Nevin Manimala

J Contemp Dent Pract. 2024 Dec 1;25(12):1179-1189. doi: 10.5005/jp-journals-10024-3799.

ABSTRACT

BACKGROUND: This systematic review and meta-analysis aimed to determine whether reciprocating file systems reduce postoperative pain more effectively than rotary file systems.

MATERIALS AND METHODS: This review followed the preferred reporting items for systematic review guidelines to ensure rigorous and transparent reporting. The databases searched included MEDLINE, Cochrane Library, and Google Scholar, targeting articles published in English between January 2000 and April 2024. Randomized controlled trials involving children aged 4-12 years requiring pulpectomy, comparing reciprocating file systems with rotary systems. Outcomes included quality of obturation, instrumentation time, and postoperative pain. The participants, settings, interventions, comparators, outcome measures, study designs, statistical analyses, results, and all other relevant data were meticulously and accurately extracted from all included studies. Data extraction was performed and recorded in Excel sheets, with separate documentation maintained for each primary outcome.

RESULTS: Out of 279 studies initially identified, 272 were excluded due to duplication, non-English language, or not meeting criteria. Seven studies that met the necessary criteria were included in the systematic review. Among them are five comparisons for instrumentation time, four for postoperative pain, and two comparisons for quality of obturation. Results of the meta-analysis showed that instrumentation time was lower in the rotary file systems than in reciprocating file systems. Postoperative visual analogue scale (VAS) scores after 6 hours and 24 hours were almost similar among both file systems.

CONCLUSION: Given the limitations of this review, it can be said that the postoperative pain scores were comparable between reciprocating and rotary file systems. The root canal preparation time was significantly shorter with the reciprocating system compared to the rotary system.

CLINICAL SIGNIFICANCE: In pediatric dentistry, behavior management plays a vital role in successful treatment. Therefore, opting for the correct file system is fundamental and helps in minimizing pain and instrumentation time, thereby enhancing the overall patient experience. How to cite this article: Sawant S, Kalaskar R, Chandanakunnummal A, et al. Comparative Evaluation of Effectiveness of Reciprocating and Rotary Files in Children: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2024;25(12):1179-1189.

PMID:40079998 | DOI:10.5005/jp-journals-10024-3799

J Contemp Dent Pract. 2024 Dec 1;25(12):1156-1161. doi: 10.5005/jp-journals-10024-3795.

ABSTRACT

AIM: This study aims to clinically evaluate whether the local administration of vitamin D3 enhances postorthodontic tooth stability over a period of 3 months immediately after debonding.

MATERIALS AND METHODS: Patients aged 15-30 years with dental malocclusion and moderate crowding in the lower arch (Little’s irregularity score of 4-6) were selected and randomly split into the experimental and the control groups. After complete alignment and leveling, vitamin D3 injection was delivered to the experimental group and the control group was given a placebo injection with 0.9% normal saline mixed with 2% lignocaine. Fourteen days after the injection, the lower archwires were removed from the control and experimental groups.

RESULTS: Relapse was significantly higher in control than in the experimental group at all-time intervals. Statistically significant values of relapse were observed at T2 and T3 intervals between the two groups, with greater relapse in the control group than in the experimental group. Inter-canine width, arch perimeter, and intermolar width showed mild changes over 3-month period, but there were no significant differences between the two groups.

CONCLUSION: Relapse was seen in both the control and the experimental in the first 4 weeks of the study. Still, the control group showed a greater relapse rate in the following 8th week and 12th week when compared to the experimental group. How to cite this article: Kothandaraman T, Anbarasu P, Dinesh SPS, et al. Impact of Vitamin D3 on Postorthodontic Treatment Stability: A Randomized Controlled Trial. J Contemp Dent Pract 2024;25(12):1156-1161.

PMID:40079995 | DOI:10.5005/jp-journals-10024-3795

J Contemp Dent Pract. 2024 Dec 1;25(12):1148-1155. doi: 10.5005/jp-journals-10024-3790.

ABSTRACT

AIM: The tenet of the study is to evaluate the efficacy of low-level laser therapy (LLLT) as an adjunct to surgical periodontal therapy [open flap debridement (OFD)] on clinical parameters, gingival crevicular fluid (GCF) alkaline phosphatase (ALP) levels in GCF and wound healing.

