Evaluation of Osteogenic Potential of a Polysaccharide-Based Hydrogel Coating on Titanium.

INTRODUCTION: Reducing the healing period after surgical placement of dental implants can facilitate the loading of dental prostheses. AIM: The aim is to compare the osteogenic potential of unmodified titanium disks with titanium disks that were surface-modified or hydrogel-coated. MATERIALS AND METHODOLOGY: One hundred eight titanium disks (Ø6 × 2-mm) were divided into three groups: (1) unmodified titanium as control (Ti-C); (2) sandblasted and acid-etched (Ti-SLA), and (3) coated with tamarind kernel polysaccharide hydrogel grafted with acrylic acid (Ti-TKP-AA). The osteogenic potential and cytotoxic effect of various groups of titanium were compared using human osteoblasts Saos-2. The surface topography of the titanium disks and morphology of osteoblasts grown on disks were investigated by scanning electron microscopy (n = 3). Cell attachment to the disks and actin expression intensity were investigated by confocal imaging (n = 3). Cytotoxicity was quantified by cell viability assay (n = 9). Osteoblast maturation was determined by alkaline phosphatase assay (n = 9). Cell mineralization was quantified by Alizarin red staining (n = 9). One-way analysis of variance followed by Tukey's multiple comparisons test was used for intergroup comparisons (α= 0.05). RESULTS: The surface modifications on Ti-SLA and Ti-TKP-AA support better morphology and proliferation of osteoblasts than Ti-C (P< 0.001) and significantly higher levels of actin cytoskeleton accumulation (P< 0.0001). Ti-TKP-AA showed a significantly higher maturation rate than Ti-C (P< 0.001). Ti-TKP-AA showed > twofold increased mineralization than Ti-C and Ti-SLA (P< 0.001). CONCLUSIONS: TKP-AA hydrogel-coated titanium promotes faster osteoblast proliferation, maturation, and mineralization than SLA-treated or untreated titanium. These advantages can be explored for achieving early osseointegration and prosthetic loading of titanium dental implants.

Clinical and CBCT Assessment of Role of Bisphosphonate on Osteotomy Site and Implant Surface.

Objectives: To assess the role of bisphosphonate on osteotomy site and implant surface. Materials and Methods: Twenty patients with adequate width and height of edentulous space and a single missing posterior tooth between the ages of 25 and 55 were incorporated in this research. Ten participants received implant therapy alone; the other ten patients received implant therapy and bisphosphonate application to osteotomy site and the implant surface. Result: Changes in the crestal bone level were seen in both the study and control groups. At 1 year, crestal bone loss was less in the bisphosphonate-treated group than in the control group. Conclusion: The quantity of crestal bone loss was reduced when bisphosphonate (sodium alendronate) was applied locally near the implant and osteotomy site.

Hydroxychloroquine- A new treatment option for erosive oral lichen planus.

CONTEXT: Oral Lichen planus (OLP) is a chronic, debilitating, immune-mediated disease whose management is considered a challenge in medical science. AIMS: To quantitatively evaluate the effect of administration of enteral hydroxychloroquine (HCQS) as a monotherapy for six months on the extent and severity of erosive OLP using reticular score, erythema score and ulcerative score (REU score), and to subjectively evaluate the success of HCQS as a therapeutic drug for OLP-e using Tel Aviv-San Francisco Scale, visual analogue scale (VAS) and severity of burning sensation (BURN score). SETTINGS AND DESIGN: Prospective clinical trial. METHODS AND MATERIAL: A total of 45 subjects received 200 mg of HCQS bid for six months. REU, VAS, BURN scores and Tel Aviv-San Francisco Scale readings were taken at the beginning of the study (baseline) and three- and six-month intervals post administration of enteral HCQS. Subjects were examined for any adverse drug outcomes for one year after the cessation of enteric HCQS therapy. Data were analysed with SPSS version 25. RESULTS: There was a stark reduction in REU, VAS and BURN scores during the study period, with a statistically significant reduction (P < 0.05) seen at three- and six-month time intervals as compared to baseline. Further, the mean of change in R, E and U scores showed a statistically significant difference, with the highest reduction seen at baseline to six-month time interval. The Tel Aviv-San Francisco Scale showed 70%-100% remission in disease in more than 70% of subjects. CONCLUSIONS: Enteral HCQS can be considered a viable treatment option for the enigma that is erosive OLP.

Comparative evaluation of surface-modified zirconia for the growth of bone cells and early osseointegration.

