Effect of Asfotase Alfa in the Treatment of Hypophosphatasia- A Systematic Review

Hypophosphatasia (HPP) is a life-threatening disease that occurs due to the mutation of the TNSALP (Tissue nonspecific isoenzyme of alkaline phosphatase) encoding gene. There is no approved treatment for Hypophosphatasia. Therefore, the only effective treatment for HPP is enzyme replacement therapy using the drug asfotase alfa which increases the patient's life span. The aim of the study is to evaluate the effectiveness and safety of asfotase alfa (enzyme replacement therapy) in treating HPP. A Literature search was done using PubMed, Google scholar, science direct, and Wiley LILACS utilizing MeSH keywords such as - Hypophosphatasia and asfotase alfa. A total of 411 articles were screened, of which four articles were taken for this qualitative analysis. Reporting of this systematic review is done by using PRISMA guidelines. Asfotase alfa/enzyme replacement therapy is examined on patients with different age groups and on congenital HPP patients to assess the effectiveness of HPP treatment. Enzyme replacement therapy using asfotase alfa is an effective and assured treatment for infants, children, and adults suffering from HPP.

Assessing the Effect of Iron on Oral Health Status among the General Population Residing in High and Low Levels of Iron Blocks in Namakkal District, Tamil Nadu, India: A Cross-Sectional Study

Aim

This study aims to assess the effect of iron on oral health status among the general population residing in high and low levels of iron blocks in the Namakkal district of Tamil Nadu, India.

Materials and Method

A cross-sectional study was conducted to assess the impact of iron on oral health among people in the Namakkal district of Tamil Nadu, India. The sample size was estimated to be 600, which were equally divided into two groups based on the high and low levels of iron (300 samples) content of water in the Namakkal district based on the multistage random sampling method. A pre-tested structured questionnaire was used to collect the demographic data and oral hygiene practices of the people. Dental stains were recorded using a modified Lobene stain index. P value < 0.05 was considered to be statistically significant.

Results

The area and intensity of the dental stains were not significant with age, gender, and blocks. There was no statistically significant difference between the high iron and low iron blocks for the area (A), intensity (I), and I × A of stains.

Conclusion

The study concludes that the water samples with both high and low levels of iron had a strong impact on the oral health of the people.

Effect of Fluoride on Oral Health Status Among General Population Residing in High- and Low-Level Fluoride Blocks in Erode District, Tamil Nadu, India: A Cross-Sectional Study

Aim

The aim of this study was to evaluate the fluoride levels in groundwater and their effect on oral health status among the general population of Erode district, Tamil Nadu, India.

Materials and Methods

A descriptive cross-sectional study was conducted among the general population of index age groups 5, 12, 15, 35-44, and 65-74 years. A total of 540 subjects participated in the study. High fluoride blocks of Erode district were selected based on the Central Ground Water Board (CGWB), Ministry of Jal Shakti, Department of Water Resources, River Development and Ganga Rejuvenation, Government of India, 2010, and the low fluoride were taken from the Groundwater Year Book (GWYB) of Tamil Nadu and UT of Puducherry, 2018. The Oral Health Assessment Form 2013 (adult and children) of the World Health Organization (WHO) was used to assess dental caries and enamel fluorosis. Clinical examination was performed using a mouth mirror and explorer under natural illumination by a single examiner. Data obtained were processed and analyzed using IBM SPSS Statistics version 26. A Chi-squared test was employed to analyze the difference between the high and low fluoride blocks. A P value of 0.05 was set to be statistically significant.

Results

The current study had a contrary finding with the CGWB on water quality analysis of fluoride levels in drinking water for high fluoride block, Ammapet (1.12 ppm) and Anthiyur (1.08 ppm). The prevalence of enamel fluorosis in high fluoride block Ammapet was 44.4% and Anthiyur was 54.8%. The prevalence of dental caries in high fluoride block Ammapet was 45.9% and in Anthiyur was 43%. The prevalence of enamel fluorosis in low fluoride block Bhavanisagar was 27.4% and in Gobichettipalayam was 28.2%. The prevalence of dental caries in low fluoride block Bhavanisagar was 61.5%, and in Gobichettipalayam was 54.8%.

Conclusion

This study's contradictory finding emphasizes the importance of drinking water; sanitation staff should monitor and report water fluoridation data on a monthly basis in accordance with the Water Fluoridation Reporting System, and CGWB should plan and organize a team for the upgradation of water quality in India. The National Program for Prevention and Control of Dental Diseases should look on to the endemic areas for the prevention of dental fluorosis, which should be assessed, implemented, and monitored by the public health dentist who should be recruited as oral health program officers in both central and state governments.

