Callistemon viminalis leaf extract phytochemicals modified silver-ruthenium bimetallic zinc oxide nanocomposite biosynthesis: application on nanocoating photocatalytic Escherichia coli disinfection

Antibiotics are of great interest due to antibiotic-resistant problems around the globe due to bacterial resistance to conventional antibiotics. In this study, a novel green biosynthesis of silver-ruthenium bimetallic zinc oxide nanocomposite using Callistemon viminalis leaf extract as a reducing agent using zinc nitrate hexahydrate, silver nitrate, and ruthenium(iii) chloride as capping agents was reported. The results demonstrated that the surface morphology of the prepared bimetallic nanocomposite by scanning electron microscopy was hexagonal in shape for zinc nanoparticle, rectangular in shape for silver nanoparticle, and tetragonal in shape for ruthenium nanoparticle, having an average surface size 25, 35, and 55 nm, respectively. Fourier transform infrared analysis confirmed the presence of compounds containing alkene, halo-, sulfoxide, phenol, nitro-, phenyl-ester, carboxylic acid, amines, and alcohols which act as functional groups attached to the surface of nanocomposites. Results from X-ray diffraction analysis found 81.12% crystallinity and hexagonal structure of zinc nanoparticles, rectangular structure of silver nanoparticles, and tetragonal structure of ruthenium nanoparticles, which are also similar to the results from transmission electron microscopy analysis. The average size distribution by dynamic light scattering of silver-ruthenium bimetallic zinc oxide nanocomposite was 255 nm, which confirms the biosynthesis of non-uniform size. Photo-disinfection activity of a silver-ruthenium bimetallic zinc oxide nanocomposite against Escherichia coli bacteria isolated from hospital wastewater under dark and ultraviolet-A irradiation conditions was observed. The antibacterial activity was calculated at 2.42704239, ensuring the silver-ruthenium bimetallic zinc oxide nanomaterials have photo-disinfection properties. The results from this study revealed that the developed novel antibacterial nanocomposite of silver-ruthenium bimetallic zinc oxide is useful in nanocoating photocatalytic Escherichia coli disinfection and can be applied to disinfect surfaces.

Efficacy of Biofilm Removal on the Dental Implant Surface by Sodium Bicarbonate and Erythritol Powder Airflow System

OBJECTIVE

 Peri-implantitis is a common complication in implant therapy and it is one of the main contributing factors to implant failure. This can be prevented by regular maintenance with mechanical debridement. One of the recent mechanical debridement methods is air abrasion therapy using different abrasive powders. This study aimed to evaluate the two common abrasive powders of different sizes (sodium bicarbonate and erythritol) for their biofilm cleaning efficacy on dental implant surfaces.

MATERIALS AND METHODS

 In an in vitro setting, a total of 33 implants were divided into three groups: Group 1 (n =11) = no treatment; group 2 (n = 11) = air abrasion therapy treated group using a sodium bicarbonate powder (AIRFLOW Powder Classic Comfort, EMS Electro Medical Systems, Nyon, Switzerland); and group 3 (n = 11) = air abrasion therapy treated group using an erythritol powder (AIRFLOW Powder Plus, EMS Electro Medical Systems, Nyon, Switzerland). The implants in each group were subjected to biofilm formation, and group 2 and group 3 were treated with air abrasion therapy of two different powders having different sizes with the same settings. The particle sizes were sodium bicarbonate (40 µm) and erythritol (14µm). The surface characteristics of the dental implants in three groups were studied from a digital camera and under the scanning electron microscope at different magnifications. The comparison of biofilm-removal efficacy between the three groups was performed by using a one-way analysis of variance with post-hoc Dunnett's T3 test. A p-value less than 0.05 was chosen to indicate statistical significance.

RESULTS

 There were no statistical differences (p > 0.05) between the two powder-treated groups for the biofilm cleaning efficacy. However, both groups showed significantly better biofilm-cleaning efficacy than the control group (p < 0.05).

CONCLUSION

 This suggests that both powders are effective in removing biofilm from the implant surface under ideal conditions. However, there was no clear distinction between the cleaning potential of the two powders, as both performed in a similar manner.

Clinical outcomes of 3-5 years follow-up of immediate implant placement in posterior teeth: a prospective study

BACKGROUND

Immediate implant placement in posterior teeth has become popular in recent years. However, only a few studies focused on evaluating the long-term success of immediate implant placement.

PURPOSE

To analyze the clinical outcomes of immediate implant placement in the posterior region with conventional loading with 3-5 years follow-up following the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference.

METHOD

The study was done in 25 bone-level implants (Straumann® SLActive® bone level tapered implant, Straumann®, Basel, Switzerland) in 19 patients who underwent immediate implant placement in a posterior tooth with conventional loading with 3-5 years follow-up. The overall success and survival of these placements were evaluated following the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference using chart records, clinical examination, radiographic evaluation, and outcomes measurement. Patient satisfaction was evaluated by using a numeric rating scale. The biological and technical status, modified Pink Esthetic Score (mPES), complications, and marginal bone change were also evaluated. The analysis was done using SPSS version 21 (SPSS Inc., Chicago, IL, USA). The data were analyzed using a paired samples t-test.

RESULTS

It was found that 24 out of the 25 (96%) dental implants survived for an average of 57 ± 8.07 months. All of the 24 surviving dental implants were considered an operational success. The average mPES was 9.75 ± 0.44. The major prosthetic complications seen were: (1) proximal contact loss (41.67%), (2) loosening of the screw (8.33%), and (3) cement debonding (4.17%).

CONCLUSIONS

Immediate implant placement in a posterior tooth with conventional loading yields a predictable result with some complications. The most prominent complications were proximal contact loss, followed by loosening of the screw and cement debonding. The implant survival rate was 96% at a mean time follow-up of 4 years and 9 months.

Oral bacteriophages: metagenomic clues to interpret microbiomes

Bacteriophages are bacterial viruses that are distributed throughout the environment. Lytic phages and prophages in saliva, oral mucosa, and dental plaque interact with the oral microbiota and can change biofilm formation. The interactions between phages and bacteria can be considered a portion of oral metagenomics. The metagenomic profile of the oral microbiome indicates various bacteria. Indeed, there are various phages against these bacteria in the oral cavity. However, some other phages, like phages against Absconditabacteria, Chlamydiae, or Chloroflexi, have not been identified in the oral cavity. This review gives an overview of oral bacteriophage and used for metagenomics. Metagenomics of these phages deals with multi-drug-resistant bacterial plaques (biofilms) in oral cavities and oral infection. Hence, dentists and pharmacologists should know this metagenomic profile to cope with predental and dental infectious diseases.

Importance of oral health in mental health disorders: An updated review

Background

Mental disorders are indeed an expanding threat, which requires raised awareness, education, prevention, and treatment initiatives nationally and globally. This review presents an updated review on the relationships between oral health and mental health disorders and the importance of oral health in mental health disorders.

