Monoclonal Antibodies: Current Advancements and Future Potential for Atopic Dermatitis Therapy.

BACKGROUND: Atopic Dermatitis (AD) is an inflammatory skin condition with a severe itch. The topical therapy using corticosteroids is not sufficient for the effective therapy of moderate to severe cases of AD. The investigation and development of immunological targetspecific human monoclonal antibodies have changed the paradigm for the therapy of moderate to severe cases of AD. OBJECTIVE: The establishment of target-specific, tolerable, and efficacious human monoclonal antibodies might lead to the better management of moderate to severe cases of AD. METHODOLOGY: The scientific literature available in databases, such as Pubmed and Clinicaltrial.gov, was searched and discussed for available clinical therapeutic information. DISCUSSION: The present review has discussed the potential immunological targets of specific monoclonal antibodies developed and approved or which are under investigation in clinical trials. CONCLUSION: The development of targeted monoclonal antibodies can improve the understanding of the role of different immunological pathways and biomarkers in AD and become the future of AD treatment.

Medial Pterygoid Abscess Masquerading as a Temporomandibular Joint Disorder: A Case Report.

A patient presenting with a history of restricted mouth opening and deflection of the mandible after a prolonged dental procedure raises a suspicion of temporomandibular joint disorder (TMD) due to its estimated high prevalence of 29%. Muscle relaxants and routine active physiotherapy established normal range of movement and pain reduction was achieved through TENS therapy and analgesics. However, the non-subsidence of deflection prompted an initial suspicion of TMD which was overturned by MRI. The MRI evaluation revealed left side medial pterygoid abscess. It is imperative to understand that despite strong history and relevant clinical features, for the definitive diagnosis radiographic evaluation is highly contributory. Misdiagnosing TMD due to its similar presentation can have significant implications for the patient's well-being and quality of life. The clinical features of medial pterygoid abscess including restricted mouth opening and pain can be similar to that of TMD. These abscesses are most commonly caused by odontogenic infections but can also occur as a result of septic inferior alveolar nerve block techniques. Limited literature reports of pterygoid space abscess have been described, but intramuscular and medial pterygoid abscess is an absolute rarity. Causal relationship to septic inferior alveolar nerve block further makes this case report an interesting read.

Efficacy of Oral Magnesium on Bone Regeneration and Implant Stability in Immediate Dental Implants: A Randomized Controlled Trial.

PURPOSE: The successful osseointegration around immediate implants requires high quality and quantity of osteogenesis around them. The role of magnesium as a boneenhancing mineral, and as an adjunctive analgesic has been well documented in orthopedic literature. However, there is a paucity of literature in its role in successful osseointegration around immediate implants. This randomized controlled trial sought to assess the promising impact of magnesium on osseointegration by examining various aspects of implant stability, correlating them with serum bone markers, and establishing a foundation for future research on its potential as a potent analgesic. MATERIALS AND METHODS: Immediate implant placement was done after the extraction of the indicated mandibular molar tooth, and all the patients were segregated into 2 groups (Placebo- Lactose, and Magnesium citrate). Bone regenerate in the peri-implant area was assessed radiographically immediate post-operatively, on the 6th week and 12 weeks. Implant stability was measured immediate post-operatively, at the 4th week and 12th week. Serum parameters were procured pre-operatively and post-operatively for serum calcium, serum alkaline phosphatase (ALP), and serum parathyroid hormone at the 8th week, and serum vitamin D3 levels preoperatively. RESULTS: 54 immediate implants placed showed the demographics and baseline serum, clinical, and radiographic parameters were comparable in both groups. Analysis of Implant Stability Quotient at 12th week showed statistically significant difference in intervention group both on intergroup and intragroup analysis. Radiodensity measurement showed a statistically significant difference in both intragroup and intergroup analysis in the intervention group at the 6th and 12th week. In bone gap analysis, the difference in mean change in the horizontal bone gap (HG) at 6 weeks was non-significant while the difference in HG at the 12th week was significant in the intervention group. On intragroup analysis, mean change HG at 6 weeks and 12 weeks both were significant only in intervention group. Intergroup analysis of vertical bone gap (VG) 12 and VG 12-0 (mean difference in the vertical bone gap from 12th week-day 0) showed a statistically significant difference in the intervention group. On intragroup analysis, VG 12 was significantly better in the intervention group. On serum analysis, ALP post-operatively was found to be significantly raised (P=0.013) in intervention group. Numerical rating Scale (NRS) analysis showed a significant decrease in post-op day 5 and 7, (P=0.017) and (P=0.002) respectively. CONCLUSION: The oral magnesium citrate supplementation after immediate implant placement helps in enhancing the stability of the immediate implants, along with improved radiodensity around them which was found to be statistically significant. It also helps in reducing the horizontal, and vertical gap around the implant and has significant analgesic potential.