Comparative Analysis of Various Forms of Local Drug Delivery Systems on a Class 2 Furcation - A Systematic Review

Class II mandibular furcation defect is a periodontal condition characterized by a cul-de-sac lesion, a definite parallel constituent with only a portion of alveolar bone remaining intact. There may be involvement of vertical bone loss. Local drug deliveries such as Boric acid, alendronate gel, and other drugs exhibited anti-inflammatory, antibacterial & osteoblastic differentiation activity. The present systematic review compares the drugs based on their outcomes and pharmacological action. To analzse & compare various forms of local drug delivery systems on a class II furcation. A search was conducted using PubMed, Google scholar, science direct, and Pub Med central using MeSH terms - local drug delivery in periodontics, boric acid in the management of class II mandibular furcation, simvastatin in the treatment of furcation. A total of 560 articles were screened; 58 out of 560 were full-text articles accessed for eligibility, and five articles were included in the systematic review. PRISMA guidelines were used for reporting this review. In addition, five randomized controlled trials were enclosed and used in this systematic review. The various local drugs used in treating class II mandibular furcation defects are effective in the prevention of bleeding on probing, bone resorption, gingival bleeding index and increase in the bone fill, and microbial deposit removal. The managing of class II mandibular furcation defect with the drugs mentioned in this review can be effective by reducing several clinical parameters such as bleeding on probing, gingival indices, osteoblastic differentiation, bone fill, etc., Considering the results of the studies, it can be concluded that it can be used as a therapeutic therapy against class II furcation defects with positive outcomes.

Systematic Review on Copper Calcium Hydroxide Nanoparticles in the Treatment of Apical Periodontitis

Apical periodontitis is an inflammation and destruction of the periradicular tissues due to various insults to the pulp in the form of infection, trauma, and faulty dental procedures. Conditions regarding this are treated employing root canal therapy. Recent innovations show that copper calcium hydroxide nanoparticles and their electrophoresis can be used to treat apical periodontitis effectively. To evaluate the effectiveness of copper calcium hydroxide nanoparticles in the treatment of apical periodontitis, a literature search was done using PubMed, Cochrane Central Register of controlled Trials (CENTRAL), Science Direct, and Lilacs using the MeSH (Medical Subject Heading) terms Copper calcium hydroxide, apical periodontitis, nanoparticles, and electrophoresis. Of a total of 167 articles screened, 44 were full-text articles assessed for eligibility and four articles were taken for the qualitative analysis. This review was recorded according to the PRISMA GUIDELINES. Four randomized controlled trials were included in the review process. The copper calcium hydroxide particles were compared with other root canal medicament materials. It was found that copper calcium hydroxide and its electrophoresis were used in the treatment of apical periodontitis and were found to be one of the effective methods. Copper calcium hydroxide nanoparticles were effective against the destruction of the periradicular tissues.

Therapeutic Use of Anti-Sclerostin Antibody in the Treatment of Multiple Myeloma: A Systematic Review

Multiple myeloma is a malignant cancerous condition that is characterized by abnormal plasma cell production and can lead to bone destruction due to increased osteoclastic activity and decreased osteoblastic activity. Many therapeutic therapies are used to treat diseases, such as chemotherapy and radiotherapy. In recent years, anti-sclerostin antibody treatment has been under investigation for its effect on the multiple myeloma. The present study was conducted to assess the effective therapeutic use of anti-sclerostin antibody in the treatment of multiple myeloma. The literature search was conducted using PubMed, Google Scholar, ScienceDirect, and PubMed Central using the following MeSH terms: "multiple myeloma", "anti-sclerostin antibody", "ubiquitin-proteasome pathway", "proteasome inhibitor", "Wnt pathway". A total of 348 articles were screened. Twenty-five out of 348 were full-text articles assessed for eligibility, and four articles were used in this systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the reporting of this systematic review. A total of four randomized control trials (RCT) were included and used in this systematic review. The anti-sclerostin antibodies were various other drugs, and it was found that the anti-sclerostin antibody was effective in preventing autoantibody formation, decreasing bone destruction, and increasing trabecular bone. Anti-sclerostin antibody was found to be effective in decreasing bone destruction by reducing osteoclastic activity and increasing osteoblastic activity associated with multiple myeloma.