Method

A literature search was done regarding mental disorders and oral health approaches in Google Scholar and PubMed from the year 1995 until 2023. All the English-language papers were evaluated based on the inclusion criteria. Publications included original research papers, review articles and book chapters.

Results

Common mental disorders include depression, anxiety, bipolar disorder, Schizophrenia, dementia, and alcohol and drug use disorders. The interplay of oral health and mental disorders involves dysregulated microbiome, translocated bacteria, and systemic inflammation, among others.

Conclusion

There is a complex relationship between mental disorders and oral diseases. Various oral health problems are associated with mental health problems. The interplay of oral health and mental disorders involves dysregulated microbiome, translocated bacteria, and systemic inflammation, among others. Mental health nurses including physicians and dental professionals should be involved in the oral health care of mental health disorder patients. Therefore, multidisciplinary should be involved in the care of mental health disorders, and they should consider oral health care as an essential part of their care for patients with mental health disorders. Future investigations should strive to elucidate the exact biological relationships, to develop new directions for treatment.

Current classification of zirconia in dentistry: an updated review

Zirconia, a crystalline oxide of zirconium, holds good mechanical, optical, and biological properties. The metal-free restorations, mostly consisting of all-ceramic/zirconia restorations, are becoming popular restorative materials in restorative and prosthetic dentistry choices for aesthetic and biological reasons. Dental zirconia has increased over the past years producing wide varieties of zirconia for prosthetic restorations in dentistry. At present, literature is lacking on the recent zirconia biomaterials in dentistry. Currently, no article has the latest information on the various zirconia biomaterials in dentistry. Hence, the aim of this article is to present an overview of recent dental zirconia biomaterials and tends to classify the recent zirconia biomaterials in dentistry. This article is useful for dentists, dental technicians, prosthodontists, academicians, and researchers in the field of dental zirconia.

Onco-immunity and therapeutic application of amygdalin: A review

Background

Amygdalin is known as a chemical compound derived from various fruits. The glycosides existing in this plant have been historically utilized as an anticancer agent. This review presented an overview of amygdalin and its onco-immunity and other therapeutic medical applications.

Method

A literature search for studies relating to amygdalin and cancer treatment was carried out using PubMed and Google Scholar. Combinations of the following terms were used in the search strategies: "amygdalin," "rhodanese," "cyanide," "cyanogenic," "hypothiocyanite," "mandelonitrile," "glucosides," "cancer," "apoptosis," and "cytotoxicity," combined with a cancer term such as "seed," "almond," or "apricot," "cancer + cell line, antiproliferation or inhibition," "BAX From the March 3, 1981 until the April 15, 2021, all of the English-language papers were evaluated based on the inclusion criteria. Publications included reviews, chapters from books, and original research papers.

Results

The FDA prohibits Amygdalin from medical usage as an anticancer treatment due to a lack of proof of cure in cancer cases. When this natural-based compound is used with conditional chemotherapeutic medicines causes synergistic effects. Besides, amygdalin is used to manage asthma, improve the immune system, induce apoptosis in human renal fibroblasts, and inhibit hyperglycemia.

Conclusion

Various medical uses of amygdalin have been found such as managing asthma, improving the immune system, inducing apoptosis in human renal fibroblasts, and inhibiting hyperglycemia. More effective in vitro and review studies are required to elucidate the exact role of this herb in medical applications.

Role of hormones in bone remodeling in the craniofacial complex: A review

Background

Diseases such as periodontitis and osteoporosis are expected to rise tremendously by 2050. Bone formation and remodeling are complex processes that are disturbed in a variety of diseases influenced by various hormones.

Objective

This study aimed to review and present the roles of various hormones that regulate bone remodeling of the craniofacial complex.

Methods

A literature search was conducted on PubMed and Google Scholar for studies related to hormones and jawbone. Search strategies included the combinations ("name of hormone" + "dental term") of the following terms: "hormones", "oxytocin", "estrogen", "adiponectin", "parathyroid hormone", "testosterone", "insulin", "angiotensin", "cortisol", and "erythropoietin", combined with a dental term "jaw bone", "alveolar bone", "dental implant", "jaw + bone regeneration, healing or repair", "dentistry", "periodontitis", "dry socket", "osteoporosis" or "alveolitis". The papers were screened according to the inclusion criteria from January 1, 2000 to March 31, 2021 in English. Publications included reviews, book chapters, and original research papers; in vitro studies, in vivo animal, or human studies, including clinical studies, and meta-analyses.

Results

Bone formation and remodeling is a complex continuous process involving many hormones. Bone volume reduction following tooth extractions and bone diseases, such as periodontitis and osteoporosis, cause serious problems and require a great understanding of the process.

Conclusion

Hormones are with us all the time, shape our development and regulate homeostasis. Newly discovered effects of hormones influencing bone healing open the possibilities of using hormones as therapeutics to combat bone-related diseases.

Biomolecular and Biochemical Aspects of the Oral Cavity

Recent advances in science, especially innovations in the field of biochemistry and materials science, greatly contribute to improvements in the prevention, diagnosis, and treatment of oral diseases [...].

Modifiable and Non-modifiable Risk Factors Affecting Oral and Periodontal Health and Quality of Life in South Asia

Objectives:

The study aimed to review the prevalence of periodontal disease and associated factors among developing South Asian countries. The review was also aimed at providing an insight into how such factors play a role in affecting the Quality of life of patients with compromised oral health.

Background:

It has been observed that Oral health directly correlates with the Quality of life of an individual, so it is imperative to understand this, particularly in the developing parts of the world.

Methods:

A MeSH keyword search was carried out with the keywords: Periodontal diseases, Oral Health, Public Health, Asia, QoL, Quality of Life, Southeast Asia, Tobacco, and Risk Factors, and based on the findings, this detailed review was compiled.

Results:

The South Asian population forms 24.89% of the world population, while periodontal disease is an inflammatory condition that affects 11% of the globe. Several studies previously conducted across developing countries have shown that various factors like the socioeconomic status of an individual, smoking habit, consumption of alcohol, hypertension, history of diabetes, obesity, and stress are indirectly related to the onset of periodontal disease. Characteristics associated with specific populations like ethnicity, behavioral characteristics, and environmental factors may affect causing periodontitis.

Conclusion:

Dental practitioners in this region should consider risk factors that can be altered significantly to uplift the periodontal health status of an individual, which is not being considered in many developing countries.

