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Objective: The objective of this study was to compare the microbial adhesion of different oral pathogens on different wires used in orthodontic treatment and to evaluate the potential of these pathogens to form biofilms on different types of orthodontic wires and brackets. Methods: In this in vitro investigation, we calculated that the sample size for each group (i.e., those with brackets [metal braces, ceramic braces, and self-ligating braces] and wires [nickel titanium, titanium molybdenum, and stainless steel]) should be 15 individuals. Five types of microbes (Streptococcus mutans, Escherichia coli, Enterococcus faecalis, Staphylococcus aureus, and Candida albicans) were used. Three types of brackets and three types of wires were used with five types of bacteria, and the process was repeated three times to collect the average. Results: No significant differences were observed in the mean concentrations of bacteria in the different brackets (p > 0.05) or in the mean concentrations in the different orthodontic materials used in these brackets. In contrast, there were considerable differences between the concentrations of bacteria in the wires and those in the brackets (p

Abstract Flame retardant (FR) finishing is crucial for developing protective textiles, traditionally relying on halogen, phosphorus, and phosphorus-nitrogen chemistries, which have limitations like toxicity and fabric stiffening. Innovative approaches such as nanotechnology, plasma treatments, and natural resource-based finishes are being explored to achieve sustainable FR textiles. This study presents the development and comprehensive characterization of hydrogel composites made from nonwoven fabrics composed of various hemp/wool blends (70/30, 80/20, and 90/10). The nonwoven fabrics were treated with a chitosan hydrogel incorporating banana sap to enhance their properties. Scanning electron microscope (SEM) examined the surface morphology and structural integrity of the composites, while Fourier transform infrared spectroscopy (FTIR) identified chemical interactions and functional groups. Differential scanning calorimeter (DSC) revealed thermal properties, water absorbency tests demonstrated hydrophilicity, mechanical testing assessed tensile strength, and vertical flammability tests evaluated fire resistance. SEM and FTIR revealed a successful coating of chitosan hydrogel with banana sap inclusions onto the hemp/wool nonwoven fabric, forming a composite structure. DSC analysis suggests higher chitosan content and hemp fiber ratio (like 70/30) lead to increased thermal stability of hydrogel composites. Higher chitosan concentrations in the hydrogel significantly improve the flame-retardant properties of hemp/wool nonwoven fabrics by reducing char length and enhancing protective char layer formation, with banana sap further promoting charring. These results indicate that the developed composite can be effectively used in flame-retardant textiles.

Abstract Background The study aimed to compare the self-perceived oral health status measured through a self-administered questionnaire with clinically determined oral health status measured by decayed-missing-filled teeth (DMFT) and community periodontal index of treatment need (CPITN) indices in university going females. In addition, access barriers to treatment related to oral healthcare were also determined. Methods A 3-month analytical cross-sectional study was designed for consenting university going females (aged 18–22 years) in Islamabad, Pakistan. The self-perceived oral health was recorded through a questionnaire requesting information regarding socio-demographics, self-perception of oral health, frequency of dental visits and barriers to seeking oral health. Seven independent examiners performed intraoral clinical examination and assessed the oral health status using globally standardized oral health assessment indices (DMFT and CPITN). Results A total of 400 students were included in the final sample. The study revealed a significant disparity between self-perceived oral health and clinical assessment. Although perceived oral health was considered “good” by 80.0% of the respondents, clinical examination revealed moderate DMFT scores (mean 2.95 ± 1.41) and periodontal disease requiring treatment in 89.5% of the individuals. The most common barriers in seeking dental care were lack of knowledge, dental phobia, affordability issue and false self-perception. Conclusion The present study demonstrated a notable discrepancy between self-perception of oral health and clinically assessed oral health. These results emphasize the importance of focused educational programs and community outreach programs, especially directed towards this demographic. Prioritizing such initiatives will help individuals to recognize their actual oral health condition thus encouraging positive oral health behaviors and outcomes.

Abstract Objectives The objective of this study was to evaluate the effect of acidic beverages on the surface topography and elemental composition of human teeth. Methods A total of five highly acidic beverages (Red Bull, Pepsi, Apple Cidra, Tang Mosambi, and Tang Orange) were investigated. The tooth specimens of experimental groups were submerged in each beverage and incubated at 37 °C for 7 days, whereas, the tooth specimens of control groups were placed in distilled water. Afterwards, tooth specimens were analyzed using scanning electron microscopic (SEM), stereomicroscopic, and energy dispersive x-ray (EDX) techniques. Results All experimental groups revealed a decline in the tooth elements compared to controls, however, such decline was not statistically significant. Nevertheless, comparing the experimental groups, the Red Bull beverage caused a marked reduction in the percentage of both calcium and phosphorus elements compared to the Pepsi, Apple Cidra, Tang Mosambi, and Tang Orange beverages but it was insignificant as well in contrast to its control counterpart. All five acidic beverages demonstrated erosive potential under SEM analysis; however, each group of specimens showed a diverse amount of demineralization. In addition, all experimental groups exhibited significant discoloration of tooth specimens compared to their respective control counterparts. Conclusions Within the limitations of study, all five acidic beverages demonstrated erosive potential in the simulated in vitro conditions under SEM analysis; however, each group of specimens exhibited a different extent of demineralization. In addition, the overall effect of all beverages was insignificant under EDX analysis as no substantial difference was revealed between the elemental composition of experimental and control group specimens.

Heavy metals employed in various industrial applications can negatively impact both the ecosystem and human beings. Common techniques for eliminating pollutants often rely on expensive materials. So, this study focuses on exploring economical alternatives obtained from nature and textile waste. In this study, a hydrogel composite was synthesized using wool nonwoven fabric mixed with alginate, gum Arabic (GA), and xanthan gum (XG) to evaluate its efficacy in adsorbing lead (Pb) from aqueous solutions. The composites were characterized using SEM, FTIR, and XPS to understand their structure and composition before and after Pb adsorption. The effects of time, pH, and initial metal ion concentration on Pb adsorption by the composite were also investigated. Maximum adsorption was observed at a basic pH, with the highest value recorded at 85.2 mg/g. Notably, 88.2 % of this maximum adsorption was achieved within 60 min, indicating a rapid adsorption process. Kinetic studies indicated that the adsorption process best fits pseudo-second-order kinetics, while the Freundlich model, with an R² value of 0.95, suggests a chemisorption mechanism. The developed wool-alginate-gum hydrogel composite has shown to be a promising candidate for the removal of Pb²⁺ ions from wastewater.

