Radiographic assessment of maxillary sinus membrane and lateral wall thickness using cone-beam CT in different facial types in southwestern Saudi Arabia

The anatomy of the edentulous posterior maxilla and maxillary sinus possess unique challenges in implant dentistry. The purpose of this study was to assess maxillary sinus membrane thickness (MT) and lateral wall thickness (LWT) in different facial index profiles and to describe the clinical implications. A retrospective image analysis of 75 CBCT scans was done, which yielded a total of 150 sinus images. The facial index was calculated as per the formula given in the text and grouped as euryprosopic, mesoprosopic and leptoprosopic. The images obtained were of 36 women (48%) and 39 men (52%), with maximum subjects in 30-39 years age group. MT and LWT were measured at three different points on the radiograph at every 3mm from the base of the sinus floor in premolar and molar regions of each image. Results showed females had significant differences from males in LWT in both premolar and molar regions (p = 0.018 and 0.032 respectively). Subjects in 40-49 years of age had significant differences (p = 0.021) in MT in premolar region only. Also, difference in MT in premolar and molar regions were also statistically significant. Lastly, the present study did not find any statistically significant difference in MT and LWT in all three facial indices groups. It can be concluded that different facial indices have no positive correlation with maxillary sinus membrane thickness and lateral wall thickness. Hence, surgical complications are avoidable with proper detailed knowledge and appropriate identification of the anatomic structures characteristic to the maxillary sinus.

Corrigendum: Stylopine: a potential natural metabolite to block vascular endothelial growth factor receptor 2 (VEGFR2) in osteosarcoma therapy

[This corrects the article DOI: 10.3389/fphar.2023.1150270.].

Biomimetic approach to strengthen the incisal fracture composite build-up: an in vitro study

OBJECTIVE

Incisal composite build-up shows a high failure susceptibility. The incorporation of fiber-reinforced composite (FRC) during composite restoration could improve its strength. Hence the study was planned to compare the effect of various positions of FRC on the strength of composite resin incisal build-ups.

METHODS

In maxillary incisors (n = 90), 3 mm of the incisal edge was cut and teeth were categorized into three groups based on the location and number of fibers used during incisal composite build-up - Group I: composite resin; Group II: composite resin and a single fiber palatally and Group III: composite resin along with two fibers palatally.

RESULTS

The data showed that group II had the maximum load-bearing values followed by group I and group III.

CONCLUSION

Within the confines of our study, it can be concluded that the addition of FRC to the conventional incisal composite build-up increased the overall strength restoration. Such composite restoration reinforced with a single fiber on the palatal side showed the highest load-bearing capacity compared to two fibers reinforced and unreinforced composites. The common mode of failure in group I was in composite resin, in two fibers reinforced at fibers-composite junction, and in one fiber reinforced composite was in the remaining part of the tooth.

Estimation of serum C-reactive protein activity in periodontal health and disease and response to treatment: a clinico-biochemical study

Background

Periodontitis is a chronic infectious disease affecting periodontium having multifactorial etiology, can cause significant systemic challengein addition to localized inflammation, tissue damage, and bone resorption. A serological marker of systemic inflammation known as C-reactive protein has been linked to an increased risk for a number of pathological conditions, including cardiovascular diseases.

Aim

To estimate levels of serum C-reactive protein in healthy individuals and subjects with periodontal diseases and to compare serum C-reactive protein levels in subjects having periodontal disease pre-operatively & post-operatively.

Materials and methods

The study was conducted on 60 subjects age ranging from 35 to 60 years. 30 individuals with healthy periodontium were in group 1 (control group) and the remaining 30 were diagnosed as adult periodontitis were in group 2 (experimental group). Periodontal examination done using gingival index, plaque index, periodontal pocket depth, and Russel's index. CRP levels were examined between group 1 and group 2 and in group 2 between baseline visit before treatment and 2 months after treatment.

Results

The findings of this study show a significant connection between periodontal disease and the inflammatory marker CRP in the body, as well as a tendency for a significant decrease in serumCRP levels following periodontitis therapy. At baseline, there was a positive correlation among C-reactive protein, probing pocket depth, and Russell's index.

Conclusion

As CRP is a key mediator for cardiovascular disease, an increase in C- reactive protein levels in periodontal diseases suggests a significant connection between periodontitis and cardiovascular diseases. Early periodontal treatment might decrease the severity of cardiovascular disease that already exists. This suggests that periodontal examination should be part of routine practicealong with cardiovascular examination.

Current appraises of therapeutic applications of nanocurcumin: A novel drug delivery approach for biomaterials in dentistry

Curcumin is a natural herb and polyphenol that is obtained from the medicinal plant Curcuma longa. It's anti-bacterial, anti-inflammatory, anti-cancer, anti-mutagenic, antioxidant and antifungal properties can be leveraged to treat a myriad of oral and systemic diseases. However, natural curcumin has weak solubility, limited bioavailability and undergoes rapid degradation, which severely limits its therapeutic potential. To overcome these drawbacks, nanocurcumin (nCur) formulations have been developed for improved biomaterial delivery and enhanced treatment outcomes. This novel biomaterial holds tremendous promise for the treatment of various oral diseases, the majority of which are caused by dental biofilm. These include dental caries, periodontal disease, root canal infection and peri-implant diseases, as well as other non-biofilm mediated oral diseases such as oral cancer and oral lichen planus. A number of in-vitro studies have demonstrated the antibacterial efficacy of nCur in various formulations against common oral pathogens such as S. mutans, P. gingivalis and E. faecalis, which are strongly associated with dental caries, periodontitis and root canal infection, respectively. In addition, some clinical studies were suggestive of the notion that nCur can indeed enhance the clinical outcomes of oral diseases such as periodontitis and oral lichen planus, but the level of evidence was very low due to the small number of studies and the methodological limitations of the available studies. The versatility of nCur to treat a diverse range of oral diseases augurs well for its future in dentistry, as reflected by rapid pace in which studies pertaining to this topic are published in the scientific literature. In order to keep abreast of the latest development of nCur in dentistry, this narrative review was undertaken. The aim of this narrative review is to provide a contemporaneous update of the chemistry, properties, mechanism of action, and scientific evidence behind the usage of nCur in dentistry.

