ROP39 is an Irgb10-specific parasite effector that modulates acute Toxoplasma gondii virulence.

Toxoplasma gondii (T. gondii) is a zoonotic apicomplexan parasite that is an important cause of clinical disability in humans. On a global scale, one third of the human population is infected with T. gondii. Mice and other small rodents are believed to be responsible for transmission of T. gondii to the domestic cat, its definitive host. Interferon-inducible Immunity-Related GTPases (IRG proteins) are important for control of murine T. gondii infections. Virulence differences between T. gondii strains are linked to polymorphic rhoptry proteins (ROPs) that cooperate to inactivate individual IRG family members. In particular, the pseudokinase ROP5 isoform B is critically important in laboratory strains of mice. We identified T. gondii ROP39 in complex with ROP5B and demonstrate its contribution to acute T. gondii virulence. ROP39 directly targets Irgb10 and inhibits homodimer formation of the GTPase leading to an overall reduction of IRG protein loading onto the parasitophorous vacuolar membrane (PVM). Maintenance of PVM integrity rescues the parasite from IRG protein-mediated clearance in vitro and in vivo. This study identifies a novel T. gondii effector that is important for specific inactivation of the IRG resistance system. Our data reveal that yet unknown T. gondii effectors can emerge from identification of direct interaction partners of ROP5B.

Catalytic Aminium Radical-Cation Salt (Magic Blue)-Initiated SN2-Type Nucleophilic Ring-Opening Transformations of Aziridines.

A simple and atom economic protocol for the construction of C-X/C-C bonds via catalytic aminium radical-cation salt (Magic Blue)-initiated SN2-type nucleophilic ring-opening transformations of racemic and nonracemic aziridines with different hetero and carbon nucleophiles to afford various amino ethers, thioethers, and amines in up to 99% yield, and with perfect enantiospecificity for some substrates but reduced ee with others (for nonracemic aziridines), is developed. This aminium radical-cation salt-initiated, SN2-type nucleophilic ring-opening strategy, along with various cyclization protocols, is employed to synthesize various biologically significant compounds.

Electrochemical Performance of High-Valence Mo6+ and Low-Valence Mn2+ Doped- Na3 V2 (PO4 )3 @C Cathode for Sodium-Ion Batteries.

The sodium superionic conductor (NASICON)-Na3 V2 (PO4 )3 (NVP) is an attractive cathode for sodium-ion batteries, which is still confronted with limited rate performance due to its low electronic conductivity. In this paper, a chemical strategy is adopted to partially replace V3+ of the NVP framework by low-valence Mn2+ and high-valence Mo6+ substitution. The crystal structure, sodium-ion diffusion coefficient and electrochemical performance of Mn-Mo-doped [Na3.94 V0.98 Mo0.02 Mn(PO4 )3 @C] cathode were investigated. X-ray diffraction confirmed the NASICON-type structure and XPS analysis confirmed the oxidation state of Mn and Mo in doped NVP cathode. The Na ion diffusion processes were inferred from Cyclic Voltammetry (CV), Galvanostatic intermittent titration technique (GITT) and Electrochemical Impedance Spectroscopy (EIS) measurement, which clearly show rapid Na-ion diffusion in NASICON-type cathode materials. The Mn-Mo-substituted NVP shows smoother charge-discharge profiles, improved rate performance (64.80 mAh/g at 1 C rate), better energy density (308.61 mWh/g) and superior Na-ion kinetics than that of unsubstituted NVP@C cathode. Their enhanced performance is attributed to large interstitial volume mainly created by high valence Mo6+ and enhanced capacity is attributed to the low valence Mn2+ doping. These results demonstrate that Mn-Mo-doped NVP cathode is strongly promising cathode material for sodium-ion batteries.

A Variable Data Fusion Approach for Electromechanical Impedance-Based Damage Detection.

