Awareness and practice of Revised Code of Dental Ethics and Consumer Protection Act among dental practitioners in Andhra Pradesh: A cross sectional study.

BACKGROUND: Given the imperative for dental practitioners to be familiar with the existing ethical principles and laws governing their practice, this study aimed to evaluate awareness and practice of the dentists (code of ethics) regulations 2014 and consumer protection act 2019 among dental practitioners in Andhra Pradesh state, India. METHODS: A cross sectional study was conducted among 384 dental practitioners in Andhra Pradesh state, India. A questionnaire consisting of 25 items was used to assess awareness and practice of the dentists (code of ethics) regulations and consumer protection act. The data collected were analysed using IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. RESULTS: Only 53(13.8%) dental practitioners in the study were aware that the dentists (code of ethics) regulations had been revised in 2014. About 190 (49.5%) practitioners were aware of the precise period for mandatory preservation of patient records. Most dental practitioners (278, 72.4%) accepted commissions in the form of gifts or cash from laboratories, radiologists, or pharmacists and 306 (79.7%) dental practitioners used unregistered dental lab technicians as employees in their practice. Furthermore, 297 (77.3%) practitioners were found to provide or sell drugs to patients in their clinic/office. The new regulations under consumer protection act 2019 were unknown to 194 (50.5%) dental practitioners. CONCLUSIONS: The present study indicates that the awareness of dental practitioners towards the dentists (code of ethics) regulations 2014 and consumer protection act 2019 is inadequate. It highlights the need for training programmes and curriculum changes with a focus on ethical and legal issues in clinical dental practice.

Knowledge, attitude, and practice of teledentistry in periodontal diagnosis: Is it the required upgrade to conventional periodontics?

Background: Teledentistry which is similar to telemedicine has emerged as a new tool for various dental disciplines. Teleperiodontics is a branch of telehealth which focuses on the application of digital communication technology into the field of periodontics without demanding a specialist presence. An early detection and diagnosis of periodontal conditions can not only treat the disease in its early stage but also prolong the health of the periodontium, thereby improving the overall quality of life of an individual. However, teledentistry has not penetrated into the field of periodontics to a level it has to in providing periodontal care. Hence, the aim of this questionnaire study was to assess the knowledge, attitude, and application of teleperiodontics into everyday practice among the dental surgeons at various levels. Materials and Methods: An electronic questionnaire consisting of 29 close-ended questions including sections assessing the knowledge, attitude, and practice of teledentistry and teleperiodontics was sent to dental colleges present in East and West Godavari districts of Andhra Pradesh. Results: A total of 350 responses were received and 80.57% dental surgeons were aware about teledentistry, and a total of 74% dental surgeons were likely to prescribe oral hygiene aids and medication for temporary management of periodontal conditions. Conclusion: Teleperiodontics is an emerging science whose knowledge, attitude, and application are yet to be explored.

Clinical performance of one shade universal composite resin and nanohybrid composite resin as full coronal esthetic restorations in primary maxillary incisors: A randomized controlled trial.