Phylogenomic evaluation of Mangrovimicrobium sediminis gen. nov. sp. nov., the first nitrogen fixing member of the family Halieaceae adapted to mangrove habitat and reclassification of Halioglobus pacificus to Pseudohaliglobus pacificus comb. nov.

The taxonomic position and genomic characteristics of a nitrogen fixing and polymer degrading marine bacterium, strain SAOS 164 isolated from a mangrove sediment sample was investigated. Sequence analysis based on 16S rRNA gene identified it as a member of family Halieaceae with closest similarity to Haliea salexigens DSM 19537T (96.3 %), H. alexandrii LZ-16-2T (96.2 %) and Parahaliea maris HSLHS9T (96.0 %) but was distantly related to the genera Haliea, Parahaliea and Halioglobus in phylogenetic trees. In order to ascertain the exact taxonomic position, phylogeny based on RpoBC proteins, whole genome, core and orthologous genes, and comparative analysis of metabolic potential retrieved the strain in an independent lineage clustering along with the genera Halioglobus, Pseudohalioglobus and Seongchinamella. Further, various genome based delimitation parameters represented by mol % GC content, percentage of conserved proteins (POCP), and amino acid identity (AAI) along with chemotaxonomic markers (i.e. fatty acids and polar lipids) supported the inferences of genome based phylogeny and indicated that the strain SAOS 164 belongs to a novel genus. The genome was mapped to 4.8 Mb in size with 65.1 % DNA mol% G + C content. In-silico genomic investigation and phenotyping revealed diverse metabolite genes/pathways related to polymer hydrolysis, nitrogen fixation, light induced growth, carbohydrate, sulfur, phosphorus and amino acid metabolism, virulence factors, defense mechanism, and stress-responsive elements facilitating survival in the mangrove habitat. Based on polyphasic taxonomic approach including genome analyses, a novel genus Mangrovimicrobium sediminis gen. nov. sp. nov. (=SAOS 164T = MTCC 12907T = KCTC 52755T = JCM 32136T) is proposed. Additionally, the reclassification of Halioglobus pacificus (=DSM 27932T = KCTC 23430T = S1-72T) to Pseudhalioglobus pacificus comb. nov. is also proposed.

Minimal clinically important difference in maxillofacial trauma patients: a prospective cohort study.

The present study estimated the minimal clinically important difference (MCID) for pain on a visual analogue scale - numerical rating scale (VAS-NRS) and mean bite force (MBF) in patients treated for maxillofacial trauma (MFT). This cohort study included 120 MFT patients treated according to AO principles. Preoperative and four-week postoperative pain on the VAS-NRS, and MBF were measured to calculate MCIDs as indicators of functional rehabilitation. The patient's perspective of the treatment was assessed using a four-item anchor question. The MCID was determined by two anchor-based approaches, namely, the change difference (CD) method and receiver operating characteristic (ROC) curve method. According to the CD method, the MCID for pain was 2.4 and the MBF was 147.9 N. Based on the ROC curve, the MCID for pain was 2.5 (sensitivity 91.7%, specificity 47.2%) and MBF was 159.1 N (sensitivity 71.4%, specificity 61.1%). This study demonstrated a high sensitivity (>70%) for MCID, which implies that pain reduction of 2.4-2.5 points on the VAS-NRS and a gain in MBF of 147.9-159.1N are clinically relevant for patients treated for MFT.

Prevalence of Pulp Stones in the Population of Rajasthan: A Cross-Sectional Study in a Tertiary Care Hospital.

Introduction This study aimed to use radiography to determine the prevalence of pulp stones in the population of Rajasthan and to evaluate the relationship between pulp stones and tooth status, type, age, and gender. Methods The radiograph data record files collected from the Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, from September 2018 to October 2019, had a total of 9918 diagnostic quality intraoral periapical radiographs. One examiner examined all the radiographs to identify pulp stones and associated factors. Pearson chi-square test of significance was used for statistical analysis. Results On screening, a total of 889 intraoral periapical radiographs were found to have pulp stones. The presence of pulp stones was significantly higher in mandibular molars (68%) and was more common in the age group of 31-45 years (37%), followed by 13-29 years (35%). Maximum of pulp stones were of attached type (64%) than free pulp stones. Conclusion The prevalence of pulp stones in the population of Rajasthan studied is 8.9%, which is much lower than the reported prevalence in the literature. Pulp stones are predominantly attached and found significantly more often in mandibular molars in the age group of 31-44 years.

