Toward this, we fabricated NIR-responsive and programmable polylactide-co-trimethylene carbonate (PLMC) scaffolds nanoengineered with polydopamine nanoparticles (PDA) by extrusion-based three-dimensional (3D) printing. The 3D-printed scaffolds demonstrated excellent (>99%), fast (under 30 s), and tunable shape recovery under NIR irradiation. PLMC-PDA composites demonstrated significantly higher osteogenic potential in vitro as revealed by the significantly enhanced alkaline phosphatase (ALP) secretion and mineral deposition in contrast to neat PLMC. Intraoperative deployability and in vivo bone regeneration ability of PLMC-PDA composites were demonstrated, using self-fitting scaffolds in critical-sized cranial bone defects in rabbits. The 3D-printed scaffolds were deformed into compact shapes that could self-fit into the defect shape intraoperatively under low power intensity (0.76 W cm-2) NIR. At 6 and 12 weeks postsurgical implantation, near-complete bone regeneration was observed in PLMC-PDA composites, unlike neat PLMC through microcomputed tomography (micro-CT) analysis. The potential clinical utility of the 3D-printed composites to secure complex defects was confirmed through self-fitting of the scaffolds into irregular defects in ex vivo models of rabbit tibia, mandible, and tooth models. Taken together, the composite scaffolds fabricated here offer an innovative strategy for minimally invasive deployment to fit irregular and complex tissue defects for bone tissue regeneration.

Higher abundance of DLD protein in buffalo bull spermatozoa causes elevated ROS production leading to early sperm capacitation and reduction in fertilizing ability.

BACKGROUD: Before fertilization, spermatozoa undergo a crucial maturation step called capacitation, which is a unique event regulates the sperm's ability for successful fertilization. The capacitation process takes place as the spermatozoa pass through the female reproductive tract (FRT). Dihydrolipoamide dehydrogenase (DLD) protein is a post-pyruvate metabolic enzyme, exhibiting reactive oxygen species (ROS) production which causes capacitation. Additionally, other vital functions of DLD in buffalo spermatozoa are hyperactivation and acrosome reaction. DLD produces the optimum amount of ROS required to induce capacitation process in FRT. Depending on physiological or pathophysiological conditions, DLD can either enhance or attenuate the production of reactive oxygen species (ROS). Aim of this study was to investigate whether changes in the production of ROS in sperm cells can impact their ability to fertilize by triggering the capacitation and acrosome reaction. RESULTS: In this study, abundance of DLD protein was quantified between high (n = 5) and low fertile bull (n = 5) spermatozoa. It was found that compared to high-fertile (HF) bulls, low-fertile (LF) bulls exhibited significantly (P < 0.05) higher DLD abundances. Herein, we optimised the MICA concentration to inhibit DLD function, spermatozoa were treated with MICA in time (0, 1, 2, 3, 4, and 5 h) and concentrations (1, 2.5, 5, and 10 mmol/L) dependent manner. Maximum DLD inhibition was found to be at 4 h in 10 mmol/L MICA concentration, which was used for further experimentation in HF and LF. Based on DLD inhibition it was seen that LF bull spermatozoa exhibited significantly (P < 0.05) higher ROS production and acrosome reaction in comparison to the HF bull spermatozoa. The kinematic parameters of the spermatozoa such as percent total motility, velocity parameters (VCL, VSL, and VAP) and other parameters (BCF, STR, and LIN) were also decreased in MICA treated spermatozoa in comparison to the control (capacitated) spermatozoa. CONCLUSIONS: The present study provides an initial evidence explaining the buffalo bull spermatozoa with higher DLD abundance undergo early capacitation, which subsequently reduces their capacity to fertilize.

Left atrial septal pouch thrombus: An unusual cause of an embolic stroke.

Left-atrial septal pouch (LASP) is a newly described anatomical variant caused by incomplete fusion of the septa primum and secundum. This case visualizes LASP as a potential nidus for blood stasis and cardiac embolism and highlights the need for consideration of TEE in the work up of cryptogenic stroke.