STATEMENT OF PROBLEM: Rapid osseointegration between implant and bone tissue for early loading of a prosthesis with sufficient primary stability depends on the surface characteristics of the implant. The development and characterization of suitable surface coatings on dental implants is a major challenge. PURPOSE: The purpose of this in vitro study was to evaluate and compare the osteogenic potential and cytotoxicity of unmodified zirconia, acid-etched zirconia, bioactive glass-coated zirconia, and tamarind kernel polysaccharide with hydrophilic acrylic acid (TKP-AA) hydrogel-coated zirconia. MATERIAL AND METHODS: Thirty-six disks each of unmodified zirconia, acid-etched, 45S5 bioactive glass-coated, and TKP-AA hydrogel-coated zirconia were evaluated for osteogenic potential and cytotoxic effect by using human osteoblast Saos-2 cells. The surface topography of the disks and the morphology of the cells grown on these surfaces were examined by scanning electron microscopy (n=3). The cell attachment was evaluated by confocal imaging (n=3). The cytotoxic effect was evaluated by cell viability assay (n=9). Osteoblast maturation was assessed by alkaline phosphatase assay (n=9) and cell mineralization by alizarin red staining (n=9). ANOVA and Bonferroni multiple comparison post hoc tests were used to evaluate the statistical significance of the intergroup differences in these characteristics (α=.05). RESULTS: The surface modifications resulted in distinct changes in the surface morphology of zirconia disks and the growth of Saos-2 cells. Zirconia disks coated with TKP-AA promoted higher proliferation of osteoblasts compared with unmodified disks (P<.001). Similarly, the surface modifications significantly increased the differentiation of mesenchymal stem cells to osteoblasts as compared with uncoated zirconia (P<.001). However, the rate of differentiation to osteoblasts was similar among the surface modifications. Acid-etched and TKP-AA-coated disks promoted mineralization of osteoblasts to the same extent, except bioactive glass coating, which significantly increased the rate of mineralization (P<.001). CONCLUSIONS: Surface modification of zirconia by acid etching and coating with Bioglass or TKP-AA hydrogel resulted in the improved growth and differentiation of osteoblasts. TKP-AA hydrogel coating promoted the proliferation of osteoblasts, whereas Bioglass coating showed better mineralization. TKP-AA hydrogel coating is a promising candidate for improving the osseointegration of dental implants that warrants further investigation.

Influence of pH on wet-synthesis of silver decorated hydroxyapatite nanopowder.

Here, effect of solution pH on precipitation of silver decorated hydroxyapatite (Ag-HAp) nano powder during its wet-synthesis was systematically studied. XRD pattern of Ag-HAp nano powder synthesised at pH ranging from 5 to 10 shows that calcium hydrogen phosphate was formed as dominating phase when the solution pH was between 5 and 9 and this phase was gradually transformed into a stable HAp above pH 9. A quantitative analysis of silver amount in Ag-HAp nano powder synthesised at different pH showed that silver can be precipitated to its maximum amount at pH 8 and the further addition of ammonia leads to the formation of a silver-ammonium complex, thereby remaining in the solution. HR-TEM and XPS analysis further confirmed the presence of silver in HAp nanocrystals, synthesised at an optimum pH 9. This trace amount of silver in HAp nano powder showed effective antibacterial activity against Staphylococcus aureus and Escherichia coli. In addition, the cytocompatibility studies carried out on MG63 cells further confirmed the present optimised silver concentration of the Ag-HAp nano powder is well within the toxic limit to be useful in various biomedical applications.

Assessment of Influence of Contact Time between Alginate and Type III Dental Stone on Properties of Cast Model: An in vitro Study.

INTRODUCTION: Alginate is a versatile, irreversible hydrocolloid impression material, which is cost-effective and forms an essential component in dental practice. For elevating the hardness of the cast models, hardeners are combined with stone. Hence, we planned the present study to evaluate the impact of altering the time of contact between alginate and stone after various interim periods. MATERIALS AND METHODS: The present study included the assessment of impact of time of contact between alginate and stone by the construction of 90 casts using a cylinder model. Two bisecting lines were marked and were named as y and y'. These lines were used for testing the dimensional stability. Using chemically cured acrylic resin, the construction of ten special trays was done. All the impression casts were randomly divided into two study groups, with 45 casts in each group-group I: control group, casts were removed after 60 minutes; group II: study group, casts were removed after 9 hours. A digital caliper was used for measuring the dimensional stability of the cast. All the data were collected and analyzed. RESULTS: In the specimens of the control group (group I) and the study group (group II), the mean dimensions from y to y' were found to be 17.54 and 17.95 respectively. The mean reading of hardness in the control group and study group was found to be 0.59 and 0.20 respectively. In groups I and II, the number of specimens showing clarity of two lines (X and X") was 0 and 5 respectively. CONCLUSION: There was no change in the dimensional stability of the dental stone model when the contact time was increased. CLINICAL SIGNIFICANCE: Within certain limits, the contact time between alginate and stone can be altered without significantly altering the properties of the cast.

Comparison of Hypersensitivity in Metal Ceramic Crowns cemented with Zinc Phosphate and Self-adhesive Resin: A Prospective Study.