There is continuing research in the area of structural health monitoring (SHM) as it may allow a reduction in maintenance costs as well as lifetime extension. The search for a low-cost health monitoring system that is able to detect small levels of damage is still on-going. The present study is one more step in this direction. This paper describes a data fusion technique by combining the information for robust damage detection using the electromechanical impedance (EMI) method. The EMI method is commonly used for damage detection due to its sensitivity to low levels of damage. In this paper, the information of resistance (R) and conductance (G) is studied in a selected frequency band and a novel data fusion approach is proposed. A novel fused parameter (F) is developed by combining the information from G and R. The difference in the new metric under different damage conditions is then quantified using established indices such as the root mean square deviation (RMSD) index, mean absolute percentage deviation (MAPD), and root mean square deviation using k-th state as the reference (RMSDk). The paper presents an application of the new metric for detection of damage in three structures, namely, a thin aluminum (Al) plate with increasing damage severity (simulated with a drilled hole of increasing size), a glass fiber reinforced polymer (GFRP) composite beam with increasing delamination and another GFRP plate with impact-induced damage scenarios. Based on the experimental results, it is apparent that the variable F increases the robustness of the damage detection as compared to the quantities R and G.

A Study of Sensor Placement Optimization Problem for Guided Wave-Based Damage Detection.

Guided waves (GW) allow fast inspection of a large area and hence have attracted research interest from the structural health monitoring (SHM) community. Thus, GW-based SHM is ideal for thin structures such as plates, pipes, etc., and is finding applications in several fields like aerospace, automotive, wind energy, etc. The GW propagate along the surface of the sample and get reflected from discontinuities in the structure in the form of boundaries and damage. Through proper signal processing of the reflected waves based on their time of arrival, the damage can be detected and isolated. For complex structures, a higher number of sensors may be required, which increases the cost of the equipment, as well as the mass. Thus, there is an effort to reduce the number of sensors without compromising the quality of the monitoring achieved. It is of utmost importance that the entire structure can be investigated. Hence, it is necessary to optimize the locations of the sensors in order to maximize the coverage while limiting the number of sensors used. A genetic algorithm (GA)-based optimization strategy was proposed by the authors for use in a simple aluminum plate. This paper extends the optimization methodology for other shape plates and presents experimental, analytical, and numerical studies. The sensitivity studies have been carried out by changing the relative weights of the application demands and presented in the form of a Pareto front. The Pareto front allows comparison of the relative importance of the different application demands, and an appropriate choice can be made based on the information provided.

Root canal morphology and variations in mandibular second molar teeth of an Indian population: an in vivo cone-beam computed tomography analysis.

OBJECTIVES: This study aims to investigate the root canal morphology of permanent mandibular second molars of an Indian population in vivo using cone-beam computed tomography (CBCT) images. METHODS: CBCT images (n = 983; males = 489, females = 494) of untreated, completely developed permanent mandibular second molar teeth were examined. CBCT scans were acquired as part of diagnosis and treatment planning for treatments unrelated to the present study. The number of roots and root canals were recorded. Canal configuration was classified based on Vertucci's and Fan's classifications. RESULTS: The most common configuration was two-root (79.35%) and three-root canals (53.50%). The incidence of three-rooted molars was 7.53%, whereas 13.12% of the studied teeth studied have fused roots with C-shaped canals. The predominant canal morphology in the mesial roots was Vertucci's type IV (45.17%), followed by type II (32.55%), type I (7.23%), type V (1.02%), and type III (0.91%). The distal root in contrast showed type I (61.14%) as the predominant canal configuration, followed by type II (18.21%) and type IV (7.53%). The incidence of three-rooted molars was higher in males (n = 55; 5.59%) than in females (n = 19; 1.94%) (p < 0.01). The canals in the extra roots exhibited type I (100%) root canal morphology. In teeth with C-shaped root canal (13.12%), the variations in the coronal, middle, and apical third ranged from C1 to C4. CONCLUSIONS: Root canal systems of the mesial roots of mandibular second molars of the study population demonstrated a high degree of variability. While three roots were rare, there was a sexual predisposition. Fused roots with C-shaped canals were rare and demonstrated significant variations from the coronal to apical third. CLINICAL RELEVANCE: Root canal morphology can demonstrate variations based on race and sex of patients. Clinicians must always consider the possible variations to ensure successful endodontic treatment.

Conservative Nonsurgical Approach for Management of a Case of Type II Dens in Dente.