Electrochemical Biosensors for Pathogen Detection: An Updated Review

Electrochemical biosensors are a family of biosensors that use an electrochemical transducer to perform their functions. In recent decades, many electrochemical biosensors have been created for pathogen detection. These biosensors for detecting infections have been comprehensively studied in terms of transduction elements, biorecognition components, and electrochemical methods. This review discusses the biorecognition components that may be used to identify pathogens. These include antibodies and aptamers. The integration of transducers and electrode changes in biosensor design is a major discussion topic. Pathogen detection methods can be categorized by sample preparation and secondary binding processes. Diagnostics in medicine, environmental monitoring, and biothreat detection can benefit from electrochemical biosensors to ensure food and water safety. Disposable and reusable biosensors for process monitoring, as well as multiplexed and conformal pathogen detection, are all included in this review. It is now possible to identify a wide range of diseases using biosensors that may be applied to food, bodily fluids, and even objects' surfaces. The sensitivity of optical techniques may be superior to electrochemical approaches, but optical methods are prohibitively expensive and challenging for most end users to utilize. On the other hand, electrochemical approaches are simpler to use, but their efficacy in identifying infections is still far from satisfactory.

Tooth root resorption: A review

Tooth root resorption is multifactorial, leading to progressive destruction and eventual loss of tooth root dentin and cement. There are internal and external types of root resorption, each having its variety. The etiology and pathogenesis of tooth root resorption are poorly understood, and the most significant etiological factors are trauma, pulpal infection, tooth bleaching, and orthodontic treatment. Tooth root resorption is primarily asymptomatic; thus, it is revealed accidentally by radiographic examination. Progressive clinical manifestations are pain, tooth discoloration, tooth mobility, and other conditions. Awareness of the causes and risk factors allowing tooth root resorption, and regular radiographic examination, in case of necessity, make it possible to reveal resorption at an early stage and to prevent its further development. Thus, the aim of this study is to present etiopathogenesis, a clinical course, and diagnostic peculiarities of internal and external types of tooth root resorption, enabling practicing dentists to timely diagnose root resorption and take appropriate measures to avoid further complications. Within the limitation of this review, even though the etiopathogenesis of tooth root resorption is yet not fully understood, it is suggested that the etiological factors fall into two groups (endogenic and exogenic) to enhance further understanding of the possible causes and mechanisms of root resorption and allow practitioners to monitor high-risk patients and make timely diagnoses. Moreover, radiographic examination and CBCT are indispensable for the diagnosis of root resorption.

Oral and Craniofacial Anomalies of Fraser Syndrome:Prosthetic Management

Fraser syndrome (FS, MIM 219000) is a rare autosomal disorder characterized by systemic and oro-facial malformation, usually comprising cryptophthalmos, laryngeal malformations, syndactyly, and urogenital defects. We presented a 21-year-old FS case with partial missing teeth seeking aesthetic dental treatment. Clinical examination revealed bilateral cryptophthalmos, extensive syndactyly of hands and feet broad nose with the depressed nasal bridge, and surgically corrected bilateral cleft lip. She presented class III jaw relation and reduced the vertical height of the face. Prosthetic rehabilitation of the patient was done with upper and lower overlay dentures made from acrylic resin (VIPI BLOCK TRILUX®, VIPI Industria, Pirassununga, SP, Brazil) using computer-aided design (CAD) and computer-aided manufacturing (CAM) process. At the follow-up visit, the patient presented improved aesthetics and function. Proper management and rehabilitation of FS patients are challenging, but standard guidelines for oral health management are currently lacking. This article presents a case of Fraser syndrome presenting oral and craniofacial anomalies, and prosthetic rehabilitation was done. We also provided recommendations for the optimal oral health care for the FS patients. Functional adaptation and rehabilitation have significant roles in the various functions, survival, and quality of the life of FS patients. Integrated medicaldental care is needed in such patients with support from family members, friends, and colleagues.

The Contemporary Management of Cleft Lip and Palate and the Role of Artificial Intelligence: A Review

Introduction:

Cleft management is an exhaustive process for the patient, the orthodontist, and the caregiver. In recent decades, a wide number of challenges have been addressed with the inclusion of various dental specialties for the detection, diagnosis, and treatment of orofacial clefts. The orthodontist plays a very pivotal role during the overall management of children with cleft lip and palate as they need to make critical decisions for when to intervene orthodontically and at what stage to set priorities for individual treatment goals.

Objectives:

The objectives of this study were to provide an in-depth review of the evolving role of various disciplines focusing on orthodontics in the management of cleft cases.

Methods:

A general search was carried out to identify the published data on cleft lip and cleft palate management on PubMed and Scopus until the 1st of June 2021 using keywords such as cleft lip, cleft palate, cleft orthodontics, naso-alveolar molding, and surgical cleft orthodontics. The related literature was then reviewed and analyzed.

Results:

With improvements in 3D modeling, CT scans of patients can be used to construct precise 3D models, and these can be utilized to demonstrate various clinical issues related to clefts. The orthodontist has a major role in the various stages and steps, follow-up, treatment care, and outcome assessment. With the advent of technological advancements and artificial intelligence, the role is only going to evolve and expand further in the management of the cleft lip and palate. Diagnostic techniques utilizing artificial intelligence to detect cleft during the prenatal period have also been tested and have been shown to have a high rate of accuracy. The evolution of distraction osteogenesis came into the limelight as a revolutionary modality for cleft treatment. Computer-assisted orthognathic surgery is a widely used modality for reshaping the osseous defects of the maxilla in patients with congenital clefts. With the development of additional modalities such as aligners, patients that need to undergo complex orthognathic surgeries can also be treated with aligners without compromising the outcomes.

Conclusion:

The cleft lip and palate can be managed by a multi-disciplinary team. Orthodontics has an important role in the overall management of a cleft affected individual as they must make critical decisions regarding orthodontic interventions as well as set priorities for each treatment goal. With the advent of technological advancements and artificial intelligence, the diagnosis and management of the cleft lip and palate have become simplified.

Antimicrobial Activity of Various Disinfectants to Clean Thermoplastic Polymeric Appliances in Orthodontics

There is a lack of research evidence on the risk–benefits of the various disinfectants in cleaning products and cleansing regimens. This systematic review compared the antimicrobial activity of various chemical disinfectants to disinfect the thermoplastic polymeric appliances in orthodontics. The study was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane Handbook of Systematic Reviews of Interventions. An electronic search was conducted on Pubmed, Google Scholar, Scopus, ScienceDirect, and Springer. Two authors independently investigated the risk of bias in duplication. A total of 225 articles were collected. After removing duplicates, 221 articles remained, and after filtering their titles and abstracts, 11 articles met eligibility qualifications remained. Finally, nine articles that met the criteria were selected. It showed that both over-the-counter orthodontic appliance cleaners and applied-chemical disinfectants were effective against bacteria. The duration and frequency of usage guidelines cannot be concluded.

Facial Esthetic Analysis of Nepalese Subjects

Background:

Facial beauty is a prime concern in facial esthetic treatments and facial plastic surgery. The cephalometric can be used in the diagnosis, treatment planning, assessing the growth pattern in the craniofacial complex and skeletal disproportion with the relationships of the teeth to their supporting bone.

Objective:

The objective of this research was to analyze the face, evaluate the variability between males and females, and determine the cephalometric norms of Nepalese subjects based on Ricketts analysis.

