Recurring SARS-CoV-2 variants: an update on post-pandemic, co-infections and immune response.

The post-pandemic era following the global spread of the SARS-CoV-2 virus has brought about persistent concerns regarding recurring coinfections. While significant strides in genome mapping, diagnostics, and vaccine development have controlled the pandemic and reduced fatalities, ongoing virus mutations necessitate a deeper exploration of the interplay between SARS-CoV-2 mutations and the host's immune response. Various vaccines, including RNA-based ones like Pfizer and Moderna, viral vector vaccines like Johnson & Johnson and AstraZeneca, and protein subunit vaccines like Novavax, have played critical roles in mitigating the impact of COVID-19. Understanding their strengths and limitations is crucial for tailoring future vaccines to specific variants and individual needs. The intricate relationship between SARS-CoV-2 mutations and the immune response remains a focus of intense research, providing insights into personalized treatment strategies and long-term effects like long-COVID. This article offers an overview of the post-pandemic landscape, highlighting emerging variants, summarizing vaccine platforms, and delving into immunological responses and the phenomenon of long-COVID. By presenting clinical findings, it aims to contribute to the ongoing understanding of COVID-19's progression in the aftermath of the pandemic.

Pathophysiology to advanced intra-articular drug delivery strategies: Unravelling rheumatoid arthritis.

Rheumatoid arthritis (RA) is one of the most prevalent life-long autoimmune diseases with an unknown genesis. It primarily causes chronic inflammation, pain, and synovial joint-associated cartilage and bone degradation. Unfortunately, limited information is available regarding the etiology and pathogenesis of this chronic joint disorder. In the last few decades, an improved understanding of RA pathophysiology about key immune cells, antibodies, and cytokines has inspired the development of several anti-rheumatic drugs and biopharmaceuticals to act on RA-affected joints. However, life-long frequent systemic high doses of commercially available drugs are currently a limiting factor in the efficient management of RA. To address this issue, various single and double-barrier intra-articular drug delivery systems (IA-DDSs) such as nanocarriers, microparticles, hydrogels, and particles-hybrid hydrogel composite have been developed which can exclusively target the RA-affected joint cavity and release the precisely controlled therapeutic drug concentration for prolonged time whilst avoiding the systemic toxicity. This review provides a comprehensive overview of the pathogenesis of RA and discusses the rational design and development of biomaterials-based novel IA-DDs, ranging from conventional to advanced systems, for improved treatment of RA. Therefore, this review aims to unravel the pathophysiology of rheumatoid arthritis and explore cutting-edge IA-DD strategies exploiting biomaterials. It offers researchers a consolidated and up-to-date resource platform to analyze existing knowledge, identify research gaps, and contribute to the scientific literature.

Coiled-coil peptide-based assembly of a plasmonic core-satellite polymer-metal nanocomposite as an efficient photothermal agent for drug delivery applications.

Polymer-metal nanocomposites have widespread applications in biomedical fields such as imaging, catalysis, and drug delivery. These particles are characterized by combined organic and inorganic properties. Specifically, photothermal nanocomposites incorporating polymeric and plasmonic nanoparticles (NPs) have been designed for both triggered drug release and as imaging agents. However, the usual design of nanocomposites confers characteristic issues, among which are the decrease of optical properties and resulting low photothermal efficiency, as well as interactions with loaded drugs. Herein, we report the design of a core-satellite polymer-metal nanocomposite assembled by coiled-coil peptides and its superior photothermal efficiency compared to electrostatic-driven nanocomposites which is the standard design. We also found that the orientation of gold nanorods on the surface of polymeric NPs is of importance in the final photothermal efficiency and could be exploited for various applications. Our findings provide an alternative to current wrapping and electrostatic assembly of nanocomposites with the help of coiled-coil peptides and an improvement of the control over core-satellite assemblies with plasmonic NPs. It paves the way to highly versatile assemblies due to the nature of coiled-coil peptides to be easily modified and sensitive to pH or temperature.

Layered KTO/BiOCl nanostructures for the efficient visible light photocatalytic degradation of harmful dyes.

