In vitro Isolation and Characterization of Multipotent Postnatal Stem Cells from Human Dental Pulp: An Approach for Regeneration of Neural Crest Tissue.

Postnatal dental pulp tissues give the proper justification of the stem cell assimilation and characteristic of the multipotent of the stem cells. Researchers use an in vitro isolation process for clarifying the different stages of staining and cell division. Data collected from various sources helps in understanding how the stem cells help in tissue regeneration. It highlights the immunological phenotypes with the synthesis with cDNA for mentioning molecular immunology. Study also mentions the mitochondrial consistency to measure the potentiality regarding the immunology and the way it differs from 0 to 21 days. Researchers also mention the way for the future development by utilizing the key advantages and definite multipotent of the dental stem cells.

Efficacy of Cucurmin and Aloevera Extracts Gel as Local Drugs Delivery Agents.

Introduction: The usage of antimicrobials as local drug delivery (LDD) agents in the treatment of periodontitis has posed limitations due to the development of bacterial resistance, high cost, and unavailability, thus indicating the need for safer and economic alternatives. Methodology: A split-mouth randomized clinical trial was carried out on 10 patients. Three sites in different quadrants were assigned, treatment modality of scaling and root planing (SRP) alone, SRP with LDD of curcumin gel, and SRP with LDD of 99% pure aloe vera gel, respectively. Clinical parameters were recorded at baseline and on 30th day postoperatively. Results: Curcumin and aloe vera in addition to SRP demonstrated improvements in clinical parameters, though 99% aloe vera extract produced more statistically significant results when used as an LDD agent, as shown in intergroup comparisons for changes in periodontal parameters. Conclusion: Curcumin 10mg (Curenext) and 99% aloe vera extract as LDD along with regular mechanical debridement is a promising therapy in the treatment of chronic periodontitis.

Impact of Postoperative Antibiotic Prophylaxis on Surgical Site Infections Rates After Mastectomy with Drains but Without Immediate Reconstruction: A Multicenter, Double-Blinded, Randomized Control Superiority Trial.

BACKGROUND: There is no consensus on the use of postoperative antibiotic prophylaxis (PAP) after mastectomy with indwelling drains. We explored the utility of continued PAP in reducing surgical site infection (SSI) rates after mastectomy without immediate reconstruction and with indwelling drains. PATIENTS AND METHODS: A multicenter, two-armed, randomized control superiority trial was conducted in Pakistan. We enrolled all consenting adult patients undergoing mastectomy without immediate reconstruction. All patients received a single preoperative dose of cephalexin within 60 min of incision, and postoperatively were randomized to receive either continued PAP using cephalexin (intervention) or a placebo (control) for the duration of indwelling, closed-suction drains. The primary outcome was the development of SSI within 30 days and 90 days postoperatively. Secondary outcomes included study-drug-associated adverse events. Intention-to-treat analysis was performed using multivariable Cox regression. RESULTS: A total of 369 patients, 180 (48.8%) in the intervention group and 189 (51.2%) in the control group, were included in the final analysis. Overall cumulative SSI rates were 3.5% at 30 days and 4.6% at 90 days postoperatively. PAP was not associated with SSI reduction at 30 (hazard ratio, HR 1.666 [95% confidence interval CI 0.515-5.385]) or 90 (1.575 [0.558-4.448]) days postoperatively, or with study-drug-associated adverse effects (0.529 [0.196-1.428]). CONCLUSIONS: Continuing antibiotic prophylaxis for the duration of indwelling drains after mastectomy without immediate reconstruction offers no additional benefit in terms of SSI reduction. There is a need to update existing guidelines to provide clearer recommendations regarding use of postoperative antibiotic prophylaxis after mastectomy in the setting of indwelling drains.

Retraction: To Study the Effect of Anterior Palatal Surface Modifications of Complete Denture on Speech Intelligibility Oral Perception and Cortical Brain Function Activity: An In Vivo Study.

[This retracts the article DOI: 10.7759/cureus.33595.].

To Study the Effect of Anterior Palatal Surface Modifications of Complete Denture on Speech Intelligibility Oral Perception and Cortical Brain Function Activity: An In Vivo Study.