Hydrogels are used in modern wound dressings due to their ability to provide comfort with quick healing. However, poor mechanical properties of hydrogels limit their availability in commercial wound dressings. Nonwovens are highly porous, strong, and flexible structures that can provide support to hydrogels without compromising their properties. In this study, a cost-effective and sustainable hydroentangled nonwoven from industrial cotton waste was prepared and incorporated into alginate hydrogel for wound dressings. The novel composite of hydroentangled cotton nonwoven and alginate hydrogel was synthesized by a simple sol-gel technique. The effect of concentration of alginate hydrogel (0.5 wt%, 1 wt%, 1.5 wt %) and drying temperature (20 °C, 40 °C, 60 °C) of composite was analyzed for high wound exudates. The properties of prepared composite samples were characterized by scanning electron microscopy (SEM), XRD, tensile strength, tear strength, Air permeability, moisture management wound exudate test, and quantitative antimicrobial testing. Moreover, the comfort performance of these samples was evaluated by air permeability and moisture management testing. The properties of developed composites are highly dependent on the concentration of alginate and drying temperature. The results showed that maximum fluid absorbency (%) of 650 was achieved with good comfort properties. This study can help to increase the commercial availability of hydrogel-based wound dressings.

Autophagy is an intrinsic breakdown system that recycles organelles and macromolecules, which influences metabolic pathways, differentiation, and thereby cell survival. Oral health is an essential component of integrated well-being, and it is critical for developing therapeutic interventions to understand the molecular mechanisms underlying the maintenance of oral homeostasis. However, because of the complex dynamic relationship between autophagy and oral health, associated treatment modalities have not yet been well elucidated. Determining how autophagy affects oral health at the molecular level may enhance the understanding of prevention and treatment of targeted oral diseases. At the molecular level, hard and soft oral tissues develop because of complex interactions between epithelial and mesenchymal cells. Aging contributes to the progression of various oral disorders including periodontitis, oral cancer, and periapical lesions during aging. Autophagy levels decrease with age, thus indicating a possible association between autophagy and oral disorders with aging. In this review, we critically review various aspects of autophagy and their significance in the context of various oral diseases including oral cancer, periapical lesions, periodontal conditions, and candidiasis. A better understanding of autophagy and its underlying mechanisms can guide us to develop new preventative and therapeutic strategies for the management of oral diseases.

Orthodontic acrylic resin is used in the construction of orthodontic appliances. It lacks antimicrobial properties and is prone to microbial infection. So, the infection associated with it can be reduced via modification of orthodontic acrylic resin with nanoparticles (NPs) incorporation. The study directed to evaluate the antifungal properties of modified orthodontic acrylic resin incorporated with magnesium oxide (MgO)-NPs and silver (Ag)-NPs. NPs were mixed with polymethylmethacrylate (PMMA) in ethanol-assisted mixing method. Disc samples (10 mm in diameter and 2 mm thick) of PMMA-MgO, PMMA-Ag nanocomposites and PMMA alone (as control) were prepared. Then, C. albicans was isolated and identified clinically through taking swabs from acrylic denture base orthodontic appliances, cultured on a Sabouraud Dextrose Agar medium, followed by transferring on HiCrome™ candida Differential agar which is a selective and differential medium to distinguish distinct Candida species. The polymerase chain reaction was performed and the amplicon was separated by 2% gel electrophoresis and then visualised by ethidium bromide. DNA sequencing was performed on the sample at Sanger sequencing/ ABI 3500. Antifungal activity of PMMA-MgO and PMMA-Ag (1%, 3% and 5% of NPs) was conducted through disc diffusion assay and colony forming unit counts. The result showed a decrease in the number of adhered Candida albicans (C. albicans) of all concentrations of both nanocomposite and the decrease was statistically significant (P

الملخص: الميتفورمين دواء متعدد الاستخدامات وله استخدامات عديدة في مجال الطب. في المقام الأول، يُعرف بأنه عقار مضاد لارتفاع سكر الدم، وقد أصبح الدواء الأول عن طريق الفم لخفض نسبة الجلوكوز في الدم لعلاج داء السكري من النوع الثاني على مستوى العالم. توضح الأدبيات الحالية أيضا استخدام الميتفورمين في مجموعة متنوعة من أمراض الفم وطب الأسنان بشكل عام. أفادت التجارب السريرية الحديثة عن فعالية التطبيق الموضعي المساعد للميتفورمين في تحسين معايير اللثة لمرضى السكري المصابين بالتهاب دواعم السن. بالإضافة إلى ذلك، أشارت الدراسات إلى أنه يضفي تمايزا سنيا وكذلك تخليقا معدنيا للخلايا الجذعية في لب الأسنان. كما أنه يحفز تكاثر بانيات العظم ويقلل من نشاط ناقضات العظم مع الميل إلى ممارسة تأثير تجديدي على عظم دواعم السن مما يجعله مرشحا حيويا لتجديد اللثة. كما يعزز العلاج الأحادي بالميتفورمين الاندماج العظمي للغرسات الداخلية بشكل كبير. وذكرت بعض الدراسات أيضا أن له آثارا مضادة للسرطان على سرطان الخلايا الحرشفية عن طريق إعاقة تطور الورم. كما توض1ح بعض الأدبيات أيضا تأثيره الإيجابي في تحسين حركة الأسنان التقويمية ومقاومة تآكل أجهزة تقويم الأسنان في النماذج الحيوانية. تهدف هذه المراجعة السردية الحالية إلى تقديم ملخص حديث للبحوث العلمية حول الاستخدامات المحتملة للميتفورمين فيما يتعلق بمجال طب الأسنان. Abstract: Metformin is a versatile drug with numerous medical uses. It is known primarily as an anti-hyperglycemic drug that has become the main oral blood-glucose-lowering medication for managing type 2 diabetes mellitus globally. Its use has been reported in a variety of oral conditions and dentistry in general. Recent clinical trials have indicated the effectiveness of adjunct topical application of metformin in improving the periodontal parameters of patients with diabetes and periodontitis. Additionally, studies have suggested that metformin stimulates odontogenic differentiation and mineral synthesis of stem cells in the tooth pulp. Metformin also stimulates osteoblast proliferation, decreases osteoclast activity and exerts regenerative effects on periodontal bone, thus making it a viable candidate for periodontal regeneration. Metformin monotherapy significantly enhances osseointegration of endosseous implants and has been reported to have anti-cancer effects on oral squamous cell carcinoma by impeding tumor progression. Animal studies have indicated that metformin improves orthodontic tooth movement and resists orthodontic appliance corrosion. This narrative review aims to provide a current summary of research highlighting the prospective uses of metformin in dentistry.

