Tag: nevin manimala

J Indian Prosthodont Soc. 2025 Jul 1;25(3):258-265. doi: 10.4103/jips.jips_97_25. Epub 2025 Jul 16.

ABSTRACT

AIM: To evaluate the effects of hydroxyapatite gypsum puger-cassava starch (HAGP-CS) scaffold on the number of osteoblasts and alkaline phosphatase (ALP) and osteocalcin (OCN) expression in the alveolar bone rat model.

SETTINGS AND DESIGN: In vivo study.

MATERIALS AND METHODS: Thirty-six Wistar rats were randomly divided into three groups: rat sockets were given a 1 mm × 1 mm × 1 mm HAGP scaffold, rat sockets were given a 1 mm × 1 mm × 1 mm HAGP-CS, and a control group (rat sockets were not given scaffold material). Following lower left molar extraction, scaffold materials were applied to the sockets. Assessments were conducted on days 7th, 14th, and 28th, with osteoblast counts determined via hematoxylin-eosin staining, and ALP and OCN expressions were analyzed using immunohistochemistry (IHC) staining.

STATISTICAL ANALYSIS USED: Two-way analysis of variance and Tukey’s test.

RESULTS: A significant increase in osteoblast count was observed on day 28 (P = 0.001). In addition, significant differences were noted in ALP expression on day 7 (P = 0.030) and day 28 (P = 0.001), as well as in OCN expression on days 7 and 28 (P = 0.001) across the groups.

CONCLUSIONS: Administering a HAGP-CS scaffold significantly enhances osteoblast proliferation and increases ALP and OCN expression in the alveolar bone rat model.

PMID:40668999 | DOI:10.4103/jips.jips_97_25

J Indian Prosthodont Soc. 2025 Jul 1;25(3):251-257. doi: 10.4103/jips.jips_130_25. Epub 2025 Jul 16.

ABSTRACT

AIM: Sustainability of dental polymethyl methacrylate (PMMA) in acidic environments is crucial as oral pH fluctuations can degrade the mechanical properties of denture bases. PMMA strengthening with polypropylene (PP) mesh has improved mechanical properties, but its effectiveness in acidic conditions remains underexplored. This investigation aimed to evaluate the mechanical properties of PP mesh reinforced PMMA (PP-PMMA) on exposure to an acidic environment as against unreinforced denture base resin (UN-PMMA).

SETTINGS AND DESIGN: Experimental In-vitro study.

MATERIALS AND METHODS: A total of 120 PMMA samples were prepared as per standardized guidelines and divided into two groups as unreinforced and PP – PMMA. Prepared specimens were immersed in artificial saliva and simulated gastric acid (0.06M HCl, pH 1.2) at 37°C for 96 hours to simulate long-term clinical exposure to an acidic environment. Flexural strength, impact strength, surface roughness and microscopic characteristics were assessed with aid of universal testing machine, Izod’s impact tester, profilometer and high-resolution scanning electron microscope (HR-SEM) in order.

STATISTICAL ANALYSIS USED: The data were statistically analyzed using ANOVA and independent t-test set at a significance level of P-values less than 0.05.

RESULTS: PP-PMMA exhibited significantly higher flexural strength in simulated gastric acid (70.03±1.4MPa) compared to UN-PMMA (68.77±2.2MPa) (P < 0.05). In simulated gastric acid (HCl), PP-PMMA showed no significant difference in surface roughness compared to UN-PMMA (P = 0.29). However, in artificial saliva, PP-PMMA exhibited lower surface roughness (0.47±0.14μm) than UN-PMMA (0.56±0.08μm) (P < 0.05), indicating improved smoothness. Impact strength remained comparable between groups in both immersion conditions (P > 0.05). The presence of mesh between the layers restricted the ingress of saliva and HCl as was perceived with rougher surface in the external area.

CONCLUSION: PP reinforcement improved the flexural strength of PMMA in acidic environments and maintained surface roughness in acidic environments but did not significantly enhance impact strength. Polypropylene mesh reinforcement effectively reduced porosities and maintained structural integrity within the PMMA matrix. These findings suggested that polypropylene mesh reinforcement enhances the durability of denture base materials and benefits patients with gastroesophageal reflux condition.

