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Marcin Karcz,1 Alaa Abd-Elsayed,2 Krishnan Chakravarthy,3 Aman Mansoor,4 Natalie Strand,5 Mark N Malinowski,6 Usman Latif,7 David Dickerson,8 Tolga Suvar,9 Timothy Lubenow,9 Evan Peskin,10 Ryan D’Souza,5 Eric Cornidez,11 Andrew Dudas,12 Christopher Lam,7 Michael Farrell II,13 Geum Yeon Sim,14 Mohamad Sebai,15 Rosa Garcia,16 Lucas Bracero,1 Yussr Ibrahim,17 Syed Jafar Mahmood,18 Marco Lawandy,19 Daniel Jimenez,20 Leili Shahgholi,15 Kamil Sochacki,21 Mohamed Ehab Ramadan,15 Vinny Francio,22 Dawood Syed,7 Timothy Deer1 1The Spine and Nerve Centers of the Virginias, Charleston, WV, USA; 2Department of Anesthesiology, University of Wisconsin, Madison, WI, USA; 3Innovative Pain Treatment Solutions, San Diego, CA, USA; 4Aurora Pain Management, Aurora Health Care, Oshkosh, WI, USA; 5Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA; 6Department of Anesthesiology, Ohio Health System, Columbus, OH, USA; 7Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA; 8Department of Pain Medicine, Northshore University Health System, Skokie, IL, USA; 9Department of Anesthesiology and Pain Medicine, Rush University Medical Center, Oak Park, IL, USA; 10Department of Pain Management, Insight Institute of Neurosurgery & Neuroscience, Flint, MI, USA; 11Pain Institute of Southern Arizona, Tucson, AZ, USA; 12Mays and Schnapp Neurospine and Pain, Memphis, TN, USA; 13Department of Pain Management, Erie County Medical Center, Buffalo, NY, USA; 14Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA; 15Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 16Department of Physical Medicine & Rehabilitation, Larkin Hospital Health System, Miami, FL, USA; 17Department of Pain Management at Northern Light Health – Eastern Maine Medical Center, Bangor, ME, USA; 18Department of Pain Medicine, University of California Davis Health System, Sacramento, CA, USA; 19Department of Physical Medicine & Rehabilitation, Montefiore Medical Center, Bronx, NY, USA; 20Department of Physical Medicine & Rehabilitation, Michigan State University, Lansing, MI, USA; 21Department of Anesthesiology and Perioperative Medicine, Rutgers Robert Wood Johnson, New Brunswick, NJ, USA; 22Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USACorrespondence: Marcin Karcz, The Spine and Nerve Centers of the Virginias, Charleston, WV, USA, Email drmarcinkarcz@gmail.comAbstract: Pain serves as a vital innate defense mechanism that can significantly impact an individual’s quality of life. Understanding the physiological effects of pain well plays an important role in developing novel pain treatments. Nociceptor neurons play a key role in pain and inflammation. Interactions between nociceptors and the immune system occur both at the site of injury and within the central nervous system. Modulating chemical mediators and nociceptor activity offers promising new approaches to pain management. Essentially, the sensory nervous system is essential for modulating the body’s protective response, making it critical to understand these interactions to discover new pain treatment strategies. New innovations in neuromodulation have led to alternatives to opioids individuals with chronic pain with consequent improvement in disease-based treatment and nerve targeting. New neural targets from cellular and structural perspectives have revolutionized the field of neuromodulation. This narrative review aims to elucidate the mechanisms of pain transmission and processing, examine the characteristics and properties of nociceptors, and explore how the immune system influences pain perception. It further provides an updated overview of the physiology of pain and neuromodulatory mechanisms essential for managing acute and chronic pain. We assess the current understanding of different pain types, focusing on key molecules involved in each type and their physiological effects. Additionally, we compare painful and painless neuropathies and discuss the neuroimmune interactions involved in pain manifestation.Keywords: neurons, nociceptive pain, neuropathic pain, nociplastic pain, physiological effects, pain pathways, sensitization

Aim: Effect of nanoparticles (NPs) loaded methylene blue (MB) mediated photodynamic therapy (PDT) on caries-affected dentin (CAD) against S.mutans, smear layer (SL) elimination, and shear bond strength (SBS) of single bottle 7th generation adhesive., Methodology: Sixty human molars with carious lesions were selected. Samples were randomly allocated into four groups, based on the disinfection regime (n = 11) Group 1-(CHX), Group 2-(MB-PDT), Group 3-(MB-CNPs-PDT), and Group 4-(MB-TiO 2 NPs-PDT). Following disinfection S.mutans' survival rate was assessed using the pour plate method. Five specimens from each disinfection group were subjected to SL removal assessment using a scanning electron microscope (SEM). Bonding of 7th generation adhesive and composite restoration was performed on ten samples from each group. Artificial aging of the bonded samples was performed followed by SBS and failure mode analysis using a universal testing machine and stereomicroscope respectively. One-way analysis of variance (ANOVA) and Tukey post hoc test were used to analyze the data., Results: Group 3 (MB-CNPs-PDT) treated CAD surface unveiled the lowest survival rate (0.12 ± 0.02 CFU/mL) of tested bacteria, maximum SL removal (1.21 ± 0.35), and highest bond strength (13.42 ± 1.05). However, Group 1 (CHX) treated specimens displayed the highest survival rate (0.53 ± 0.11 CFU/mL) with the lowest SL removal (2.24 ± 0.30) and SBS (8.88 ± 0.73 MPa)., Conclusion: MB-CNPs-PDT appears to be a suitable alternative to CHX for CAD disinfection as it displayed better antibacterial efficacy, SL removal, and SBS with 7th generation single bottle adhesive., (Copyright © 2024. Published by Elsevier B.V.)