Dens in dente is a developmental dental anomaly which poses a challenge for the endodontist due to its complex pulpal anatomy. In this case report, a class 2 dens in dente was managed nonsurgically. A 32-year-old female reported with a palatal swelling and pain in the upper front region of the jaw. On examination, #7 was observed to be malformed and showed a negative pulpal sensibility test. Radiographic and CBCT analysis revealed Ohler's type 2 dens in dente with a periapical radiolucency. In the first visit, invagination was removed using diamond-coated ultrasonic tips, the canal was minimally instrumented, and premixed calcium hydroxide was injected in the canal which accidentally extruded periapically. After two weeks, a draining sinus was observed on the palatal side which when traced, lead to #7. Intracanal dressing was replaced with a mix of powdered calcium hydroxide and saline. The dressing was replaced every two weeks, and radiographs were taken, which revealed the resorption of extruded calcium hydroxide and reduction in the osseous defect. Biodentine was used to obturate the entire canal space. Subsequent follow-up radiographs till 24 months showed significant periapical healing and resorption of extruded calcium hydroxide.

Data-driven dentistry: Computational revelations redefining pulp capping.

Introduction: Pulpal and periradicular diseases stem from immune reactions to microbiota, causing inflammation. Limited blood supply hampers dental pulp self-healing. Managing inflammation involves eliminating bacteria and reducing pro-inflammatory mediators especially MMP-9, which has a significant correlation with pulpitis. s. Flavonoids like Hesperidin, Baicalein, Epigallocatechin gallate, Genistein, Icariin, and Quercetin show potential for pulp capping. Aim: This in-silico study compares various Flavonoids for their anti-inflammatory effects on MMP-9, with Chlorhexidine as a control, a known MMP-9 inhibitor. Materials and Methods: Protein and Ligand Preparation: The human MMP-9 catalytic domain (PDB ID: 4XCT) structure was retrieved, and necessary modifications were made. Flavonoids from PubChem database were prepared for docking using AutoDock Vina. A grid for docking was created, and molecular dynamics simulations were conducted using Gromacs-2019.4 with GROMOS96 force field. Trajectory analysis was performed, and MM-PBSA calculation determined binding free energies. Results: Analysis of MMP-9 and ligand interactions revealed Hesperidin's high binding affinity, forming numerous hydrogen bonds with specific amino acids. Molecular dynamics simulations confirmed stability, with RMSD, RMSF, Rg, and SASA indicating consistent complex behaviour over 100 ns. MM-PBSA calculation affirmed favourable energy contributions in MMP-9-Hesperidin interactions. Conclusion: MMP-9 plays a crucial role in prognosis of pulpitis. Incorporating MMP-9 inhibitors into pulp capping agents may enhance therapeutic efficacy. Hesperidin emerges as a potent MMP-9 inhibitor, warranting further in vivo validation against other agents.

An in vitro comparative evaluation of efficiency of three rotary nickel-titanium file systems in terms of remaining dentin thickness using cone-beam computed tomography.

Aim: The objective of the present research was to assess and compare the residual dentin thickness after biomechanical preparation of teeth using three distinct rotary nickel-titanium (Ni-Ti) file systems. Materials and Methods: In the current experimental study, a total of 45 single-rooted teeth were selected for the analysis. The cementoenamel junction of each tooth was decoronated using a diamond disc. The teeth were randomly allocated to three groups, with each group representing a different rotary file system: Group 1: Hero GOLD (Micro Mega), Group 2: One Curve (Micro Mega), and Group 3: HyFlex electro-discharge machining (EDM) (Coltene-Whaledent, Altstatten, Switzerland). To evaluate the initial condition of the teeth, cone-beam computed tomography (CBCT) scans were conducted before the biomechanical preparation. The teeth were positioned on a modeling wax sheet, and the CBCT scans provided baseline measurements. The biomechanical preparation of the root canals followed the manufacturer's recommended guidelines for each file system. After the completion of the canal preparation, follow-up CBCT scans were conducted. The postprocedure CBCT scans were then compared with the initial scans to assess any changes in the residual thickness of dentin in the teeth. Statistical Analysis: Post hoc Tukey analysis of variance tests was utilized to examine differences between the groups. A statistically significant result was defined as P = 0.05 or less for every test. Results: The comparison of preinstrumentation and postinstrumentation CBCT images showed that the HyFlex EDM group removed less dentin clinically compared to the other two groups, i.e., Hero GOLD and One Curve. No significant statistical difference was found between Hero GOLD versus One Curve, One Curve versus HyFlex EDM, and Hero GOLD versus HyFlex EDM. Conclusion: Based on the results of this study, the HyFlex EDM file system exhibited superior cutting efficiency at various levels. Nonetheless, additional investigations are required to comprehensively assess the influence of Ni-Ti rotary file systems on the remaining dentin thickness.