Role of Chitosan Hydrogels in Clinical Dentistry

Biopolymers are organic polymers that can be treated into intricate designs with porous characteristics that mimic essential biologic components. Due to their superior biosafety, biodegradability, biocompatibility, etc., they have been utilized immensely in biomedical engineering, regeneration, and drug delivery. To obtain the greatest number of results, a literature search was undertaken in scientific search engines utilizing keywords. Chitosan is used in a variety of medical sectors, with the goal of emphasizing its applications and benefits in the clinical dental industry. Chitosan can be dissolved in liquid form and combined with other substances to create a variety of products, including fibers, hydrogels, membranes, microspheres, resins, sponges, pastes, tablets, and micro granules. Chitosan has been studied in a variety of dental applications. Chitosan is used in the prevention of caries and wear, in pulpotomy to accelerate osteogenesis in guided tissue regeneration due to its hemostatic property, and primarily to benefit from its antimicrobial activity by adding it to materials, such as glass ionomer cement, calcium hydroxide, and adhesive systems. With its antibacterial activity and biocompatibility, chitosan is leading the pack as a promising ingredient in the production of dental materials. The current review provides an update on the background, fundamentals, and wide range of uses of chitosan and its gels in dental science.

Metabolic syndrome in relation to dietary acid load: a dose-response meta-analysis of observational studies

Background and aim

Several studies have identified that dietary acid load (DAL) may be associated with the odds of metabolic syndrome (MetS); however, the evidence is inconclusive. This dose-response meta-analysis aimed to examine the relation of DAL to MetS.

Methods

A systematic literature search was carried out in PubMed and Scopus up to April 2023 for pertinent studies evaluating the relation of DAL scores, including potential renal acid load (PRAL) and net endogenous acid production (NEAP), to the odds of MetS. The odds ratios (OR) with 95% confidence intervals (CI) were pooled using a random-effects meta-analysis to test the association.

Results

Eight studies, with an overall sample size of 31,351 participants, were included in this meta-analysis. Higher DAL scores were significantly related to the elevated odds of MetS (NEAP: OR = 1.42, 95%CI = 1.12-1.79; PRAL: OR = 1.76, 95%CI = 1.11-2.78), with significant evidence of heterogeneity across studies. The linear dose-response analysis proposed that a 10 mEq/day elevation in NEAP and PRAL was linked to a 2% (OR = 1.02, 95%CI = 1.001-1.05) and 28% (OR = 1.28, 95%CI = 1.11-1.47) increased odds of MetS, respectively. No non-linear association was observed between MetS and NEAP (P-non-linearity = 0.75) and PRAL (P-non-linearity = 0.92).

Conclusion

This study revealed a significant direct relationship between DAL and MetS. Therefore, lower acidogenic diets are suggested for the prevention of MetS.

In-Vitro Inhibitory Efficacy of 3 Types of Probiotics on the Growth of Aggregatibacter actinomycetemcomitans Bacteria

BACKGROUND

Amongst the specific plaque pathogen Aggregatibacter actinomycetemcomitans (Aa) ATCC 43718 serotype b is one of the highly virulent bacteria that causes periodontitis. Probiotic therapy is a treatment in which the lactic acid bacteria in are utilized to impede the colonization and growth of the pathogenic bacteria to prevent the further formation of dental plaque.

OBJECTIVE

The present research aimed to evaluate inhibiting effect of purified bacteria from various commercially available yogurt product containing bacteria named (Lactobacillus casei strain Shirota; Lactobacillus bulgaricus and Streptococcus thermophilus; Lactobacillus reuteri Prodentis) on the growth of Aa.

METHODS

The research made use of the diffusion method by fixing Aa on BHIB (brain heart infusion broth) medium, incubated at 37 °C and 24 hours later planted on MHA (Mueller-Hinton agar) media. Aa were divided into four subgroups each with a paper disk; group 1 consists of untreated bacteria (i.e., control group), group 2 with purified bacteria from Yakult 0.5 μL, group 3 with purified bacteria from Cimory Yogurt Drink 0.5 μL and group 4 with purified bacteria from BioGaia Prodentis 0.5 μL. All commercially available yogurt were treated to get the purified probiotic. Additionally, it was incubated for 24 hours at 37 °C and later the inhibition zone diameter was observed.

RESULTS

In the research, it was found that the average impeding ability, so-called inhibition zone, in group 1 indicated 0 mm, group 2 indicated 12.70 mm, group 3 indicated 16.60 mm and group 4 indicated 19.60 mm. The statistical test outcomes showed a significance of 0.000 (p < 0.05).

CONCLUSIONS

The purified bacteria from three probiotics indeed inhibit the growth of the Aa bacteria and a substantial difference in the diameter of the inhibition zone were found among the three probiotics.

