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Nevin Manimala Statistics

An Observational Study on Cystic Alterations in Normal Dental Follicles Associated with Impacted Lower Third Molar for Early Intervention

J Contemp Dent Pract. 2023 Oct 1;24(10):809-812. doi: 10.5005/jp-journals-10024-3552.

ABSTRACT

AIM: To evaluate the cystic changes in the radiographically normal dental follicle associated with impacted mandibular third molar.

MATERIALS AND METHODS: This study was conducted on 80 patients. Samples were selected using a convenient sampling technique from the patients who had impacted mandibular third molars in Pell and Gregory’s positions B and C, with follicular space less than 2.5 mm in diameter. After surgical removal of an impacted tooth, the dental follicle was sent for histopathologic evaluation.

RESULTS: Pathologic alterations were found in 19% of cases out of 80 samples. Odontogenic keratocystic and dentigerous cystic changes were found in 7% of cases. A statistically significant cystic alteration was found in female patients and distoangular impacted teeth.

CONCLUSION: This study shows a significant cystic alteration in the radiologically normal dental follicles. Clinical and radiographic features alone may not be a reliable indicator of the absence of pathology. Early intervention of impacted teeth will help to reduce morbidity due to the development of pathology.

CLINICAL SIGNIFICANCE: This study will help educate patients on the risks of retaining impacted teeth, based on scientific facts, in order to minimize the risks and to assess the correlation of pathologic alterations with the depth of impaction and angular position of the impacted tooth.

PMID:38152915 | DOI:10.5005/jp-journals-10024-3552

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Comparative Evaluation of the Effectiveness of Triphala and Chlorhexidine in Full-mouth Disinfection Treatment of Periodontitis in Type 2 Diabetes Patients

J Contemp Dent Pract. 2023 Oct 1;24(10):798-801. doi: 10.5005/jp-journals-10024-3573.

ABSTRACT

AIM: To evaluate and compare the efficacy of triphala and chlorhexidine (CHX) in the treatment of stages II and III periodontitis with one-stage complete mouth disinfection in type 2 diabetes mellitus (DM) patients.

MATERIALS AND METHODS: A total of 24 type 2 diabetic subjects with either stage II or stage III periodontitis were randomly divided into test and control groups with 12 patients in each group. For control group, full-mouth disinfection (FMD) was done using CHX and for test group, FMD was done using triphala. Clinical parameters were evaluated at baseline and at 6 months which comprised of probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), papillary bleeding index (PBI). The primary outcomes considered were a reduction in PPD and a gain in CAL. The data were recorded, tabulated, and statistically analyzed.

RESULTS: The PPD reduction for the test group was 3.38 ± 0.75 mm and for the control group was 3.39 ± 0.76 mm. The CAL gain for the test group was 3.39 ± 0.76 mm and for the control group was 3.18 ± 0.74 mm. Although there was a statistically significant PPD reduction, statistically not significant CAL gain was observed.

CONCLUSION: Both the groups with the FMD protocol showed beneficial results in terms of PPD reduction and CAL gain but the test group showed slightly better results.

CLINICAL RELEVANCE: Clinically, there is more PPD reduction and CAL gain from baseline to 6 months in the test group compared to the control group. Clinically, the test group has more favorable results compared to the control group.

PMID:38152913 | DOI:10.5005/jp-journals-10024-3573

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Can an Alginate-based Wound Dressing Modified with Garden Cress Substitute for COE-PAK as a Wound Dressing? An In Vitro Study

J Contemp Dent Pract. 2023 Oct 1;24(10):787-797. doi: 10.5005/jp-journals-10024-3584.

ABSTRACT

AIM: The aim of the current study was to prepare a natural oral wound dressing from alginate modified with garden cress (GC), a rich source of antibacterial phytochemical compounds essential for wound healing.

MATERIALS AND METHODS: Sodium alginate (SA) dressing (negative control group), was prepared and modified with GC seeds extracts (25 µg/mL and 50 µg/mL) as the intervention groups, and COE-PAK was the positive control group. Cytotoxicity was measured using WST-1 assay (n = 15) after 24 and 48 hours. The in vitro wound healing assay (n = 15) was assessed in terms of wound width, and cell migration rate (0, 24, 48, and 72 hours). Agar diffusion test was performed to investigate the antibacterial action (n = 15) of the groups against Streptococcus mutans and Lactobacillus casei strains. Results were significant at p ≤ 0.05.