BACKGROUND:  The classic maxillary full denture covers the whole palate, preventing the tongue from touching the denture base tissues itself. Thus, it has deleterious effects on cortical brain function and the ability to understand spoken language. AIM:  This study aimed to determine the effect of anterior palatal surface modifications of the complete denture on speech intelligibility oral perception and cortical brain function activity. METHODS AND MATERIALS:  This study compared the speech clarity, oral discernment, and cortical mind capability activity of complete denture wearers in three study groups: a) complete denture wearers with a small opening (SO) in the maxillary front palatal base; b) complete denture patients who wear regular complete denture; c) complete denture patients who did not wear complete denture; and d) complete denture patients who wear a functionally contoured modified palate (FCMP). Patients with no teeth at all underwent four phases of testing to assess their cognitive abilities and speech quality (pitch and volume). In the first phase, partial dentures were used. During phase 2, a conventional full denture was inserted. In the third phase, a palatal base denture was functionally altered. In phase 4, dentures with a little aperture at the front of the palatal base were used.  Results: The values of pitch and intensity of sound in category A with FCMP modification I were 180.76 ± 24.12 and 73.27 ± 9.74, respectively. On the other hand, the values of pitch and intensity of sound in category B with FCMP modification I were 185.41 ± 27.29 and 73.91 ± 8.31, respectively. The values of pitch and intensity of sound in category A with SO modification II were 188.52 ± 21.11 and 76.13 ± 5.21, respectively. On the other hand, the values of pitch and intensity of sound in category B with SO modification II were 194.59 ± 24.02 and 75.21 ± 6.12, respectively. The findings for values of pitch and intensity were statistically significant among the four phases (p < 0.001). The highest speech intelligibility and cortical brain function were observed in phase 4 in both categories A and B, with the highest scores by experts of 3.21 and 3.42, respectively. Conclusion: Based on the findings of this in vivo investigation, it can be concluded that using modified dentures (modification types I and II) following denture installation improves speech intelligibility, oral perception, and cortical brain function activity.

An In Vitro Assessment of Marginal Accuracies in Copings Fabricated With Two Dissimilar Alloys: An Original Research Study.

BACKGROUND: Marginal accuracy is one of the serious factors that play a key role in the overall success of prostheses. It is openly associated with marginal activities of microorganisms, which may develop micro-leakage and other problems. Therefore, this in vitro study was conducted to assess marginal accuracies in copings fabricated with two different alloys used in fixed partial dentures. MATERIALS AND METHODS:  Two popularly used metal alloys, Mealloy (nickel-chromium alloy) (Dentsply India Pvt. Ltd., New Delhi, India) and Supranium (nickel-chromium alloy) (Bombay Precision Alloy Inc., Mumbai, India), were studied. Group 1 has 20 copings of Mealloy; group 2 also has 20 copings of Supranium. Blue inlay wax was used for wax pattern fabrication. All copings were cast and made by similar casting techniques. After adequate seating of copings on metal dies, the marginal difference was assessed under a stereomicroscope at typical intensification. All measurements were noticed and converted to the nearest micron. For each coping sample, four measurements were recorded; however, the means of all four surfaces were taken into account for further analysis. RESULTS: All interrelated data was processed by statistical analysis using the Statistical Package for the Social Sciences (SPSS) software version 22.0 (IBM Corp., Armonk, NY, USA). The overall mean marginal gap of the samples of group 1 was higher than group 2. For group 1 coping samples, a maximum mean marginal gap of 43.379 was noticed at the buccal surface of the copings. P-value computation revealed non-significant values (0.60). For group 2 coping samples, a maximum mean marginal gap of 41.218 was found at the buccal surface of the copings. The measured value was 41.218. One-way ANOVA analysis showed that the degree of freedom was 132.13 for cumulative comparison, while it was 2.930 and 6.837 for calculations between groups and within groups, respectively. Two-sample t-test assessments revealed a p-value of 0.001 (significant) for group 1 and a p-value of 0.810 (non-significant) for group 2. CONCLUSION:  The marginal space at the margin of the metal coping and the die was minimum for Supranium and maximum for Mealloy. Also, highly significant values were also identified for the metal samples of Supranium. Additionally, the selection of the perfect metal alloy should be entirely dependent on operator skills and clinical decision-making.

Comparative Evaluation of Surface Roughness of Porcelain Fused to Metal and Stainless-Steel Crown Following Ultrasonic and Hand Scaling: A Comparative Study.

Introduction Surface roughness encourages plaque retention and causes mechanical, chemical, and biological irritation to surrounding soft tissues. Hence, a smooth surface of restoration is preferred for optimal plaque control and the health of the periodontium. Aim The aim is to evaluate and compare the surface roughness of porcelain fused to metal and stainless-steel crowns following ultrasonic and hand scaling techniques. Material and methods An in-vitro study was conducted on 30 porcelain fused to metal crowns and 30 stainless-steel crowns. Their surface roughness following instrumentation was evaluated by scanning electron microscope (SEM) and profilometry. Results Evaluation by profilometry indicated that porcelain fused to metal following ultrasonic instrumentation has a statistically more significant surface roughness and indentation as compared to hand scaling with p-values < 0.05. Conclusion The surface roughness of any restoration may act as a plaque retentive factor which would affect the health of the periodontium. Ultrasonic scaling is capable of creating roughness to a more extent as compared to hand scaling and porcelain fused to the metal type of restorations is more vulnerable to roughness.