Background: Strip crowns are the first treatment of choice for restoring anterior teeth affected with early childhood caries. However, shade matching of resin composites is still an issue. The broad color matching ability of a recently introduced single shade composite, Omnichroma eliminates the need for shade-matching procedure, reduces composite inventory, and minimizes chair-side time. Aim: The aim is to evaluate the color match, color stability, and retention of one shade universal composite resin, Omnichroma and nanohybrid resin composite, Tetric-N-Ceram. Design: The study design involves split-mouth randomized controlled trial. Methods: The study was conducted on 25 children aged 3-5 years with multi-surface caries lesions in primary maxillary anterior teeth. Teeth were allocated to two groups randomly: Group 1 - One shade universal composite, Omnichroma (n = 25), Group 2 - Nanohybrid composite, Tetric-N-Ceram (n = 25). After caries excavation and tooth preparation, teeth were restored with corresponding materials using strip crowns. Color match at baseline, color stability, and retention after 6- and 12-month follow-up were evaluated using the Modified United States Public Health Services criteria. Analysis: The Mann-Whitney U test and Wilcoxon signed-rank test were used to analyze the data. Results: On comparison of Omnichroma and Tetric-N-Ceram groups, no statistically significant difference was observed in the color match at baseline (P = 0.716) as well as color stability (P = 0.575 at 6 months and 0.990 at 12 months) and retention (P = 0.153 at 6 months and 0.226 at 12 months) at both 6- and 12-month intervals. On intragroup comparison, the difference in the color stability at 6 and 12-month interval was statistically significant (P = 0.001) for both the groups, indicating that the color stability of restorations was better at 6-month interval compared to 12-month interval. In both Omnichroma and Tetric-N-Ceram groups, retention of restorations was better at 6-month interval compared to 12-month interval and this difference was statistically significant (P = 0.025 and 0.014, respectively). Conclusion: The clinical performance of Omnichroma in terms of color match, color stability, and retention was comparable to nanohybrid composite, Tetric-N-Ceram.

Role of Orthoboon (glucosamine sulfate + collagen + Vitamin C): A novel host-modulating agent in the management of chronic periodontitis.

BACKGROUND: Recent trends suggest using novel host-modulating agents as a treatment strategy for chronic periodontitis. Glucosamine sulfate (GS) was proven to have anti-inflammatory actions related to its ability to suppress neutrophil functions. Orthoboon, an anti-arthritic and anti-inflammatory drug, has shown to have a positive therapeutic effect due to its constituents made of a combination of GS, Vitamin C, and collagen. The aim of the study was to evaluate the host modulatory effects of Orthoboon on periodontal status and to estimate the C reactive protein (CRP) levels before and after nonsurgical periodontal therapy (NSPT). MATERIALS AND METHODS: A total number of 40 patients with chronic periodontitis were randomly divided into two groups of 20 patients each. The test group patients (n = 20) received 500 mg Orthoboon three times daily for 45 days. Prior to the initiation of Orthoboon, all patients in both test group and control group were subjected to Phase I periodontal therapy. CRP levels were estimated immediately after phase I therapy and 45 days after therapy. Clinical parameters including plaque index, gingival index, and bleeding index were recorded before and after NSPT for the two groups. RESULTS: The mean CRP levels were reduced significantly in the test group before and after administration of Orthoboon and also there were statistically significant differences in the mean CRP levels at the end of 45 days between the test group and the control group. CONCLUSION: Administration of Orthoboon, i.e., GS, with a combination of Vitamin C and collagen was proved to be of a significant benefit in the test group than in the control group.

Estimation of Salivary Parameters among Autoimmune Thyroiditis Patients.

INTRODUCTION: Saliva is a complex secretion that protects and lubricates the oral cavity. Various systemic diseases and their treatment alter the salivary gland function; one such disease is Autoimmune Thyroid Disease (AITD). AITD has been postulated to exert its hormonal influence on the salivary glands, leading to reduced salivary output. There's a paucity of literature, verifying the stated conjunction in human subjects. AIM: The aim was to investigate the salivary profile in AITD patients and its comparison with controls. MATERIALS AND METHODS: Descriptive cross-sectional comparative study was conducted using convenience sampling method for screening the presence of thyroid disorders. Two groups comprising of 30 patients in each group diagnosed with autoimmune hypothyroiditis (n=30) and hyperthyroiditis (n=30) respectively and thirty healthy volunteers who were age and sex matched were included as controls. Saliva was collected and evaluated for Unstimulated Salivary Flow Rate (USSFR), pH and buffer capacity. ANOVA and Tukey post-hoc test was performed to find the statistical significance and for pairwise comparison. RESULTS: Statistically significant difference was observed between autoimmune hypothyroiditis, autoimmune hyperthyroiditis and control group with respect to USSFR (p<0.007), pH (p<0.001) and buffer capacity (p<0.001). On pairwise comparisons statistically significant difference was observed between autoimmune hypothyroiditis and autoimmune hyperthyroiditis with respect to controls. CONCLUSION: We conclude that significant involvement of salivary glands may occur in cases of AITD. Our study showed significant reduction of sialometric values in AITD patients when compared to controls. A strong clinical suspicion of thyroid diseases should be considered when there is chronic hyposalivation; hence thyroid profile must also be done, if the known causes have been excluded.