Dentinal tubule penetration following ultrasonic, sonic, and single-cone technique of a biosealer: An ex vivo study.

Background: The endodontic space is complex, and using a single-cone obturation technique fails to ensure a complete filling. Introduction: This study aimed to investigate the effect of ultrasonic activation, sonic activation, and single-cone technique of a biosealer on its dentinal tubular penetration. Materials and Methods: In the experiment, single-root mandibular premolars were randomly assigned to three groups (n = 20): group A, ultrasonic activation; Group B, sonic activation; and Group C, single-cone technique. Penetration of the fluorescently labeled biosealer was investigated using a confocal laser scanning microscope. Results: The data were statistically analyzed using Kruskal-Wallis and Mann-Whitney tests (P = 0.05). The highest penetration of biosealer was observed in Group A, followed by Group B (P < 0.05). Conclusions: Dentinal tubule penetration of biosealer was significantly improved by ultrasonic and sonic activation techniques.

In vitro comparative evaluation of apical leakage using a bioceramic sealer with three different obturating techniques: A glucose leakage model.

Context: Bioceramic sealers have improved sealing ability by forming an interfacial apatite layer that chemically bonds the sealer and radicular dentin thus decrease apical leakage. Aim: This study aims to evaluate and compare the apical leakage of Cerafill RCS bioceramic sealer and gutta percha when used with three different obturating techniques. Materials and Methods: Thirty-four extracted single-rooted premolars were decoronated and prepared up to size F3. Then, the specimens were randomly divided into 3 experimental groups (n = 10) cold lateral obturation technique, warm vertical obturation technique, single-cone obturation technique, positive and negative control groups (n = 2), according to the obturation technique used along with a bioceramic sealer. To evaluate apical leakage, all specimens were mounted in a glucose leakage model and assessed at 7 and 14 days using an ultraviolet-visible spectrophotometer. Statistical Analysis: The results were subjected to ANOVA/Kruskal-Wallis ANOVA; followed by post hoc analysis using Bonferroni correction. Results: Significant differences were found in the cumulative leakage of all the three experimental groups. Significantly higher leakage was found in groups obturated using single-cone obturation technique as compared to warm vertical compaction technique at both 7 and 14 days. Conclusions: Warm vertical compaction showed a better sealing result than single-cone obturation techniques at all observation periods.

The reparative immunologic consequences of stem cell transplantation as a cellular therapy for refractory Crohn's disease.

Background: Treatment strategies for Crohn's disease (CD) suppress diverse inflammatory pathways but many patients remain refractory to treatment. Autologous hematopoietic stem cell transplantation (SCT) has emerged as a therapy for medically refractory CD. SCT was developed to rescue cancer patients from myelosuppressive chemotherapy but its use for CD and other immune diseases necessitates reimagining SCT as a cellular therapy that restores appropriately responsive immune cell populations from hematopoietic progenitors in the stem cell autograft (i.e. immune "reset"). Here we present a paradigm to understand SCT as a cellular therapy for immune diseases and reveal how SCT re-establishes cellular immunity utilizing high-dimensional cellular phenotyping and functional studies of the stem cell grafts. Methods: Immunophenotyping using CyTOF, single cell RNA sequencing (scRNA-seq) and T cell receptor (TCR) sequencing was performed on peripheral blood and intestinal tissue samples from refractory CD patients who underwent SCT. The stem cell graft from these patients was analyzed using flow cytometry and functionally interrogated using a murine model for engraftment. Results: Our study revealed a remodeling of intestinal macrophages capable of supporting mucosal healing that was independently validated using multimodal studies of immune reconstitution events including CyTOF and scRNA-seq. Functional interrogation of hematopoietic stem cells (HSCs) using a xenograft model demonstrated that HSCs shape the timing of immune reconstitution, the selected reconstitution of specific cell lineages and potentially the clinical efficacy of SCT. Conclusions: These studies indicate that SCT serves as a myeloid-directed cellular therapy re-establishing homeostatic intestinal macrophages that support intestinal healing and suggest refractory CD evolves from impairment of restorative functions in myeloid cells. Furthermore, we report heterogeneity among HSCs from CD patients which may drive SCT outcomes and suggests an unrecognized impact of CD pathophysiology on HSC in the marrow niche.