Caries is a common dental problem brought on by factors like excessive sugar consumption, poor oral hygiene, and the presence of microorganisms in the mouth. This dental pathology is treated with a variety of filling materials, including tooth-colored direct resin dental composite (RDC), glass ionomer cement (GIC), and dental amalgam (also known as silver filling). RDC is the most preferred filling material in dental clinics due to its excellent esthetics and minimal tooth preparation, making it the need of the modern era. However, antimicrobial agents were added to this material in order to enhance its ability to prevent secondary caries. The antibacterial activity of RDC has been tested using a variety of methods, but testing protocols have been found to vary. Thusly, the point of this article is to examine the disparity in the strategy involved by specialists for testing the antibacterial properties of RDCs.

Autophagy is a unique catabolic process that degrades irrelevant or damaged components in eukaryotic cells to maintain homeostasis and eliminate infections from pathogenesis. Pathogenic bacteria have developed many autophagy manipulation techniques that affect host immune responses and intracellular bacterial pathogens have evolved to avoid xenophagy. However, reducing its effectiveness as an innate immune response has not yet been elucidated. Bacterial pathogens cause autophagy in infected cells as a cell-autonomous defense mechanism to eliminate the pathogen. However, harmful bacteria have learned to control autophagy and defeat host defenses. Intracellular bacteria can stimulate and control autophagy, while others inhibit it to prevent xenophagy and lysosomal breakdown. This review evaluates the putative functions for xenophagy in regulating bacterial infection, emphasizing that successful pathogens have evolved strategies to disrupt or exploit this defense, reducing its efficiency in innate immunity. Instead, animal models show that autophagy-associated proteins influence bacterial pathogenicity outside of xenophagy. We also examine the consequences of the complex interaction between autophagy and bacterial pathogens in light of current efforts to modify autophagy and develop host-directed therapeutics to fight bacterial infections. Therefore, effective pathogens have evolved to subvert or exploit xenophagy, although autophagy-associated proteins can influence bacterial pathogenicity outside of xenophagy. Finally, this review implies how the complex interaction between autophagy and bacterial pathogens affects host-directed therapy for bacterial pathogenesis.

This study evaluated the prevalence and frequency of teeth cleaning and last dental visits, along with associated socio-demographic factors, among residents of Bangladesh, Bhutan, and Nepal. The World Health Organization (WHO) STEPwise approach to surveillance (STEPS) survey data from Bangladesh (N = 8,164), Bhutan (N = 5,374) and Nepal (N = 5,371) were analyzed. After descriptive analysis, a multivariable multilevel logistic regression was conducted to identify the factors associated with oral hygiene. The following variables were considered as outcomes of interest: daily teeth cleaning frequency and visitation to the oral healthcare providers in the last six/twelve months at the time of data collection. Bangladesh had the highest proportion of respondents who cleaned their teeth at least once or twice a day, while Nepal had the lowest. Bhutan had the highest proportion of respondents who visited a dentist within the last six months (10.5%) or 12 months (16.0%). Almost 94.5% of Nepalese participants never visited a dentist. Participants of older age, who were females and had increased educational attainment, were more likely to follow oral hygiene measures. The populations of all the countries included in the study show poor adherence to oral hygiene practices. Health promotion programs should raise awareness regarding the advantages of regular teeth cleaning and dental check-ups.

Objective: This study aims to determine the prevalence and degree of Burnout during the COVID 19 pandemic in practicing Pakistani dentists. Introduction: The COVID-19 pandemic has significantly impacted dental practices worldwide, leading to increased stress and burnout among dental practitioners. Burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, can have detrimental effects on the quality of care and patient safety. Previous studies have shown high rates of burnout among healthcare workers, including dentists. The pandemic has added new challenges, such as financial losses and increased costs due to safety protocols. Recognizing and managing burnout is crucial to mitigate its severe consequences. By understanding the prevalence of burnout in this unique context, strategies can be developed to support dental practitioners and improve their well-being. Methods: A cross-sectional study was conducted using a 22-items based validated Maslach Burnout Inventory. The study was conducted between July and September 2021. Practicing dentists across Pakistan were approached via social media platforms. The questions were answered on a 7-point Likert scale. The sums of the scores were used as the evaluation criteria. Data analysis was done using SPSS version 24. Shapiro Wilk test was used to check normality of data. Mann Whitney U and Kruskal Wallis tests were utilized to analyze the differences in the prevalence of burnout amongst the different demographic groups. A P-value of

Background: The emergence of dental implants has revolutionized the management of tooth loss. However, the placement of clinical implants exposes them to complex oral environment and numerous microscopic entities, such as bacteria. Cold atmospheric plasma (CAP) is often used to treat the surfaces of dental implants, which alters morphological features and effectively reduces bacterial load. Purpose: This systematic review aims to assess the existing literature on the bactericidal properties of CAP when used on various kinds of dental implant surfaces. Review Method: An in-depth examination of MEDLINE/PubMed and EMBASE was performed to identify relevant studies, with the most recent search conducted in May 2023. Studies were selected based on their exploration of CAP’s effects on dental implants compared to control groups, focusing on CAP’s bactericidal efficacy. However, studies that lacked a control group or that failed to measure bactericidal effects were excluded. Results: After applying the selection criteria, 15 studies were ultimately included in the systematic review. The collected data suggest that CAP can effectively reduce bacterial loads on dental implant surfaces, including pathogens like Streptococcus mitis and Staphylococcus aureus. Furthermore, CAP appears to combat biofilms and plaques that are key contributors to periimplantitis. Conclusion: CAP emerges as a promising treatment option, exhibiting significant bactericidal activity on dental implant surfaces. CAP can decrease the rates of bacterial biofilm and plaque formation, leading to improved outcomes for dental implant patients.

Abstract Acrylic resins-based artificial teeth are frequently used for the fabrication of dentures has and contribute a very strong share in the global market. However, the scientific literature reporting the comparative analysis data of various artificial teeth is scarce. Focusing on that, the present study investigated various types of commercially available artificial teeth, composed of polymethyl methacrylate (PMMA). Artificial teeth are characterized for chemical analysis, morphological features, thermal analysis, and mechanical properties (surface hardness, compressive strength). Different types of artificial teeth showed distinct mechanical (compression strength, Vickers hardness) and thermal properties (thermal gravimetric analysis) which may be attributed to the difference in the content of PMMA and type and quantity of different fillers in their composition. Thermogravimetric analysis (TGA) results exhibited that vinyl end groups of PMMA degraded above 200 °C, whereas 340–400 °C maximum degradation temperature was measured by differential thermal analysis (DTA) for all samples. Crisma brand showed the highest compressive strength and young modulus (88.6 MPa and 1654 MPa) while the lowest value of Vickers hardness was demonstrated by Pigeon and Vital brands. Scanning electron microscope (SEM) photographs showed that Crisma, Pigeon, and Vital exhibited characteristics of a brittle fracture; however, Artis and Well bite brands contained elongated voids on their surfaces. According to the mechanical analysis and SEM data, Well bite teeth showed a significantly higher mechanical strength compared to other groups. However, no considerable difference was observed in Vickers hardness of all groups. Graphical abstract