Safety and Efficacy of Resveratrol in Healing of Maxillofacial Fractures: A Randomized Controlled Study.

Objectives: To assess the efficacy of resveratrol in improving functional outcomes following open reduction and internal fixation of maxillofacial fractures. Study Design: A single-center, randomized, parallel group, prospective, double-blind clinical trial was conducted on 40 patients between the age 20 and 60 years, requiring open reduction and internal fixation of maxillofacial fractures. The selected patients were randomly divided into two groups, Group 1 (placebo) and Group 2 (resveratrol) where tablets resveratrol 500 mg were given twice daily for 1 month following open reduction and internal fixation of fractured segments. Bite force was calculated pre-operatively and on the 1st, 4th, 8th and 12th week postoperatively. Serum markers osteocalcin and alkaline phosphate were calculated pre-operatively and at 4th and 12th week postoperatively. Results: Bite force (690.55 ± 262.00) in the resveratrol group was higher than the placebo group (553.27 ± 300.08) at 12th week postoperatively. However, the difference was non-significant statistically (p = 0.132). Resveratrol group (116.80 ± 55.25) showed better maintenance of serum ALP level as compared to placebo group (107.90 ± 42.99) at 12th week postoperatively, but again it lacked statistical significance (p = 0.573). Resveratrol group after initial reduction at 4th week showed serum osteocalcin levels nearly equal to the preoperative values at 12th week, while the placebo group showed a decline both at 4th and 12th week postoperatively. However, these results were not statistically significant (p = 0.065). Conclusion: There was no statistically significant difference in bite force, serum ALP level and serum osteocalcin levels between placebo group and resveratrol group. Though not statistically significant but early increased level of serum osteogenic markers, better restoration of bite force in group 2 (tab. Resveratrol) indicates toward its possible optimistic role in maxillofacial fracture healing. More studies with larger sample sizes are needed in order to confirm the efficacy of this drug in maxillofacial fracture.

Surveillance of central line associated bloodstream infection (CLABSI) - comparison of current (CDC/NHSN) and modified criteria: A prospective study.

Background and Aims: There is a huge load of central line-associated bloodstream infection (CLABSI) being reported in developing countries, with increased mortality and healthcare costs. Effective surveillance is a must to reduce the incidence of CLABSI. The current criteria (Centre for Disease Control and Prevention/National Healthcare Safety Network [CDC/NHSN]) for CLABSI surveillance have their own shortcomings. For diagnosing CLABSI, current CDC/NHSN CLABSI surveillance criteria are laborious and time consuming with low predictive power. Hence, modified criteria have been postulated, which are simple and implementable at resource-constrained setups. The primary objective was to compare modified criteria with CDC criteria. The secondary objective was to determine the prevalence of CRBSI. Material and Methods: A total of 98 patients with central line in situ or having the central venous line removed ≤24 hrs prior to the date of the event were enrolled. Paired blood cultures were obtained and results were analyzed using differential time to positivity. Results: The incidence of CLBSI was 8.16% and the device utilization rate was 11.6%. The negative predictive value of both the surveillance criteria was found to be excellent and comparable (96.2% for modified criteria and 97.1% for CDC criteria), therefore both can be used for screening purposes. AUC for current CDC/NHSN criteria was better than modified criteria (0.76 versus 0.66, P < 0.0001), suggesting it to be a better criterion for surveillance of CLABSI. Conclusion: Modified criteria were not superior to CDC/NHSN criteria for surveillance. Thus, there is a scope of improving the modified criteria for the purpose of surveillance. CLBSI load was higher; CLABSI bundle for prevention is thus highly recommended.

Efficacy of novel, three jaw adventitia holding microclamps compared to Acland microclamps in patients undergoing end-to-end microvascular anastomosis: A randomized control trial.