PMID:40668998 | DOI:10.4103/jips.jips_130_25

J Indian Prosthodont Soc. 2025 Jul 1;25(3):244-250. doi: 10.4103/jips.jips_33_25. Epub 2025 Jul 16.

ABSTRACT

AIM: To validate the CBCT classification for immediate implant placement (IIP) given by Howard Gluckman in the local population of Gujarat, India, and additionally evaluate the available bone beyond the tooth apex for IIP in the direction of proposed osteotomy.

SETTING AND DESIGN: Cross-sectional Observational study.

MATERIALS AND METHODS: A total of 103 cone beam computed tomography (CBCT) scans involving the six maxillary anterior teeth were scrutinized in the radial plane. Each CBCT was divided into six slices (n = 618), which were classified according to Gluckman’s classification, followed by making the osteotomy lines. Six measurements (L, W1, W2, W3, W4, and W5) were made from root to nasal floor. Bone length (L) was measured in the direction of proposed osteotomy, whereas the bone width was measured at five different points along the proposed osteotomy.

STATISTICAL ANALYSIS USED: Chi-square p value, One-way ANOVA and Post hoc Tukey test.

RESULTS: As per Gluckman’s classification, it was found that class I showed the highest bone width with the lowest bone length, whereas Class V showed the lowest bone width. The highest bone length was observed in Class IV. The prevalence of different radial root position (RRP) starting from class I to class V was 1%, 75%, 15%, 16%, and 3%, respectively.

CONCLUSION: A distinct correlation was found between the anterior root position and the available bone between the root tip and the nasal floor as per Gluckman’s classification.

CLINICAL SIGNIFICANCE: This study helps in the radiographic evaluation of available bone around the roots of maxillary anterior teeth, which is a critical determining factor for treatment planning in IIP cases. A deep knowledge of RRP, bone morphology, and available alveolar bone beyond the apex provides useful perception to the clinician to plan surgical and grafting procedures to achieve primary stability. This will also help the clinicians to visualize the final prosthetic outcome with respect to the position of access hole.

PMID:40668997 | DOI:10.4103/jips.jips_33_25

J Indian Prosthodont Soc. 2025 Jul 1;25(3):235-243. doi: 10.4103/jips.jips_270_24. Epub 2025 Jul 16.

ABSTRACT

AIM: The aim of the study is to assess the antimicrobial efficacy at Implant-Abutment Interface (IAI) coated with metal ions (silver and gold) causing peri-implantitis, with the objective of comparing its antimicrobial properties.

STUDY SETTING AND DESIGN: The study conducted is an in vitro experimental study.

MATERIAL AND METHODS: A total of 90 specimens 45 Titanium alloy discs substitute for Implant (Ti-6Al-4V, Grade V) and 45 Stainless Steel (315L SS) disc substitute for Abutment were serially ground, polished and cleaned to be coated with gold (Au) and silver (Ag) ions by sputtering technique which was later tested for antimicrobial efficacy by means of agar disk diffusion method with gram negative microorganisms causing peri-implantitis, the measurement of inhibition zone (ZOI) encircling each sample were taken and noted.

STATISTICAL ANALYSIS USED: The mean zone of inhibition data for all the groups were subjected for statistical analysis by Tukey’s multiple comparison test and one way ANOVA.

RESULTS: The results showed that the antimicrobial efficacy of gold coated Titanium alloy-Stainless steel, (TiAu -SSAu) and Silver coated Titanium- stainless steel (TiAg-SSAg) were significantly higher with a mean ZOI value of 24.6mm (Prevotella intermedia) for gold coated and 17 mm for silver coated groups compared to Uncoated group Titanium alloy- stainless steel (Ti-SS) with a mean zone of inhibition of 10mm, also proved by Tukeys multiple comparison test with statistical significant difference in the antibacterial activity of gold coated group compared to other groups where p <0.0001 against Porphyromonas Gingivalis, Prevotella Intermedia and Aggregatibacter Actinomyces.

CONCLUSIONS: The surface modification of titanium alloy and stainless steel with metal ion coating (Au and Ag) significantly reduces the signs of peri-implantitis and thus leading to lasting success of implants.