Assessment of Periodontal Health Among Removable and Fixed Partial Denture Wearers in Aseer Region of Saudi Arabia

BACKGROUND Prosthetic rehabilitation will have harmful effects on periodontal structure if the patient fails to maintain an oral hygiene protocol. This study aimed to evaluate oral hygiene in fixed and removable partial denture wearers in the Aseer Province of Saudi Arabia. MATERIAL AND METHODS This was a cross-sectional study done on 286 prosthesis wearers aged between 25 and 55 years; 142 were men and 144 women. Clinical examination was done using 3 periodontal parameters: plaque index, gingival index, and calculus surface index. RESULTS It was found that 72% and 25% of patients used fixed and removable partial prostheses, respectively. Most patients were in the 45-55 year age group (38.1%), were medically fit (78%), and used toothbrush and paste (70.6%). Most patients were instructed regarding the use of oral hygiene measures for their prostheses (71.3%). However, around half of the study group (52.8%) had odor from their prostheses. Most fixed prostheses were in the posterior teeth (73.2%) and had 3 units or more (58.7%). Removable partial dentures were mostly tooth-tissue supported (74%). A statistically significant difference was found for plaque index and gingival index between natural teeth and abutments in terms of various prosthetic parameters (P£0.001). The higher prevalence of gingival inflammation, plaque, and calculus accumulation in this study may be correlated to improper oral hygiene methods used by patients. CONCLUSIONS It can be concluded that there is a need to reinforce meticulous oral hygiene practices among patients using prosthodontic appliances.

Glucagon-like peptide-1 receptor promotes osteoblast differentiation of dental pulp stem cells and bone formation in a zebrafish scale regeneration model

Bone cells express the glucagon-like peptide 1 receptor (GLP-1R). However, its presence and role in human dental pulp derived stem cells (hDPSCs) remains elusive. Hence, in the current study, we isolated hDPSCs and differentiated them into osteoblasts, where GLP-1R expression was found to be upregulated during osteoblast differentiation. GLP-1 receptor agonist, liraglutide peptide treatment, increased osteoblast differentiation in hDPSCs by increasing calcium deposition, ALP activity, and osteoblast marker genes, Runx2, type 1 col, osteonectin, and osteocalcin. Furthermore, activation of long non-coding RNA (LncRNA) LINC00968 and microRNA-3658 signalling increased Runx2 expression. Specifically, liraglutide increased LncRNA-LINC00968 expression while decreasing miR-3658 expression. LINC00968 targets miR-3658, and miR-3658 targets Runx2. Additionally, in an in-vivo study, zebrafish scale regeneration model, liraglutide promoted calcium deposition, osteoblastic cell count, collagen 1α, osteonectin, osteocalcin, runx2a MASNA isoform expression (transcribed from promoter P1), and Ca/P ratio in scales. Overall, GLP-1R activation promotes osteoblast differentiation via Runx2/LncRNA-LINC00968/miR-3658 signalling in hDPSCs and promotes bone formation in zebrafish scale regeneration.

Stylopine: A potential natural metabolite to block vascular endothelial growth factor receptor 2 (VEGFR2) in osteosarcoma therapy

Vascular endothelial growth factor (VEGF) signals cell survival, cell migration, osteogenesis, cell proliferation, angiogenesis, and vascular permeability by binding to VEGF receptor 2 (VEGFR-2). Osteosarcoma is the most common primary bone cancer, majorly affects young adults. Activation of VEGFR-2 signaling is a therapeutic target for osteosarcoma. The present study aimed to evaluate the potency of stylopine in regulation of the VEGFR-2 signaling pathway and its anti-tumour effect human MG-63 osteosarcoma cells. The in silico study on benzylisoquinoline alkaloids was carried out for analyzing and shortlisting of compounds using a virtual screening, Lipinski's rule, bioavailability graphical RADAR plot, pharmacokinetics, toxicity, and molecular docking studies. Among the benzylisoquinoline alkaloids, stylopine was selected and subjected to in-vitro studies against human MG-63 osteosarcoma cells. Various experiments such as MTT assay, EtBr/AO staining, mitochondrial membrane potential assessment, transwell migration assay, gene expression analysis by a quantitative real time polymerase chain reaction (qRT-PCR) method, SDS-PAGE followed by immunoblotting were performed to evaluate its anti-tumour effect as compared to standard axitinib. The MTT assay indicates that stylopine inhibits cell proliferation in MG-63 cells. Similarly, as confirmed by the EtBr/Ao staining method, the MMP assay indicates that stylopine induces mitochondrial membrane damage and apoptosis as compared to axitinib. Moreover, stylopine inhibits the VEGF-165 induced MG-63 cell migration by a trans-well migration assay. The immunoblotting and qRT-PCR analysis showed that stylopine inhibits the VEGF-165 induced VEGFR2 expression in MG-63 cells. It is concluded that stylopine has potential to regulate VEGFR2 and can inhibit osteosarcoma cells to offer a new drug candidate for the treatment of bone cancer in future.

Awareness of COPD and Its Risk Factors Among the Adult Population of the Aseer Region, Saudi Arabia

Introduction

Epidemiological studies are urgently needed to assess the prevalence of COPD in the region to determine the baseline, against which the future trends in the risk factor levels can be assessed and preventive strategies be planned to promote health among the population. Therefore, this study was undertaken to assess the awareness of COPD and its risk factors in Saudi Arabia.

Materials and Methods

The cross-sectional study was conducted among the general adult population aged 18 years and above living in the Aseer region. A minimum sample of 385 was targeted, using the Raosoft sample size calculator. An online questionnaire was prepared in both English and Arabic language using Google forms and distributed among participants through social media.

Results

It was observed that less than one-third (116, 30.12%) of the study population had ever heard about COPD. Nearly one-third spent time with smokers. Among all, 223 (57.3%) respondents had never heard and 46 (11.9%) respondents did not know anything about COPD. The majority correctly knew that the lungs are the primary organ affected by COPD (92, 79.3%). Age, sex, marital status, income, and occupation showed a significant association with COPD awareness. Nearly 41.4% knew that COPD progresses exclusively with age, COPD is more expensive for society than lung cancer (49.0%), cigarette smoking affects COPD (34.5%), COPD is fully recoverable with short-term antibiotics (35.0%), COPD lasts more than 18 months (48.1%), COPD can worsen with smoke exposure (37.4%), lead to disability (46.7%) and quitting smoking has an important role in preventing COPD (34.0%).