OBJECTIVE: To evaluate the efficacy of three jaw adventitia holding (TADH) microclamps in end-to-end microvascular anastomosis. BACKGROUND: Acland clamps, though highly efficacious, require a steep learning curve and are associated with complications such as back walling and incomplete bites. METHODS: A single center, parallel group, 30-patient randomized clinical trial was conducted with a 1:1 allocation ratio in Acland and TADH microclamp groups. Primary outcome was time taken for microvascular anastomosis in terms of arterial and venous clamping and suturing time. Secondary outcomes included ease of use, need for clamp flipping and adventitia trimming, and need for assistance and flap survival. RESULTS: TADH microclamps were found to be beneficial when compared to Acland microclamps in end-to-end microvascular anastomosis, in terms of artery clamp time (19.07 ± 3.751 min, 95% CI 10.058-17.942, p < 0.001), artery suture time (15.87 ± 3.357 min, 95% CI 10.660-17.206, p < 0.001), vein clamp time (21.50 ± 3.849 min, 95% CI 12.131-19.469, p < 0.001), and vein suture time (16.58 ± 3.147 min, 95% CI 13.232-20.368, p < 0.001). The TADH microclamps did not require flipping to enable suturing of the posterior walls of the vessel. Statistically significant difference was found in surgeon-reported ease of use with TADH microclamps (Chi-square value 9.867, p < 0.001). Statistically significant difference was found in relation to the need for assistance with TADH microclamps (Chi-square value 19.286, p < 0.001). CONCLUSION: This study found TADH microclamps to be faster, easier to use, and clinically efficacious in reducing the anastomosis time compared to those of the Acland clamps.

Effects of delayed appointments in fixed orthodontic patients due to lockdown during the COVID-19 pandemic.

Objectives: To determine the frequency of orthodontic emergencies and their impact on the treatment progress caused by delayed appointments due to the lockdown during the COVID-19 pandemic. Materials and methods: Two hundred thirty-eight patients undergoing fixed orthodontic treatment participated in this cross-sectional study. A pre-structured questionnaire was divided into six parts (Part A-C comprised of orthodontic emergencies and Part D-F comprised of various adverse effects and impacts on treatment progress). Two specialist orthodontists performed clinical examinations to complete the questionnaire. The final data were expressed as frequency and percentage. Results: Maximum number of patients reported four months after lockdown. Nearly half of the patients reported debonding of at least one of the brackets. Loosening of molar bands and debonding of second molar tubes were observed in 12.6% and 18.9% of patients, respectively. Ligation method failures were reported in 41.2% of the patients. Patients fitted with transpalatal arch/lingual arch skeletal anchorage showed a failure rate of 26.1% and 10%, respectively. Almost 29% of the patient complained of discomfort due to distal wire impingement. Undesired tooth movements were seen in almost 25% of patients. Alignment, space closure, and settling of occlusion were affected in 47.6%, 17.4%, and 35.7% of patients, respectively. Conclusions: This study helps to determine various types of adverse effects that can occur due to delayed appointments. The study's outcomes suggest that clinicians should be prepared to deal with future pandemics or other causes that might lead to delayed appointments.

Efficacy of Enhanced Recovery after Surgery (ERAS) protocol in maxillofacial trauma: A randomized controlled trial.

INTRODUCTION: Enhanced Recovery after surgery (ERAS) guidelines have been formulated in the literature for various different specialties but none is present for maxillofacial trauma patients. Hence, we have formulated ERAS protocol for maxillofacial trauma (ERAS-MT) patients and compared with the patients receiving the standard traditional care for post trauma outcomes. METHODOLOGY: A randomized controlled trial included 74 patients divided into two groups: Group 1 (ERAS group:37 patients) and Group II (Control group:37 patients). ERAS group were intervened according to the formulated ERAS protocol based on the previous literature and the control group received the standard of care. The both groups were compared for various post trauma outcomes. RESULTS: Baseline demographic data was non-significant between both the groups. There was significant decrease in pre-operative IV fluid use and total number of IV analgesics used till 72 h as well as in the immediate post operative period in the ERAS group(p = 0.001). ERAS group started oral feeds within 6 h and they were significantly compliant for oral carbohydrates in the pre-operative phase(p = 0.001). PONV episodes, swelling and infections were insignificantly less in the ERAS group(p > 0.05), however a significant difference was seen throat pain and decreased anxiety as well as Oral Hygiene Index(p = 0.001). At two weeks, a significant difference was seen in overall patient's satisfaction and cost analysis in the ERAS group (p = 0.001). CONCLUSION: Our study suggested that ERAS protocol was associated with shorter hospital stay, early recovery with better overall satisfaction of the patients, lesser post-operative complications and significantly decreased cost analysis.