PMID:40668996 | DOI:10.4103/jips.jips_270_24

J Indian Prosthodont Soc. 2025 Jul 1;25(3):229-234. doi: 10.4103/jips.jips_49_25. Epub 2025 Jul 16.

ABSTRACT

AIM: Microbial assessment of internal recess of two different internal implant connections in an in vivo study.

STUDY SETTINGS AND DESIGN: This randomized, in vivo study included 40 patients requiring mandibular single-tooth implant-supported prostheses, allocated into two equal groups based on implant connection design.

MATERIALS AND METHODS: Group Internal Hex (IH) and group Conical Connection (CC) received implants with IH and CC, respectively. On the day of prosthetic loading, peri-implant sulcular fluid (PISF) sample was collected and stored. PISF samples were recollected after 3 months. Subsequently, the screw access hole was exposed, and the abutment screw was removed. Implant-abutment recess was washed with saline, lavage was sent for microbiological assay. The abutment screw and crown were restored. PISF was analyzed for interleukin-6 (IL-6).

STATISTICAL ANALYSIS USED: For nonparametric values Chi square test and for parametric values t-test was used to analyse the data.

RESULTS: No implant failure or patient fallout was observed. In Group IH, 17 out of 20 samples were positive for aerobic viz-a-viz 7 samples from Group CC; P = 0.001. For anaerobic bacteria, similar results were obtained with a number of positive samples 19 as compared to 6 in respective groups; P = 0.00002. IL-6 values did not differ significantly from baseline to 3 months in either group.

CONCLUSION: Within the limitations of the study, results show higher bacterial contamination of implant recess in IH than CC. However, the bacterial load had an insignificant contribution to IL-6 levels in PISF of the patients of either group in this time period.

PMID:40668995 | DOI:10.4103/jips.jips_49_25

J Indian Prosthodont Soc. 2025 Jul 1;25(3):220-228. doi: 10.4103/jips.jips_51_25. Epub 2025 Jul 16.

ABSTRACT

AIM: Facial imaging technology has become a pivotal tool in modern medical practice, particularly within fields such as maxillofacial prosthodontics, orthodontics, and smile design. The creation of digital twins, or virtual patients, enhances diagnostic accuracy, aids in treatment planning, and improves outcome prediction. The aim of the study was to assess the accuracy of various facial scanners, determine overall accuracy of each scanner, and identify which scanner demonstrates superior accuracy in specific facial regions.

SETTINGS AND DESIGN: An observational crossover study.

MATERIALS AND METHODS: Cone beam computed tomography volumetric scan was used as a control group, as it has been considered as a gold standard in terms of accuracy. For comparison, scan data were obtained from three different scanners, namely Carestream facial scanner, Medit intraoral scanner for facial scan, and MetiSmile face scanner. The standard tessellation language files thus obtained were compared for accuracy in Geomagic X software by superimposition technique and were evaluated for their accuracy using various reference points on the face.

STATISTICAL ANALYSIS USED: Normality was confirmed using the Shapiro-Wilk test. One-way analysis of variance for comparison among groups and Tukey test for pairwise comparison was used using SPSS software (IBM SPSS version 29 USA).

RESULTS: The study concluded that MetiSmile was the best facial scanner among the three groups with a mean discrepancy of (0.35 ± 0.33) mm and P = 0.001, indicating significant difference between the scanners.

CONCLUSION: Each scanner evaluated demonstrated acceptable performance, with notable variations attributable to their distinct scanning methodologies. Among these, the MetiSmile scanner emerged as the most accurate, delivering the most favorable results in terms of accuracy.

PMID:40668994 | DOI:10.4103/jips.jips_51_25

J Indian Prosthodont Soc. 2025 Jul 1;25(3):210-219. doi: 10.4103/jips.jips_76_25. Epub 2025 Jul 16.

ABSTRACT

AIM: The purpose of the study was to comparatively evaluate temporomandibular joint function and treatment response using joint vibration analysis (JVA) in patients exhibiting disc displacement with reduction (DDR), treated with three variable thickness of stabilization splints. JVA analyzed these vibrations to detect internal joint abnormalities, and their patterns were further categorized using the Piper classification was highly accurate and hence used over magnetic resonance imaging.