Conclusion

The awareness regarding the disease was low among the respondents. Only one-third correctly knew that quitting smoking has an important role in preventing COPD. This study projects an urgent need of improving awareness of COPD and its risk factors in the general population.

Knowledge, perception, and acceptance toward the booster dose of COVID-19 vaccine among patients visiting dental clinics in Aseer region of KSA

Scientists have emerged with innovative research on non-human primates showing that the booster dose of the COVID-19 vaccine increases neutralizing antibody levels against all variants. The current cross-sectional survey was designed to evaluate the knowledge, perception, and acceptance of the booster dose of the COVID-19 vaccine among the patients visiting the various dental clinics in Aseer region, Kingdom of Saudi Arabia. A total of 609 dental patients were selected from various dental clinics by a simple random probability sampling method. The questionnaire was designed in multiple languages and categorized as demographic information, knowledge, perception, and acceptance of participants to a booster dose. An anonymous, self-administered, closed-ended online, and paper-based questionnaire was used to assess the above parameters. In the current survey, the majority of the participants were Saudis (80.8%) with an age mean of 37.7 ± 8.7 years. About 68.6% (418 out of 609) of participants had poor knowledge about the booster dose. Significant differences in the levels of knowledge were found in relation to gender, area of residency, education, nationality, and occupation. The distribution of level of perception of booster dose differs significantly among participants of different marital statuses and nationalities. Hesitation to booster was reported more in the rural than in the urban population. Despite a low level of knowledge, a higher level of good perception and acceptance of booster doses were reported among the studied population.

Perceptions, motivation factors, and barriers to a COVID-19 booster immunization in a subpopulation of KSA: A cross-sectional study

The current cross-sectional survey was designed to evaluate the perception, motivation factors and barriers to a COVID-19 booster immunization in a subpopulation of the Kingdom of Saudi Arabia. A total of 520 respondents were selected by a simple random sampling method. The questionnaire was designed in multiple languages and categorized as; demographic details, perceptions, motivation factors, and barriers to acceptance of a booster dose of COVID-19 vaccine among the respondents. Both anonymous, self-administered, closed-ended online, and paper-based questionnaire was used to assess the above parameters. A higher proportion of the respondents were females (55.2%) with an age range of 36.7 ± 7.7 years. About 36.2% of respondents had a poor perception of the booster dose. Significant differences in the levels of perceptions were found among different age groups and also among the respondents with or without chronic medical conditions. Nearly 49.8% of respondents had hesitation about the booster dose, 58.8% of respondents recommended others to get the booster vaccine at the earliest and 49.8% preferred to develop natural immunity to infection. The hesitation for the booster was more among the female respondents and the older age groups (≥ 60 years) though a large number (43.2%) believe that the booster vaccination is going to end the pandemic worldwide. Further nationwide studies involving different subpopulations are recommended. Public health education is the need of the hour to reduce such barriers and hesitancy.

Perception of Synchronized Online Teaching Using Blackboard Collaborate among Undergraduate Dental Students in Saudi Arabia

Blackboard is a collaborative virtual learning tool used for higher learning that has been found to be an effective and efficient means of interactions between teachers and students and offers effective educational information management. The aim of this research work is to assess the preclinical and clinical dental students' perception of Blackboard Collaborate as a quality teaching and learning tool as well as to find out areas that might appear as barriers to quality teaching and learning. This cross-sectional study was conducted online using survey monkey involving 245 dental students who had participated in the virtual classroom lectures during the pandemic with 18 students not completing the survey. The survey instrument was a nine-item questionnaire that included the age, sex, and year of study of the students as well as previous exposure to online lectures. The data collated was analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for windows version 22. Among 245 respondents that were enrolled in the study, 227 respondents completed the survey, of which 58.1% (n = 132) were male while 41.9% (n = 95) were females. Of the 227 respondents that completed this study, 74.8% (n = 170) of them experienced minimum to moderate technical problems regarding connectivity during the online sessions while 1.8% (n = 4) of the respondents experienced very severe technical problems. The majority of the respondents 54.2% (n = 123) support the continuation of online lectures even after the pandemic. In conclusion, we found a positive perception of our respondents to online lectures using Blackboard Collaborate. Internet connectivity as well as a decline in the comprehension of the lectures as compared to face-to-face learning were found as barriers to online learning.

Comparative Evaluation of 3 Commercial Mouthwash Formulations on Clinical Parameters of Chronic Gingivitis

BACKGROUND Chlorhexidine (CHX) is not prescribed as a mouthwash for long-term use; therefore, probiotic/herbal mouthwashes are being investigated. This study compared the effect of 3 commercial mouthwashes on plaque index (PI), gingival index (GI), and bleeding index (BI) in patients with chronic gingivitis. MATERIAL AND METHODS Forty-five patients (all with moderate plaque) were randomly allocated into 3 groups (Gp): Gp 1 (CHX), Gp 2 (Manuka), and Gp 3 (Pro-Dental). Three periodontal clinical parameters - PI, GI, and BI - were recorded at baseline and on days 7, 14, and 28. An oral hygiene maintenance program was followed by a double-blinded intervention (coded bottle containing mouthwash). Both inter-group and intra-group comparisons were made using analysis of variance (ANOVA) with multiple t tests. All probable values were considered to have various levels of significance at P<0.05 or below. RESULTS All indices for all groups showed higher values (mean) at baseline, which were lower on days 7, 14, and 28. No differences in any clinical parameter at any point of time existed between Gp 1 and Gp 2. There were, however, significant differences (P<0.05) between Gp 1/Gp 3 and Gp 2/Gp 3 for all clinical parameters at all observed time periods (days 7, 14, 28). Intra-group comparison for all groups demonstrated highly significant differences between baseline values and other time points. CONCLUSIONS For managing chronic gingivitis, Manuka mouthwash is as effective as a CHX mouthwash, as there were no differences observed in any clinical parameters at any point points.