Comparison of Kaltenborn mobilization technique and muscle energy technique on range of motion, pain and function in subjects with chronic shoulder adhesive capsulitis.

Background: Shoulder adhesive capsulitis (AC) is a common musculoskeletal condition causing pain, loss of range of motion (ROM) in the shoulder, and a decrease in its functionality, yet poorly defined and understood since its identification. Kaltenborn mobilization technique (KMT) and muscle energy technique (MET) are commonly used physiotherapeutic techniques for their treatment. To the best of our understanding, there was no study found to compare the effectiveness of one technique over another. Objective: The objective of this study was to compare the effectiveness of KMT and MET on the ROM, pain and function in subjects with chronic shoulder AC. Methods: In this single-centred, single-blinded quasi-experimental study with a pretest-posttest design 35 subjects were randomized into two groups: Group A (n=18) received KMT and Group B (n=17) received MET along with the moist hot pack (MHP), supervised exercises and home exercises common to both the groups. A total of 32 subjects completed the study with three dropouts. Subjects were evaluated before and after 10 treatment sessions for the outcomes, shoulder external rotation passive range of motion (ER-PROM) and abduction passive range of motion (ABD-PROM) using the universal goniometer, intensity of pain using the numeric pain rating scale (NPRS) and functional disability using the shoulder pain and disability index (SPADI). Results: Analysis of 32 subjects showed that both groups were homogenous at baseline. The within-group analysis showed significant improvement (p<0.05) in both groups related to all the outcomes. But when we compared the groups, Group B showed significant (p<0.05) improvement in NPRS and SPADI in comparison to Group A. However, there was non-significant (p>0.05) difference found in ER-PROM and ABD-PROM. Conclusion: Both KMT and MET are effective in improving ROM, pain and function but MET showed a significant reduction of pain and improvement in function in subjects with chronic shoulder AC, thus supporting its use as a physiotherapeutic treatment technique.

Comparative Evaluation of Maintenance of Cell Viability of an Experimental Transport Media "Ringer's Lactate" with Dextrose Normal Saline ORS Egg White and Infant Milk Formula for Transportation of an Avulsed Tooth.

Background and objective: The viability of the periodontal ligament (PDL) cells on the root surface of the avulsed tooth determines the prognosis of the replanted tooth, which in turn is determined by a suitable transport medium in which the tooth was stored. The aim of the present study is to evaluate and compare the effectiveness of Ringer's lactate (RL) as a storage medium for an avulsed tooth in maintaining the PDL cell viability with dextrose normal saline (DNS), oral rehydration salt (ORS), egg white (EW), and infant milk formula (IMF). Materials and methods: A total of 85 freshly extracted human teeth were divided into five experimental groups and two control groups. The positive and negative controls corresponded to 0-minute and 8-hour dry time, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in one of five experimental media (RL, DNS, ORS, EW, and IMF) for 45 minutes. The teeth were then treated with collagenase type III and trypsin for 10 minutes. The number of viable PDL cells was counted with a hemocytometer and analyzed. Results: Statistical analysis showed that IMF, RL, and EW had no statistically significant differences among them in maintaining the viability of the PDL cells but were significantly better than DNS. No statistically significant difference between RL, EW, and ORS in the number of viable PDL cells. Conclusion: Infant milk formula (IMF), RL, and EW showed similar results within the parameters of the study; they can be used as alternative storage media for avulsed teeth. DNS showed poor results, and ORS could serve as short-term storage media if the other solutions are not readily available. Clinical significance: The search for an appropriate storage media with favorable pH and osmolality along with easy availability is the basic thought behind this study. How to cite this article: Kumar P, Kotumachagi SS, Fabi AJ, et al. Comparative Evaluation of Maintenance of Cell Viability of an Experimental Transport Media "Ringer's Lactate" with Dextrose Normal Saline ORS Egg White and Infant Milk Formula for Transportation of an Avulsed Tooth. Int J Clin Pediatr Dent 2023;16(3):453-458.

Gap areas in mitigation of oral cancer: A cross-sectional study evaluating awareness and knowledge of risk factors in oral cancer in a tertiary hospital.