SETTINGS AND DESIGN: Randomized clinical trial.

MATERIALS AND METHODS: The splint of different thicknesses, i.e., Group A (3 mm), Group B (4 mm), and Group C (5 mm) were given to the study participants for 10 week interval, and pre and posttreatment efficacy was recorded using JVA. Stress perseverance and tooth wear index were recorded with a pre and postquestionnaire.

STATISTICAL ANALYSIS USED: The one way analysis of variance f test and Turkey’s post hoc test for multiple comparisons were used to statistically assess the results.

RESULTS: The treatment response with Group A and B thickness of stabilization splints was significant (P = 0.01) and with Group C was not significant (P = 5.28). The statistical result of stress perseverance was not significant between the three groups, although reflecting female participants were affected more. The tooth wear index was significant with all the three groups (P = 0.09).

CONCLUSION: The study concluded that the splints given to Group A and Group B showed effective treatment response, while Group C showed positive response in a few individuals, but some individuals compliant of discomfort. The stress level was high in female individuals. Among all the participants, the concern of tooth wear was present.

PMID:40668993 | DOI:10.4103/jips.jips_76_25

J Indian Prosthodont Soc. 2025 Jul 1;25(3):204-209. doi: 10.4103/jips.jips_459_24. Epub 2025 Jul 16.

ABSTRACT

AIM: To evaluate and compare the surface roughness and impact strength of conventional polymethyl methacrylate (PMMA) with microcrystalline cellulose (MCC)-reinforced PMMA.

SETTINGS AND DESIGN: An in-vitro experimental study was conducted. Fifty PMMA specimens were fabricated and divided into five groups based on MCC concentration (2% or 5%) and particle size (20 μm or 50 μm).

MATERIALS AND METHODS: Specimens (80 mm × 10 mm × 4 mm) were categorized as follows: Group A (control; conventional PMMA), Groups B and D (2% MCC with 20 µm and 50 µm particles, respectively), and Groups C and E (5% MCC with 20 µm and 50 µm particles, respectively). Surface roughness was measured using a contact profilometer, and impact strength was tested with a ZwickRoell impact testing machine.

STATISTICAL ANALYSIS USED: Statistical analysis was performed using IBM SPSS Version 28.0. One-way ANOVA followed by Tukey’s post hoc test was used to determine intergroup differences, with the significance level set at p<0.05.

RESULTS: Surface roughness was lower in Groups B (0.89±0.43), C (1.07±0.34), and E (0.77±0.27) compared to the control Group A (1.25±0.42), while Group D (1.84±0.25) showed higher values. Impact strength in Groups C (1.85±0.23), D (1.80±0.17), and E (1.81±0.26) was slightly lower than the control (1.88±0.31), though not statistically significant. However, Group B (1.56 ± 0.20) showed a significant reduction.

CONCLUSION: The addition of 20 μm MCC reduced surface roughness at both 2% and 5% concentrations, whereas 50 μm MCC increased roughness at 2% but decreased at 5%. Impact strength remained comparable to the control in all groups except PMMA + 2% MCC (20 μm), which exhibited a significant decline. MCC reinforcement influences PMMA’s mechanical and surface properties, suggesting its potential for denture base modifications.

PMID:40668992 | DOI:10.4103/jips.jips_459_24

J Indian Prosthodont Soc. 2025 Jul 1;25(3):198-203. doi: 10.4103/jips.jips_396_24. Epub 2025 Jul 16.

ABSTRACT

AIM: This study delves into how different printing orientations following polishing and coating affect surface roughness and color stability, aiming to refine fabrication methods and enhance patient satisfaction.

STUDY SETTING AND DESIGN: Twenty-seven polymethyl methacrylate (PMMA) resin samples were designed with dimensions of 10 mm × 2 mm and were 3D printed with three different printing orientations (0°, 45°, and 90°), followed by support removal and polishing. After the evaluation, the samples were coated with the layer of PMMA resin.