Evaluating Time-Dependent Extraction of Exfoliated Oral Mucosal Cells from Used Toothbrushes and Miswak

An integral part of forensic work is DNA quantification and profiling, which necessitates many highquality samples for good results. Oral mucosal cells have become an essential source of genomic DNA in epidemiological studies. The time of collecting DNA samples is a critical factor in forensic science. To compares the time-dependent extraction of DNA yield and purity from exfoliated oral epithelial cells from toothbrushes and miswak used for time intervals up to 5 months. Thirty healthy volunteers were given toothbrushes and miswak to use for six days. The used toothbrushes and miswak were collected, stored at room temperature, and analyzed immediately and at the end of the first, second, third, fourth, and fifth months. Comparisons between the two independent groups of toothbrush and miswak were done by an independent two-sample t-test. The changes over time for each outcome were analyzed using repeated-measures ANOVA. DNA yield of the exfoliated oral epithelial cell samples was higher from female samples, while DNA purity was higher in the male samples. The Miswak contained a sufficient amount of DNA similar to toothbrushes. The yield and purity are not significantly altered by storing them for at least five months at room temperature.

Effect of Common Mouthwashes on Mechanical Properties of Suture Materials Used in Dental Surgeries: A Laboratory Experiment

Background: Sutures play a pivotal role in promoting healing in any surgical procedure. However, the versatile nature of the oral environment entails additional properties in the suture materials to assure uneventful healing. A surgeon needs to understand these delicate intricacies in the immediate postoperative phase and needs some kind of algorithm in the selection of sutures that suits the different surgical scenarios. Therefore, a study was designed to observe the effect of four different types of mouthwash, viz. Avohex, Aloedent, Parodontax and Betadine, on the mechanical properties of Vicryl (polyglactin 910), PTFE (polytetrafluoroethylene), Prolene (polypropylene) and Mersilk. Methods: A total of 288 suture samples were divided in four equal groups (72 = each group) and used for the experiments. Tensile load, tensile strength as well as percentage elongation of the suture materials were evaluated in the various stated media at 3rd, 7th, 10th and 14th days, which were compared with the controls. The results were analyzed statistically and inferences were drawn. Results: Mersilk in (Avohex, Parodontax and Betadine) solutions showed a statistically significant decrease in tensile load over time. All the sutures had the highest tensile strength in Parodontax and had the lowest in Betadine solution. Vicryl and PTFE presented significant percentage elongation over time as compared to Prolene and Mersilk. Conclusion: The author has given certain recommendations but also states that there is no standard rule for the use of a particular suture material in all clinical situations. However, the selection of the suture material should be based on the type of surgery and preferences of the surgeon.

GC/MS characterization and computational kinome-wide screening of pomegranate fruit extract identifies key phytochemicals interacting to CDK kinases implicated in acute myeloid leukemia cells

Punica granatum (Pomegranate fruit) and its constituents are proven effective against various cancer types. However, a kinome-wide screening for the active phytochemicals against kinases is not reported. This study aims in validating pomegranate fruit extract (PFE) against acute myeloid leukemia (AML) cells, and computationally identifying the phytochemicals interacting with active kinases. PFE was made with Soxhlet extractor using absolute ethanol. Gas-chromatography-mass spectroscopy (GC-MS) for phytochemical identification and MTT assay for cytotoxicity in AML (THP-1, TF-1 and HL-60) cells were performed. Apoptosis, CDK5 and CDK8 were assessed with flow cytometry. Kinase profiling was performed using In silico kinome screening. GC-MS analysis revealed 38 bioactive phytochemicals in PFE including pyrazoles, aldehydes, phenols, esters, pyranosides, and octadecadienoic acids. The extract inhibited the AML cell proliferations with GI₅₀ values of 195.5 μg/ml, 289.1 μg/ml, and 353.5 μg/ml in THP-1, THP-1, and HL-60 cells, respectively. PFE also exhibited a dose-responsive increase in apoptotic cell populations when treated to the AML cells. Computational screening and modeling predicted three critical constituents, viz., Deoxyartemisinin, 3-Methyl-3-phenyl-3H-indazole, and 8-fluoro-5,6-dimethoxy-3,4-dihydro-2H-naphthalen-1-one of pomegranate extract to interact mainly with cyclin-dependent kinases, including CDK5 and CDK8. Proteinand ligand docking predicted binding energies, and binding pose for top candidate lead molecules. In vitro assay exhibited the anticancer properties of PFE in AML cells. Computational kinome screening predicted top three PFE constituents targeting CDKs which may be responsible for the demonstrated anticancer efficacy of the extract against AML. This hypothesis further aligned with observed efficacy of PFE to inhibit CDK5 and CDK8 in all AML cells tested. PRACTICAL APPLICATIONS: Though Punica granatum (Pomegranate fruit) and its constituents are proven effective against various cancer types, a kinome-wide screening for the active phytochemicals against kinases is not reported. In this study, we have conducted GC/MS characterization of the active phytochemicals of PFE and have performed a kinome-wide screening for all the 38 identified compounds toward 310 active kinases commonly expressed in cancers. These observations warrant isolation and further evaluation of these phytochemicals or their analogues as effective CDK inhibitors against AML proliferation. Further, the computational methods used in this study will throw light on literature for new options of kinome panel screening of active phytochemicals or small molecules.

Coronavirus Disease (COVID-19) Associated Anxiety, Fear and Preparedness Among Healthcare Students at University Teaching Hospital in KSA

Purpose

The infectious pandemics are generally accompanied by an often-overlooked impact it has on the psychology of the masses. Healthcare students and workers are expected to develop significant levels of stress as compared to the general population. The significance of this study is to assess the depression, anxiety and stress faced by the healthcare students that may lead to unfavourable effects on learning and their overall psychological health.