Materials and Methods:

Craniofacial analysis of 106 Nepalese Brahmins subjects (60 females and 46 males) was done using the lateral cephalogram. The samples were criteria selected who met the criteria; well-balanced face, class I canine relation, and class I molar relation with normal occlusion. Ten parameters of Ricketts analysis were measured and analyzed using SPSS 20. The results were compared among males and females using Independent T-test with P value = 0.05.

Results:

The mean values of the facial axis, mandibular plane angle, mandibular arc, convexity at A were higher among the Brahmin females compared to Brahmin males. While the mean values of lower facial height, lower incisor to A Pog distance, lower incisor to A Pog angle, upper molar to PTV, and distance from lower lip to E plane were higher among the Brahmin males compared to Brahmin females. Female had smaller craniofacial variables compared to males. The mean values of upper molar position are higher for both males and females compared to the standard value of 12 ±3 mm; however, the mean values are significantly higher among males compared to females (P = 0.001). It showed that the facial axis, chin position, lower facial height, and facial depth were no significant differences between Nepalese males and females.

Conclusion:

There was sexual dimorphism in craniofacial features in Nepalese Brahmins. Female had smaller craniofacial variables compared to males. This research provided an overview of craniofacial features and they can be a norm for Nepalese Brahmins in orthodontic diagnosis and treatment planning.

White Spot Lesions: A Serious but Often Ignored Complication of Orthodontic Treatment

Objective:

The objective of this narrative review is to present an overview of the prevalence, clinical manifestation, diagnosis, and latest advances on white spot lesions.

Background:

White spot lesions have been defined as the earliest stage of demineralization on enamel surfaces that are easily discernible to the human eye.

Methods:

Relevant articles on white spot lesions were searched and reviewed from March 1975 till May 2021 in Pubmed, Scopus, Google Scholar, and ScienceDirect and were included in this review.

Results:

Even though the orthodontic field has seen several advances over the last few years, this is one complication that persists. White spot lesions are very commonly seen after completion of fixed orthodontic therapy when brackets are debonded. Previously conducted research has shown that there is a high prevalence rate of white spot lesions, which ranges from 50 to 90%. On intra-oral examination, a white spot can be seen as a matte-textured, opaque white lesion. Since the demineralization process takes place below the enamel surface, the outer layer only demonstrates pores that affect the natural light refractory properties of a tooth. This is what leads to the characteristic appearance of these lesions. One of the goals of modern dentistry is to treat non-cavitated lesions by promoting remineralization without the involvement of any invasive procedures.

Conclusion:

Fixed orthodontic therapy is usually a lengthy process and requires active cooperation between the orthodontist and the patient. However, it is the responsibility of the treating orthodontist to examine the tooth surfaces at each appointment to diagnose a developing white spot lesion as early as possible. With recent advances in diagnostic techniques, it has become much easier to identify these initial lesions and prevent their progression to cavitated lesions.

Comparison of Different Types of Static Computer-Guided Implant Surgery in Varying Bone Inclinations

This research aimed to compare the accuracy of dental implant placement among three types of surgical guide: metal sleeve with key handle (Nobel guide, Nobel Biocare, Göteborg, Sweden), metal sleeve without key handle, and non-sleeve without key handle (Dentium full guide kit, Dentium Co., Seoul, Korea) when placing the implant in different bone inclinations. A total of 72 polyurethane bone models were fabricated in different inclinations (0°, 45°, and 60°). The dental implants were placed in bone models following the company’s recommendations. After dental implants were installed, the digital scans were done by an extraoral scanner. The deviations of the dental implant position were evaluated by superimposition between post-implant placement and reference model by using GOM inspect software. The deviation measurement was shown in 5 parameters: angular deviation, 3D deviation at the crest, 3D deviation at the apex, lateral linear deviation, and vertical linear deviation. The data were analyzed using One-way ANOVA and post-hoc tests at a significance level of 0.05. The accuracy of the dental implant position was not significantly influenced by the difference in the surgical guide system (p > 0.05). There were significant differences between placed and planned implant positions in the different inclinations of the bone. A significant difference was found in all parameters of 0° and 60° bone inclinations (p < 0.05). At 0° and 45°, angulated bone showed significant differences except in 3D deviation at the apex. Between 45° and 60° were significant differences only in angular deviation. Within the limitations of this study, the accuracy of implant placement among three types of surgical guides (Non-sleeve without key handle, Metal sleeve without key handle, and Metal sleeve with key handle) from two companies (Dentium and Nobel Biocare) was similar. Hence, the operators can choose the surgical guide system according to their preference. The inclination of bone can influence the angulation of dental implants.

PEEK Biomaterial in Long-Term Provisional Implant Restorations: A Review

Polyetheretherketone (PEEK) has become a useful polymeric biomaterial due to its superior properties and has been increasingly used in dentistry, especially in prosthetic dentistry and dental implantology. Promising applications of PEEK in dentistry are dental implants, temporary abutment, implant-supported provisional crowns, fixed prosthesis, removable denture framework, and finger prosthesis. PEEK as a long-term provisional implant restoration has not been studied much. Hence, this review article aims to review PEEK as a long-term provisional implant restoration for applications focusing on implant dentistry. Articles published in English on PEEK biomaterial for long-term provisional implant restoration were searched in Google Scholar, ScienceDirect, PubMed/MEDLINE, and Scopus. Then, relevant articles were selected and included in this literature review. PEEK presents suitable properties for various implant components in implant dentistry, including temporary and long-term provisional restorations. The modifications of PEEK result in wider applications in clinical dentistry. The PEEK reinforced by 30-50% carbon fibers can be a suitable material for the various implant components in dentistry.

Magnification of Iris through Clear Acrylic Resin in Ocular Prosthesis

The study on the magnification of the clear acrylic resin in prosthetic dentistry is important but lacking. Hence, this research aimed to investigate the magnification of the iris in the ocular prosthesis with various thicknesses of clear heat cure acrylic resin. A total of 60 ocular prostheses were divided into six groups with various thicknesses of clear heat cure acrylic resin over the iris; T0 (control): no acrylic resin, T1: 2, T2: 4, T3: 6, T4: 8, and T5: 10 mm of clear acrylic resin over the iris. Each ocular prosthesis was manufactured from white acrylic, with a 10.250 mm iris. Then, the clear heat cure resin was placed over the iris, cured, then polished. The final diameter of the iris was measured with a vernier caliper. The sizes of the iris were compared among various groups using one-way ANOVA, and a significant level was chosen at p value = 0.01. The mean sizes of iris were T0 = 10.25, T1 = 10.92, T2 = 11.26, T3 = 11.91, T4 = 12.75, and T5 = 13.43 mm. The size of the iris was significantly different among the group (p < 0.0001). The magnification of the iris for different groups was 1.06 for T1, 1.10 for T2, 1.16 for T3, 1.24 for T4, and 1.31 for T5. The magnification of the iris increased as the thickness of clear heat cure acrylic resin over the iris is increased on the ocular prosthesis.