Coronavirus disease 2019 is a severe communicable pulmonary medical problem that has been a challenging disease for everyone in the globe, but vaccines development and administration against this severe acute respiratory syndrome-inducing disease (coronavirus disease 2019) are currently yielding fabulous results. The mean duration of the coronavirus disease 2019 pandemic for this study spanned from 2020 until 2022. These manifestations are accompanied by symptoms of respiratory tract illnesses such as non-productive cough, sore throat, and nasal discharge. Relevant reviews on coronavirus disease 2019 manifestations and outcomes, consisting mainly of the infections/outbreaks, experimental information, and pre- and post-serovaccination details that occurred, were described. After a typical vaccination course, the study aims to summarize and understand more about the effectiveness of exercise on the pre-and post-coronavirus disease 2019 vaccination and its implementations. Physical activity is an immunological function adjuvant to decrease communicable disease risk and enhance immunity post-viral infection vaccination. Moderate-intensity resistance exercisesession directly before getting the influenza vaccine decreases vaccine responses in older adults, such as redness, pain, or inflammation at the injection spot or other adverse consequences compared to the inactive circumstance. However, it was reported that exercise after a shot is generally safe as long as vaccinated people feel well enough. Though exercise before or after vaccination has no negative impact on the protection afforded by the vaccine, people can exercise immediately after receiving the vaccine, as any changes in blood flow will not affect the vaccine’s response. One episode of light-to-moderate-intensifying exercise after vaccination may improve the antibody reactions to influenza or the coronavirus disease 2019 vaccine. Vaccination administered pre- and post-regular exercise is an effective approach for boosting antibody responses due to its immunostimulant effects. Future research should investigate how different vaccine antibodies respond to low, moderate, and high physical activity levels.

Optical coherence tomography (OCT) is an optics-based imaging technique, which may be called an “optical biopsy.” It can be used to acquire structural information about a tissue at a resolution comparable to histopathology. OCT is based on the principle of low-coherence interferometry where near-infrared (NIR) light is shown on a tissue sample and then cross-sectional images are obtained based on backscattered light and echo time delay. Two main types of OCT are characterized as time-domain OCT (TD-OCT) and Fourier-domain OCT (FD-OCT). The applications of OCT in dentistry can be broadly divided into two groups, i.e., assessment of pathologies and assessment of surfaces and interfaces. Lately, OCT has made its transition from experimental laboratories to mainstream clinical applications. Starting from the short-term training courses, clinicians working in specialities like oral pathology, oral medicine, and oral implantology may find it a useful tool for their practices. It is now clear that OCT will be considered a gold standard diagnostic tool for the detection and characterization of several conditions and lesions of the orofacial region. However, the next challenge will be to incorporate it into the undergraduate and postgraduate curriculum and train dental healthcare staff in the use of these devices.

Choosing an adequate occlusion is challenging during the construction of artificial dentures, and critical for patient satisfaction. However, there is no conclusive evidence to support which occlusal design is more appropriate. The aim of this systematic review was to evaluate canine-guided occlusion in comparison to other occlusal schemes in removable complete denture wearers. The review was conducted according to the Preferred Reported Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. An extensive search was carried out on (PubMed (National Library of Medicine)), Scopus (Elsevier), Cochrane collaboration (Wiley), Science Direct (Elsevier) and Europe PMC (European Bioinformatics Institute). English and non-English studies were identified using keywords on canine-guided occlusion, denture occlusion, dental occlusion and artificial occlusal schemes. Out of 1759 articles searched, 18 were selected based on the inclusion criteria. The included studies were interpreted for the descriptive analysis for the calculation of occlusal schemes, occlusion assessment parameters, the outcome of the occlusal schemes and types of removable prosthesis used. The systematic analysis of occlusal schemes revealed that canine-guided occlusion is viable compared with other occlusal designs in terms of patient satisfaction, mastication, retention, esthetics, phonetics, oral-health-related quality of life and muscle activity. The type of occlusal scheme influences the complete denture patient’s’ masticatory efficiency, satisfaction, retention, phonetics and esthetics. Nevertheless, physical, physiological, mechanical and psychological factors play a vital role in the success of removable complete dentures. The canine-guided occlusal scheme is preferred because of its simplicity, less time consumption, good masticatory performance, ease of fabrication and modification into bilateral balanced occlusion if required. Further studies are required to reduce the controversies related to jaw relations, gnathology and occlusal schemes in complete dentures.

Denture-induced stomatitis (DIS) represents a pathological condition caused by ill-fitting dentures trauma, manifested as inflammation of the palatal tissue beneath the denture. The fungal infections are the principal contributory factors to DIS. Although the aetiology of DIS is multifactorial, the Candida albicans fungal infection remains the main cause. The objective of the present systematic review was to evaluate the latest literature on the addition of nystatin into the tissue conditioners (TCs) in the management of DIS. To search the published literature about “the addition of nystatin in TCs for treating DIS”, electronic databases (PubMed (National library of medicine) and Cochrane Library (Wiley)) were searched (from 1975 until December 2020) using different keywords. Various studies described the effectiveness and efficacy of incorporating nystatin into several TCs. The present systematic review reported that the addition of nystatin is beneficial, with slight or no consequences on both the mechanical and physical features of TCs. Adding nystatin to various TCs for treating DIS can be suggested.

Background: The polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) are the two most well-known of the polyaryletherketone (PAEK) family. PEKK is a new evolving polymeric material. 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. Aims of Review: The aim of this review is to present a comprehensive overview of PEKK and its various applications in restorative, prosthetic, and implant dentistry highlighting its prospects for clinical applications. Key Scientific Concepts of Review: 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.

Objective: To evaluate the marginal adaptation of computer-aided designing and computer-aided machining (CAD/CAM) fabricated cobalt-chromium and zirconium-oxide-based ceramic crowns compared to those produced by a conventional method. Material and Methods: The study consists of three groups; 45 crowns fabricated from cobalt-chromium (CAD-CoCr) and 45 crowns manufactured from zirconium CAD/CAM technology (CAD-Z), and 45 control (C) which consists of conventional metal-ceramic crowns. The marginal discrepancies in vertical dimensions were assessed utilizing a microscope in four surfaces (mesial, distal, vestibular, and oral) for each crown. On completion of the microscopic evaluation, multivariate analysis of variance (MANOVA) was used to study the difference in the four surfaces, considered altogether. Two-way ANOVA revealed the effect of three systems used for gap measurements of each landmark. The differences observed were considered significant at p

Improvement in the performance and compatibility of face masks has remained the focus of researchers in recent years, especially after the emergence of the COVID pandemic. Although a lot of progress in the design, tolerability, and comfort of the mask has been reported, there are certain limitations, requiring further improvement. The present review aims to highlight the filtration efficacy, comfort, and associated characteristic of various types of face masks and respirators as a function of their design and structure. In addition, the air pollutants, their adverse effects on health, certified respirators, and face masks are also discussed. The present review also provides an insight into different types of commercially available face masks in terms of their materials, filtration efficiency, and limitations. The role of emerging trends (such as nanotechnology and high-performance polymers) in the improvement and development of face masks and respirators is also discussed.