MATERIALS AND METHODS: Thirty subjects afflicted with chronic periodontitis showing evidence of horizontal bone loss on the radiograph, pocket probing depth (PPD) between 4 and 7 mm, and ≥20 natural teeth present in the oral cavity were included in the study. In every patient, OFD+LLLT was done in one quadrant and OFD in another was performed. The clinical parameters were assessed at baseline, 3 and 6 months visits while the GCF sample was collected at baseline visit and 6 months recall. Wound healing indices were recorded 1-week post-op surgery for each group.

RESULTS: The results showed an evident improvement in all the clinical parameters [pocket probing depth, gingival index (GI), plaque index (PI), and CAL] from baseline-6 months values; however, no statistically significant difference was seen on the intergroup comparison. Wound healing was statistically significantly superior in the OFD + LLLT group in comparison to the OFD group, indicating a positive effect of lasers on healing. Gingival crevicular fluid ALP levels in the two groups decreased after 6 months and a statistically significant reduction in the laser group indicated an anti-inflammatory effect.

CONCLUSION: The results clearly indicated the efficacy of lasers in terms of acceleration of wound healing and control of inflammation.

CLINICAL SIGNIFICANCE: Lasers as an adjunct to surgical periodontal therapy evidently have an anti-inflammatory effect (decrease in GCF ALP levels) as well as accelerate the wound healing process. How to cite this article: Gupta R, Arora SA, Gupta G, et al. Effect of Open Flap Debridement with and without LLLT in Patients with Periodontitis on Wound Healing, GCF ALP Levels, and Clinical Parameters. J Contemp Dent Pract 2024;25(12):1148-1155.

PMID:40079994 | DOI:10.5005/jp-journals-10024-3790

J Contemp Dent Pract. 2024 Dec 1;25(12):1141-1147. doi: 10.5005/jp-journals-10024-3797.

ABSTRACT

AIM: The study aims to assess the long-term clinical outcomes and biocompatibility of resin-modified glass ionomer cement and light-curable tricalcium silicate cement in preserving pulp vitality and preventing further carious progression in deep carious lesions.

MATERIALS AND METHODS: A total of 46 participants with deep carious lesions and reversible pulpitis were selected and divided into two groups (n = 23): Group I was treated with resin-modified glass ionomer cement (RMGIC) and group II was treated with TheraCal LC (a light-curable tricalcium silicate cement). Once the indirect pulp capping (IPC) material was placed on the pulpal/axial walls, the cavity was temporized using intermediate restorative material, while the permanent restoration was done at 3rd-week recall period. Clinical and radiographic assessments were evaluated at intervals of 24 hours, 3 weeks, 3 months, and 6 months. Data were recorded and statistically analyzed.

RESULTS: The mean visual analog scale (VAS) scores for the RMGIC group were 20.21, 12.90, 1.33, 0.00, and 0.00 at baseline, 24 hours, 3 weeks, 3 months, and 6 months, respectively, while the TheraCal LC group showed mean scores of 12.60, 5.95, 2.58, 1.50, and 0.00 at the same intervals. The Mann-Whitney U-test revealed no significant difference in VAS scores between the two groups at any time point (p > 0.05). Intragroup comparisons using the Friedman test indicated statistically significant reductions in VAS scores over time within both groups (p < 0.001). At the 6-month follow-up, there were no significant differences between the groups regarding pain on palpation, swelling, percussion, or mobility (p > 0.05 for all comparisons using the Chi-square test). All teeth in the RMGIC group remained vital at the end of the study, while the vitality rate in the TheraCal LC group was 81%.

CONCLUSION: The study concluded that both RMGIC and TheraCal LC are effective as IPC materials for deep carious lesions with reversible pulpitis, though RMGIC showed a slight advantage in maintaining pulp vitality, reducing symptoms, and minimizing periapical changes over time.

CLINICAL SIGNIFICANCE: The clinical significance of this study is to offer evidence-based guidance for dental practitioners in choosing suitable materials for IPC in cases of deep carious lesions with reversible pulpitis. This research aims to support clinicians in making informed decisions that promote optimal patient care and improve the success and longevity of restorative treatments. How to cite this article: Deshmukh SN, Shenoy VU, Margasahayam SV, et al. Comparative Evaluation of Efficacy of Resin-modified Glass Ionomer Cement and Light-curable Tricalcium Silicate Cement as Indirect Pulp Capping Materials: A Randomized Clinical Trial. J Contemp Dent Pract 2024;25(12):1141-1147.

PMID:40079993 | DOI:10.5005/jp-journals-10024-3797

J Contemp Dent Pract. 2024 Dec 1;25(12):1127-1134. doi: 10.5005/jp-journals-10024-3787.