Novel KTO/BiOCl nanostructured photocatalysts with various weight proportions were synthesized using a simple hydrothermal process. The as-prepared nanostructured composite catalysts were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, UV-vis diffused reflectance spectroscopy, Raman spectroscopy, field emission scanning electron microscopy, transmission electron microscopy with high resolution, X-ray photoelectron spectroscopy, and photoluminescence (PL). The photocatalytic activity of prepared catalysts was examined using Rhodamine B (RhB) and Congo Red (CR) as the aimed pollutants. BiOCl nanoparticles were distributed uniformly on the surface of the K2Ti4O9 nanobelts. The optical properties showed that the layered titanate with BiOCl nanostructured photocatalyst displayed improved photoresponsivity due to the narrowed bandgap. The PL results showed that the greater inhibition of the electron-hole recombination process and KTO/BiOCl with a mass proportion of 20% revealed the most favorable photocatalytic behavior. The rate constant of RhB and CR degradation was five times as high as that of the bare BiOCl and titanate. The superior photocatalytic performance was attributed to the advancement of heterojunction between the KTO nanobelt and BiOCl. The KTO/BiOCl nanostructure is a promising visible, active photocatalyst, and the photocatalytic mechanism is discussed using the possible band structures of BiOCl and KTO.

A Comparative Study to Evaluate the Effectiveness of Silver Diamine Fluoride at Different Time Durations of Application in Treating Carious Primary Teeth: A Randomized Trial.

Background and objectives: Ideally every child must have access to preventive and restorative care of greater quality. However, in rural areas, resources and dental care services are limited. Silver diamine fluoride (SDF) has been identified as an efficient topical cariostatic and preventive medicament for managing ECC in children who cannot be treated conventionally. Since SDF is an emerging alternative for caries prevention and arrest, AAPD recommends more practice-based research to evaluate its efficacy. The aim of this study was to evaluate the effectiveness of silver diamine fluoride at different time durations of application in treatment of carious primary teeth in children with least access to dental care. Methodology: This was a prospective, randomized, field trial that included patients with primary tooth. Primary tooth presenting carious lesion in ICDAS 3-6 category were randomly assigned to one of the three groups. Results: At 3-week mean rank of lesions arrested in Group 1 and Group 2 were 73.3 and 72.29, whereas it was 86.9 in case of Group 3. At 6 months it was 79.15, 77.29, and 75.96 in Group 1, 2, and 3, respectively (p > 0.05). Conclusion: SDF is effective in controlling caries progression in both cavitated and non-cavitated lesion with minimal time duration of application (30 seconds). This approach may be of great utility as an alternative to other expensive preventive and therapeutic methods in communities with limited resources. Nonetheless obtaining caregiver consent is mandatory. How to cite this article: Thakur S, Sojan M, Singhal P, et al. A Comparative Study to Evaluate the Effectiveness of Silver Diamine Fluoride at Different Time Durations of Application in Treating Carious Primary Teeth: A Randomized Trial. Int J Clin Pediatr Dent 2022;15(S-2):S147-S150.

Development of difficulty index for management of impacted maxillary canine: A CBCT-based study.

BACKGROUND: The aim of this study was to propose an Impacted Canine Treatment Difficulty Index using Cone-beam Computed Tomography (CBCT) imaging to assess difficulty anticipated during the alignment of impacted maxillary canine and further validate the index in clinical set up. METHODS: Pre-treatment CBCT of 15 patients with unilateral or bilateral impacted maxillary canine aged between 12 and 30 years were selected. All the following five factors were assessed on CBCT image: 1) angulation, 2) vertical position, 3) bucco-palatal position, 4) horizontal position and 5) rotation. Two orthodontists evaluated the pre-treatment CBCT for the selected five factors and allocated a total difficulty score. To validate the proposed difficulty index in clinical settings, a team of oral and maxillofacial surgeons were included in the study to grade the difficulty encountered during surgical procedure. RESULTS: The distribution of difficulty score recorded by observer 1 was significantly associated with the difficulty score recorded by observer 2 (P-value < 0.001), with relatively higher level of linearly weighted Cohen's kappa value of 0.610. The distribution of difficulty score recorded by oral and maxillofacial surgeon was significantly associated with the difficulty score recorded by observer 1 (P-value < 0.01), with relatively higher level of linearly weighted Cohen's kappa value of 0.667. The distribution of difficulty score recorded by orthodontist was significantly associated with the difficulty score recorded by observer 1 (P-value < 0.001), with relatively higher linearly weighted Cohen's kappa value of 0.819. CONCLUSION: Impacted Canine Treatment Difficulty Index using CBCT imaging could be used to assess the difficulty that would be anticipated during the alignment of impacted maxillary cuspid.