Textiles have been used for clothing purposes since ancient times. However, due to their functional properties, their importance—as well as their use in various fields such as filtration, protective clothing, and medical applications—increased over time. Properties of the textile fabrics depend mostly on the fiber type, fabrication technique, and structure. Moreover, fabric porosity is one of the properties that provide comfort, increased thermal insulation, and filtration capability to the end products. The porous structure of woven, knitted, and nonwoven fabrics has been used for many years to get the desired porosity. Usually, macroporous structures are achieved using these types of textiles. Electrospinning is used to produce nanoporous textile fibrous web, but its poor mechanical properties and low production rate limit its use. Aerogels are solid materials with ultrahigh porosity at the nanoscale with low density and good thermal insulation properties, due to which they are considered potential insulation materials today. On the other hand, pure aerogels are sometimes brittle and have poor mechanical properties. Thus, they cannot be directly used in various applications. Consequently, textile reinforced aerogel composites have been developed, which could provide flexibility and strength to aerogels and impart nanoporous structure to textiles. This review summarizes conventional techniques to produce the porous structure in textiles followed by the modern techniques to develop a nanoporous structure. Further, different mechanisms to synthesize textile reinforced aerogel composites are discussed to get a nanoporous structure for filtration and thermal insulation applications. The porosity, mechanical properties, and thermal insulation of textile reinforced aerogel composites are also highlighted. In the end, we give a conclusion that not only summarizes the literature, but also includes recommendations for the researchers.

During the last 10 years, various companies have marketed different “bulk-fill” resin dental composites for the restoration of posterior stress-bearing teeth; however, the impact of acidic conditions on these relatively newer materials has not been thoroughly investigated. Therefore, an attempt was made to evaluate the effect of acidic beverages on the mechanical biomimetic characteristics of four bulk-fill and one conventional nanohybrid resin-based dental composites (RBCs). The specimens of each RBC were stored in two acidic beverages namely ‘Orange Juice’ and ‘Coca-Cola’, whereas ‘dry’ and ‘distilled water’ storage of specimens served as controls. After 1 week of storage, flexural and surface hardness properties of specimens were determined using a universal testing machine and Vickers hardness tester, respectively. In general, the ‘Coca-Cola’ beverage caused the greatest degradation of flexural strength, flexural modulus, and surface hardness characteristics in all RBCs in contrast to the ‘dry’, ‘distilled water’ controls and ‘Orange Juice’ storage conditions. However, the overall mechanical biomimetic performance of nanohybrid RBCs was relatively better than all other bulk-fill RBCs and may, therefore, be considered a suitable candidate for the restoration of posterior stress-bearing permanent dentition.

In the last few decades, biomimetic concepts have been widely adopted in various biomedical fields, including clinical dentistry. Endodontics is an important sub-branch of dentistry which deals with the different conditions of pulp to prevent tooth loss. Traditionally, common procedures, namely pulp capping, root canal treatment, apexification, and apexigonesis, have been considered for the treatment of different pulp conditions using selected materials. However, clinically to regenerate dental pulp, tissue engineering has been advocated as a feasible approach. Currently, new trends are emerging in terms of regenerative endodontics which have led to the replacement of diseased and non-vital teeth into the functional and healthy dentine-pulp complex. Root- canal therapy is the standard management option when dental pulp is damaged irreversibly. This treatment modality involves soft-tissue removal and then filling that gap through the obturation technique with a synthetic material. The formation of tubular dentine and pulp-like tissue formation occurs when stem cells are transplanted into the root canal with an appropriate scaffold material. To sum up tissue engineering approach includes three components: (1) scaffold, (2) differentiation, growth, and factors, and (3) the recruitment of stem cells within the pulp or from the periapical region. The aim of this paper is to thoroughly review and discuss various pulp-regenerative approaches and materials used in regenerative endodontics which may highlight the current trends and future research prospects in this particular area.

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.

It is always difficult to avoid subjectivism in the assessment of the properties of prosthodontics materials due to the ambiguity in the evaluation criteria of dental research [...]

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.

The aim of this review paper is to concentrate on the use and application of photonics in dentistry. More than one hundred review and research articles were comprehensively analysed in terms of applications of photonics in dentistry, including surgical applications, as well as dental biomaterials, diagnosis and treatments. In biomedical engineering, various fields, such as biology, chemistry, material and physics, come together in to tackle a disease/disorder either as a diagnostic tool or an option for treatment. Engineers believe that biophotonics is the application of photonics in medicine, whereas photonics is simply a technology for creating and connecting packets of light energy, known as photons. This review paper provides a comprehensive discussion of its main elements, such as photoelasticity, interferometry techniques, optical coherence tomography, different types of lasers, carbon nanotubes, graphene and quantum dots.

The aim of this article is to comprehensively review the revolution of dental zirconia (Zir), including its types, properties, applications, and cementation procedures. A comprehensive search of PubMed and Embase was conducted. The search was limited to manuscripts published in English. The final search was conducted in October 2021. Newly developed monolithic Zir ceramics have substantially enhanced esthetics and translucency. However, this material must be further studied in vitro and in vivo to determine its long-term ability to maintain its exceptional properties. According to the literature, monolithic translucent Zir has had promising results and a high survival rate. Thus, the utilization of this material is indicated when strength and esthetics are needed. Both the materials and methods used for cementation of monolithic Zir have significantly improved, encouraging dentists to use this material, especially when a conservative approach is required. Zir restorations showed promising outcomes, particularly for monolithic Zir crowns supported with implant and fixed dental prostheses.