Purpose and Objectives: One of the main causes of the increasing oral cancer (OC) burden in India is a lack of awareness and a significant gap in knowledge about risk factors and symptomology of OC. Materials and Methods: A questionnaire-based cross-sectional study was to evaluate the knowledge and awareness about OC among 500 random patients presenting for care at a tertiary hospital in western Rajasthan which serves a wide area of western, northern, and central Rajasthan. Results: A total of 446 participants, among which 83.6% were males enrolled in the study. Much to our despair, the results showed 35.23% of the participants (P = 0.007) started their habit at age <15 years. Nearly 60.3% of the participants were well aware of the harmful temporary or permanent effects of the tobacco. Around 40.85% of the participants taking tobacco products were ignorant about their changes in the tissues (site of tobacco placement). TV and Radio (50.5%) were the main source of information of the ill effects of tobacco and form a major contribution in public awareness. More than 90% of the participants had read the warnings on the tobacco packets. No doubt participants have knowledge about the ill effects of tobacco still there was a lack in behavioral modifications for tobacco cessation, leading to nonsuccess in quitting, with actual nonunderstanding about the ill effects of tobacco and overall lack of belief in the tobacco control measures. Conclusion: Our findings have found a gap in the awareness efforts of OC for the general population and will make public health professionals, clinicians, policymakers, and government a better judge and motivate them to strengthen existing national tobacco control efforts.

An in-vitro analysis to evaluate the disinfection effectiveness of Cold Atmospheric Pressure (CAP) plasma jet in Enterococcus faecalis infected root canals.

Cold Atmospheric Pressure (CAP) plasma has shown successful antibacterial efficacy in different medical applications which have prompted researchers to explore its possible use in endodontics. The aim of the present study was to comparatively evaluate the disinfection effectiveness of CAP Plasma jet with 5.25% sodium hypochlorite (NaOCl) and Qmix in Enterococcus Faecalis infected root canals at different time intervals (2, 5, and 10 min). 210 single-rooted mandibular premolars were chemomechanically prepared and infected with E. faecalis. The test samples were exposed to CAP Plasma jet, 5.25% NaOCl, and Qmix for 2, 5, and 10 min. The residual bacteria from the root canals if any were collected and evaluated for colony-forming units (CFUs) growth. ANOVA and Tukey's tests were used to evaluate the significant difference between treatment groups. 5.25% NaOCl showed significantly more antibacterial effectiveness (<0.001) when compared with all other test groups except Qmix at 2 and 10 min of exposure time. A minimum contact time of 5 min with 5.25% NaOCl is recommended to get zero bacterial growth in E. faecalis infected root canals. QMix requires a minimum contact time of 10 min to achieve optimal CFUs reduction and CAP plasma jet requires a minimum contact time of 5 min to achieve substantial CFUs reduction.

Recent Trends in Nanocarriers for the Management of Atopic Dermatitis.

BACKGROUND: Atopic dermatitis (AD) is a pruritic inflammatory skin condition with increasing global prevalence, almost affecting 15% to 30% of children and 5% of adults. AD results due to a complex interaction between the impaired skin barrier function, allergens, and immunological cells. Topical corticosteroids or calcineurin inhibitors in the form of creams or ointments are the mainstay of therapy, but they have low skin penetration and skin barrier repair efficiency. OBJECTIVE: The above limitations of conventional dosage forms have motivated the development of nanoformulations of drugs for improved penetration and deposition in the skin for better management of AD. METHODS: Databases, such as Pubmed, Elsevier, and Google Scholar, were reviewed for the investigations or reviews published related to the title. RESULTS: The present review discusses the advantages of nanoformulations for the management of AD. Further, it also discusses the various types of topically investigated nanoformulations, i.e., polymeric nanoparticles, inorganic nanoparticles, solid lipid nanoparticles, liposomes, ethosomes, transfersomes, cubosomes, and nanoemulsion for the management of atopic dermatitis. In addition, it also discusses advancements in nanoformulations, such as nanofibres, nanosponges, micelles, and nanoformulations embedded textiles development for the management of AD. CONCLUSION: The nanoformulations of drugs can be a better alternative for the topical management of AD with enhanced skin penetration and deposition of drugs with reduced systemic side effects and better patient compliance.

Rate and anchorage loss during en-masse retraction between friction and frictionless mechanics: A randomized clinical trial.