ABSTRACT

AIM AND BACKGROUND: The balance between mechanical properties, esthetics, and therapeutic benefits in restorative materials, especially for high-risk patients, is lacking. Effective comparative study designs are required. This randomized clinical trial evaluated the clinical performance of Alkasite bioactive restorative material vs resin-modified glass ionomer (RMGI) in cervical carious lesions according to United States Public Health Service (USPHS) criteria over 1 year.

MATERIALS AND METHODS: Twenty-eight high-risk adult patients with Class V cavities in anterior or premolar teeth were randomly assigned to two groups (n = 14 each). The first group received restorations with an RMGI. In contrast, using a selective etching technique and a universal adhesive, the second group was restored with a bulk-fill alkasite. All materials were applied according to the manufacturer’s instructions. The restorations were evaluated at baseline (1 week), after 6 months, and after 12 months using modified USPHS criteria. Data were recorded and statistically analyzed.

RESULTS: Regarding the primary outcome of marginal integrity, no statistically significant difference was found between the alkasite and RMGI restorations at any follow-up interval. However, within the RMGI group, a statistically significant change in marginal integrity was observed across different follow-up periods. All secondary outcomes showed no statistically significant differences in either intragroup or intergroup comparisons at the various follow-up intervals, except for anatomic form, where a statistically significant difference was observed within the RMGI group over different follow-up periods.

CONCLUSION: Both restorations have shown similar clinical performance over a year, indicating their effectiveness in cervical restorations. Alkasite restoration can successfully replace RMGI for cervical restorations in patients with a high caries index.

CLINICAL SIGNIFICANCE: This study addressed the need for restorative materials that balance mechanical strength, esthetics, and therapeutic benefits in high-risk patients. Alkasite restorations are promising alternatives to RMGI. The findings will guide material selection for enhanced functionality, esthetics, and long-term caries prevention.

CLINICAL TRIAL REGISTRATION NUMBER: NCT04716517. How to cite this article: Al-Salamony H, Akah M, Naguib EA, et al. Clinical Evaluation of Bulk-fill Alkasite Restoration vs Resin-modified Glass Ionomer in Class V Carious Lesions: 1-year Randomized Clinical Trial. J Contemp Dent Pract 2024;25(12):1127-1134.

PMID:40079991 | DOI:10.5005/jp-journals-10024-3787

J Contemp Dent Pract. 2024 Dec 1;25(12):1118-1126. doi: 10.5005/jp-journals-10024-3792.

ABSTRACT

AIM: To assess the root-crown ratio (RCR) of maxillary and mandibular anterior permanent teeth from cone-beam computed tomography (CBCT) acquired from a sample of Yemeni adults.

MATERIALS AND METHODS: This was a retrospective radiographic observational cross-sectional study. The study included 233 CBCTs. Root length, crown length, and RCR of all anterior teeth were measured using Ez-3Di software. Factors considered for correlation included gender differences, skeletal classifications (class I, II, and III), overjet (OJ), and overbite (OB). The data were entered and analyzed using the Statistical Package for the Social Sciences software. Significance was set at a value of p < 0.05.

RESULTS: Mean RCR of maxillary and mandibular anterior teeth ranged between 1.2 and 1.3 for central incisors, 1.3 and 1.4 for lateral incisors, and 1.5 and 1.6 for canines. The length of roots and crowns was generally greater in males, except for the mean crown length of the left mandibular central incisor. Class III participants exhibited the longest root length for maxillary and mandibular canines, 15.75 and 14.7 mm, respectively, compared with class I and II participants. Participants with increased OJ (>4 mm) showed the lowest root and crown lengths in all canines and lateral incisors while displaying the highest root length in all central incisors. However, no statistically significant variances were observed in root length and the RCR (p > 0.05). Those with a deep bite had the longest roots for maxillary lateral and central incisors and the shortest roots for maxillary canines. In contrast, participants with an open bite displayed the opposite measurements.

CONCLUSIONS: Gender differences in RCR were insignificant except for the mandibular right central incisor. No significant differences were observed among the three skeletal classes in all study parameters. Furthermore, RCR variations based on OJ and OB were not statistically significant, except for the mandibular left lateral incisor in relation to OB.

CLINICAL SIGNIFICANCE: Understanding RCR variations supports clinicians in treatment planning, especially in anchorage selection, force application, and predicting treatment outcomes. This knowledge is important for minimizing potential complications and improving treatment effectiveness in various orthodontic cases. How to cite this article: Alhaidary SA, Al-Haddad KA, Al-Harazi GA, et al. Root-crown Ratio of Maxillary and Mandibular Anterior Permanent Teeth in Yemeni Adults using CBCT. J Contemp Dent Pract 2024;25(12):1118-1126.