Periodontal disease can cause irreversible damage to tooth-supporting tissues such as the root cementum, periodontal ligament, and alveolar bone, eventually leading to tooth loss. While standard periodontal treatments are usually helpful in reducing disease progression, they cannot repair or replace lost periodontal tissue. Periodontal regeneration has been demonstrated to be beneficial in treating intraosseous and furcation defects to varied degrees. Cell-based treatment for periodontal regeneration will become more efficient and predictable as tissue engineering and progenitor cell biology advance, surpassing the limitations of present therapeutic techniques. Stem cells are undifferentiated cells with the ability to self-renew and differentiate into several cell types when stimulated. Mesenchymal stem cells (MSCs) have been tested for periodontal regeneration in vitro and in humans, with promising results. Human umbilical cord mesenchymal stem cells (UC-MSCs) possess a great regenerative and therapeutic potential. Their added benefits comprise ease of collection, endless source of stem cells, less immunorejection, and affordability. Further, their collection does not include the concerns associated with human embryonic stem cells. The purpose of this review is to address the most recent findings about periodontal regenerative mechanisms, different stem cells accessible for periodontal regeneration, and UC-MSCs and their involvement in periodontal regeneration.

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.

Periodontal health plays an important role in the longevity of prosthodontic restorations. The issues of comparative assessment of prosthetic constructions are complicated and not fully understood. The aim of this article is to review and present the current knowledge regarding the various technical, clinical, and molecular aspects of different prosthetic biomaterials and highlight the interactions between periodontal health and prosthetic restorations. Articles on periodontal health and fixed dental prostheses were searched using the keywords “zirconium”, “CAD/CAM”, “dental ceramics”, “metal–ceramics”, “margin fit”, “crown”, “fixed dental prostheses”, “periodontium”, and “margin gap” in PubMed/Medline, Scopus, Google Scholar, and Science Direct. Further search criteria included being published in English, and between January 1981 and September 2021. Then, relevant articles were selected, included, and critically analyzed in this review. The margin of discrepancy results in the enhanced accumulation of dental biofilm, microleakage, hypersensitivity, margin discoloration, increased gingival crevicular fluid flow (GCF), recurrent caries, pulp infection and, lastly, periodontal lesion and bone loss, which can lead to the failure of prosthetic treatment. Before starting prosthetic treatment, the condition of the periodontal tissues should be assessed for their oral hygiene status, and gingival and periodontal conditions. Zirconium-based restorations made from computer-aided design and computer-aided manufacturing (CAD/CAM) technology provide better results, in terms of marginal fit, inflammation reduction, maintenance, and the restoration of periodontal health and oral hygiene, compared to constructions made by conventional methods, and from other alloys. Compared to subgingival margins, supragingival margins offer better oral hygiene, which can be maintained and does not lead to secondary caries or periodontal disease.

Periodontitis is characterized by inflammation of the periodontium and leads to loss of teeth if untreated. Although a number of surgical and pharmacological options are available for the management of periodontitis, it still affects a large proportion of population. Recently, metformin (MF), an oral hypoglycemic, has been used to treat periodontitis. The aim of this review is to systematically evaluate the efficacy of MF in the treatment of periodontitis. An electronic search was carried out using the keywords ‘metformin’, ‘periodontal’ and ‘periodontitis’ via the PubMed/Medline, ISI Web of Science and Google Scholar databases for relevant articles published from 1949 to 2016. The addressed focused question was: ‘Is metformin effective in reducing bone loss in periodontitis? Critical review and meta-analysis were conducted of the results obtained in the selected studies. Following the removal of the duplicate results, the primary search resulted in 17 articles and seven articles were excluded based on title and abstract. Hence, 10 articles were read completely for eligibility. After exclusion of four irrelevant studies, six articles were included. The topical application of MF resulted in improved histological, clinical and radiographic outcomes. Additionally, results from the meta-analysis indicated that application of metformin improved the clinical and radiographic outcomes of scaling and root-planing, but at the same time heterogeneity was evident among the results. However, because of a lack of histological and bacterial studies, in addition to short follow-up periods and risk of bias, the long-term efficacy of MF in the treatment of bony defects is not yet ascertained. Further studies are needed to envisage the long-term efficacy of MF in the management of periodontitis. Keywords: Metformin, Periodontitis, Systematic review, Periodontal bone loss, Treatment of periodontitis

Odontogenic infections are associated with a variety of microorganisms. Antibiotics are commonly used for the management of various dental infections and have a proven role in decreasing morbidity and mortality caused by infectious diseases. The frequent and over usage of antibiotics has been associated with a number of consequences such as the selection of drug resistant strains, and the formation of antibiomas. Antibiomas are characterized by the formation of a localized pathology surrounded by thick fibrous tissues in response to long term antibiotics use. An established antibioma is characterized by a tough fibrous swelling accompanied by painful or painless swelling, intermittent fever and constitutional symptoms. In this article, we are reporting the case of a facial antibioma formed due to prolonged use of antibiotics prescribed for a residual periapical infection following endodontic treatment. In addition, the association of using antibiotics in this context is discussed.

It has been nearly two years since the pandemic caused by the novel coronavirus disease (COVID-19) has affected the world. Several innovations and discoveries related to COVID-19 are surfacing every day and new problems associated with the COVID-19 virus are also coming to light. A similar situation is with the emergence of deep invasive fungal infections associated with severe acute respiratory syndrome 2 (SARS-CoV-2). Recent literature reported the cases of pulmonary and rhino-cerebral fungal infections appearing in patients previously infected by COVID-19. Histopathological analysis of these cases has shown that most of such infections are diagnosed as mucormycosis or aspergillosis. Rhino-orbital-cerebral mucormycosis usually affects the maxillary sinus with involvement of maxillary teeth, orbits, and ethmoidal sinuses. Diabetes mellitus is an independent risk factor for both COVID-19 as well as mucormycosis. At this point, there is scanty data on the subject and most of the published literature comprises of either case reports or case series with no long-term data available. The aim of this review paper is to present the characteristics of COVID-19 related mucormycosis and associated clinical features, outcome, diagnostic and management strategies. A prompt diagnosis and aggressive treatment planning can surely benefit these patients.

The aim of the study was to critically assess and review the latest evidence relating the associations between host defence peptides (HDPs), periodontal diseases (PD) and diabetes mellitus type 2 (DM2). To explore studies on HDPs, periodontal disease, and DM2, researchers utilised specific key phrases to search the electronic databases PubMed (National Library of Medicine), Embase (Ovid), Medline (EBSCO), and Dentistry and Oral Sciences (EBSCO). Quality assessment was conducted by means of the Newcastle Ottawa scale and the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. Following a thorough screening process, a total of 12 papers (4 case-control, 6 cross-sectional, 1 animal, and 1 in vitro) fulfilled the selection criteria and were included. The majority of research found that HDPs were upregulated in DM2 patients with PD. Three investigations, however, found that HDPs were downregulated in DM2 patients with PD. HDPs play a part in the pathophysiology of PD and DM2. Nonetheless, more human, animal and laboratory investigations are needed to fully understand validation of the link, as the evidence is limited. Understanding HDPs as common moderators is critical, aimed at unlocking their potential as therapeutic and diagnostic agents.