Comparative clinical evaluation of modified and conventional Grayson's presurgical nasoalveolar molding technique in infants with complete unilateral cleft lip and palate.

BACKGROUND: Presurgical nasoalveolar molding (PNAM) was introduced by Grayson et al., in 1993 to presurgically mold the alveolus, lip, and nose in infants with cleft lip and palate (CLP). The aim of this comparative clinical trial was to evaluate the efficacy and efficiency of Modified and Conventional Grayson's PNAM in patients concerning morphological and anatomical changes in maxillary alveolus, nasal symmetry, number of visits, and duration of treatment. MATERIALS AND METHODS: In this comparative clinical trial study, 16 infants with unilateral complete CLP were equally divided into two groups: Group I (modified PNAM technique using titanium molybdenum alloy [TMA] wire nasal stent) and Group II (conventional PNAM technique using stainless steel wire nasal stent). Patient photographic evaluation of nasal symmetry and maxillary study model CAD-CAM analysis, pre- and post-operatively in both groups, were compared using a paired t-test between the groups using the Chi-square test with P < 0.05 as statistically significant. RESULTS: In both groups, on evaluating nasal measurements, statistically significant (P < 0.05) decrease in nasal width and increase in columella deviation angle, a decrease of nostril length, and an increase of columella length in Group I were observed. On maxillary study model evaluation, a statistically significant (P < 0.05) decrease in width of the alveolar cleft was noticed in both groups and lateral deviation of the incisal point in Group I and width of the palatal cleft in Group II was noticed. CONCLUSION: This study showed a morphological improvement in nasal symmetry and maxillary alveolar morphology in complete unilateral CLP patients, treated with both Modified and Conventional PNAM techniques, with the Modified PNAM technique being more efficient for treatment duration and the number of adjustments as there are less number of visits.

Nanotechnology synergized immunoengineering for cancer.

Novel strategies modulating the immune system yielded enhanced anticancer responses and improved cancer survival. Nevertheless, the success rate of immunotherapy in cancer treatment has been below expectation(s) due to unpredictable efficacy and off-target effects from systemic dosing of immunotherapeutic(s). As a result, there is an unmet clinical need for improving conventional immunotherapy. Nanotechnology offers several new strategies, multimodality, and multiplex biological targeting advantage to overcome many of these challenges. These efforts enable programming the pharmacodynamics, pharmacokinetics, and delivery of immunomodulatory agents/co-delivery of compounds to prime at the tumor sites for improved therapeutic benefits. This review provides an overview of the design and clinical principles of biomaterials driven nanotechnology and their potential use in personalized nanomedicines, vaccines, localized tumor modulation, and delivery strategies for cancer immunotherapy. In this review, we also summarize the latest highlights and recent advances in combinatorial therapies availed in the treatment of cold and complicated tumors. It also presents key steps and parameters implemented for clinical success. Finally, we analyse, discuss, and provide clinical perspectives on the integrated opportunities of nanotechnology and immunology to achieve synergistic and durable responses in cancer treatment.

Synthesis and characterization of an injectable microparticles integrated hydrogel composite biomaterial: In-vivo biocompatibility and inflammatory arthritis treatment.