PMID:40079990 | DOI:10.5005/jp-journals-10024-3792

J Contemp Dent Pract. 2024 Dec 1;25(12):1110-1117. doi: 10.5005/jp-journals-10024-3794.

ABSTRACT

AIM: The aim of this study was to compare and evaluate the phase transformation and effect on the bond strength and fracture toughness of monolithic zirconia after surface treatment with alumina and synthetic diamond particles.

MATERIALS AND METHODS: Forty samples of monolithic sintered zirconia discs (Y-TZP) were divided into two groups of 20 samples each. Group A – air abrasion with alumina particles (n = 20); group B – air abrasion with synthetic diamond particles (n = 20). Pretreatment phase and posttreatment of each zirconia sample from group A and group B were evaluated using an X-ray diffraction machine. The surface roughness of each zirconia sample was evaluated using a profilometer. Composite discs were fabricated and bonded to the air-abraded surface of each zirconia sample from group A and group B using a dual-cured resin cement, respectively. These samples were mounted in an acrylic block to determine the bond strength of zirconia with resin cement using a universal testing machine. This was followed by a fracture toughness test of the samples using a Vickers indentation hardness tester. The results were subjected to statistical analysis using a t-test, and relevant statistical conclusions were drawn.

RESULTS: The mean ± SD of monoclinic content in group A (alumina particles) and group B (synthetic diamond particles) was 0.82 ± 0.010% and 0.76 ± 0.015%, respectively. The mean ± SD of surface roughness in group A (alumina particles) and group B (synthetic diamond particles) was 0.507 ± 0.106 and 0.513 ± 0.116 µm, respectively, and the mean ± SD of bond strength in group A (alumina particles) and group B (synthetic diamond particles) was 6.11 ± 1.47 and 6.49 ± 0.83 MPa, respectively. The mean ± SD of fracture toughness in group A (alumina particles) and group B (synthetic diamond particles) was 2.63 ± 0.46 0.5 and 5.70 ± 1.03 MPam^0.5, respectively. p < 0.05 was considered statistically significant.

CONCLUSION: The distribution of mean monoclinic content was significantly higher in zirconia samples abraded by alumina (Group A) as compared to synthetic diamond particles (Group B). The mean surface roughness and bond strength results were statistically insignificant between both groups. The distribution of mean fracture toughness was significantly higher in group B compared to group A.

CLINICAL SIGNIFICANCE: Synthetic diamond particles for air abrasion of Y-TZP can be a promising alternative to alumina as they cause minimal changes in the structural integrity without compromising the bond strength. How to cite this article: Kazi AI, Dugal R, Madanshetty P, et al. Evaluation of Physical Changes and Bond Properties of Monolithic Zirconia Following Surface Treatment with Alumina and Synthetic Diamond Particles: A Comparative X-ray Diffraction Analysis. J Contemp Dent Pract 2024;25(12):1110-1117.

PMID:40079989 | DOI:10.5005/jp-journals-10024-3794

Eur Stroke J. 2025 Mar 13:23969873251325076. doi: 10.1177/23969873251325076. Online ahead of print.

ABSTRACT

INTRODUCTION: A better understanding of who will develop dementia can inform patient care. Although MRI offers prognostic insights, access is limited globally, whereas CT-imaging is readily available in acute stroke. We explored the prognostic utility of acute CT-imaging for predicting dementia.

PATIENTS AND METHODS: We included stroke or transient ischaemic attack (TIA) survivors from participating stroke centres in Scotland. Acute CT-scans were rated using ordinal scales for neurodegenerative and cerebrovascular changes (old infarcts, white matter lesions (WMLs), medial temporal lobe atrophy (MTA), and global atrophy (GA)) and combined together to a ‘brain-frailty’ score. Dementia status was established at 18-months following stroke or TIA.

RESULTS: Among 195 participants, 33% had dementia after 3 years of follow-up. High brain-frailty score (⩾2/4) correlated with higher risk of dementia (HR (95% CI) 6.02 (1.89-19.21)). As individual predictor, severe MTA was most strongly associated with dementia (adjusted HR (95% CI) 2.09 (1.07-4.08)). Other predictors associated with dementia included older age, higher prestroke morbidity (mRS), WMLs, and GA. Integrated in a prediction model with clinical parameters, prestroke mRS, cardiovascular disease, GA, MTA and Abbreviated-Mental-Test were the strongest predictors of dementia (c-statistic: 0.77).