Innovative Pulp Preservation: The Use of Platelet-Rich Fibrin (PRF) and Mineral Trioxide Aggregate (MTA) in Treating Dental Pulp Exposure.

The dental pulp, essential for tooth vitality, often becomes inflamed when exposed due to caries, fractures, or dislodged restorations. Untreated inflammation can lead to pulpal death, necessitating vital pulp therapies (VPTs) such as pulp capping and pulpotomy. Recent trends favor partial caries removal to avoid overtreatment and preserve pulp health. This shift is illustrated through two cases of young female patients with dislodged restorations and deep caries. Both underwent direct pulp capping using platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA), followed by composite restorations. These cases underscore the importance of biocompatible materials like MTA and PRF in maintaining pulp vitality and promoting dental tissue repair.

Differential protein repertoires related to sperm function identified in extracellular vesicles (EVs) in seminal plasma of distinct fertility buffalo (Bubalus bubalis) bulls.

Buffalo bulls are backbone of Indian dairy industry, and the quality of semen donating bulls determine the overall production efficiency of dairy farms. Seminal plasma harbor millions of lipid bilayer nanovesicles known as extracellular vesicles (EVs). These EVs carry a heterogenous cargo of essential biomolecules including fertility-associated proteins which contribute to fertilizing potential of spermatozoa. In this study, we explored size, concentration, and complete proteome profiles of SP EVs from two distinct fertility groups to uncover proteins influencing bull fertility. Through Dynamic Light Scattering (DLS) it was found that purified EVs were present in 7-14 size exclusion chromatographic (SEC) fractions with sizes ranging from 146.5 to 258.7 nm in high fertile (HF) and low fertile (LF) bulls. Nanoparticle Tracking Analysis (NTA) confirmed the size of seminal EVs up to 200 nm, and concentrations varying from 2.84 to 6.82 × 1011 and 3.57 to 7.74 × 1011 particles per ml in HF and LF bulls, respectively. No significant difference was observed in size and concentration of seminal EVs between two groups. We identified a total of 1,862 and 1,807 proteins in seminal EVs of HF and LF bulls, respectively using high throughput LC-MS/MS approach. Out of these total proteins, 1,754 proteins were common in both groups and about 87 proteins were highly abundant in HF group while 1,292 were less abundant as compared to LF bulls. Gene ontology (GO) analysis, revealed that highly abundant proteins in HF group were mainly part of the nucleus and involved in nucleosome assembly along with DNA binding. Additionally, highly abundant proteins in EVs of HF group were found to be involved in spermatogenesis, motility, acrosome reaction, capacitation, gamete fusion, and cryotolerance. Two highly abundant proteins, protein disulfide-isomerase A4 and gelsolin, are associated with sperm-oocyte fusion and acrosome reaction, respectively, and their immunolocalization on spermatozoa may indicate that these proteins are transferred through EVs. Our evidences support that proteins in EVs and subsequently their presence on sperm, are strongly associated with sperm functions. Altogether, our investigation indicates that SPEVs possess crucial protein repertoires that are essential for enhancing sperm fertilizing capacity.

Metamorphosing Smiles Through Esthetic Vital Bleaching: A Twin Case Report.

Patients have been recently observed to have undergone a noticeable increase in the concern over tooth discoloration making it a common cosmetic issue. This cumulative number of visits to dental experts is in search of ways to whiten their teeth because they desire to improve their looks. Often, the desire for a brighter smile is associated with health and beauty perceptions. Thus, patients tend to go after what they think is the perfect form of an unflawed grin. Diverse treatment modalities exist for tooth discolorations, such as composite laminate and veneers, porcelain veneers, and partial crowns. Amongst these options, bleaching, therefore, appears to be a conservative manner of dealing with teeth discoloration. This twin case report shows that discoloration can be managed best through bleaching using McInnes solution, resulting in good outcomes. Using McInnes solution instead makes bleaching an affordable and conservative technique for removing stains.