The beneficial effects of fluoride on human oral health are well studied. There are numerous studies demonstrating that a small amount of fluoride delivered to the oral cavity decreases the prevalence of dental decay and results in stronger teeth and bones. However, ingestion of fluoride more than the recommended limit leads to toxicity and adverse effects. In order to update our understanding of fluoride and its potential toxicity, we have described the mechanisms of fluoride metabolism, toxic effects, and management of fluoride toxicity. The main aim of this review is to highlight the potential adverse effects of fluoride overdose and poorly understood toxicity. In addition, the related clinical significance of fluoride overdose and toxicity has been discussed.

Abstract Diabetes mellitus (DM) may adversely affect periodontal tissues during orthodontic tooth movement (OTM). The aim of this review is to systematically analyze and review animal studies investigating the effect of DM on periodontal tissues during OTM. An electronic search was conducted via PubMed/Medline, Google Scholar, Embase, ISI Web of Knowledge, and Cochrane Central Register of Controlled Trials (CONTROL) using the keywords “diabetes,” “orthodontics,” and “tooth movement” for studies published between January 2000 and August 2016. After elimination of duplicate items, the primary search resulted in 89 articles. After exclusion of irrelevant articles on the basis of abstract and title, full texts of 25 articles were read to exclude additional irrelevant studies. Seven animal studies were included in this review for qualitative analysis. When compared to healthy animals, more bone resorption and diminished bone remodeling were observed in diabetic animals in all studies. Furthermore, DM decreased the rate of OTM in one study, but in another study, DM accelerated OTM. DM may adversely affect bone remodeling and tooth movement during application of orthodontic forces. However, a number of potential sources of bias and deficiencies in methodology are present in studies investigating the association between OTM and DM. Hence, more long-term and well-designed studies are required before the exact mechanism and impact of DM on outcomes of orthodontic treatment is understood.

There are many human oral antimicrobial peptides responsible for playing important roles including maintenance, repairing of oral tissues (hard or soft) and defense against oral microbes. In this review we have highlighted the biochemistry, physiology and proteomics of human oral histatin peptides, secreted from parotid and submandibular salivary glands in human. The significance of these peptides includes capability for ionic binding that can kill fungal Candida albicans. They have histidine rich amino acid sequences (7–12 family members; corresponding to residues 12–24, 13–24, 12–25, 13–25, 5–11, and 5–12, respectively) for Histatin-3. However, Histatin-3 can be synthesized proteolytically from histatin 5 or 6. Due to their fungicidal response and high biocompatibility (little or no toxicity), these peptides can be considered as therapeutic agents with most probable applications for example, artificial saliva for denture wearers and salivary gland dysfunction conditions. The objectives of current article are to explore the human histatin peptides for its types, chemical and biological aspects. In addition, the potential for therapeutic bio-dental applications has been elaborated.

Cardiovascular diseases such as ischemic heart diseases or stroke are among the leading cause of deaths globally, and evidence suggests that these diseases are modulated by a multifactorial and complex interplay of genetic, environmental, and lifestyle factors. Genetic predisposition and chronic exposure to modifiable risk factors have been explored to be involved in the pathophysiology of CVD. Environmental factors contribute to an individual’s propensity to develop major cardiovascular risk factors through epigenetic modifications of DNA and histones via miRNA regulation of protein translation that are types of epigenetic mechanisms and participate in disease development. Periodontal disease (PD) is one of the most common oral diseases in humans that is characterized by low-grade inflammation and has been shown to increase the risk of CVDs. Risk factors involved in PD and CVD are determined both genetically and behaviorally. Periodontal diseases such as chronic inflammation promote DNA methylation. Epigenetic modifications involved in the initiation and progression of atherosclerosis play an essential role in plaque development and vulnerability. Epigenetics has opened a new world to understand and manage human diseases, including CVDs and periodontal diseases. Genetic medicine has started a new era of epigenetics to overcome human diseases with various new methodology. Epigenetic profiling may aid in better diagnosis and stratification of patients showing potential predisposed states for disease. A better understanding of the exact regulatory mechanisms of epigenetic pathways driving inflammation is slowly emerging and will aid in developing novel tools for the treatment of disease.

The fracture resistance of computer-aided designing and computer-aided manufacturing CAD/CAM fabricated implant-supported cantilever zirconia frameworks (ISCZFs) is affected by the size/dimension and the micro cracks produced from diamond burs during the milling process. The present in vitro study investigated the fracture load for different cross-sectional dimensions of connector sites of implant-supported cantilever zirconia frameworks (ISCZFs) with different cantilever lengths (load point). A total of 48 ISCZFs (Cercon, Degudent; Dentsply, Deutschland, Germany) were fabricated by CAD/CAM and divided into four groups based on cantilever length and reinforcement of distal-abutment: Group A: 9 mm cantilever; Group B: 9 mm cantilever with reinforced distal-abutment; Group C: 12 mm cantilever; Group D: 12 mm cantilever with reinforced distal-abutment (n = 12). The ISCZFs were loaded using a universal testing machine for recording the fracture load. Descriptive statistics, ANOVA, and Tukey’s test were used for the statistical analysis (p < 0.05). Significant variations were found between the fracture loads of the four ISCZFs (p = 0.000); Group-C and B were found with the weakest and the strongest distal cantilever frameworks with fracture load of 670.39 ± 130.96 N and 1137.86 ± 127.85 N, respectively. The mean difference of the fracture load between groups A (810.49 + 137.579 N) and B (1137.86 ± 127.85 N) and between C (670.39 ± 130.96 N) and D (914.58 + 149.635 N) was statistically significant (p = 0.000). Significant variations in the fracture load between the ISCZFs with different cantilever lengths and thicknesses of the distal abutments were found. Increasing the thickness of the distal abutment only by 0.5 mm reinforces the distal abutments by significantly increasing the fracture load of the ISCZFs. Therefore, an increase in the thickness of the distal abutments is recommended in patients seeking implant-supported distal cantilever fixed 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.

Objective: The purpose of this study was to assess the clinical effectiveness of using a combination of enamel matrix protein derivative and acellular dermal matrix in comparison to acellular dermal matrix alone for treating gingival recessions. Methods: The Cochrane Library (Wiley), PubMed by Medline (NLM), Medline (EBSCO), and Embase (Ovid) databases were searched for entries up to April 2020. Only clinical trials were included. Primary outcomes were root coverage (%), changes in keratinized tissue width and recession (mm). Meta-analysis was conducted for root coverage, changes in keratinized tissue width, recession, clinical attachment level and probing depth. Results: Four studies were selected for the analysis. In primary outcomes, root coverage, change in keratinized tissue width and recession analysis showed a mean difference of 4.99% (p = 0.11), 0.20 mm (p = 0.14) and 0.13 mm (p = 0.23) respectively between the two groups. Secondary outcomes analysis also exhibited a statistically insignificant difference between the test and control group with mean difference of 0.11 mm (p = 0.32) in clinical attachment level gain and -0.03 mm (p = 0.29) in probing depth reduction analysis. Conclusions: Within the limits of this study, enamel matrix protein derivative combined with acellular dermal matrix used for treating gingival recession defects resulted in no beneficial effect clinically than acellular dermal matrix only.