RESULTS: There was no statistically significant difference in cytotoxicity in all groups (p = 0.24 at 24 hours and 0.1 at 48 hours). Garden cress-containing groups revealed the lowest mean value of wound width (0.27 mm ± 0.01 and 0.23 mm ± 0.01 for 25 µg/mL and 50 µg/mL, respectively at 48 hours) and the highest mean value of cell migration rate (0.013 mm/hour ± 0.004 and 0.014 mm/hour ± 0.004 for 25 µg/mL and 50 µg/mL, respectively at 48 hours), in addition to the highest antibacterial action (1.49 mm ± 0.05 and 2.14 mm ± 0.09 for 25 µg/mL and 50 µg/mL, respectively against S. mutans, 1.43 mm ± 0.07 and 2.55 mm ± 0.09 for 25 µg/mL and 50 µg/mL, respectively against L. casei).

CONCLUSION: Alginate wound dressing modified with GC extract could be considered a promising wound dressing material in terms of wound healing and antibacterial action.

CLINICAL SIGNIFICANCE: Ready-to-use alginate-based wound dressing modified with GC extract may represent a promising natural alternative to the most commonly used oral wound dressing (COE-PAK).

PMID:38152912 | DOI:10.5005/jp-journals-10024-3584

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Soluble Receptor Activator of Nuclear Factor Ligand and Osteoprotegerin Levels in Gingival Crevicular Fluid among Cigarette Smokers and Non-smokers with and without Periodontitis

J Contemp Dent Pract. 2023 Oct 1;24(10):771-778. doi: 10.5005/jp-journals-10024-3580.

ABSTRACT

AIM: This study aimed to measure and compare the levels of soluble receptor activator of nuclear factor ligand (RANKL) and osteoprotegerin (OPG) in the gingival crevicular fluid (GCF), as well as their ratio, in smokers and nonsmokers with periodontitis.

MATERIALS AND METHODS: Gingival crevicular fluid samples were collected using PerioPaper strips, from 150 individuals, who were categorized into three groups: current smokers with periodontitis stage III grades C and B (n = 50), nonsmokers with periodontitis stages I and II grade A (n = 50), and control healthy individuals (n = 50). The concentrations (pg/mL) of sRANKL and OPG in the GCF were measured by enzyme-linked immunesorbent assays (ELISA).

RESULT: The smokers’ group exhibited the highest sRANKL (pg/mL) concentration as a subsequent lead to a higher sRANKL/OPG ratio. The healthy control group exhibited higher OPG and lower sRANKL concentration, subsequently, the sRANKL/OPG ratio was reduced compared with the other study groups. However, there was no statistical significance of sRANKL and its relative ratio between periodontitis stage III grades C and B, periodontitis stages I and II grade A, and healthy control individuals. There was a statistically significant positive moderate correlation between smoking duration (years) and the sRANKL (pg/mL) concentration and a statistically significant negative moderate correlation between OPG (pg/mL) concentration and cigarettes smoked per day.

CONCLUSION: As a result, compared to the other research groups, smokers with periodontitis stage III grades C and B had greater GCF concentrations of sRANKL, lower OPG, and a higher sRANKL/OPG ratio. The difference in OPG (pg/mL) level was statistically significant. However, there was no statistically significant difference in sRANKL (pg/mL) or its relative ratio, sRANKL/OPG, across the groups.

CLINICAL SIGNIFICANCE: A characteristic that sets periodontitis apart is alveolar bone loss. Resorption is induced by RANKL and inhibited by OPG, resulting in a relative ratio. In light of this, the levels of RANKL and OPG may be helpful indicators for monitoring the activity of periodontal disease in both smokers and nonsmokers with and without periodontitis.

PMID:38152910 | DOI:10.5005/jp-journals-10024-3580

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Z-shaped Miniplates vs Conventional Miniplates for Fixation of Mandibular Parasymphyseal Fractures

J Contemp Dent Pract. 2023 Oct 1;24(10):761-770. doi: 10.5005/jp-journals-10024-3578.