Perfecting Posterior Dental Simulacrum: Unveiling the Stamp Technique for Tooth Restoration.

Dentistry is currently undergoing a phase where the pursuit of excellence has become continuous, and there is a rising demand for aesthetic standards, especially in the posterior region of the oral cavity. The "stamp technique" introduces a novel, straightforward method to restore carious teeth with unaltered occlusal structures using composite restoration. It effectively replicates the natural occlusal anatomy with remarkable precision. This method applies to preoperative carious teeth with preserved anatomy, minimally affected by carious lesions. Essentially, it involves creating an occlusal matrix from an undamaged occlusal surface of the tooth, aiming to achieve an accurate restoration resembling the natural tooth. This facilitates the restoration of the tooth's natural contour and contact, ensuring precise functional occlusion. This procedure offers increased efficiency, requires less time while maintaining high accuracy, and reduces the time needed for finishing and polishing.

A Rare Case of Single-Rooted Maxillary First Molar With Type II Canal Configuration.

The morphological variations in roots and root canals vary greatly in multi-rooted teeth making it a challenge for accurate diagnosis and effective endodontic therapy. In addition to using technology appropriately, this article highlights how important it is to have a complete understanding of root canal morphology. With the assistance of cone-beam computed tomography (CBCT) images and a dental operating microscope (DOM), successful endodontic treatment was performed on a single-rooted maxillary first molar with Vertucci's type II canal configuration. CBCT and DOM proved to be valuable tools for the effective diagnosis and management of this atypical morphology.

Challenges Faced in Treating Maxillary Second Premolars With Three Canals: A Case Report.

The maxillary second premolar has long been regarded as a tooth with a straight root canal anatomy, typically featuring a single root with two canals. However, emerging evidence suggests this tooth may harbor a more intricate internal morphology, challenging conventional perceptions, and treatment approaches. One such variation is three root canals within the upper second premolar, which has been gaining increasing attention in endodontic literature. Root canal treatment of maxillary second premolars with three canals demands meticulous debridement, shaping, and disinfection. A combination of magnification, illumination, and appropriate instrumentation aids in locating, negotiating, and cleaning the accessory canals effectively. Thorough cleaning of accessory canals can be achieved through effective irrigation solutions such as sodium hypochlorite, ethylenediaminetetraacetic (EDTA), and chlorhexidine, which help dissolve organic tissues and remove debris. Techniques like ultrasonic and sonic activation, as well as negative pressure irrigation systems, enhance the penetration and effectiveness of these irrigants. Additionally, the use of modern nickel-titanium rotary files, ultrasonic irrigation, and supplementary chelating agents enhances the management of complex canal configurations.

The Management of Open Apex Using a Bioactive Material: A Case Report.

The management of teeth with open apices poses unique challenges in endodontics, requiring effective strategies to promote continued root development and maintain pulp vitality. This abstract explores the utilization of bioactive materials in the treatment of open apices, specifically focusing on their role in achieving optimal outcomes. Bioactive materials, such as Biodentine (Septodont, Saint-Maur-des-Fossés, France), have gained prominence for their favourable physiochemical properties, biocompatibility, and ability to stimulate dentinogenesis. The application of a bioactive material as an apical plug not only addresses immediate concerns but also contributes to long-term health and stability. This abstract reviews relevant literature, discusses clinical cases, and emphasizes the importance of tailoring treatment plans to the individual characteristics of open apex cases. The findings underscore the promising role of bioactive materials in reshaping the landscape of endodontic interventions for teeth with open apices, highlighting their potential to enhance both clinical and radiographic success.

Diving Deep: Exploring Dual Palatal Canals in the Upper Second Molar.