Disruption of the serine proteinase gene (sep) in Aspergillus flavus leads to a compensatory increase in the expression of a metalloproteinase gene (mep20).

The serine proteinase gene (sep) in Aspergillus flavus was disrupted by homologous recombination with a hygromycin resistance gene as the marker. The gene-disrupted mutant GR-2 contained a single-copy insertion of the marker gene and did not express the sep gene. Serine proteinase activity, 36-kDa protein labeled by 3H-diisopropylfluorophosphate, and immunologically detectable proteinase were not detected in the culture fluid of GR-2. Despite the absence of the serine proteinase, the total elastinolytic activity levels in the mutant and the wild-type A.flavus were comparable. Immunoblots revealed that the mutant secreted greater amounts of an elastinolytic metalloproteinase gene (mep20) product than did the wild type. Furthermore, mep20 mRNA levels, measured by RNase protection assay, in the mutant were higher than those in the wild type. Inhibition of the serine proteinase by Streptomyces subtilisin inhibitor (SSI) in the culture medium of wild-type A.flavus also resulted in an elevation of mep20 gene products. Although no serine proteinase activity could be detected, the level of elastinolytic activity of the SSI-treated culture was comparable to that of the control. Immunoblots revealed that the addition of SSI caused an elevation in the levels of metalloproteinase and its mRNA. These results suggest that the expression of the genes encoding serine and metalloproteinases are controlled by a common regulatory system and the fungus has a mechanism to sense the status of extracellular proteolytic activities.

Cloning and characterization of the cDNAs and genes (mep20) encoding homologous metalloproteinases from Aspergillus flavus and A. fumigatus.

Aspergillus fumigatus (Afu) and A. flavus (Afl), two causative agents of invasive aspergillosis, produce highly homologous serine proteinases. In addition, the former produces a 42-kDa metalloproteinase (MEP), whereas the latter produces a 23-kDa MEP. The cDNA and the gene encoding the 42-kDa MEP were cloned and sequenced. Here, we report the cloning of the cDNA and the gene encoding the 23-kDa MEP from Afl and a homologous gene from the Afu. Using degenerate primers based on the amino acid (aa) sequence of A. oryzae (Ao) MEP and thermolysin-like proteinases, a 282-bp fragment of the 23-kDa MEP-encoding gene of Afl was cloned by PCR. A 6.5-kb KpnI fragment of Afl genomic DNA containing the complete gene was cloned. The open reading frame (ORF) in this gene encodes a protein of 381 aa. Since the mature enzyme from this and other aspergilli would have a theoretical molecular mass of about 20 kDa, this MEP-encoding gene is designated mep20. A Western blot of the protein in the culture filtrate of Afl with polyclonal antibodies prepared against the MEP showed a single band at 23 kDa. The N-terminal sequence of the extracellular MEP20, TKVAS, was found at aa 194-198 within the ORF. Thus, the primary translation product has a putative 19-aa signal and a pro region of 174 aa. A homologous gene cloned from a genomic DNA library of Afu showed an ORF encoding 365 aa. Comparison of the nucleotide (nt) sequences of the cDNAs cloned by RT-PCR with their respective genes showed that there are no introns in the ORF of mep20 in Afl, but there is a 59-bp intron in the gene from Afu. The MEP20 of Afl and Afu have 68% identity and show weak immunological cross reactivity. MEP20 from both these fungi share about 60% sequence identity with the penicillolysin of Penicillium citrinum and the neutral protease II of Ao. MEP20 of Afl and Afu show only the conserved sequence, HEFTHA, but not the two other conserved sequences seen in thermolysins and similar MEP.