Surgical Management of Impacted Lower Second Molars: A Comprehensive Review

Impacted lower second molars (ILM2) are rarely reported in the literature, but various studies have been done for its treatment. Apart from solely orthodontic approaches, different surgical management techniques were reported to have successful outcomes. Surgical intervention of ILM2 can help expose the tooth for further orthodontic purposes, simplifying complex treatment methods, and reducing treatment time. This review illustrates the comprehensive evaluation and updated methods of surgical uprighting, repositioning, and transplantation of ILM2 with future directions for better understanding and treatment planning in the clinical setting. The successful outcome of surgical intervention depends on case selection, root development of ILM2, careful surgical manipulation, and adherence to sound biological principles.

Wear Resistance, Color Stability and Displacement Resistance of Milled PEEK Crowns Compared to Zirconia Crowns under Stimulated Chewing and High-Performance Aging

Recently, polyetheretherketone (PEEK) has been introduced to the dental market as a high-performance and chemically inert biomaterial. This study aimed to compare the wear resistance, abrasiveness, color stability, and displacement resistance of zirconia and PEEK milled crowns. An ideal tooth preparation of a first maxillary molar was done and scanned by an intraoral scanner to make a digital model. Then, the prosthetic crown was digitally designed on the CAD software, and the STL file was milled in zirconia (CaroZiir S, Carol Zircolite Pvt. Ltd., Gujarat, India) and PEEK (BioHpp, Bredent GmbH, Senden, Germany) crowns using five-axis CNC milling machines. The wear resistance, color stability, and displacement resistance of the milled monolithic zirconia with unfilled PEEK crowns using a chewing simulator with thermocyclic aging (120,000 cycles) were compared. The antagonist wear, material wear, color stability, and displacement were evaluated and compared among the groups using the Wilcoxon-Mann-Whitney U-test. Zirconia was shown to be three times more abrasive than PEEK (p value < 0.05). Zirconia had twice the wear resistance of PEEK (p value < 0.05). Zirconia was more color stable than PEEK (p value < 0.05). PEEK had more displacement resistance than zirconia (p value < 0.05). PEEK offers minimal abrasion, better stress modulation through plastic deformation, and good color stability, which make it a promising alternative to zirconia crown.

Rare Report Case of Oral Verruca Vulgaris on Torus Palatinus

Verruca vulgaris, also known as common warts, is most often seen on the skin of hands and feet. Human papilloma virus (HPV) plays an aetiological role in the development of this lesion. Oral verruca vulgaris (OVV) may occur on the palate, buccal mucosa, and tongue. Although asymptomatic and benign, HPV has been linked to squamous cell carcinoma in the oral cavity and oropharyngeal areas. Therefore, prompt surgical removal of OVV is warranted. We report a case of a OVV in a 48-year-old male patient on palate. The lesion was a white nonscrapable lesion in the middle of a torus palatinus. Excisional biopsy was done together with surgical removal of torus palatinus. Histopathological analysis confirmed the diagnosis of OVV.

Dental-Facial Midline: An Esthetic Based Classification

Background:

The facial midline and dental midline play an important role in facial esthetics, cosmetic dentistry, facial plastic surgery, and anthropologic studies.

Objective:

This study studied the dental-facial midline in Nepalese subjects and to classify the midline.

Methods:

The study was conducted in 150 Nepalese subjects, mostly consisting of University students (80 males and 70 females). After obtaining ethical approval, facial and dental midlines were analyzed using a scale.

Results:

It showed 26 (18%) study subjects showed the coincidence of the facial midline with the maxillary and mandibular dental midlines. It showed that only 44 (30%) subjects showed the coincidence of facial midline with only maxillary dental midline, and 26 (17%) subjects showed the facial midline coincidence with only mandibular dental midline. The dental midline discrepancy was more prevalent in the maxillary arch and more prevalent on the right side. Midline discrepancy is seen more in males compared to females. The majority of the deviation showed 1 mm, followed by 2 mm, and 3 mm.

Conclusion:

The coincidence of the facial midline with both the maxillary and mandibular dental midlines is uncommon. Midline discrepancy is seen more in males compared to females. The majority of the subjects show a mild discrepancy of 1 mm. The midline discrepancy was more seen on the right side and in the maxillary arch.

Biofilm inhibition and bactericidal activity of NiTi alloy coated with graphene oxide/silver nanoparticles via electrophoretic deposition

Biofilm formation on medical devices can induce complications. Graphene oxide/silver nanoparticles (GO/AgNPs) coated nickel-titanium (NiTi) alloy has been successfully produced. Therefore, the aim of this study was to determine the anti-bacterial and anti-biofilm effects of a GO/AgNPs coated NiTi alloy prepared by Electrophoretic deposition (EPD). GO/AgNPs were coated on NiTi alloy using various coating times. The surface characteristics of the coated NiTi alloy substrates were investigated and its anti-biofilm and anti-bacterial effect on Streptococcus mutans biofilm were determined by measuring the biofilm mass and the number of viable cells using a crystal violet assay and colony counting assay, respectively. The results showed that although the surface roughness increased in a coating time-dependent manner, there was no positive correlation between the surface roughness and the total biofilm mass. However, increased GO/AgNPs deposition produced by the increased coating time significantly reduced the number of viable bacteria in the biofilm (p < 0.05). Therefore, the GO/AgNPs on NiTi alloy have an antibacterial effect on the S. mutans biofilm. However, the increased surface roughness does not influence total biofilm mass formation (p = 0.993). Modifying the NiTi alloy surface using GO/AgNPs can be a promising coating to reduce the consequences of biofilm formation.

Pain in Oral and Maxillofacial Surgery and Implant Dentistry: Types and Management

Over the years, the pain has been defined numerous times in several ways. In oral and maxillofacial surgery, the occurrence of pain, especially postoperatively, is anticipated. Pain arises as a combination of various processes after tissue damage. Distinct pain experiences in oral surgery were depicted in several previous studies, adding knowledge to the field. The management of these encounters has been suggested over time, improving treatment approaches in the clinical setting. This review aims to understand the pain and its types and intervention in the field of oral and maxillofacial surgery.

Bacteriological Evaluation of Gingival Crevicular Fluid in Teeth Restored Using Fixed Dental Prostheses: An In Vivo Study

The present in vivo study determined the microbiological counts of the gingival crevicular fluid (GCF) among patients with fixed dental prostheses fabricated using three different techniques. A total of 129 subjects were divided into three study groups: first, cobalt-chrome-based, metal-ceramic prostheses fabricated by the conventional method (MC, n = 35); the second group consisted of cobalt-chrome-based, metal-ceramic prostheses fabricated by the computer-aided design and computer-aided manufacturing (CAD/CAM) technique (CC-MC, n = 35); the third group comprised zirconia-based ceramic prostheses fabricated using the CAD/CAM technique (CC-Zr, n = 35). The control consisted of 24 patients using prostheses fabricated with either MC, CC-MC, or CC-Zr. The GCF was obtained from the subjects before treatment, and 6 and 12 months after the prosthetic treatment. Bacteriological and bacterioscopic analysis of the GCF was performed to analyze the patients’ GCF. The data were analyzed using SPSS V20 (IBM Company, Chicago, IL, USA). The number of microorganisms of the gingival crevicular fluid in all groups at 12 months of prosthetic treatment reduced dramatically compared with the data obtained before prosthetic treatment. Inflammatory processes in the periodontium occurred slowly in the case of zirconium oxide-based ceramic constructions due to their biocompatibility with the mucous membranes and tissues of the oral cavity as well as a reduced risk of dental biofilm formation. This should be considered by dentists and prosthodontists when choosing restoration materials for subjects with periodontal pathology.

Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses

The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III (p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.

Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses

The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III (p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.

Dental-Facial Midline: An Esthetic Based Classification

Background:

The facial midline and dental midline play an important role in facial esthetics, cosmetic dentistry, facial plastic surgery, and anthropologic studies.

Objective:

This study studied the dental-facial midline in Nepalese subjects and to classify the midline.

Methods:

The study was conducted in 150 Nepalese subjects, mostly consisting of University students (80 males and 70 females). After obtaining ethical approval, facial and dental midlines were analyzed using a scale.

Results:

It showed 26 (18%) study subjects showed the coincidence of the facial midline with the maxillary and mandibular dental midlines. It showed that only 44 (30%) subjects showed the coincidence of facial midline with only maxillary dental midline, and 26 (17%) subjects showed the facial midline coincidence with only mandibular dental midline. The dental midline discrepancy was more prevalent in the maxillary arch and more prevalent on the right side. Midline discrepancy is seen more in males compared to females. The majority of the deviation showed 1 mm, followed by 2 mm, and 3 mm.

Conclusion:

The coincidence of the facial midline with both the maxillary and mandibular dental midlines is uncommon. Midline discrepancy is seen more in males compared to females. The majority of the subjects show a mild discrepancy of 1 mm. The midline discrepancy was more seen on the right side and in the maxillary arch.

Dental Practice during COVID-19 in Nepal: A Descriptive Cross-sectional Study

Introduction:

Currently, coronavirus disease (COVID-19) has become pandemic and spread globally. In Nepal, the number of COVID-19 is increasing day-by-day. This research was done to find out the impact of COVID-19 on dentists, patients, and dental practice in Nepal.

Methods:

This study is a cross-sectional study conducted using an online survey from May 10 to17, 2020. A questionnaire was designed and uploaded in Freeonlinesurveys.com. Following ethical approval, the questionnaire was distributed among 500 dentists, and 406 dentists participated in the study. The survey link was dispersed to the Nepali dentists through social media and e-mail, and the results of the responses were received online. The questionnaire consisted of a total of 34 closed-ended questions containing three parts; demographic details, knowledge of dentists on COVID-19, and the impact of COVID-19 on dentists, patients, and dental treatments.

Results:

It showed that majority of the participants were females 243 (60%) of the age group 25-29 years with the clinic as the workplace. Patients receive dental treatments only from 40 (10%) of the dentist. A high number of dentists: 284 (70%) were severely affected by the financial burden and were not receiving a salary during this lockdown. About 349(86%) of the dentist think they should do regular dental treatments, but only 101 (25%) think the dentist should do only dental emergency treatments for COVID-19 infected cases.

Conclusions:

Dentists, patients, and dental practice are severely affected by the COVID-19. The majority of the dentists have faced financial burdens. The dental treatments should be done with high standards of care and infection control following proper recommendations.

Cytomorphometric Analysis of Inflammation Dynamics in the Periodontium Following the Use of Fixed Dental Prostheses

Cytomorphometry is used in the sampling of biological materials and diagnostic procedures. The use of cytological studies in periodontal diseases is not well described in the literature. Our study aimed to quantitatively assess the inflammation dynamics using cytomorphometric analysis of the periodontium before and after the use of fixed dental prostheses. Following ethics approval, a total of 105 subjects were divided in 3 groups as gingivitis (n = 23), periodontitis (n = 58), and healthy periodontium (control) (n = 24). The fixed dental prostheses (crowns and fixed partial dentures) were fabricated from cobalt-chrome metal-ceramic prostheses using the conventional method (C/M-CoCr), cobalt-chrome metal-ceramic prostheses by the computer-aided design and computer-aided manufacturing (CAD/CAM) technique (C/C-CoCr), and zirconia-based ceramic prostheses by the CAD/CAM technique (C/C-Zr) among subjects with gingivitis and periodontitis. The gingival crevicular fluid (GCF) was obtained from subjects before and after the use of the prostheses. The total count of epithelial cells and the connective tissue cells or polymorphonuclear neutrophils (PMNs) in GCF were studied using cytomorphometric analysis. The Statistical Package Tor the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA) was used to analyze the results and the significance level was set at p = 0.05. The data for before and after the use of the prostheses were compared using independent t-Tests. Similarly, the results after the use of prostheses in gingivitis, periodontitis, and control in each type of prostheses were compared using One-way ANOVA with post hoc using Scheffe. The total epithelial cells and the PMNs were determined along with the epithelium/leukocyte index. Regardless of the prostheses type used, no significant change in the parameters was identified among patients with a healthy periodontium, before and after prosthetic treatment. In all study groups, a statistically increase (p value < 0.05) was observed in the oral epithelial cell counts and a statistically decrease (p < 0.05) in the PMNs count following the use of the fixed prostheses. Data on cytomorphometric analysis could enable the selection of the most appropriate prostheses for use in patients with periodontal pathologies. When choosing prostheses, changes in the composition of GCF could be considered as a useful criterion for their use.

Can Coronavirus Disease-19 Lead to Temporomandibular Joint Disease?

BACKGROUND: The coronavirus disease (COVID-19) has become pandemic spreading globally. The outbreak of COVID-19 has led to psychological problems and compromised the mental health of the people. Temporomandibular disorder (TMD) shows the pain and dysfunction of the masticatory apparatus. History of trauma, stress, psychosocial impairment, drinking alcohol, and catastrophizing are related to the TMD. AIM: We aimed to present some background information, in which COVID-19 may be correlated with TMD. METHODS: The outbreak of COVID-19 has led to psychological problems and compromised the mental health of the people. RESULTS: The outbreak of COVID-19 has led to psychological problems and compromised the mental health of the people, not those only who suffered from coronavirus but also to those in self-isolation, social-distancing, and quarantined. TMD shows the pain and dysfunction of the masticatory apparatus, and one of the major causes of TMD is stress and psychosocial impairment apart from drinking alcohol and history of trauma. Hence, TMD may be correlated with COVID-19. The consequences of anxiety, depression, and stress in people from the outbreak of COVID-19 may lead to TMD. CONCLUSION: Hence, COVID-19 may be correlated with TMD as one of the major causes of TMD is stress and psychosocial impairment.