Dental anatomy exhibits considerable variation with the presence of additional canals being a common occurrence. The upper second molar typically presents with three canals and three roots; however, variations such as the existence of an extra canal or a root can pose challenges during endodontic treatment. Maxillary molar is characterized by an additional canal located within the palatal root, often exhibiting complex configurations and variations in morphology. Access refinement is critical to gaining adequate visibility and facilitating instrumentation. Meticulous exploration of the pulp chamber floor and careful examination of radiographs from different angles are essential for accurate diagnosis. Careful negotiation and cleaning of the extra canal with appropriate files and irrigants are essential to remove pulp tissue and debris effectively. Furthermore, obturation of the canal space with biocompatible materials is crucial to ensure a three-dimensional seal and prevent bacterial ingress. Clinically, the inability to detect and treat the extra palatal canal can lead to persistent infection, incomplete debridement, and compromised treatment outcomes. This case report delves into the significance of this anatomical variation, diagnostic modalities, and effective management strategies.

Chitosan: A Versatile Biomaterial Revolutionizing Endodontic Therapy.

Owing to their nanoscale dimensions, nanomaterials have special chemical and physical properties that set them apart from their bulk counterparts. The exterior dimensions of a minimum of half of the particles span several nanometers in their size distribution. Silver nanoparticles (AgNPs) are one type of nanomaterial that has been widely used because of their strong antibacterial properties, which can kill bacteria that are resistant to many drugs. Due to its potential for regulated release, localized retention, and safeguarding the active ingredients against environmental or enzymatic deterioration, nanoparticle technology has also emerged as a promising medication delivery method. The techniques for creating nanoparticles can be easily scaled up and used for a wide variety of medications. Since polymeric nanoparticles are biodegradable, biocompatible, and have more readily available formulation techniques than other nanoparticle drug delivery approaches, their range of applications has been expanding. Chitosan, also known as deacetylated polysaccharide, is a straight-chain cationic polymer that is typically a cationic copolymer. It can be generated naturally or by deacetylating chitin. Consequently, it contains an extensive array of biomedical applications, such as efficient healing of wounds, regeneration of tissues, regeneration of bone, and anti-infection. Because of its functional diversity, accessibility, and being both biodegradable and biocompatible, it has a wide spectrum of uses in dentistry. Recent research on chitosan-based nanoparticles is founded on the field's growing comprehension of the characteristics of chitosan and techniques for chemical or physical modification that are used to optimize the drug loading and release characteristics of the nanoparticles.

Management of a Case of a Large Perforation Repair With Biodentine.

Perforations, which are artificial contact connections among teeth and supporting tissues, have a substantial impact on the success of root canal therapy, whether caused by iatrogenic or pathological causes. This case report describes a 51-year-old female who had intermittent jaw pain that was diagnosed as perforation and was successfully controlled with endodontic intervention following a referral due to procedural problems. The perforation in the furcation zone of a molar was treated with biodentine, demonstrating its sealing, biocompatibility, and tissue restoration properties. The discussion emphasizes the necessity of choosing the right repair materials and techniques based on perforation size and location. Biodentine emerges as a viable option due to its capacity to form a dependable seal in demanding settings.  The study concluded by emphasizing the need for physician competence, tooth morphology understanding, and operative proficiency in preventing and properly treating perforations for the best treatment outcomes.

Hemisection: A Paradigm Shift in Prolonging Tooth Viability.

Splitting a molar means removing or separating the root and the accompanying crown portion. Hemisection of a damaged tooth aids in preserving the tooth structure and the existing alveolar bone surrounding the preserved root while also enabling the installation of a fixed prosthesis. This case report defines hemisection as an effective modality for preserving carious mandibular first molars with periodontal and periapical pathology.

Reviving the Art of Onlay Cast Metal Restoration.