Polymeric hydrogels and microparticles have been widely used for localized drug delivery applications for the treatment of arthritis. Nonetheless, owing to initial burst drug release, non-specific biodistribution and low retention time at the target site in body, these polymeric drug delivery systems have been found with low in-vivo performance. Hence, the above limitations need to be resolved by designing a smart novel drug delivery system which is the current need in biomedicine. Herein, a novel localized injectable thermoresponsive microparticles embedded hydrogel composite drug delivery system has been developed for the treatment of inflammatory arthritis. In the current study, methotrexate (MTX) loaded alginate microparticles (MTX-Microparticles) are embedded into thermoreversible hydrogel matrix (MTX-MPs-H) prepared by physical blending of sodium hyaluronate and methylcellulose (SHMC). Microparticles-hydrogel composite system exhibited appropriate in-vitro thermoreversibility (sol at 4 °C and gel at 37 °C), biocompatibility (>80 %), hemocompatibility, and controlled drug release profile. The in-vivo biocompatibility studies for 10 days revealed that composite system is non-toxic in nature. The developed MTX-MPs-H composite drug delivery system effectively decreased the swelling/ inflammation of the arthritis affected paw in wistar rats in comparison to only alginate microparticles and pure MTX up to 30 days.

Evaluation of Efficacy of Oral Ketamine and Midazolam Combination Drug in Different Doses in Different Groups Used for Moderate Sedation in Pediatric Dentistry Randomized-comparative Trial.

Background: Dental phobia and apprehension in children lead to difficulty with behavior management. During dental procedure if a child had a bad experience, he will develop greater apprehension, which makes further treatment difficult. Aim and objective: The aim and objective of the present study is to assess and compare the sedation and wake-up behavior status of oral combinations of three different doses of ketamine and midazolam drugs in three different groups mixed in 1 mL of honey. Methodology: This study was a randomized, clinical study that included patients ranging from 3 to 9 years of age with American Society of Anesthesiologists-I status with carious teeth, were randomly allocated among three groups where group (A) received 0.2 mg/kg of oral midazolam and 5 mg/kg oral ketamine combination drugs, group (B) received 0.3 mg/kg of oral midazolam with 3 mg/kg of oral ketamine combination drugs and group (C) received 0.4 mg/kg of oral midazolam with 2 mg/kg of oral ketamine combination drugs mixed in 1 mL of honey.Child patient's who fulfilled the inclusion criteria, heart rate, blood pressure, and oxygen saturation was recorded from starting of the treatment until discharged from the monitoring room. Ease of treatment completion was evaluated according to the Houpt scale, patients' behavior, sedation, and wake-up behavior status were evaluated with modified observer assessment of alertness and sedation scale (MOAAS). Results: In the study, various doses of ketamine-midazolam combination drugs in three different groups resulted in a clement increase in heart rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP) during the procedure but variations among the groups were not significant. As per MOAAS, the sedation success rate in group B (83.3%) was more than group A (66.6%) and group C (66.6%).All the three groups equally showed the same i.e., (91.6%), behavior score during treatment. Ease of treatment completion was excellent in group B (83.3%) followed by group A and group C [i.e.], (66.7%). Whereas, wake-up behavior score as per MOAAS scale was found to be calm and cooperative in group B (91.7%) followed by group C (88.9%) and group A (83.3%). Conclusion: In the present study oral ketamine-midazolam combination drugs can be used without harm and effectively as moderate sedation in an uncooperative pediatric patient. How to cite this article: Thakur S, Verma K, Singhal P, et al. Evaluation of Efficacy of Oral Ketamine and Midazolam Combination Drug in Different Doses in Different Groups Used for Moderate Sedation in Pediatric Dentistry Randomized-comparative Trial. Int J Clin Pediatr Dent 2021;14(S-2):S151-S156.

A randomized control trial comparing the efficacy of 3Mixtatin and Modified 3Mix-MP paste using lesion sterilization and tissue repair technique to conventional root canal treatment in primary molars of children aged 4-8 years: An in vivo study.