Methods

This assessment was done by means of an anonymous, online, closed-ended questionnaire. DASS-21 scale was the primary instrument used for this purpose. The responses were recorded on a 4-point Likert scale.

Results

The study had more male students, majority were between 21 and 23 years of age, asymptomatic and almost equal proportion of students from the fraternity of dentistry, medicine, pharmacy and nursing. Dental and pharmacy students were associated with lower stress than medical students whereas nursing students experienced higher anxiety as compared to medical students. Close contact with confirmed COVID-19 cases experienced higher stress and anxiety. Daily patient exposure was associated with significantly higher stress anxiety and depression.

Conclusion

Based on the observations of the present study, a support program for psychological training for these health care students should be introduced.

Anti-Diabetic Activity of Bioactive Compound Extracted from Spondias mangifera Fruit: In-Vitro and Molecular Docking Approaches

Spondias mangifera is a drupaceous fruit popular for its flavour and health advantages. There is little scientific knowledge about S. mangifera, despite its widespread usage in traditional medicine, in the North-Eastern region of India. Inhibiting the key carbohydrate hydrolysing enzymes is one of the strategies for managing diabetes. Therefore, this study studied the antioxidant and anti-diabetic properties of different fraction S. mangifera fruit extract (SMFFs) from Indian geographical origin by in vitro experimental assays and silico docking simulation studies. The ADMET prediction for active substances was also investigated using the AdmetSAR database. Based on the binding affinity/molecular interactions between phytocompounds and target enzymes, in silico investigations were done to confirm the in vitro enzymatic inhibitory capability. β-sitosterol in EtOH-F was analysed using RP-HPLC with RP-C18 column as stationary phase and photo diode array detector. The percentage of β-sitosterol was found to be 1.21% ± 0.17% of total weight of extract (w/w). S. mangifera fruit ethanolic extract had a significant inhibitory concentration of 50% against free radicals produced by ABTS (89.71 ± 2.73%) and lipid peroxidation assay (88.26 ± 2.17%) tests. Similarly, the in vitro antidiabetic test findings indicated that S. mangifera inhibited alpha-amylase (73.42 ± 2.01%) and alpha-glucosidase (79.23 ± 1.98%) enzymes dose-dependently. The maximum glycosylated Hb percentage inhibitory activity shown in the ethanolic fraction was (83.97 ± 2.88%) at 500 µg/mL. The glucose uptake of the ethanolic fraction by the yeast cell showed significant (p < 0.05) at 500 µg/mL when compared with metformin (91.37 ± 1.59%), whereas the other fraction did not show the uptake of glucose by the yeast cell at the same concentration. In the docking study, the main phytoconstituents of S. mangifera fruit, such as oleanolic acid, beta-sitosterol, and beta amyrin, show strong affinity for pancreatic α-amylase. These results imply that S. mangifera has α-amylase and α-glucosidase inhibitory properties and may be used as antidiabetic with antioxidant characteristics.

Pharmacological Efficacy of Tamarix aphylla: A Comprehensive Review

Tamarix aphylla is a well-known species of the genus Tamarix. T. aphylla (Tamaricaceae) is a perennial tree in Asia, the Middle East, and Central Africa. It is used as a carminative diuretic in tuberculosis, leprosy, and hepatitis. Various pharmacological properties have been shown by T. aphylla, such as antidiabetic, anti-inflammatory, antibacterial, antifungal, anticholinesterase, and wound-healing activity. However, T. aphylla has not received much attention for its secondary metabolites and bioactive constituents. Research has shown that this plant has hidden potential that needs to be explored. This review aims to cover botanical classification, geographical distribution, taxonomy, ethnobotanical uses, and the phytochemical compounds found in T. aphylla. The toxicology and pharmacological effects of T. aphylla are also discussed. We examined various scholarly resources to gather information on T. aphylla, including Google Scholar, Scopus, Science Direct, Springer Link, PubMed, and Web of Science. The finding of this work validates a connection between T. aphylla in conventional medicine and its antidiabetic, antibacterial, anti-inflammatory, wound-healing, antifungal, anticholinesterase, and other biological effects. T. aphylla's entire plant (such as bark, leaves, fruits) and root extracts have been used to treat hypertension, stomach discomfort, hair loss, cough and asthma, abscesses, wounds, rheumatism, jaundice, fever, tuberculosis, and gum and tooth infection. The phytochemical screening revealed that noticeably all extracts were devoid of alkaloids, followed by the presence of tannins. In addition, different parts have revealed the existence of steroids, flavonoids, cardiac glycosides, and byproducts of gallic acid and ellagic acid. T. aphylla has shown many valuable activities against different diseases and supports its traditional uses. Therefore, high-quality preclinical research and well-designated clinical trials are needed to establish the efficacy and safety of this plant in humans.

Glycyrrhiza glabra (Licorice): A Comprehensive Review on Its Phytochemistry, Biological Activities, Clinical Evidence and Toxicology

There are more than 30 species of Glycyrrhiza genus extensively spread worldwide. It was the most prescribed herb in Ancient Egyptian, Roman, Greek, East China, and the West from the Former Han era. There are various beneficial effects of licorice root extracts, such as treating throat infections, tuberculosis, respiratory, liver diseases, antibacterial, anti-inflammatory, and immunodeficiency. On the other hand, traditional medicines are getting the attraction to treat many diseases. Therefore, it is vital to screen the medicinal plants to find the potential of new compounds to treat chronic diseases such as respiratory, cardiovascular, anticancer, hepatoprotective, etc. This work comprehensively reviews ethnopharmacological uses, phytochemistry, biological activities, clinical evidence, and the toxicology of licorice, which will serve as a resource for future clinical and fundamental studies. An attempt has been made to establish the pharmacological effect of licorice in different diseases. In addition, the focus of this review article is on the molecular mechanism of licorice extracts and their four flavonoids (isoliquiritigenin, liquiritigenin, lichalocone, and glabridin) pharmacologic activities. Licorice could be a natural alternative for current therapy to exterminate new emerging disorders with mild side effects. This review will provide systematic insights into this ancient drug for further development and clinical use.