Exploring the scope of homoeopathy in combating the unfortunate consequences of post-COVID-19 survivors based on non-COVID conditions: a narrative review.

OBJECTIVES: The long-term consequences of COVID-19 survivors care and post-coronavirus infection are not yet well understood. The review aims to see whether homoeopathy can help COVID-19 survivors recover from its consequences and improve their quality of life. CONTENT: A systematic search of published articles for post-COVID sequelae and the impact of Homoeopathy were conducted. For the literature search, the major electronic bio-medical database PubMed/MEDLINE was used. In addition, supplementary searches were conducted through the references of those published articles. SUMMARY: A total of 113 records were identified of which 61 studies included for this review. Homoeopathy is effective in the treatment of mental disorders including anxiety and depressive disorder (ADD), some research studies have found, although systematic reviews disagree. Likewise, some medical societies denounce homoeopathy for pain management; other literature shows that it can be used to treat pain effectively. Homoeopathy can aid in the treatment of cardiovascular diseases, as Crataegus, a homoeopathic medication, was found to be just as effective as a standard angiotensin-converting enzyme (ACE) inhibitor and diuretic treatment for minor cardiac insufficiency. The outcomes for Chronic Fatigue Syndrome (CFS), Influenza, and Acute Respiratory Tract Infections (ARTIs) are also promising. OUTLOOK: Based on the results of homoeopathy in non-COVID conditions, it can be thought of in the management of post-COVID-19 outcomes. Consequently, we propose that while investigating post-COVID-19 patient rehabilitation, homoeopathic management may be included as part of the follow-up route and as much data as possible in the context of homoeopathy should be collected, so that in future, the role of homoeopathy in dealing with it can be better demonstrated.

An in vitro comparison of incisal preparation design on load-to-failure of ceramic veneers.

Introduction: This in vitro study aimed to compare the load-to-failure values of two different ceramic veneers (IPS e.max Press [Ivoclar Vivadent] and Vintage lithium disilicate [LD] press [Shofu]) with incisal preparation designs under standardized conditions. Materials and Methods: Twenty-two intact extracted maxillary incisors were selected and divided randomly into two groups (n = 11). The veneer tooth preparation was standardized in both groups where a butt joint incisal preparation was done along with chamfer margin. Group 1 included veneers made from IPS e.max Press (Ivoclar Vivadent) and Group 2 included veneers fabricated from Vintage LD Press (Shofu). Veneers were luted to their respective abutment teeth using standardized bonding protocols and resin cement for both groups. Later, every specimen was loaded to failure utilizing a universal testing machine, and the outcomes were noted in Newtons (N). Results: The mean load-to-failure value obtained for Group 1 (IPS e.max Press) was 1386.46 N while that obtained for Group 2 was 1777.07 N. Statistically significant difference was found in this intergroup comparison (P = 0.006). Conclusion: The load-to-failure value of Vintage LD Press veneers (Shofu) was greater than that of IPS e.max Press veneers (Ivoclar Vivadent).

An in vitro comparative evaluation of intraorifice barriers and bleaching agents on the fracture resistance of the endodontically treated anterior teeth.

Aim: This study aimed to evaluate and compare the impact of different bleaching agents on the fracture resistance of endodontically treated teeth when using either GC Fuji type 2 glass ionomer cement (GIC) or Shofu Glass Ionomer RX EASE as intraorifice barriers (IOB). Materials and Methods: A total of 80 single-rooted human maxillary central incisors were prepared and obturated. Three millimeters of gutta-percha was then removed from the orifice. The specimens were divided into two primary groups based on the type of IOB material used: GC Fuji type 2 GIC and Shofu Glass Ionomer RX EASE (n = 40). Each group was further divided into four subgroups based on the bleaching agent used: Carbamide peroxide (CP) 37%, sodium perborate (SP), hydrogen peroxide (HP) 35%, and distilled water used as the control (n = 10). The teeth were subjected to fracture resistance testing. Results: The study found that the order of root fracture resistance was control > CP > SP > HP. There was no statistically significant difference in fracture resistance between GC Fuji type 2 GIC and Shofu Glass Ionomer RX EASE when used as IOB materials. Conclusion: The study concluded that the choice of bleaching agent significantly affects the fracture resistance of endodontically treated teeth. It was observed that fracture resistance is lowest with HP, followed by SP and CP. Both GC Fuji type 2 Glass Ionomer and Shofu Glass Ionomer RX EASE are effective as IOB.