DISCUSSION AND CONCLUSION: Increased brain-frailty, and its individual components (WMLs, MTA, and GA) are associated with a higher risk of dementia in participants with stroke. Combining clinical and brain-frailty parameters created a moderate dementia prediction model but added little value over clinical parameters in combination with cognitive testing. CT-based brain-frailty may provide better prognostic insights when cognitive testing isn’t feasible and for identifying highest-risk individuals for dementia prevention trials to increase trial efficiency.

PMID:40079226 | DOI:10.1177/23969873251325076

Infect Control Hosp Epidemiol. 2025 Mar 13:1-11. doi: 10.1017/ice.2025.33. Online ahead of print.

ABSTRACT

OBJECTIVE: Evaluate Department of Defense (DoD) antimicrobial stewardship programs (ASPs) by assessing the relationship between key clinical outcome metrics (antibiotic use, incidence of resistant pathogens, and incidence of Clostridioides difficile infections) and CDC Core Element (CE) adherence.

DESIGN: Retrospective, cross-sectional study of DoD hospitals in 2018 and 2021.

METHODS: National Healthcare Safety Network Standardized Antimicrobial Administration Ratios (SAARs) were used to measure antibiotic use and microbiology results to evaluate four types of pathogen incidence. A novel CE scoring approach used scores to quantitatively assess relationships with CE adherence and outcome metrics using correlation and regression models. Assessments were repeated with 2021 data for Priority CE adherence and to conduct adjusted regressions for CEs and Priority CEs controlling for categorical bed size.

RESULTS: Compared to 2022 national data, DoD hospitals in 2021 had a similar proportion of facilities with a SAAR statistically significantly > 1.0. Leadership, Action, and Tracking CEs followed a more normal score distribution, while Reporting and Education were somewhat left-skewed. Unadjusted models often showed a positive relationship with higher CE scores associated with worse outcomes for the SAAR and pathogen incidence. Adjusted models indicated that procedural CEs, particularly Priority Reporting, were associated with better ASP-related outcomes.

CONCLUSIONS: CEs should be more quantitatively assessed. Results provide initial evidence to prioritize procedural CE implementation within the DoD; however, additional investigation for structural CEs is needed. Patient outcome data should be collected as an important indicator of ASP performance.

PMID:40079217 | DOI:10.1017/ice.2025.33

Neurol Neurochir Pol. 2025 Mar 13. doi: 10.5603/pjnns.103718. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to identify predictive factors for long-term incomplete nidus obliteration following stereotactic radiosurgery (SRS) for brain arteriovenous malformations (AVMs).

MATERIAL AND METHODS: A systematic search across the PubMed, Web of Science, and Scopus databases identified observational studies reporting such factors. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The study protocol was registered through PROSPERO. Each eligible study’s quality was assessed using the modified Newcastle-Ottawa Scale. Odds ratios (ORs) were calculated for dichotomous parameters.

RESULTS: Two high-quality prospective cohort and three high-quality retrospective cohort studies were included, covering patients with complete (n = 638) and incomplete (n = 297) nidus obliteration. The mean age of the patients was 25.54 ± 12.81 years and the mean follow-up time was 95.98 ± 27.64 months. Predictors for incomplete obliteration of nidus included: AVM classified as Spetzler-Martin (SM) grade ≥ IV (odds ratio (OR) 10.57, 95% confidence interval (CI) 2.00-55.96, p = 0.006), the presence of multiple (> 1) feeding arteries (OR 6.47, 95% CI 2.20-19.10, p = 0.0007), nidus volume > 10 mL (OR 5.08, 95% CI 1.68-15.33, p = 0.004), and the occurrence of intranidal aneurysm (OR 3.33, 95% CI 1.10-10.08, p = 0.03). No statistically significant difference in proportions of patients with incomplete nidus obliteration was found between paediatric (≤ 18 years) and adult (> 18) patient cohorts (p = 0.95).

CONCLUSIONS: The following factors were found to be predictive for long-term incomplete nidus obliteration post-SRS for brain AVMs: SM grade equal to or higher than IV; the presence of multiple feeding arteries; AVM nidus volume exceeding 10 mL; and the occurrence of intranidal aneurysm. These findings will be beneficial in refining patient selection for radiosurgical treatment.

PMID:40079216 | DOI:10.5603/pjnns.103718