ABSTRACT

AIM: The aim of this study was to evaluate a clinically and radiographically Z-shaped miniplate for the fixation of the parasymphyseal fractures.

PATIENTS AND METHODS: Twenty patients (10 patients in each group) who had parasymphseal mandibular fractures were randomly selected for this study. In this study, open reduction and internal fixation were performed for mandibular parasymphyseal region fractures using two miniplates as group I, and open reduction and internal fixation were performed for mandibular parasymphyseal region fractures using a newly designed Z-shaped miniplate as group II. Clinical and radiographic evaluations were made. Each patient was evaluated: (1) clinically evaluated preoperatively and postoperatively for operating time, ease of placement of the miniplate, and occlusion and (2) radiological: postoperative reduction of fracture was evaluated radiologically at 5-day, 1-month, 2-month, and 3-month intervals with orthopantomogram, and lingual splaying was evaluated by cone-beam computed tomography (CBCT) immediately postoperatively and at an interval of 3 months. The collected data were subjected to statistical analysis. Data analysis was performed by SPSS software, version 25 (SPSS Inc., PASW statistics for Windows version 25). Chicago: SPSS Inc.

RESULTS: There was a statistically significant difference (p < 0.001) between the mean intraoperative time. This indicates that group I had a longer time for fracture fixation than group II. Group I had a longer time elapsed for plate adaptation and definitive fixation than group II. Occlusion and reduction stability in both groups were similar. There was a statistically significant difference in postoperative lingual display control after 5 days and 3 months between the studied groups. This indicates that lingual display control in group II is better than in group I.

CONCLUSION: The Z-shaped miniplate is effective and provides three-dimensional stability for the fixation of parasymphyseal fractures, ease of use, easily adapted in cases of fractures near the mental nerve reduced operative time, and better control of lingual splaying than conventional miniplates.

CLINICAL SIGNIFICANCE: The newly designed Z-shaped miniplate is a valuable option for fixation parasymphysis fractures that need open reduction and internal fixation instead of using conventional miniplates, which are less successful in controlling lingual splaying.

PMID:38152909 | DOI:10.5005/jp-journals-10024-3578

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Impact of Dental Institutions’ Values on Students’ Intent to Practice in Underserved Communities: A Cross-sectional Study

J Contemp Dent Pract. 2023 Oct 1;24(10):729-732. doi: 10.5005/jp-journals-10024-3585.

ABSTRACT

AIM: To evaluate how an institution’s values can impact students’ intent to practice in underserved areas.

MATERIALS AND METHODS: The values of 71 accredited dental schools in the United States were searched and tabulated. The American Dental Education Association (ADEA) survey results were used to tabulate the desire to serve the underserved population before entering dental school and upon graduation. Additionally, responses on the total amount of educational debt on graduation was compiled for LLUSD and all other dental schools. Fisher’s exact test was performed to compare the difference between the two cohorts and Wilcoxon test was used to assess difference within the groups. Tests were conducted at an alpha level of 0.05 with SAS v 9.1.3 (SAS Institute, Cary, NC, USA).

RESULTS: The top five values of US dental institutions based on frequency were excellence, diversity/inclusion, integrity, innovation, and respect. There was no statistically significant difference between LLUSD and all other dental schools in their desire to serve the underserved community upon graduation (p > 0.05, in all instances). Overall, there was a trend that upon graduation, the desire to serve the underserved had less impact on students’ decision-making on their career choices. This drop in the desire to serve the underserved was statistically significant within both cohorts in the year 2021 (p < 0.001).

CONCLUSIONS: Dental institutions should focus on better understanding of how their values impact their students’ career choices so that they can develop strategies to better align their values with the mission of addressing the dentist shortage in underserved areas.

CLINICAL SIGNIFICANCE: Dental institutions’ values play a major role in impacting students’ career choices upon graduation and should be assessed using metrics that are measurable.

PMID:38152903 | DOI:10.5005/jp-journals-10024-3585

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Mitochondrial DNA copy number and cancer risks: A comprehensive Mendelian randomization analysis

Int J Cancer. 2023 Dec 27. doi: 10.1002/ijc.34833. Online ahead of print.