Polyetherketoneketone (PEKK): An emerging biomaterial for oral implants and dental prostheses

Polyetherketoneketone (PEKK) is a new evolving polymeric material. The present article comprehensively reviewed an overview of various applications of PEKK in prosthodontics and oral implantology, highlighting its prospects for clinical applications. PEKK biomaterials is an elastic material with good shock absorbance and fracture resistance and present ultra-high performance among all thermoplastic composites for excellent mechanical strength, chemical resistance, and high thermal stability. Available articles on PEKK for dental applications were reviewed from January 1957 to August 2020) using MEDLINE/PubMed, Web of Science, and ScienceDirect resources. PEKK presents suitable physical, mechanical, and chemical properties for applications in prosthodontics and oral implantology. PEKK has good potential for a wide range of dental applications, including tooth restorations, crowns, bridge, endoposts, denture framework, implant-supported fixed prosthesis, and dental implants. PEKK dental implants have shown lesser stress shielding compared to titanium for dental implant applications. Further modifications and improving material properties can result in broader applications in the field of dentistry. Long term evaluations are needed as PEKK is recently applied in dentistry, and there are limited studies published on PEKK.

Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment

Despite the success rates of dental implants, peri-implantitis presents as the most common complication in implant dentistry. This review discusses various factors associated with peri-implantitis and various available treatments, highlighting their advantages and disadvantages. Relevant articles on peri-implantitis published in English were reviewed from August 2010 to April 2020 in MEDLINE/PubMed, Scopus, and ScienceDirect. The identified risk indicators of peri-implant diseases are plaque, smoking, history of periodontitis, surface roughness, residual cement, emergence angle >30 degrees, radiation therapy, keratinized tissue width, and function time of the implant, sex, and diabetes. Peri-implantitis treatments can be divided into nonsurgical (mechanical, antiseptic, and antibiotics), surface decontamination (chemical and laser), and surgical (air powder abrasive, resective, and regenerative). However, mechanical debridement alone may fail to eliminate the causative bacteria, and this treatment should be combined with other treatments (antiseptics and surgical treatment). Surface decontamination using chemical agents may be used as an adjuvant treatment; however, the definitive clinical benefit is yet not proven. Laser treatment may result in a short-term decrease in periodontal pocket depth, while air powder abrasive is effective in cleaning a previously contaminated implant surface. Surgical elimination of a pocket, bone recontouring and plaque control are also effective for treating peri-implantitis. The current evidence indicates that regenerative approaches to treat peri-implant defects are unpredictable.

Quackery in Dental Practice in Nepal

Quackery and fraud in dental practice, seen in many countries, is also rampant in Nepal, and they are unethical practices. There is a growing need for strict enforcement of government policy measures to eliminate quackery and fraudulent dental practice in Nepal. The government should mobilize all dental workforce (dental specialists, dentists, and dental auxiliaries) and aware of their responsibilities and limitations. This article presents a brief review showing some cases of malpractice in dentistry in Nepal.

Corrosion Resistance of Graphene oxide/Silver Coatings on Ni-Ti alloy and Expression of IL-6 and IL-8 in Human Oral Fibroblasts

Graphene based materials (GBMs) have potentials for dental and medical applications. GBMs may cause changes in the levels of cytokine released in the body. This study aimed to study the corrosion resistance of graphene oxide (GO) and GO/silver (GO/Ag) nanocomposite coated nickel-titanium (NiTi) alloy by electrophoretic deposition and to access the viability of human pulp fibroblasts, and the interleukin (IL)-6 and IL-8 expression level. The bare and coated NiTi samples were characterized by scanning electron microscope (SEM), energy-dispersive X-ray spectroscopy (EDS), Raman spectroscopy, surface profilometry, and X-ray diffraction (XRD). The corrosion resistance of the bare NiTi and coated NiTi samples were investigated by potentiodynamic polarization and electrochemical impedance spectroscopy in 3.5% NaCl solution. The cell viability of human pulp fibroblasts was accessed by the treated culture medium of the bare NiTi and coated NiTi alloys containing 1% fetal bovine serum. IL-6 and IL-8 expression levels were studied by human enzyme-linked immunosorbent assay (ELISA). Data were analyzed using One-way ANOVA (α  =  0.05). Both the GO-coated NiTi and GO/Ag-coated NiTi alloys showed better corrosion resistance, a lower rate of corrosion, and higher protection efficiency than the bare NiTi alloy. The coated NiTi alloys were biocompatible to human pulp fibroblasts and showed upregulation of IL-6 and IL-8 levels.

Evaluation of Fracture Resistance and Sites of Failure of Different Dowel Core Restorations: An In-Vitro Study

Background:

Dowel Cores are often required in endodontically treated tooth to aid retention and resistance for a final prosthetic crown. Studies concerning the role of post-core systems on the fracture resistance with different dowel material remain controversial.

Aim:

This experimental study aimed to investigate the fracture resistance strength and failure mode of 3 dowel systems (glass fiber, indirect resin, and prefabricated metal with resin core).

Methods:

Twenty-one extracted human maxillary central incisors were first endodontically treated and then separated into 3 equal groups randomly;1st group consisted of glass fiber dowel, 2nd group consisted of indirect resin dowel, and 3rd group consisted of the prefabricated metal dowel. All specimens were restored with resin core and indirect resin crown. A testing force was applied with a universal testing machine (at 135 o angle) at 3 mm from the incisal edge of crown and forces were measured. Statistical tests were done using One-way ANOVA and Chi-square Test.

Results:

There was no significant difference (P-value >0.05) of the fracture resistance among glass fiber dowel, indirect resin dowel and pre-fabricated dowel with indirect resin crown. The prefabricated metal dowel had maximum fracture resistance (566 ±157.771 N) followed by Glass fiber dowel (541.047 ±199.571 N) and indirect resin dowel and post (444.550 ±139.788 N).

Conclusion:

Glass fiber dowel, indirect resin dowel and prefabricated metal dowel with resin core and indirect resin crown systems showed statistically insignificant fracture strength values and mode of failure.

Bioactive Glass Applications in Dentistry

At present, researchers in the field of biomaterials are focusing on the oral hard and soft tissue engineering with bioactive ingredients by activating body immune cells or different proteins of the body. By doing this natural ground substance, tissue component and long-lasting tissues grow. One of the current biomaterials is known as bioactive glass (BAG). The bioactive properties make BAG applicable to several clinical applications involving the regeneration of hard tissues in medicine and dentistry. In dentistry, its uses include dental restorative materials, mineralizing agents, as a coating material for dental implants, pulp capping, root canal treatment, and air-abrasion, and in medicine it has its applications from orthopedics to soft-tissue restoration. This review aims to provide an overview of promising and current uses of bioactive glasses in dentistry.

