Fungal footprints in oral cancer: unveiling the oral mycobiome.

Oral squamous cell carcinoma (OSCC) is the most common type of head and neck cancer, with a high mortality rate. There is growing evidence supporting a link between oral cancer and the microbiome. The microbiome can impact various aspects of cancer, such as pathogenesis, diagnosis, treatment, and prognosis. While there is existing information on bacteria and its connection to oral cancer, the fungi residing in the oral cavity represent a significant component of the microbiome that remains in its early stages of exploration and understanding. Fungi comprise a minuscule part of the human microbiome called the mycobiome. Mycobiome is ubiquitous in the human body but a weakened immune system offers a leeway space for fungi to showcase its virulence. The role of mycobiome as a colonizer, facilitator, or driver of carcinogenesis is still ambiguous. Reactivating the mycobiome that undergoes collateral damage associated with cancer treatment can be watershed event in cancer research. The coordinated, virulent, non-virulent behavior of the fungi once they reach a critical density must be hacked, considering its diagnostic, prognostic and therapeutic implications in cancer. This review highlights the diversity of the mycobiome and its potential role in oral cancer.

Prevalence of root caries in Indian population - a systematic review and meta-analysis.

AIM: To evaluate the pooled prevalence of root caries among Indian population through systematic review and meta-analysis. MATERIALS AND METHODS: The study protocol adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and was registered in PROSPERO (CRD42022367365). Research articles published in English language till July 2022 were evaluated with the use of databases like PubMed, Science Direct, Google Scholar, Cochrane, and Scopus and employed standard Boolean operators. RESULTS: The search turned up a total of 194 articles; however, only 14 of those matched the requirements for inclusion and were used to compile the meta-analysis. MedCalc® Statistical Software version 20.2 was used to determine the pooled estimates. Using the random effect model, the analysis was carried out. By estimating the heterogeneity using Higgins' I2 statistics, the extent and importance of differences between the chosen studies were ascertained. Publication bias was assessed using the funnel plot and Egger's test. The random effects model yielded a pooled prevalence of 27.617 (95% CI = 17.422-39.154). CONCLUSION: Three out of ten persons in India may be affected by root caries, which is a serious health issue. To enhance the quality of life for the aged population, oral health policies and preventive actions should concentrate on this issue.

Effect of novel biomodification strategies on bonding to pulp chamber dentin - An In Vitro study.

Context: Adhesion to dentin remains a tough challenge due to its heterogeneous composition, complex histologic structure and high tubular content, warranting the need to investigate methods to improve the bond strength of the commonly used access restorative materials to pulp chamber dentin. Aims: To evaluate the effect of dentin biomodification using 6.5% grape seed extract and a 980 nm diode LASER on the shear bond strength of resin-based bonded restoration to pulp chamber dentin. Methods and Materials: Access cavities were prepared in 42 extracted human maxillary premolars, which were then sectioned in a buccolingual direction. The samples were serially immersed in 5.25% NaOCl for 40 minutes and 17% EDTA for 3 minutes and allocated into three groups: the control group, the group pre-treated with 6.5% grape seed extract (GSE) and the group pre-treated with a 980 nm diode light amplification by stimulated emission of radiation (LASER). All the samples were restored with resin composites and subjected to shear bond strength testing using a universal testing machine. Statistical Analysis Used: Statistical analysis was done using SPSS version 23 software. Results: The mean shear bond strength was highest in the group pre-treated with GSE, followed by that pre-treated with diode LASER and finally in the control group. Conclusions: Dentin biomodification using both chemical and physical agents such as grape seed extract and diode LASER was shown to improve the shear bond strength of resin composite endodontic access restorations to the pulp chamber dentin.

Characterization of dynamic process of carious and erosive demineralization - an overview.

To review the analytical methods for carious and erosive demineralization an initial search of peer-reviewed scientific literature from the digital library database of PubMed/Medline indexed journals published up to early 2022 was carried out based on keywords relevant to the topic criteria including bibliographic citations from the papers to gather the most updated information. This current review aims to provide an updated overview of the advantages, limitations, and potential applications of direct and indirect research methods available for studying various dynamic stages of carious and erosive demineralization in enamel and dentin. This paper categorizes and describes the most suitable, frequently adopted and widely used quantitative and qualitative techniques in in vitro/in vivo research which are well-established, emerging, or comparatively novel techniques that are being explored for their potential validation.

Bioactive remineralization of dentin surface with calcium phosphate-based agents: An in vitro analysis.