The objectives of this study were to investigate the pH of common beverages and to evaluate the effects of common acidic beverages on the surface hardness and weight loss of human tooth specimens. A total of 106 beverages were conveniently purchased from supermarkets in Karachi, Pakistan. Prior to evaluation, beverages were refrigerated or stored at room temperature in accordance with the manufacturers’ recommendations. Beverages were categorized into six groups: ‘Sports and Energy drinks’, ‘Water’, ‘Fruit Juices and Drinks’, ‘Sodas’, ‘Milk and Flavored Milk’ and ‘Teas and Coffee’. Using a pH meter, the pH of each beverage was measured in triplicate at room temperature. In addition, the influence of five highly acidic beverages on the weight loss and surface hardness of human tooth specimens was evaluated using gravimetric analysis and the Vickers hardness tester, respectively. ‘Sports and Energy drinks’, ‘Fruits Juices and Drinks’ and ‘Sodas’ were the most acidic beverage categories, with a pH range of 3.00−5.00. A total of 33% of beverages tested in this study were highly acidic (pH less than 4.00), 29% of beverages were moderately acidic (pH 4.00−4.99) and 31% were mildly acidic (pH 5.00−6.99). Significant weight loss was observed in all immersed specimens compared to control counterparts (p < 0.05). Similarly, for surface hardness, five highly acidic beverages (Red Bull, Pepsi, Apple Cidra, Tang Mosambi and Tang Orange) significantly decreased the surface hardness of specimens (p < 0.05). The pH levels of commonly available beverages in Pakistan are highly acidic, which may encourage loss of minerals from teeth; hence, affecting their surface hardness.

Background: Conventional heat cure polymerized acrylic resin(unmodified) is most acceptable denture base material in dentistry since decades. It has been modified with reinforcement of fillers and different processing techniques were introduced to enhance its mechanical and physical properties. The objective of this research is to determine and compare the effect of different processing techniques on flexural strength of modified and unmodified denture base acrylic resin. Air circulating oven is introduced for the first time in this study and its efficacy is also compared with other conventional processing techniques., Methods: In this study total number of 114 rectangular specimens were fabricated by conventional heat cured acrylic (Stellon QC 20, Dentsply) for Group A (n=57), and rubber reinforced acrylic resin (High impact, Meadway) for Group B (n=57). Three equipment including water bath, dry oven and air circulating oven were utilized for processing specimens individually. Each sub-group of processing techniques (n=19) were tested for flexural strength through a three-point bending test by a universal testing machine. The statistical analysis initiated with descriptive analysis followed by independent t test for mean comparison of flexural strength of all three processing techniques among both testing group. One-way ANOVA and 2-way ANOVA followed by Scheffe post hoc test were also applied. p-value of 0.05 or less was considered as significant., Results: Statically significant p-value <0.001 was found in response of flexural strength in all processing techniques (water bath, dry oven, air circulating oven) of both testing groups. Water bath processing demonstrated highest flexural strength values in both denture base material used in this study. The unit used for flexural strength was MPa., Conclusion: This study manifested highest flexural strength in conventional and rubber reinforced heat cure samples when processed through water bath. Air circulating oven also presented acceptable flexural strength in conventional heat cure acrylic resin specimens when compared with other techniques.

Decreased nerve blood flow may be a pathogenetic factor in diabetic neuropathy. Previously it was shown that insulin treatment, commenced at the onset of streptozotocin-diabetes, prevents the development of a nerve blood flow deficit in the diabetic rat. The present study sought to determine the effect of short-term (one month) and acute (one hour) insulin reversal treatment on nerve blood flow deficits in streptozotocin-diabetes. Sciatic nerve blood flow was assessed using laser Doppler flowmetry. Treatment was initiated after one month of diabetes. One month of reversal insulin treatment ameliorated nerve laser Doppler flux (NDF) deficits; in untreated diabetic rats NDF was 51% of that in control animals (P < 0.01), in insulin-treated diabetic rats NDF was 85% of control values (P < 0.01 vs. untreated diabetic, P < 0.05 vs. control). In association with blood flow increases, we found a significant amelioration of motor (P < 0.05 vs. untreated diabetic) and sensory (P < 0.01 vs. untreated diabetic) nerve conduction velocities but not of exaggerated resistance to hypoxic conduction block. Insulin partially reversed hyperglycaemia and sciatic nerve polyol and sugar levels. In a second experiment, in rats with one month of diabetes, acute infusion of insulin led to a 47% (P < 0.001 vs. pre-insulin values) reduction of plasma glucose. This fall in plasma glucose was accompanied by a 38% (P < 0.05 vs. pre-insulin values) increase in NDF. Sensory nerve conduction velocity was marginally increased (6%, P < 0.05 vs. pre-insulin values) after insulin infusion, but motor conduction velocity was not. The data indicate that insulin can partially reverse deficits in nerve blood flow and conduction in diabetic rats.