Graphene Oxide/Silver Nanoparticle Coating Produced by Electrophoretic Deposition Improved the Mechanical and Tribological Properties of NiTi Alloy for Biomedical Applications

The aim of this study was to evaluate the mechanical and tribological properties of graphene oxide/silver nanoparticle (GO/AgNP) coated medical grade nickel-titanium (NiTi) alloy. The alloy substrates were coated using electrophoretic deposition at 30 V for 1, 5, and 10 min and were characterized by SEM, Raman spectroscopy, EDS, and surface profilometer. Mechanical and tribological tests were performed for hardness, Young's modulus, and friction coefficient. The data were analyzed using the Kruskal-Wallis test at a significance level of 0.05 to compare the coatings' roughness, thickness, friction coefficient, and hardness at the different coating times. The GO/AgNP coatings were confirmed with Raman spectroscopy, which demonstrated the presence of D bands and G bands at ∼1300 cm^-1 and ∼1600 cm^-1. The intensity ratios of the D and G bands (I_D/I_G) were 0.838, 0.836, and 0.837 in the 1, 5, and 10 min coated groups, respectively. The coating thickness ranged from 0.46-1.34 μm and the mean surface roughness (Ra) ranged from 50.72-69.93 nm. Increasing the coating time from 1-10 min increased the roughness, thickness, and Young's modulus of surface coating. The friction coefficients of the coated NiTi alloy were significantly lower compared with that of the uncoated NiTi allloy (p < 0.001). The GO/AgNP nanocomposite coated NiTi alloy demonstrated improved mechanical strength and a reduced friction coefficient that would be more favorable for biomedical applications.

Maxillary Anterior Teeth Proportions for Creating Esthetically Pleasuring Smile in Nepalese Patients

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Relationship Between Prosthodontic Treatment and Nutritional Status: A Review

Pertinent literature search about changes or effects of prosthodontic treatment on nutritional status was performed. The articles were electronically and hand searched in all available journals including research works, reviews, randomized controlled trials and systematic reviews. The information were obtained to answer the question whether denture therapy has a role in altering nutritional intake or not. Most articles agreed that the risk of malnutrition is elevated by being edentulous. However, there were contrasting results about improvement of nutrition by providing prosthodontic treatment. Thus, many authors have emphasized the role of nutritional counseling along with denture therapy for the benefits of geriatric patients who undergo the inevitable process of being edentulous.BJHS 2018;3(1)5 : 385 - 389

Polymeric materials and films in dentistry: An overview

The use of polymeric materials (PMs) and polymeric films (PMFs) has increased in medicine and dentistry. This increasing interest is attributed to not only the excellent surfaces of PMs and PMFs but also their desired mechanical and biological properties, low production cost, and ease in processing, allowing them to be tailored for a wide range of applications. Specifically, PMs and PMFs are used in dentistry for their antimicrobial, drug delivery properties; in preventive, restorative and regenerative therapies; and for corrosion and friction reduction. PMFs such as acrylic acid copolymers are used as a dental adhesive; polylactic acids are used for dental pulp and dentin regeneration, and bioactive polymers are used as advanced drug delivery systems. The objective of this article was to review the literatures on the latest advancements in the use of PMs and PMFs in medicine and dentistry. Published literature (1990–2017) on PMs and PMFs for use in medicine and dentistry was reviewed using MEDLINE/PubMed and ScienceDirect resources. Furthermore, this review also explores the diversity of latest PMs and PMFs that have been utilized in dental applications, and analyzes the benefits and limitations of PMs and PMFs. Most of the PMs and PMFs have shown to improve the biomechanical properties of dental materials, but in future, more clinical studies are needed to create better treatment guidelines for patients.

An epidemiological study on the prevalence of temporomandibular disorder and associated history and problems in Nepalese subjects

BACKGROUND

Temporomandibular disorder (TMD) represents a subgroup of painful orofacial disorders involving pain in the temporomandibular joint (TMJ) region, fatigue of the cranio-cervico-facial muscles (especially masticatory muscles), limitation of mandible movement, and the presence of a clicking sound in the TMJ. TMD is associated with multiple factors and systemic diseases. This study aimed to assess the prevalence of TMD in Nepalese subjects for the first time.

METHODS

A total of 500 medical and dental students (127 men and 373 women) participated in this study from May 2016 to September 2016. The Fonseca questionnaire was used as a tool to evaluate the prevalence of TMD, and Fonseca's Anamnestic Index (FAI) was used to classify the severity of TMD.

RESULTS

The majority of the participants with TMD had a history of head trauma, psychological stress, and dental treatment or dental problems. The prevalence of TMD in Nepalese students was mild to moderate.

CONCLUSIONS

The prevalence of TMD in Nepalese subjects was mild to moderate. The majority of the study subjects had eyesight problems, history of head trauma, psychological stress, and drinking alcohol and had received dental treatments.

Full Coverage Crowns and Resin-bonded Bridge Combination for Missing Mandibular Anterior Teeth

Most often the anterior teeth and those that are visible when a patient speaks or smiles are chosen for esthetic restorations. The mandibular anterior fixed bridge often presents problems to the dentist due to the size of the natural teeth and their visibility. In addition, due to high cost factor, many patients are not able to afford fixed partial denture for missing anterior teeth. This article describes a cost effective technique for the restoration of missing mandibular anterior teeth by fabrication of full coverage crowns and resin-bonded fixed bridge combination.

Nepalese Esthetic Dental (NED) Proportion in Nepalese Population

Background Lots of studies on maxillary anterior teeth proportions have been studied in different populations in various countries, but no studies have been conducted in Nepal on the esthetic maxillary anterior teeth proportions. Objective The study was done to investigate the maxillary anterior teeth proportions in a Nepalese population. Teeth proportions in the total population were compared with golden proportion (GP) and golden standard (GS). Method A total of 150 Nepalese subjects were divided in three facial types; broad, average and narrow group. Maxillary anterior teeth were measured from dental casts using digital calipers. The perceived width ratios of lateral to central incisor (LI/CI) and canine to lateral incisor (CN/LI), ratios of mean central incisor length to 2 central incisor widths (CIL/2CIW), and actual width to length ratios (WLRs) (%) were calculated in each facial type and compared. Mean LI/CI, CN/LI and CIL/2CIW in total population were calculated and compared with GP (0.618), and mean WLRs in the total population were compared with GS (80%). All teeth proportions were compared among three facial types. One-sample t-test and one-way ANOVA were performed to analyze the data (α = 0.05). Result The LI/CI, CN/LI, CIL/2CIW and WLRs in three facial types showed no significant difference. The LI/CI, CN/LI and CIL/2CIW in the total population were 66%, 70% and 55% respectively, and were significantly different from GP. The WLRs for CI, LI and CN in the total population were 90%, 86% and 89% respectively and significantly differed from GS. These values were considered to constitute the Nepalese Esthetic Dental (NED) proportion. Conclusion No significant difference of maxillary anterior teeth proportions were observed among three facial types. Teeth proportions in the total population significantly differed from GP and GS. We propose the NED proportion as a guideline for dental treatment in the maxillary anterior region in Nepalese populations.