ABSTRACT

Mitochondrial DNA plays a critical role in the pathophysiology of cancer. However, the associations between mitochondrial DNA copy number (mtDNA-CN) and cancer risk are controversial. Mendelian randomization (MR) analyses were performed using three independent instrumental variables (IVs) to explore potential associations between mtDNA-CN and 20 types of cancer. The three sets of IVs were primarily obtained from participants in the UK Biobank and the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium using different methods. The outcome data of cancers were investigated using summary statistics from the FinnGen cohort. The potential causal associations were evaluated using the MR-Egger regression, weighted median, inverse-variance weighted (IVW), and weighted mode methods. The robustness of IVW estimates was validated using leave-one-out sensitivity analysis. Additionally, a meta-analysis was conducted to pool results from three sets of IVs. The results revealed that genetically predicted mtDNA-CN was not associated with cancer risk (odds ratio = 1.02; 95% confidence interval: 0.95-1.10). Subgroup analyses indicated no causal association between mtDNA-CN and breast, lung, prostate, skin, colorectal, gastric, liver, cervical uteri, esophageal, thyroid, bladder, pancreas, kidney, corpus uteri, ovary, brain, larynx, and anus cancers. It was observed that mtDNA-CN was associated with lip, oral cavity, and testis cancers. However, these results should be interpreted with caution because a small number of patients with lip and oral cavity or testis cancers were included. The comprehensive MR analysis demonstrated that mtDNA-CN is not a suitable biomarker for tumor risk assessment.

PMID:38151753 | DOI:10.1002/ijc.34833

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Health disparities in hymenoptera venom allergy management

Allergy Asthma Proc. 2024 Jan 1;45(1):50-52. doi: 10.2500/aap.2024.45.230071.

ABSTRACT

Background: Hymenoptera venom anaphylaxis (HVA) is reported in up to 3% of stings and accounts for approximately 40 US deaths annually. HVA patients require immediate availability of epinephrine and Allergist referrals for consideration of venom immunotherapy. Data regarding epinephrine autoinjector prescriptions, Allergist referral rates, and potential racial disparities are limited. Objective: The primary objective was to determine if there were statistically significant differences in epinephrine autoinjector prescriptions and Allergist referrals between white and African American patients. The secondary objectives were to determine if there were statistically significant differences between adult and pediatric patients and to determine if there were significant differences between epinephrine prescriptions between patients with and without Allergist referrals. Method: This study is a retrospective, descriptive chart review analyzing patients seen between January 01, 2019 and December 31, 2021. Data were obtained utilizing the Epic Systems (Verona, WI) application Slicer Dicer. Individual chart review was performed for age, race, epinephrine autoinjector prescription, and Allergist referral. Results: 342 patients were identified as having HVA. White patients (60 out of 219; 27.4%) were more likely to get epinephrine autoinjector prescriptions than African American patients (17 out of 109; 15.6%) (p = 0.018). Adult patients (25 out of 314; 8.0%) were less likely than pediatric patients (8 out of 28; 28.6%) to have Allergist referrals (p = 0.004). Patients with Allergist referrals (25 out of 32; 78.1%) were more likely to be prescribed an epinephrine autoinjector than patient without Allergist referrals (54 out of 310; 17.4%) (p < 0.00001). Conclusion: Epinephrine autoinjector prescriptions and Allergist referrals are low overall in HVA. Racial disparities were identified with African American patients being significantly less likely to receive epinephrine autoinjector prescriptions. Additionally, adult patients, who may be at increased risk, were less likely to receive Allergist referrals.

PMID:38151734 | DOI:10.2500/aap.2024.45.230071

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The reproducibility of breathing maneuvers as a vasoactive stimulus in the heart: an oxygenation-sensitive resonance imaging study

J Cardiovasc Magn Reson. 2023 Dec 27;25(1):81. doi: 10.1186/s12968-023-00983-4.