Evaluation of apical sealing ability of four different sealers using centrifuging dye penetration method: an in vitro study.

AIM: The aim of this in vitro study was to evaluate the apical seal obtained with four root canal sealers AH 26, Sealapex, Endoflas FS and AH Plus, with lateral condensation. MATERIALS AND METHODS: Sixty root canals were prepared using the step-back technique. The specimens were divided into four experimental groups of 12 teeth and two control groups of 12 teeth. The experimental groups were obturated by laterally condensed gutta-percha with one of the tested sealers and control groups were obturated without any sealer. Methylene blue dye penetration with centrifuging method was used to evaluate the apical sealing ability. The quantitative apical leakage of each specimen was measured after 2 weeks. RESULTS: The results showed no significant differences between all groups except between AH Plus and Endoflas FS (<0.05). AH Plus showed significantly less leakage than Endoflas FS. CONCLUSION: AH Plus showed the least leakage compared to AH 26, Sealapex and Endoflas FS.

The morphology of the pulp chamber floor of permanent mandibular first and second molars in an Indian subpopulation-a descriptive cross-sectional study employing Pawar and Singh classification.

Background: Mandibular molars are multi-rooted teeth with a complex and strenuous root canal anatomy. Because there is relatively negligible literature describing the pulp chamber floor anatomy, predicting the exact anatomical layout and its variations is daunting. A thorough comprehension and knowledge of the same is required for efficacious endodontic treatment consequence. The purpose of this study was to characterise and ascertain the pulp chamber floor anatomy of permanent mandibular first (ManFMs) and second (ManSMs) molars in an Indian population. Methods: On 2,134 extracted human mandibular first (ManFMs = 1,067) and second molars (ManSMs = 1,067), a descriptive cross-sectional investigation was executed. Cleaning and removal of hard and soft tissue debris were performed, followed by flattening the anatomical crown until the pupal architecture was uncovered. A stereomicroscope with a magnification of 4.5 magnification was used to investigate the pulpal anatomy. Statistical analysis was carried out using chi square test, with 95% confidence intervals and a p value of 0.05 considered statistically significant. Results: The majority of the ManFMs showed presence of three canal orifices in 57.73%, followed by four orifices 31.31%, five orifices 8.81%, and six orifices 2.15%. For ManSMs, majorly three orifices were found in 39.83% specimens, followed by two orifices in 37.39%, four orifices in 16.31%, and single root canal orifice was observed in 6.47%. The mesio-buccal, mesio-lingual, disto-buccal, disto-lingual canal orifices exhibited round and oval shapes in both ManFMs and ManSMs. The shape was predominantly oval with a single distal canal orifice (84.25% ManFMs and 74.16% ManSMs). In ManSMs, among the single root canal orifice, 66.66% were round in shape and 33.34% were C-shaped. In ManSMs with two root canal orifices, mesially 79.44% exhibited oval and 20.56% round shape. Distally, 74.16% were oval and 25.84% were round. The shapes of the access cavities for ManFMs were rectangular in 46.67% and triangular in 53.33%. For the ManSMs, the access cavities were triangular in 39.83%, rectangular in 16.31% and non-classified (others) in 43.86% of specimen. In both ManFMs and ManSMs, the pulp chamber floor morphology was predominately Y shaped (57.73% and 39.83%) according to the Pawar and Singh classification© of pulp chamber floor anatomy. Conclusion: Our study indicated that the orifices on the pulp chamber floor are arranged in a typical manner, supporting the proposed categorization. Furthermore, description of the anatomical patterns of the pulp chamber guides the clinicians in chair-side treatment decisions.

Root canal anatomy of human permanent mandibular incisors and mandibular canines: A systematic review.