BACKGROUND: The aim of this study was to evaluate clinical and radiographic success rates of 3Mixtatin and Modified 3Mix-MP paste and compare it with conventional root canal treatment procedure in primary molars requiring pulpectomy. MATERIALS AND METHODS: In this in vivo study, 66 primary molars in 52 children aged between 4 and 8 years with primary molars having chronic periapical abscess were treated randomly with 3Mixtatin, Modified 3Mix-MP paste, and Metapex. The subjects were reviewed at 6 and 12 months both clinically and radiographically after pulpal therapy to evaluate and compare the healing process. The data obtained were subjected to statistical analysis at a significance level of 0.05. RESULTS: By the end of 12-month follow-up among the three groups, Group I seemed to be performing consistently better as compared to the other two groups when evaluated clinically and radiographically. However, Group III resulted in the greatest number of failures, with success rate being mere 42.9% at the end of follow-up period. CONCLUSION: Radiographic and clinical healing occurred in all the three groups; however, based on our results, Group I seemed to be performing consistently better among the three groups at 12-month follow-up. Hence, it can be inferred that 3Mixtatin used as a localized agent is effective and comparable to both Modified 3Mix-MP paste and conventional pulpectomy procedure involving calcium hydroxide and iodoform paste in primary teeth.

Effect of Chemical Disinfection on Surface Detail Reproduction and Dimensional Stability of a New Vinyl Polyether Silicone Elastomeric Impression Material.

BACKGROUND: Surface detail reproduction (SDR) and dimensional stability of elastomeric impression material play a crucial role in fixed prosthodontics. AIM AND OBJECTIVES: The aim of this study was to compare the effect of chemical disinfection on SDR and dimensional stability of polyvinyl siloxane (PVS) and polyether (PE) with a new vinyl polyether silicone (VPES) elastomeric impression material. MATERIALS AND METHODS: A stainless steel mold was made to fabricate the study specimens for nonaqueous PVS, PE, and VPES elastic dental impression materials. Single mix impression techniques with light- and heavy-body consistency of all three materials were used to prepare the test specimens. The specimens were immersed in glutaraldehyde (Cidex) 2.45% and sodium hypochlorite (Hypo) 3.0% disinfection for 15 min (T1) and 12 h (T2) immersion after which dimensional stability and SDR were recorded using stereomicroscope and digital Vernier caliper. STATISTICAL ANALYSIS: The data were analyzed using the one-way ANOVA, paired t-test, Kruskal-Wallis test, and Wilcoxon signed-rank test. RESULTS: Dimensional stability at the T2 time interval showed a highly significant difference for control and glutaraldehyde groups (P < 0.001), whereas a statistically significant difference for Hypo group (P < 0.05). SDR of the three materials when compared at T1 time interval showed a statistically significant difference (P = 0.015). A comparison between two disinfectants at T1 time interval revealed a highly significant difference (P < 0.001), while at T2 interval significant difference was obtained (P = 0.009). CONCLUSION: VPES impressions display acceptable dimensional stability and SDR for clinical use with immersion disinfection. Although some statistically significant differences in linear dimensional stability and semidefinite programming were observed among VPES, PE, and PVS, but the clinical impact of these differences is minor considering the overall accuracy of casts which was high.

Comprehensive Review on Current Interventions, Diagnostics, and Nanotechnology Perspectives against SARS-CoV-2.

The coronavirus disease 2019 (COVID-19) has dramatically challenged the healthcare system of almost all countries. The authorities are struggling to minimize the mortality along with ameliorating the economic downturn. Unfortunately, until now, there has been no promising medicine or vaccine available. Herein, we deliver perspectives of nanotechnology for increasing the specificity and sensitivity of current interventional platforms toward the urgent need of quickly deployable solutions. This review summarizes the recent involvement of nanotechnology from the development of a biosensor to fabrication of a multifunctional nanohybrid system for respiratory and deadly viruses, along with the recent interventions and current understanding about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Liposomal nanotheranostics for multimode targeted in vivo bioimaging and near-infrared light mediated cancer therapy.

Developing a nanotheranostic agent with better image resolution and high accumulation into solid tumor microenvironment is a challenging task. Herein, we established a light mediated phototriggered strategy for enhanced tumor accumulation of nanohybrids. A multifunctional liposome based nanotheranostics loaded with gold nanoparticles (AuNPs) and emissive graphene quantum dots (GQDs) were engineered named as NFGL. Further, doxorubicin hydrochloride was encapsulated in NFGL to exhibit phototriggered chemotherapy and functionalized with folic acid targeting ligands. Encapsulated agents showed imaging bimodality for in vivo tumor diagnosis due to their high contrast and emissive nature. Targeted NFGL nanohybrids demonstrated near infrared light (NIR, 750 nm) mediated tumor reduction because of generated heat and Reactive Oxygen Species (ROS). Moreover, NFGL nanohybrids exhibited remarkable ROS scavenging ability as compared to GQDs loaded liposomes validated by antitumor study. Hence, this approach and engineered system could open new direction for targeted imaging and cancer therapy.