Immunophenotypic and Molecular Analysis of Human Dental Pulp Stem Cells Potential for Neurogenic Differentiation.

BACKGROUND: Growing evidence shows that dental pulp (DP) tissues could be a potential source of adult stem cells for the treatment of devastating neurological diseases and several other conditions. AIMS: Exploration of the expression profile of several key molecular markers to evaluate the molecular dynamics in undifferentiated and differentiated DP-derived stem cells (DPSCs) in vitro. SETTINGS AND DESIGN: The characteristics and multilineage differentiation ability of DPSCs were determined by cellular and molecular kinetics. DPSCs were further induced to form adherent (ADH) and non-ADH (NADH) neurospheres under serum-free condition which was further induced into neurogenic lineage cells and characterized for their molecular and cellular diversity at each stage. STATISTICAL ANALYSIS USED: Statistical analysis used one-way analysis of variance, Student's t-test, Livak method for relative quantification, and R programming. RESULTS: Immunophenotypic analysis of DPSCs revealed >80% cells positive for mesenchymal markers CD90 and CD105, >70% positive for transferring receptor (CD71), and >30% for chemotactic factor (CXCR3). These cells showed mesodermal differentiation also and confirmed by specific staining and molecular analysis. Activation of neuronal lineage markers and neurogenic growth factors was observed during lineage differentiation of cells derived from NADH and ADH spheroids. Greater than 80% of cells were found to express ß-tubulin III in both differentiation conditions. CONCLUSIONS: The present study reported a cascade of immunophenotypic and molecular markers to characterize neurogenic differentiation of DPSCs under serum-free condition. These findings trigger the future analyses for clinical applicability of DP-derived cells in regenerative applications.

Bloch Sulzberger syndrome (Incontinentia Pigmenti): a rare case report with dental defects.

Incontinentia Pigmenti (IP) is a multisystem genodermatosis characterized by cutaneous, neurologic, ophthalmologic, and dental abnormalities. This article reports the clinical features and management of a 4-year-old girl diagnosed with IP.

Colposcopy - a novel diagnostic technique for oral mucosal lesions.

The incidence of premalignant lesions and oral cancers is steadily increasing globally. In spite of advancement in early detection, there is increased mortality and morbidity related to oral cancers. The diagnosis of a dysplastic premalignant lesion of the oral mucosa cannot be based solely on clinical findings. Therefore histologic evaluation of a representative biopsy specimen is necessary. Therefore, the selection for a biopsy site is highly significant. In this article, we present a current review of the colposcope and oral application of the colposcopy technique and its use as an adjunct in the early diagnosis of premalignant and malignant lesions of the oral mucosa. We stress upon the fact that colposcopy (direct oral microscopy) of oral mucosal lesions helps in selecting more representative sites for biopsy than routine clinical examination alone. Because of its precision, versatility, ease of use, and being a non-invasive technique, colposcopy might prove to be a useful step toward continuing to learn and improve the care for our patients.

Pain Perception and Anxiety Levels during Menstrual Cycle Associated with Periodontal Therapy.

Objectives. To compare the pain perception and anxiety levels of female patients undergoing scaling and root planing during menstrual (perimenstrual) period with those observed during postmenstrual period. Materials and Methods. This was a single blind study, with a split-mouth design. Forty-four women with chronic periodontitis with regular menstrual cycles were subjected to complete Corah's Dental Anxiety Scale (DAS) during their first debridement visit. Patients were randomly selected to undergo their first debridement visit during either their menstrual or postmenstrual period. Scaling was performed under local anesthesia in bilateral quadrants of patients during the periods. Visual Analogue Scale (VAS) was used to score pain levels for each quadrant after performing scaling and root planing. Results. Increase in pain perception among females during their menstrual or perimenstrual period was significantly greater than their postmenstrual period (P < 0.05). It is observed that women whose first appointment was given in perimenstrual period had more pain (VAS) (P = 0.0000) when compared to those women whose first appointment was given in postmenstrual period. Conclusion. Females in their menstrual period demonstrated higher pain responses and high anxiety levels to supra- and subgingival debridement. This increase in the pain levels of women during their menstrual period was statistically significant. If the appointments are given in postmenstrual period, women feel less pain.