Mandibular incisors and canines show variations in their root canal anatomy. It is imperative to be aware of these variations to lower the frequency of missed canals. The objective was to systematically review the existing studies to recognize the root and root canal anatomy of the mandibular incisors and canines among the population of various geographical locations, as studied by different methods. This systematic review was registered in the International Prospective Register of Systematic Reviews database under the number CRD42020185146. An exhaustive search was undertaken in three electronic databases - MEDLINE PubMed, EBSCOhost, and Google Scholar - along with hand-searching for the identification of studies. Studies were selected following strict inclusion and exclusion criteria. Selected studies were scored using the Joanna Briggs Institute Critical Appraisal tool for prevalence studies to determine the risk of bias. This review included data from 26 countries including the analysis of 71,404 mandibular anterior teeth. The risk of bias of all included studies was either low or moderate. Overall, it was seen that the percentage of second canals was higher in lateral than in central incisors. Mandibular canines occasionally showed the presence of two roots. Deviations in anatomy were high in the Middle Eastern European countries and the Indian subcontinent. Limitations are as follows: lack of homogeneity across data reported in the studies concerning the methods used to study the root canal anatomy. Diversities seen in the root canal configurations of mandibular incisors and canines vary according to ethnicity, and thus, one must have a thorough knowledge before commencing endodontic treatment.

Assessment of Knowledge, Attitude, and Practices Regarding Advanced Local Anesthetic Techniques among Students Attending a Private Dental College in Navi Mumbai, India: A Cross-sectional Study.

Aim and objective: Local anesthesia (LA) administration is an anxiety-provoking phenomenon in patients. Several alternative and advanced techniques make LA administration patient-friendly. This study assesses the knowledge, attitude, and practices of these advances, creating awareness and encouraging further studies and innovations to make these techniques more accessible, available, and economical to be utilized in the Indian population for controlling pain by targeting the budding dentists who actively imbibe and are abreast with the current state of affairs. Methods and materials: A descriptive cross-sectional questionnaire-based study was conducted among the undergraduate and postgraduate students of a private college in Navi Mumbai. The self-administered questionnaire contained 13 questions. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 17 software and a Chi-square test were applied. Results: A majority of the respondents were unaware of the alternative techniques (59.4%) with a significant difference between undergraduates and postgraduates. 95.7% thought conventional methods caused dental anxiety and 55.1% thought alternatives would be better. The pain management techniques currently used were mostly reassurance and distraction (84.2%) and Topical anesthesia (74.9%). Only 9.6% had actually practiced these techniques, the reason for inexperience being inadequate knowledge. Out of those who had used these techniques, 47.82% saw positive results with patients experiencing less pain. Conclusion: Knowledge of advanced local anesthetic techniques in the dental fraternity is necessary to enhance practice and provide the best care to the patients. Its inclusion in the curriculum with adequate practical training shall ensure its use efficiently. Clinical significance: Today dentistry is propelling toward minimally invasive, painless, and patient-friendly procedures. The incorporation of advanced LA techniques to help achieve this goal begin with assessing its awareness among future dentists which would help make them accessible and affordable and contribute toward providing patients a holistic treatment. How to cite this article: Bhanushali NV, Atre SY, Kumar V, et al. Assessment of Knowledge, Attitude, and Practices regarding Advanced Local Anesthetic Techniques among Students Attending a Private Dental College in Navi Mumbai, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(1):94-98.

Recommended clinical practice guidelines of aesthetic dentistry for Indians: An expert consensus.

Objective: The research for analyzing the smile characteristics in the Indian population has been limited with contradictory outcomes. This consensus statement aims to critically review the literature and provide basic practice guidelines on dental aesthetics related to the Indian population. Clinical Considerations: 9 clinicians and 6 resource persons from dental colleges in India collaborated in this consensus statement which covered 6 topics along with 6 introductory and 6 conclusive remarks. The statement was developed through a colloquium conducted on topics; global aesthetics: different smile design proportions and guidelines, patient perspective towards aesthetic dentistry in India, a literature survey of aesthetic dentistry for the Indian population, macro and micro-aesthetics, multidisciplinary approach in aesthetic dentistry, inclusion of high-end technologies in Indian modern-day practice, followed by a panel discussion to devise and establish the practice guidelines of aesthetic dentistry in India. The Consensus Statement has been formulated according to AGREE Reporting checklist. Conclusion: The experts and panelists reached a Consensus on protocols to institute clinical practice guidelines of aesthetic dentistry for Indians. However, based on all available literature from India, further research is required to investigate many questions that have not been previously considered.