Recombinant Human Adenovirus-p53 Therapy for the Treatment of Oral Leukoplakia and Oral Squamous Cell Carcinoma: A Systematic Review

Background and Objectives: Oral cancer is the 6th most common cancer in the world and oral leukoplakia is an oral potentially malignant disorder that could develop into oral cancer. This systematic review focusses on randomized clinical trials for recombinant adenovirus p-53 (rAD-p53) therapy for the treatment of oral leukoplakia and cancer. Materials and Methods: We searched for research articles on various databases such as Pubmed/Medline, Embase, CNKI (China National Knowledge Infra-structure), Springerlink, cochrane and Web of sciences from 2003 to 2020. MeSH (Medical Subject Headings) terms were used for the search. Inclusion criteria included original research, randomized clinical trials and articles only in English language. Exclusion criteria were any articles that were not research articles, not randomized trials, non-human studies, etc. The articles were further graded on the Jadad scale. Results: 578 articles were assessed from various databases; only 3 articles were found to be appropriate for this review. Thus, meta-analysis was not performed because of heterogeneity and lack of data. In the three studies, whether rAD-p53 was used as a standalone therapy or with other therapies, there was a beneficial effect of the therapy. Furthermore, there were no serious adverse events and the only adverse events reported were fever, pain at the local injection site, flu-like symptoms and lowered WBC count. Conclusions: Thus, we can conclude that this therapy has a potential for beneficial therapeutic effects and further clinical trials with more patients need to be performed to get better understanding of the effect of rAD-p53 therapy, which probably will pave the way to its approval in other parts of the world.

In-vitro evaluation of commonly used beverages on tensile strength of different suture materials used in dental surgeries

Sutures are used for the approximation of incised flaps, assistance in primary healing, and hemorrhage control. In oral and periodontal surgery, the appropriate selection of suture material is vital for favorable healing.The aim of the present in-vitro experiment was to evaluate the tensile strengths of 4 different types of suture materials (silk, polygalactine 910, polypropylene, chromic catgut) by simulating potential short-term intraoral exposure to various beverages (saliva, Arabic coffee, tea, cola).A total of 280 suture specimens were prepared, out of which 10 specimens from each group were selected for pre-immersion testing. Remaining suture specimens were immersed in 4 different thermostatically controlled media (1 control [artificial saliva], 3 tests [Cola drink, Arabic coffee, Tea]). Tensile strength was measured at pre-immersion, 3, 7, and 14 days using a universal tensile testing machine. The maximum load required to break the suture material was recorded in Newton.At day 3, tea caused significant reduction in tensile strength of silk and cola caused significant reduction in tensile strengths of polygalactine 910 and chromic catgut. Whereas, at day 7, silk and polypropylene retained their tensile strengths better than others.The authors recommend precaution in the use of these beverages in the first postoperative week, to avoid adverse effect on the mechanical strength of sutures. When exposure to these beverages are anticipated, it is better to use polypropylene sutures that resists rapid fall in tensile strengths in the early postoperative period.

The Knowledge, Attitude and Practices of the Caregivers about Oral Health Care, at Centers for Intellectually Disabled, in Southern Region of Saudi Arabia

Oral health is perhaps the most neglected aspect of healthcare for persons living in rehabilitation centers, compared to the general population. The caregivers play a vital role in administering daily oral care to residents in rehabilitation centers: The aim of the present questionnaire-based study was to evaluate the caregivers’ knowledge, attitude and practices towards oral healthcare at centers for the intellectually disabled in the Southern region of Saudi Arabia (SA). The present study was designed as a cross-sectional one-point time survey. The samples were selected by using a non-probability convenience sampling method. The self-administered closed-ended questionnaire comprised of 22 items divided into four sections, which was designed to elicit the demographic information, awareness of oral care, attitude towards oral health and practice of the oral healthcare regime among the participants. Of the164 participants, 53.0% and 47.0% were male and female, respectively. Most of the participants—54.9%—were between 30–39 years of age. Participants were almost equally distributed between educational groups, and about 87% had more than 2 years of experience. A brief overview showed a fair level of knowledge and attitude among 61.6% and 58.5% of respondents, respectively. Participants with an education level above that of high school showed good knowledge and attitude scores (p < 0.05), whereas females showed better attitude scores compared to the males (p < 0.05). Respondents mentioned the difficulties they faced while treating the subjects. The special healthcare workers generally had acceptable oral health knowledge and practices. Caregivers who had lower education levels should be advised for training programs that addressed the importance of oral health services.

Comparison of Accuracy in Determining the Root Canal Working Length by Using Two Generations of Apex Locators - An In Vitro Study

AIM

The present in-vitro study aims to compare the accuracy of root canal working length determination between the third generation and fourth generation electronic apex locators.

MATERIAL AND METHODS

Fifty extracted single-rooted single canal teeth were selected for the study, and a definite coronal plane was prepared. Actual working length (AL) was measured using a stereomicroscope under 8X magnification. Electronic working length measurements were recorded using Root ZX (EL1) and Elements Diagnostic Unit (EL2) apex locators. One-way ANOVA test was carried out to analyse the data among the experimental groups.