Cast metal restorations have been a cornerstone in restorative dentistry for decades, providing durable and reliable solutions for restoring damaged teeth. This case report explores the evolution of cast metal restoration techniques, highlighting recent advancements and their implications in modern dental practice involving indirect cast metal onlay restoration as a successful treatment option that involves the replacement of the tooth cusp and reinforcement of the tooth through indirect restoration. Historically, cast metal restorations, commonly fabricated from alloys such as gold, have offered superior mechanical properties, biocompatibility, and longevity compared to other materials. However, concerns regarding esthetics and cost have prompted the development of alternative materials such as ceramics and composite resins. Nonetheless, cast metal restorations remain indispensable for certain clinical scenarios, particularly in cases of extensive damage or high occlusal forces.

Effortless Precision: A Case Report on the Stamp Technique for Posterior Teeth.

The stamping technique, a pivotal process, has undergone significant advancements with the integration of composites. Traditionally, direct or indirect restorative cements, e.g., amalgam or composite resin, have been used to restore teeth, often presenting challenges in achieving optimal fit, esthetics, and durability. This process begins with creating an accurate impression of the prepared tooth, which serves as a blueprint for crafting the restoration. In contrast, the stamp technique, also known as the indirect restoration technique, offers several distinct advantages. The stamping technique enables the use of advanced materials that offer superior esthetics and durability. Composite resins used in stamp restorations can be shade-matched to the patient's natural teeth, resulting in seamless integration with the smile. These materials also exhibit excellent strength and wear resistance, ensuring restorations that last longer and are capable of withstanding stresses without fracture.

Management of an Intracanal Separated Instrument in the Lower Right First Molar: A Case Report.

Separating an endodontic instrument is one of the most frequent errors during a root canal treatment. If endodontic instruments get separated, it could hinder disinfection and prevent access to the apical portion of the root. It compromises the success of the treatment by impeding the proper debris removal from the canal. But now that techniques and tools have advanced, it is feasible to remove a separated instrument from the root canal successfully. This case report presents the management of a separated instrument, demonstrating the successful removal of the separated instrument.

Preserving Vitality: A Case Report of Partial Pulpotomy in Dental Practice.

This paper aims to evaluate the outcomes of a partial pulpotomy with mineral trioxide aggregate (MTA) in a maxillary first premolar with reversible pulpitis symptoms and signs. An intraoral periapical radiograph revealed a deep pulp-involving carious lesion without any indications of a periapical lesion, no history of night pain, and no tooth tenderness when percussion was applied. Caries removal is done using a round bur, 2-3 mm of inflamed pulp from the crown portion was removed, and bleeding was controlled within four minutes using 2.5% sodium hypochlorite, over which MTA was placed. After the setting of MTA, resin-modified glass ionomer cement was placed over it, and the tooth was restored using composite. The patient was asymptomatic in six months and one-year follow-up with no periapical changes and showed dentin bridge formation. Careful case selection, a precise selection of biomimetic material, and long-term follow-up validate the success of the treatment.

Anatomical Variations in Mandibular Molars: Focus on Midmesial Canals.

Endodontic therapy focuses on the root canal system to treat infected or damaged pulp tissue within the tooth, ultimately preserving the tooth and restoring its function. The root canal space should be cleaned with the use of proper instruments and chemical disinfectants to eradicate infected pulpal tissue and its remnants. The failure of endodontic therapy is attributed to a lack of understanding of the differences in anatomy among teeth, as evidenced by research. Canals are identified, and endodontic treatment is facilitated by the use of dental operating microscopes. Therefore, to achieve a favorable endodontic result, it is imperative to use all available methods to identify additional aberrant root canals. Failure to detect and adequately treat the midmesial canal (MMC) can lead to persistent infection, treatment failure, and the need for retreatment. This case underscores the importance of meticulous assessment and advanced techniques in treating complex canal configurations, ultimately leading to favorable outcomes in endodontic therapy. The MMC, a challenging anatomical feature, was located through careful clinical and radiographic examination. Advanced techniques, including ultrasonic activation and meticulous instrumentation, were employed to navigate and clean the canal effectively. Sodium hypochlorite irrigation and passive ultrasonic activation were utilized for thorough disinfection. The MMC was sealed with biocompatible materials, ensuring comprehensive obturation of the root canal system.