Background: With the increasing prevalence of erosive tooth wear affecting both adults and children; designing optimum protocols of management in a noninvasive manner is gaining precedence. Aim: Comparative evaluation of topically applied calcium phosphate-based agents casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and beta tricalcium phosphate (ß-TCP) on the surface of eroded dentin. Materials and Methods: Dentin blocks from human third molars in four groups were subjected to the surface treatment: (G1) sound dentin (G2) demineralized dentin (G3) CPP-ACP (G4) ß-TCP. All the samples except control (G1) were immersed in an acidic solution incubated at 37°C for 96 h. The samples in G3 and G4 were topically treated with CPP-ACP and ß-TCP for 4 min twice daily for 14 days; followed by pH-cycling for 21 days. Surface hardness testing and surface morphology were observed using the scanning electron microscopy. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software with Kruskal-Wallis test and post hoc test. Results: Dentin treated with both CPP-ACP (37.25) and ß-TCP (32.05) recorded significantly higher VHN than demineralized (G2-23.51) but lower compared to sound control (G1-57.06). Conclusion: The topical application of CPP-ACP and ß-TCP agents shows definite potential in promoting the hardening of demineralized dentin surface.

Dental practice management during COVID-19 times-Now and beyond.

AIM: Coronavirus disease 2019 (COVID-19) being declared a global public health emergency has become a significant challenge for all healthcare workers, including dentistry, recognised as a high-risk profession during these times. This consensus statement aims to highlight and provide guidelines necessary to be implemented for a clinical dental practice. MATERIALS AND METHODS: A total of nine conservative Dentists and Endodontists and one Oral and Maxillofacial Surgeon; with four panelists from government dental colleges, one each from the North, South, East and West India and six resource persons from private colleges in South India, all of them being clinicians and administrators practicing dentistry since the inception of the pandemic, collaborated in this consensus statement. The consensus statement was developed through a symposium conducted on the topics; general dental practice during COVID-19 times, the importance of aerosols in clinical dental practice in the spread of COVID-19, effective standard operating protocols for clinical dental practice and Institutional settings with scientific evidence-based justifications, followed by a panel discussion with to devise mandatory protocols to be followed in clinical and institutional settings. The symposium was attended by 46 practitioners who participated in the deliberation. RESULTS: This consensus statement provides clinicians and researchers with protocols for the dental practice, agreed upon by experts in the field. The Consensus Statement has been formulated according to the AGREE Reporting checklist for the formulation of guidelines. CONCLUSION: The experts and panelists reached a Consensus on the protocols and guidelines for the safe clinical and institutional dental practice.

To assess the occurrence of middle mesial canal using cone-beam computed tomography and dental operating microscope: An in vitro study.

INTRODUCTION: Failures of root canal treatments are mainly attributed to missed canals and ignorance about the complex anatomy of the root canal system. One such example of anatomic variation is the middle mesial canal (MMC) in mandibular molars which is often missed, and literature on methods for identifying them is limited. AIM: This in vitro study aimed to assess the occurrence of MMCs with cone-beam computed tomography (CBCT) and then under magnification in the mandibular first and second molars. MATERIALS AND METHODOLOGY: A total of 120 extracted intact human permanent mandibular first and second molars were selected. These were subjected to CBCT imaging and magnification for the detection of MMCs. The percentage of incidence in the detection of MMC was compared between these two methods. RESULTS: The incidence of MMC detected in mandibular molars using CBCT was 13.33% (16 of 120 teeth), while using a dental operating microscope, the incidence was 18.33% (22 of 120 teeth) and the comparison between the two methods was statistically not significant. The MMCs were classified based on the Pomeranz Classification. The most prevalent canal configuration was a confluent type which was found to be in 72% cases (16 of 22), followed by fin type which was 22.7% (5 of 22) and independent type was only 4.54% (1 of 22). The incidence of the location of MMC orifice was studied. In 50% of the cases, orifice was located closer to the mesiolingual canal, whereas in 27% of the cases, it was closer to the mesiobuccal canal and in 4.95% of the cases, it was detected midway. CONCLUSIONS: Since the incidence of MMC was higher with the use of a microscope, it is preferred to use simpler, chairside aids like magnification and ultrasonic troughing. On the other hand, one should be judicious while subjecting a case to preoperative CBCT evaluation owing to its ionizing radiation.

Root dentin surface activation to improve bioceramic bonding: A scanning electron microscopic study.