RESULTS

The results of the one-way ANOVA test showed that difference in the working length determined by either apex locators (EL1 and EL2) and actual length determined under a stereomicroscope (AL) was statistically not significant. The independent 't' test comparing between groups EL1 and AL; and EL2 and AL showed that working length determined by either of the apex locators (EL1 and EL2) and actual length determined under a stereomicroscope (AL) was statistically not significant.

CONCLUSION

In this in vitro study, the Root ZX and Elements Diagnostic Unit apex locators are equally accurate for determination of working length when compared to actual working length.

Microbial Etiology and Antimicrobial Therapy of Peri-implantitis: A Comprehensive Review

Introduction:

Implants have turned out to be a well-established therapy in dental practice for the replacement of missing teeth and restoration of function.

Peri-implant disease denotes the inflammatory condition of surrounding soft and hard tissues.

Two terminologies are covered under the impression of peri-implant pathology; peri-implantitis and mucositis. Peri-implant mucositis is a reversible inflammatory process limited to soft tissues around an implant. Peri-implantitis is an inflammatory condition of hard and soft tissue around the dental implant.

Microbial Etiology:

Bacterial infections are the most common cause of peri-implantitis. It is a variable poly-microbial infection, although generally dominated by Gram-negative anaerobic bacteria Anti-infective therapy should be included in the treatment regime, while treating the peri-implant disease. Antimicrobial therapy includes local debridement, antibiotic therapy and surface decontamination of the implant.

Conclusion:

The current article gives a detailed overview of microbial etiology, antimicrobial therapy and its limitations for the treatment of peri-implant Pathology.

Effect of Smoking and Tobacco Chewing on Periodontal Disease and Non-Surgical Treatment Outcome: A Clinical and Biochemical Study

OBJECTIVE

The purpose of this study was to compare effects of smoking and smokeless forms of tobacco consumption (tobacco chewing) on periodontal disease parameters and response of these subjects to non-surgical periodontal therapy.

METHODS

One hundred sixty-eight patients with chronic periodontitis were screened for the study. Eighteen patients were excluded as they decided to quit the tobacco habit. One hundred fifty patients fulfilling the inclusion and exclusion criteria were grouped as: Group 1, 50 smokers; Group 2, 50 tobacco chewers; and Group 3, 50 non-smokers, non-tobacco chewers (controls). Scaling and root planing was performed at the initial visit as a part of initial therapy. The clinical parameters recorded at baseline, 1 month, 2 months and 3 months were plaque index (PI), gingival index (GI), probing depth (PD), gingival recession (GR), and gingival crevicular fluid (GCF) measurement.

RESULTS

With respect to the comparison between smokers and tobacco chewers, smokers had significantly more probing depth at baseline examination, while tobacco chewers had more gingival recession. Gingival inflammation, response to non-surgical treatment and oral hygiene maintenance were more suppressed in smokers as compared to tobacco chewers.

CONCLUSION

Tobacco consumption in both forms affects the severity of periodontal disease. It affects the response of periodontal tissues to non-surgical treatment. In addition it leads to poorer oral hygiene and hampers maintenance of oral hygiene.

Paralleling technique for frenectomy and oral hygiene evaluation after frenectomy

Background:

High frenum attachment is a very common problem in the population. Various conventional techniques are available which has certain disadvantages; in addition to that high frenum also hinders oral hygiene maintenance. This study aims to evaluate patient's response to two different frenectomy technique, and oral hygiene maintenance before and after frenectomy.

Materials and Methods:

Twenty patients with high labial frenum were randomly selected from the outpatient department. Patients were divided into two groups according to the technique used. Each group contained ten patients. One group was treated by “conventional scalpel technique” and other group by “new paralleling technique”. To evaluate patients response, visual analogue scale for pain and speech were taken at first postoperative day, 1-week and 1-month. In other part of the study the oral hygiene maintenance was evaluated by using plaque and gingival bleeding index at baseline before frenectomy, 1-week and 1-month after frenectomy.

Results:

Results showed that new paralleling technique for frenectomy causes less postoperative discomfort and also there was significant improvement in the oral hygiene maintenance by the patient after frenectomy.

Conclusion:

High maxillary frenum causes hindrance in oral hygiene maintenance. Paralleling technique for frenectomy causes less discomfort to the patient during healing phase when compared with the conventional technique.

Efficacy of irrigation with different antimicrobial agents on periodontal health in patients treated for chronic periodontitis: A randomized controlled clinical trial

Introduction:

Periodontitis is inflammation of supporting tooth structure. Most individuals get affected by this disease if oral hygiene is not maintained. There are various mechanical and chemical methods for oral hygiene maintenance. In recent past, interest has been diverted toward the herbal/traditional product in oral hygiene maintenance as they are free from untoward effect.

Aim:

To assess the efficacy of subgingival irrigation with herbal extract (HE) as compared with 0.2% chlorhexidine (CHX) on periodontal health in patients who have been treated for chronic periodontitis, and still have residual pocket of 3–5 mm.

Materials and Methods:

This was a controlled, single-blind, randomized study for 3 months. Patients were allocated in two groups (n = 15 each): (1) 0.2% CHX (control group); (2) HE consisting of Punica granatum Linn. (pomegranate), Piper nigrum Linn. (black pepper), and detoxified copper sulfate (test group). Solutions were used for the irrigation using pulsated irrigating device, WaterPik. Clinical outcomes evaluated were plaque index (PI), sulcus bleeding index (SBI), probing depth at baseline, 15^th, 30^th, 60^th, and 90^th day. Microbiologic evaluation was done at baseline and 90^th day.

Results:

Significant reduction in PI was seen in the group of irrigation with HE. While comparing SBI, irrigation with CHX shows a better result. Other parameters such as probing pocket depth and microbiological counting were similar for both groups.

Conclusion:

Irrigation with HE is a simple, safe, and noninvasive technique with no serious adverse effects. It also reduces the percentage of microorganism in periodontal pocket.