Cloning and sequencing of the Thermoanaerobacterium saccharolyticum B6A-RI apu gene and purification and characterization of the amylopullulanase from Escherichia coli.

The amylopullulanase gene (apu) of the thermophilic anaerobic bacterium Thermoanaerobacterium saccharolyticum B6A-RI was cloned into Escherichia coli. The complete nucleotide sequence of the gene was determined. It encoded a protein consisting of 1,288 amino acids with a signal peptide of 35 amino acids. The enzyme purified from E. coli was a monomer with an M(r) of 142,000 +/- 2,000 and had same the catalytic and thermal characteristics as the native glycoprotein from T. saccharolyticum B6A. Linear alignment and the hydrophobic cluster analysis were used to compare this amylopullulanase with other amylolytic enzymes. Both methods revealed strictly conserved amino acid residues among these enzymes, and it is proposed that Asp-594, Asp-700, and Glu-623 are a putative catalytic triad of the T. saccharolyticum B6A-RI amylopullulanase.

Isolation, characterization, and cloning of cDNA and the gene for an elastinolytic serine proteinase from Aspergillus flavus.

An elastinolytic serine proteinase produced by Aspergillus flavus 28 that was isolated from a patient who died of aspergillosis has been purified and characterized. The enzyme was inhibited by the serine proteinase inhibitors phenylmethylsulfonyl fluoride and diisopropyl fluorophosphate. The metal-chelating agents EDTA and EGTA [ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid] did not severely inhibit the enzyme. A cDNA and a 2.95-kb segment of genomic DNA containing the proteinase gene were sequenced. The open reading frame that would code for a protein containing 403 amino acids was interrupted by three introns. The mature protein lacks 121 N-terminal amino acids including a putative 21-amino-acid signal peptide. The purified mature protein showed a molecular mass of 36 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, whereas that calculated from the deduced protein sequence was 30 kDa. This elastinolytic serine proteinase of A. flavus has 83 and 82% sequence homology to the similar proteinases from A. fumigatus and A. oryzae. The catalytic properties and the sequence homology around the putative catalytic amino acids suggest that this enzyme belongs to the serine proteinases of the subtilisin family.

Cloning, sequencing and biochemical characterization of xylose isomerase from Thermoanaerobacterium saccharolyticum strain B6A-RI.

The xylose isomerase gene from Thermoanaerobacterium saccharolyticum strain B6A-RI was cloned by complementation using Escherichia coli xyl-5 mutant strain HB101. One positive clone was detected and the recombinant plasmid, pZX16, was isolated. The clone contained the vector pUC18 and an insert fragment of 4.5 kb. The cloned xylose isomerase gene (xylA) was expressed constitutively in E. coli. The gene contained one open reading frame (ORF) of 1317 bp, which corresponds to 439 amino acid residues. The molecular mass of the gene product was calculated to be 50474 Da from the deduced amino acid sequence. A putative promoter region (Pribnow box), TATAATATATAAT, which repeated twice at the -10 region in E. coli, was found 25 bp upstream of the ribosomal binding site. The deduced amino acid sequence of T. saccharolyticum strain B6A-RI xylose isomerase exhibited very high homology to those from Thermoanaerobacterium thermosulfurigenes 4B (formerly Clostridium thermosulfurogenes 4B) and Thermoanaerobacter ethanolicus 39E (formerly Clostridium thermohydrosulfuricum 39E). Codon usage in xynA, xynB and xylA showed a clear propensity for AT-containing isocodons. The native molecular mass of the purified recombinant thermostable xylose isomerase was 200 kDa, and the enzyme was a tetramer comprised of identical subunits. The apparent temperature and pH optima for activity of the cloned xylose isomerase were 80 degrees C and 7.0 to 7.5, respectively.