Comparative evaluation of clinical and radiographic success of three different lesion sterilization and tissue repair techniques as treatment options in primary molars requiring pulpectomy: An in vivo study.

INTRODUCTION: Paediatric endodontics is part of paediatric dental practice. Teeth with infected root canals, particularly those in which the infection has spread around the apical foramen and furcation area, is a common problem in primary dentition for such conditions pulpectomy is the procedure. Pulpectomy procedure proves to be long and complicated and has remained controversial for a number of reasons. Lesion sterilization and tissue repair therapy (LSTR) is a relatively new biologic approach for carious lesions with or without pulpal and periapical involvement using a mixture of antibiotics. OBJECTIVES: The aim of this study was to evaluate clinical and radiographic success of three different LSTR techniques as treatment options in primary molars requiring pulpectomy. METHODS: Sixty-three primary molars of fifty children aged between 4 and 8 years with primary molars requiring pulpectomy were treated with modified 3Mix-MP antibiotic paste without removal of accessible radicular pulp (Group I), modified 3Mix-MP with removal of accessible radicular pulp (Group II) and Chloramphenicol, tetracycline and zinc oxide eugeno (CTZ) paste (Group III). The subjects were followed up clinically at one, six, and twelve months whereas radiographically at six and twelve months, respectively. RESULTS: The results showed that clinical success rates of Group I, Group II and Group III were 90%, 90.5% and 81.8% respectively and radiographical success rates were 75%, 76.2% and 63.6% respectively after twelve months observation. CONCLUSION: On the basis of the overall success rates of all the three LSTR techniques, following order of performance can be inferred clinical success and radiographical success: - 3Mix-MP without removal of radicular pulp = 3Mix-MP with removal of radicular pulp >CTZ paste.

Comprehensive Evaluation of Degradable and Cost-Effective Plasmonic Nanoshells for Localized Photothermolysis of Cancer Cells.

Integrating the concept of biodegradation and light-triggered localized therapy in a functional nanoformulation is the current approach in onco-nanomedicine. Morphology control with an enhanced photothermal response, minimal toxicity, and X-ray attenuation of polymer-based nanoparticles is a critical concern for image-guided photothermal therapy. Herein, we describe the simple design of cost-effective and degradable polycaprolactone-based plasmonic nanoshells for the integrated photothermolysis as well as localized imaging of cancer cells. The gold-deposited polycaprolactone-based plasmonic nanoshells (AuPCL NS) are synthesized in a scalable and facile way under ambient conditions. The synthesized nanoshells are monodisperse, fairly stable, and highly inert even at five times (250 µg/mL) the therapeutic concentration in a week-long test. AuPCL NS are capable of delivering standalone photothermal therapy for the complete ablation of cancer cells without using any anticancerous drugs and causing toxicity. It delivers the same therapeutic efficacy to different cancer cell lines, irrespective of their chemorefractory status and also works as a potential computed tomography contrast agent for the integrated imaging-directed photothermal cancer therapy. High biocompatibility, degradability, and promising photothermal efficacy of AuPCL NS are attractive aspects of this report that could open new horizons of localized plasmonic photothermal therapy for healthcare applications.

Graphene Oxide Supported Liposomes as Red Emissive Theranostics for Phototriggered Tissue Visualization and Tumor Regression.