OBJECTIVE: To compare rate and anchorage loss during en-masse retraction of anterior maxillary teeth between friction mechanics (FM) and frictionless mechanics (FLM). SETTING AND SAMPLE POPULATION: Thirty-eight patients requiring en-masse retraction of protruded anterior maxillary teeth were randomly allocated into FM and FLM groups. METHODS: En-masse retraction with sliding mechanics (FM) using an elastomeric chain was compared with continuous mushroom loop archwire mechanics (FLM). Study models and lateral cephalograms were taken before (T1) and immediately after retraction (T2). The primary outcome was the rate of en-masse retraction. Anchorage loss was the secondary outcome. Intergroup comparison was performed using an independent t test (P < .05). RESULTS: Baseline characteristics were similar between groups. Thirty-six patients completed the trial. Two patients were lost to follow-up in the FLM group. The rate of en-masse retraction did not differ significantly (P = .625) between FM (0.7 mm/mo) and FLM (0.8 mm/mo) groups. The intragroup comparison showed significant anchorage loss in FM (2.28 mm) and FLM (1.13 mm) groups; however, the intergroup comparison showed no statistically significant difference (P = .093). Maxillary first molar showed a statistically significant change in angulation between the two mechanic groups (P < .001). Vertical movement of the maxillary incisor and first molar showed no significant difference between FM and FLM groups (P = .143, P = .546, respectively). CONCLUSIONS: The rate of en-masse retraction and anchorage loss was comparable between the FM and FLM groups. Significant anchorage loss was seen with both mechanics. The result suggests that both the mechanic group require external reinforcement to prevent anchorage loss.

Comparison of Teriparatide and Combination of Cissus Quadrangularis and Dalbergia Sissoo on Bone Healing Against the Control Group in Maxillofacial Fractures: A Randomized Open-label Control Trial.

Study Design: Randomized Control Trial. Objective: A randomized control trial was planned to aim to assess whether subcutaneous Injection of Teriparatide and Tablet Reunion (combination of Cissus Quadrangularis and Dalbergia sissoo) improves maxillofacial fracture healing as compared to the control group. Methods: 24 patients of mandibular fracture with or without concomitant maxillofacial fractures were randomly divided into 3 equal groups (Group 1- Control, Group 2- Tablet Reunion, and Group 3- Injection Teriparatide) and the treatment duration was 4 weeks. Pain, fracture site mobility, bite force, serum markers, and radiographic healing were assessed preoperatively and postoperatively at regular intervals till 12 weeks. Results: Group 2 showed early pain relief, although it was insignificant. Group 3 showed the highest anterior bite force at all the time points. Change in mean posterior bite force (PBF) showed a statistically significant increase at 8th week and 12th week in intergroup comparison; however, at 12th week, Group 3 was significantly better than Group 1 and reported the highest posterior bite force compared to other groups. Serum calcium and PTH level showed no significant difference, whereas Serum ALP showed a statistically significant increase in Group 3. The radiographic assessment showed no significant difference among the 3 groups. Conclusions: Both the intervention group drugs showed a promising effect on accelerating the fracture healing and improving bite force restoration with the osteoanabolic action; however, early radiographic healing and increased serum osteogenic markers in Group 3 indicate its possible optimistic role in maxillofacial fracture healing.

Treatment Outcome Comparison Between two 3-Dimensional Plates (Y-Shaped Plate Versus Trapezoidal Condylar Plate) in Management of Mandible Condylar Fracture: A Randomized Control Trial.

Aim: To compare the treatment outcomes (clinical, functional and radiographical) using the two different 3-Dimensional plates in open reduction internal fixation of mandibular condylar fracture (MCF). Assessment of ease of fixation and fixation time were also performed. Methodology: 20 MCF patients were divided equally into two groups (Group A: Trapezoidal Condylar Plate and Group B: Y-shaped plate) and the treatment outcomes were compared. Intraoperatively time required for fixation was also compared. The patients were followed up at different timelines till 3 months. Result: Baseline parameters had statistically insignificant distribution in both groups implying effective randomization and balanced confounding factors. Intraoperatively, adequate anatomical reduction was achieved in both groups with statistically insignificant difference in time required for fixation. Postoperatively, no statistically significant difference was found in radiographic and functional parameters. None of the patients in either group reported with facial nerve injury, condylar resorption, Temporomandibular Disorders. However, 02 patients in Group A and 01 patient in Group B presented with infection, parotid fistula, and hardware failure respectively with statistically insignificant difference. Conclusion: This study concluded that the treatment outcomes were satisfactory with the use of both 3-D plate, but further studies with larger sample size and longer follow up are required.