Background. Bioceramics need to interact chemically with dentin to exhibit adequate bioactivity. Proper bonding of bioceramics with dentin is of considerable importance. This study aimed to evaluate the wettability and marginal adaptation of bioceramics after the use of surface-active agents on dentin: %0.5 cetrimide and %1 alkylbenzene sulfonate. Methods. Of ninety maxillary central incisors, 45 teeth were sectioned longitudinally with 45 root halves randomly assigned to three groups (n=15): group I: no pre-treatment; group II: %0.5 cetrimide; group III: %1 alkylbenzene sulfonate. Then, the samples were subdivided into three subgroups (n=5): subgroup I: MTA; subgroup II: Biodentine, and subgroup III: BioRoot. A controlled-volume droplet of bioceramic material was placed on each root half, which was positioned in a dynamic contact angle analyzer to record the static contact angle for wettability. The remaining 45 samples were decoronated; the root canals were prepared and randomly categorized, as mentioned above. The root canal surfaces were treated, filled with the bioceramic material, transversely sectioned, and then each middle section was analyzed microscopically for marginal adaptation. Statistical tests used included post hoc Tukey tests and one-way ANOVA. The level of statistical significance set at %95 (P<0.05). Results. The contact angle values and interfacial gap width values after surface pre-treatment were significantly lower when compared to no pre-treatment group (P<0.05). The values were significant for %0.5 cetrimide in the case of Biodentine and %1 alkylbenzene sulfonate in the case of BioRoot (P<0.05). Conclusion. The two surfactants yielded promising results for enhancing the wettability and marginal adaptation of materials to the root dentin, which is required for obtaining an adequate seal, penetration, and bond strength of bioceramics.

Salivary alkaline phosphatase and calcium in caries-active type II diabetes mellitus patients: An in vivo study.

BACKGROUND: Diabetes Mellitus is a metabolic syndrome, affecting the oral health in various ways with dental caries being one of the most common problems encountered. Saliva is one of the most abundant secretions in the human body with a variety of natural protective and defence molecules bathing the oral cavity maintaining equilibrium. Its collection is easy and non-invasive. AIMS: To compare and evaluate salivary alkaline phosphatase levels and calcium ion levels between caries active type II diabetes mellitus patients and non-diabetics. MATERIALS AND METHODS: This study was carried out on caries-active age and gender matched 60 non-diabetic and 60 patients with known Type II diabetes mellitus subjects of age group 25-50 years with DMFT index >10. Saliva sample was collected to analyse for alkaline phosphatase enzyme and concentration of calcium ions using Agappe kits. STATISTICAL ANALYSIS: Student 't' test was used to correlate the salivary electrolyte concentration in non- diabetic and diabetic patients with dental caries. A 'P' value of 0.05 or less was considered significant. Results are presented as mean ± standard deviation (X ± SD). RESULTS: The alkaline phosphatase (ALP) activity in saliva was higher in diabetic patients when compared to that of non-diabetic patients with salivary calcium ions were significantly higher in non-diabetic individuals. CONCLUSION: Diabetes Mellitus patients are more prone to dental caries, hence require intervention to improve the quality of saliva.

Comparative evaluation of effect of acidic beverage on enamel surface pre-treated with various remineralizing agents: An In vitro study.

AIM: This study aimed at quantitatively evaluating the effect of colabased beverage on the calcium loss of enamel surface pre-treated with fluorideenriched casein phosphopeptideamorphous calcium phosphate (CPP-ACPF) and ßeta-ricalcium phosphate (ß-TCP) using energy dispersive X-ray analysis (EDX). MATERIALS AND METHODS: 24 enamel specimens were prepared from the buccal and palatal surfaces of extracted intact human premolars and were randomly assigned to study groups and control group. Specimens of Group II were pre-treated with CPP-ACPF and Group III treated with ß-TCP twice daily for 4 for 28 days, followed by storage in artificial saliva. All specimens were evaluated for mineral (calcium and phosphorus) content (wt%) after pre-treatment using SEM-EDAX. The specimens were then placed in the acidic beverages for 4 days for 10 Mineral content was again measured using SEM-EDAX. RESULTS: Statistical analysis using one-way ANOVA followed by Tukey's HSD test was applied to compare the re-mineralization and de-mineralization of the samples. CONCLUSION: The present study concluded that both the remineralizing agents tested were found to be effective in inhibiting the de-mineralization caused by colabased beverage. Among the remineralizing agents tested, ß-TCP was found to be more effective than CPP-ACPF.