MATERIALS AND METHODS: Standard tessellation language files as the basis for sample preparation were generated using the Autodesk Meshmixer software and exported to 3D printer for the AM of the specimens. The samples underwent assessment for surface roughness and color stability, forming the three groups with different printing orientations. Subsequently, each sample was coated with unpolymerized PMMA resin and polymerized with ultraviolet light, forming the other three groups following coating. After this process, the samples were reevaluated for surface properties, forming the basis of the study’s six distinct groups.

STATISTICAL ANALYSES USED: The data was tabulated and evaluated for the mean and the standard deviation.

RESULTS: Upon statistical analysis, the surface roughness of 3D printed polished PMMA resin polished and coated PMMA resin for all printing orientations (P < 0.001). The surface roughness was highest at a 45° angle, followed by 90°, with the lowest roughness observed at 0°. Similarly, in polished and coated PMMA resin, roughness was significantly higher at 45° compared to 0° and 90° but no significant difference between 0° and 90° (P > 0.05). For the color stability parameter, color change (∆E) values showed no significant difference for the three printing orientations (P > 0.05) and among the six study groups.

CONCLUSIONS: Different printing orientation markedly affects surface roughness and color stability, while coating with PMMA resin had significantly reduced the surface roughness without a significant impact on color stability. Thus, meticulous selection of printing orientation is essential for achieving desired surface properties.

PMID:40668991 | DOI:10.4103/jips.jips_396_24

JAMA Netw Open. 2025 Jul 1;8(7):e2517160. doi: 10.1001/jamanetworkopen.2025.17160.

ABSTRACT

IMPORTANCE: Allergic rhinitis (AR) affects 10% to 30% of the adult population globally. The current framework of pharmaceutical care for managing AR focuses on community pharmacies, with limited structured pharmaceutical care in public health care settings.

OBJECTIVE: To evaluate the effectiveness of a pharmacist-led education intervention (AR-PRISE) in a public health care institution compared with standard care for managing AR among adults.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial used a 2-arm, parallel-group, open-label design in the otorhinolaryngology clinic of a government-funded tertiary referral hospital in northern Malaysia. Enrollment occurred from June 1, 2023, to February 15, 2024, with follow-up completed August 6, 2024. The trial included Malaysian patients aged 18 to 80 years who had received a diagnosis of AR and were able to comprehend English or Malay. Of the 209 screened patients, 154 were recruited and randomly assigned into intervention and control groups, with 149 completing the study.

INTERVENTIONS: The AR-PRISE intervention involved an 8-minute educational video on AR and structured pharmacist counseling.

MAIN OUTCOMES AND MEASURES: The primary outcomes were between-group differences at day 180 in knowledge level, symptom control (Total Nasal Symptom Score [TNSS] for the past 12 hours and past 2 weeks), medication adherence (number of days of intranasal corticosteroid use), and quality of life (assessed by the European Quality of Life 5-Dimension 5-Level Instrument and European Quality of Life Visual Analog Scale). Assessments were conducted at baseline and days 60 (±7), 120 (±7), and 180 (±7). All analyses were performed on an intention-to-treat basis.

RESULTS: Among the 154 participants, the mean (SD) age was 46.5 (17.0) years, and 97 (63.0%) were women; 77 participants were randomized to each group. In the intention-to-treat analysis, the intervention group showed statistically significant improvement in TNSSs for the past 2 weeks compared with controls (estimate [SE], 0.14 [0.06]; 95% credible interval [CrI], 0.03-0.25). Significant reductions in the TNSS for the past 2 weeks were observed at all time points (day 60: estimate [SE], 0.18 [0.05]; 95% CrI, 0.08-0.28; day 120: estimate [SE], 0.21 [0.05]; 95% CrI, 0.11-0.31; and day 180: estimate [SE], 0.11 [0.05]; 95% CrI, 0.01-0.21). No significant differences were observed for knowledge level, TNSS for the past 12 hours, medication adherence, or quality of life.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, the AR-PRISE intervention significantly improved AR symptom control (TNSS for the past 2 weeks) compared with standard care over 180 days but did not show significant effects on other coprimary outcomes (AR knowledge, TNSS for the past 12 hours, medication adherence, or quality of life). These findings suggest that while pharmacist-led education can enhance symptom management, additional strategies may be needed to address broader aspects of AR care.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06027736.

PMID:40668584 | DOI:10.1001/jamanetworkopen.2025.17160