Antimicrobial peptides (AMPs) are a wide-ranging class of host-defense molecules that act early to contest against microbial invasion and challenge. These are small cationic peptides that play an important in the development of innate immunity. In the oral cavity, the AMPs are produced by the salivary glands and the oral epithelium and serve defensive purposes. The aim of this review was to discuss the types and functions of oral AMPs and their role in combating microorganisms and infections in the oral cavity.

Melatonin (N-acetyl-5-methoxy tryptamine) is a substance secreted by multiple organs in vertebrates. In addition to playing a part in the circadian cycle of the body, melatonin is known to have antioxidant, antiinflammatory, and antioncotic effects on human tissues. Oral cavity is affected by a number of conditions such as periodontitis, mucositis, cancers, and cytotoxicity from various drugs or biomaterials. Research has suggested that melatonin is effective in treating the aforementioned pathologies. Furthermore, melatonin has been observed to enhance osseointegration and bone regeneration. The aim of this review is to critically analyze and summarize the research focusing on the potential of melatonin in the field of oral medicine. Topical administration of melatonin has a positive effect on periodontal health and osseointegration. Furthermore, melatonin is particularly effective in improving the periodontal parameters of diabetic patients with periodontitis. Melatonin exerts a regenerative effect on periodontal bone and may be incorporated into of periodontal scaffolds. The cytotoxic effect of various drugs and dental materials may be countered by the antioxidant properties of melatonin. Topical administration of melatonin promotes the healing of tooth extraction sockets and may also impede the progression of oral cancer. Although, there are a number of current and potential applications of melatonin, further long term clinical and animal studies are needed to assess its efficacy. Moreover, the role of melatonin supplements in the management of periodontitis should also be assessed.

Background and objective: The exact etiology of recurrent aphthous ulcers (RAS) is unknown. The management of RAS is not always straightforward. The aim of this review is to critically analyze and summarize the clinical literature focusing on the management of aphthous ulcers using low-level lasers. Materials and methods: The Medline (PubMed), Web of Knowledge (ISI), Cochrane Central Register of Controlled Trials (CENTRAL) and Embase databases were searched electronically for studies published in last 20 years (1995–2015) using the keywords “recurrent aphthous stomatitis,” “aphthous ulcers,” and “laser.” Results: A total of 85 articles were found during the initial search; 76 studies were excluded for not fulfilling the criteria whereas nine studies were deemed suitable for this review. Among the included studies, two articles were case reports and seven were randomized clinical trials. Study design, sample size, type of intervention and control of each study were critically analyzed and summarized according to the CONSORT protocol. In majority of the patients, immediate pain relief and accelerated ulcer healing was observed following irradiation with lasers. Conclusions: Although various types of lasers have succeeded in providing immediate pain relief to patients, carbon dioxide (CO2) lasers have the unique advantage of requiring a short exposure time (5–10 s). In order to ascertain the efficacy of laser for treating ulcers in the clinical setting, more clinical trials are required.

Biomimetic has emerged as a multi-disciplinary science in several biomedical subjects in recent decades, including biomaterials and dentistry. In restorative dentistry, biomimetic approaches have been applied for a range of applications, such as restoring tooth defects using bioinspired peptides to achieve remineralization, bioactive and biomimetic biomaterials, and tissue engineering for regeneration. Advancements in the modern adhesive restorative materials, understanding of biomaterial–tissue interaction at the nano and microscale further enhanced the restorative materials’ properties (such as color, morphology, and strength) to mimic natural teeth. In addition, the tissue-engineering approaches resulted in regeneration of lost or damaged dental tissues mimicking their natural counterpart. The aim of the present article is to review various biomimetic approaches used to replace lost or damaged dental tissues using restorative biomaterials and tissue-engineering techniques. In addition, tooth structure, and various biomimetic properties of dental restorative materials and tissue-engineering scaffold materials, are discussed.

The amalgamation of natural polysaccharides with synthetic polymers often produces fruitful results in the area of drug delivery due to their biodegradable and biocompatible nature. In this study, a series of blend films composed of chitosan (CS)/poly(allylamine hydrochloride) (PAH) in different compositions were prepared as smart drug delivery matrices. The properties of these polymeric films were then explored. Attenuated total reflectance-Fourier transform infrared (ATR-FTIR) analysis confirmed an intermolecular hydrogen bonding between CS and PAH. Atomic force microscopy (AFM) revealed improvements in surface morphology as the percentage of PAH in the blend films increased up to 60% (w/w). Water contact angle (WCA) ranged between 97° to 115°, exhibiting the hydrophobic nature of the films. Two films were selected, CTH-1 (90% CS and 10% PAH) and CTH-2 (80% CS and 20% PAH), to test for in vitro cumulative drug release (%) at 37 ± 0.5 °C as a function of time. It was revealed that for simulated gastric fluid (SGF) with pH 1.2, the cumulative drug release (CDR) for CTH-1 and CTH-2 was around 88% and 85% in 50 min, respectively. Both films converted into gel-like material after 30 min. On the other hand, in pH 7.4 phosphate buffer saline (PBS) solution, the maximum CDR for CTH-1 and CTH-2 was 93% in 90 min and 98% in 120 min, respectively. After 120 min, these films became fragments. Sustained drug release was observed in PBS, as compared to SGF, because of the poor stability of the films in the latter. These results demonstrate the excellent potential of blend films in sustained-release drug delivery systems for hydrophilic or unstable drugs.

Cathelicidins are a group of oral antimicrobial peptides that play multiple vital roles in the human body, such as their antimicrobial (broad spectrum) role against oral microbes, wound healing, and angiogenesis, with recent evidences about their role in cancer regulation. Cathelicidins are present in humans and other mammals as well. By complex interactions with the microenvironment, it results in pro-inflammatory effects. Many in vitro and in vivo experiments have been conducted to ultimately conclude that these unique peptides play an essential role in innate immunity. Peptides are released in the precursor form (defensins), which after cleavage results in cathelicidins formation. Living in the era where the major focus is on non-invasive and nanotechnology, this ultimately leads to further advancements in the field of salivaomics. Based on current spotlight innovations, we have highlighted the biochemistry, mode of action, and the importance of cathelicidins in the oral cavity.