ABSTRACT

BACKGROUND: Endothelial dysfunction and impaired oxygenation of the heart is a hallmark of several diseases, including coronary artery disease, hypertension, diabetes, and sleep apnea. Recent studies indicate that oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR) imaging combined with breathing maneuvers may allow for assessing coronary vascular responsiveness as a marker for coronary vascular function in various clinical settings. However, despite the use of OS-CMR in evaluating tissue oxygenation, the reproducibility of these standardized, combined breathing maneuvers as a vasoactive stimulus has yet to be systematically assessed or validated. In this study, we aimed to assess the reproducibility of vasoactive breathing maneuvers to assess vascular function in a population of healthy volunteers.

METHODS: Eighteen healthy volunteers were recruited for the study. Inclusion criteria were an age over 18 years and absence of any evidence or knowledge of cardiovascular, neurological, or pulmonary disease. MRI was performed on a clinical 3 T MRI system (MAGNETOM Skyra, Siemens Healthineers, Erlangen, Germany). The OS-CMR acquisition was performed as previously described (1 min hyperventilation followed by a maximal, voluntary breath-hold). Standard statistical tests were performed as appropriate.

RESULTS: Data from 18 healthy subjects was analyzed. The healthy volunteers had a mean age of 42 ± 15 years and a mean BMI of 25.4 ± 2.8 kg/m2, with an average heart rate of 72 ± 11 beats per minute, and ten of whom (56%) were female. There were no significant differences between global myocardial oxygenation (%[Formula: see text] SI) after hyperventilation (HV1: – 7.82 [Formula: see text] 5.2; HV2: – 7.89 [Formula: see text] 6.4, p = 0.9) or breath-hold (BH1: 5.34 [Formula: see text] 3.1; BH2: 6.0 [Formula: see text] 3.3, p = 0.5) between the repeated breathing maneuvers. The Bland-Altman analysis showed good agreement (bias: 0.074, SD of bias: 2.93).

CONCLUSION: We conclude that in healthy individuals, the myocardial oxygenation response to a standardized breathing maneuver with hyperventilation and a voluntary breath-hold is consistent and highly reproducible. These results corroborate previous evidence for breathing-enhanced OS-CMR as a robust test for coronary vascular function.

PMID:38151725 | DOI:10.1186/s12968-023-00983-4

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Gut microbiome composition: link between sports performance and protein absorption?

J Int Soc Sports Nutr. 2024 Dec;21(1):2297992. doi: 10.1080/15502783.2023.2297992. Epub 2023 Dec 27.

ABSTRACT

BACKGROUND: Sufficient protein intake is essential for adequate physical condition and athletic performance. However, numerous factors can influence the absorption of consumed protein, including timing, type of protein intake, and gut microbiota. In the present study, elite male water polo players consumed a plant-based, vegan protein supplement with (n = 10) or without (n = 10) pre- and probiotics daily during the 31-day study period.

METHODS: We determined the anthropometric characteristics and body composition, dietary habits, gut microbiota composition, and blood parameters of the players at the beginning and at the end of the study. Body composition parameters were analyzed using the InBody 970 bioimpedance analyzer. Gut microbiome composition was determined from stool samples by metagenome sequencing. Paired and unpaired t-tests were used to determine differences between body composition and blood parameters within the groups and between the two groups at the two different sampling times. The Wilcoxon test was used to determine the change in bacterial composition during the study. Correlations between changes in body composition, blood parameters, and taxonomic groups were analyzed using a linear correlation calculation.

RESULTS: Skeletal muscle mass (p < 0.001), body cell mass (p = 0.002), arm circumference (p = 0.003), and protein mass (p < 0.001) increased, while body fat mass (p = 0.004) decreased significantly in the intervention group which consumed pre- and probiotics in addition to protein supplement. Activated acetate (reductive TCA cycle I) and propionate (pyruvate fermentation to propanoate I) pathways correlated positively with increased skeletal muscle mass (p < 0.01 and p < 0.05), and the relative abundance of butyrate-producing species showed a significant positive correlation with changes in body fat mass in the intervention group (p < 0.05). These correlations were not observed in the control group without the intake of pre- and probiotics.

CONCLUSIONS: The composition of the gut microbiota may influence protein absorption and therefore body composition and consequently physical condition and sports performance.

PMID:38151716 | DOI:10.1080/15502783.2023.2297992