Selective tissue visualization and localized tumor regression without affecting the surrounding healthy tissues are critical concerns in cancer nanomedicine. Importantly, the complete wrapping of a flimsy matrix like liposome by multifunctional graphene oxide is an interesting engineering idea for nanomedicine design. Moreover, designing a safe and biodegradable nanohybrid with significant theranostic ability is a current need for targeted combined therapies. Here, we report a comprehensive result of in vivo tumor diagnosis and phototriggered tumor regression using a biodegradable red emissive nanotheranostic system, viz., graphene oxide flakes fortified liposome (GOF-Lipo), functionalized with folic acid (FA): GOF-Lipo-FA. Graphene oxide support enhances the stability of drug-loaded liposomes in an extracellular environment that prevents the premature release of loaded anticancer drug from the liposomal cavity. Promising outcomes of tumor regression (∼300 to 25 mm3) from organized cellular and animal studies are demonstrated in this work. These studies reveal superior biocompatibility, deep intracellular localization, 4T1 breast tumor diagnosis, and long time tumor binding ability of an injected emissive nanohybrid. Overall, a single dose of designed multifunctional systems demonstrates the best tumor regression.

In vivo Comparative Evaluation of Esthetics after Microabrasion and Microabrasion followed by Casein Phosphopeptide-Amorphous Calcium Fluoride Phosphate on Molar Incisor Hypomineralization-Affected Incisors.

BACKGROUND: Molar incisor hypomineralization (MIH) is an esthetic setback for the patient as well as for the dentist, treatment options for MIH includes minimally invasive techniques like microabrasion which has a limited literature of its effect. Furthermore, the effect of remineralizing such as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) agent on MIH-affected teeth is minimally studied. AIM: Comparative evaluation of the esthetic after microabrasion and microabrasion followed by Tooth Mousse Plus on hypomineralized incisors of MIH-affected patients. SETTINGS AND DESIGN: The study was a randomized clinical trial. MATERIALS AND METHODS: The study comprised Grade I MIH patients in the age strata of 7-16 years having lesions on incisors. As per inclusion criteria, 46 lesions were divided into two groups of microabrasion and microabrasion followed by CPP-amorphous calcium fluoride phosphate (ACFP). Photographs were obtained before treatment, just after treatment, and 6 months after treatment. The photographic evaluation was done using the CIE L*a*b* scoring method. STATISTICAL ANALYSIS USED: ANOVA and posthoc Tukey's test were applied to compare the difference in lightness ΔL and total color change ΔE of these two groups. RESULTS: In microabrasion group, the overall change in ΔL of white tooth discoloration came -0.9 standard deviation (SD) 7.3. In microabrasion followed by CPP-ACFP group, statistically significant difference was found between both these groups with P value of P ≤ 0.001. CONCLUSIONS: Microabrasion followed by the remineralizing agent can improve the esthetics of white tooth discoloration with time.

Enhanced EPR directed and Imaging guided Photothermal Therapy using Vitamin E Modified Toco-Photoxil.

Herein we report synthesis, characterization and preclinical applications of a novel hybrid nanomaterial Toco-Photoxil developed using vitamin E modified gold coated poly (lactic-co-glycolic acid) nanoshells incorporating Pgp inhibitor d-α-tocopheryl polyethylene glycol 1000 succinate (TPGS) as a highly inert and disintegrable photothermal therapy (PTT) agent. Toco-Photoxil is highly biocompatible, physiologically stable PTT material with an average diameter of 130 nm that shows good passive accumulation (2.3% ID) in solid tumors when delivered systemically. In comparison to its surface modified counterparts such as IR780-Toco-Photoxil, FA-Toco-Photoxil or FA-IR780-Toco-Photoxil accumulation are merely ~0.3% ID, ~0.025% ID and ~0.005% ID in folate receptor (FR) negative and positive tumor model. Further, Toco-Photoxil variants are prepared by tuning the material absorbance either at 750 nm (narrow) or 915 nm (broad) to study optimal therapeutic efficacy in terms of peak broadness and nanomaterial's concentration. Our findings suggest that Toco-Photoxil tuned at 750 nm absorbance is more efficient (P = 0.0097) in preclinical setting. Toco-Photoxil shows complete passiveness in critical biocompatibility test and reasonable body clearance. High tumor specific accumulation from systemic circulation, strong photothermal conversion and a very safe material property in body physiology makes Toco-Photoxil a superior and powerful PTT agent, which may pave its way for fast track clinical trial in future.