BACKGROUND: Luting agents used to fix artificial prostheses, such as fixed partial denture (FPD) to tooth are basically viscous in nature and show chemical reaction for fixation. Postcementation hypersensitivity is a frequent complaint of patients. The present study was conducted to compare postcementation hypersensitivity with zinc phosphate and self-adhesive resin in complete coverage crown. MATERIALS AND METHODS: This study included 30 patients in which 60 porcelein fused to metal crowns was placed. Two metal crowns were placed in each patient in nonantagonis-tic contralateral quadrants. First crown was cemented with zinc phosphate cement, while the other was cemented with self-adhesive resin. Hypersensitivity was evaluated by visual analog scale (VAS) score and by clinical test. For clinical evaluation of sensitivity, hot and cold water was applied to the cervical margin of restoration for 5 seconds and response was recorded. RESULTS: This study consisted of 30 patients in which 60 crowns were given. There was no statistical difference in VAS score of mastication in zinc phosphate cement recorded at baseline, 1 week, 4 weeks, 6 months, 1 year, and 2 years (p > 0.05). Cold response also did not show a significant difference at six time points. Warm response showed slight decrease in subsequent time points but was nonsignificant (p > 0.05). Similarly, with self-adhesive resin cement, VAS score during mastication, hot and cold response was statistically nonsignificant (p > 0.05). CONCLUSION: Postcementation hypersensitivity is a frequent complaint that patient may experience. However, we found no statistically significant difference in both cements tested. CLINICAL SIGNIFICANCE: Postcementation hypersensitivity is an unpleasant sensation experienced by patients. This may affect the success of any prosthesis. Thus, selection of luting agent for cementation plays an important role to eliminate this symptom.

Intricate Estimation and Evaluation of Mandibular Movements in Geriatric Patients Suffering from Rheumatoid Arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disorder that usually affects joints and making them warm, painful, and swollen. The chief purpose of this study was to evaluate movements of mandible in geriatric patients suffering from RA with or without temporomandibular joint dysfunction. MATERIALS AND METHODS: A total of 45 people were included in this study with age of 60 years and above. Partially or completely edentulous patients were divided into experimental and control group. Experimental group consists of 20 people suffering from arthritis and control group consists of 25 people without arthritis. Movements were recorded with or without prosthesis while mastication in both experimental and control group. RESULTS: Statistical evaluation of two studied groups showed decrease opening angle (p < 0.05) during mastication; however, insertion of new prosthesis showd a significant increase in values in both groups, with an increase in opening and closing angles. CONCLUSION: Positive correlation was found between arthritis and movements of the mandible in older people suffering from RA. CLINICAL SIGNIFICANCE: Patients suffering from RA are having restricted mandibular movements thus imposing an overall negative impact however; presence of prosthesis has been shown to enforce a positive effect on mandibular movement.

Prosthodontic management of flat mandibular ridge by mini implant supported over denture.

Loosening of lower denture has always been a common complaint of denture wearer, particularly in case of severe bone resorption. Various treatment modalities including preprosthetic surgery or ridge augmentation therapy to improve the ridge height and conventional implant treatments are available. But many patients are not willing to undergo through such extensive surgical procedure or conventional twin stage implant therapy owing to the chronic old age ailment and cost factor. So mini implant (SENDAX MDI) supported over denture is a boon for them who want a quick and minimally invasive solution, with a much lower cost. In this article we shall discuss the case report of a 60-year-old female patient with atropic mandibular ridge rehabilitated with MDI, (mini dental implant), Sendax mini implant.

Dental students' regard for patients from often-stigmatized populations: findings from an Indian dental school.

The aim of this study was to evaluate and compare a group of Indian dental students' attitudes toward HIV-positive status, substance misuse, intellectual disability, acute mental illness, and lesbian, gay, bisexual, transgender (LGBT) orientation. Two hundred and twelve students at various stages in the dental curriculum anonymously completed the Medical Condition Regard Scale (MCRS) for these conditions. Friedman and Kruskal-Wallis tests were used, respectively, to analyze the intrastage and interstage differences in MCRS scores. The results revealed that the regard of dental students was considerably positive for all the conditions except LGBT, for which it was just borderline positive. Intellectual disability received the highest regard among all the conditions and LGBT the least. An intermediary and comparable regard was noted for acute mental illness and HIV-positive status followed by substance misuse. While the regard for LGBT remained consistent throughout the curriculum, those for other conditions showed a marginal decrease at the completion of the clinical training. Active curricular reforms are required to ensure a more inclusive and nondiscriminatory dental care environment for patients from such often-stigmatized populations, especially those with LGBT orientation and substance misuse.

A Comparative Study of the Stress Distribution in Different EndodonticPost-RetainedTeeth with and without Ferrule Design-A Finite Element Analysis.

Purpose. To analyze the stress distribution in an endodontically treated maxillary central incisor restored with various post-core systems and assess the benefit of ferrule using finite element analysis. Material and Methods. Twelve models with metal ceramic crown were created based on the combination of three types of post-core systems (titanium post-composite resin core, nickel-chromium post-core, and fiber reinforced composite resin post-composite resin core), two varieties of posts (tapered, parallel), and with or without ferrule. 100 N load was applied in three directions and the von Mises stress was compared. Results. Ferrule made no difference in stress distribution for the titanium and nickel-chromium posts, though it showed some stress reduction in fiber-reinforced composite resin posts. Nickel-chromium cast post-core transmitted the least amount of stresses to the dentin despite producing the maximum stress. Conclusion. Incorporation of ferrule offered some degree of stress reduction in nonmetal post, and it increased the stresses within cervical dentin.