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Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study

J Contemp Dent Pract. 2021 Jul 1;22(7):774-777.

ABSTRACT

AIM: Aim of the current study was to assess the anticariogenic effectiveness of different fluoride varnishes on artificially induced enamel lesions employing scanning electron microscope.

MATERIALS AND METHODS: Eighty healthy, normal premolars without dental caries that were extracted in course of orthodontic therapy with all the surfaces intact were included in this study. A window, 4 × 4 mm, was made discernible on the buccal surface of each sample tooth. A demineralizing solution at 37°C was used to immerse the teeth for 48 hours to induce artificial lesions on the surface of the enamel. Following preparation of the artificial enamel lesions, the 80 premolar teeth were allocated into the four groups (20 each) depending on the fluoride varnish system used as Group I: control, Group II: Duraphat varnish, Group III: MI Varnish, and Group IV: Clinpro White Varnish. The anticariogenic effectiveness of different fluoride varnishes was evaluated employing a scanning electron microscope (SEM).

RESULTS: The MI Varnish (fluoride varnish) group exhibited slightly greater (127.20 ±0.14) mean demineralized lesions, pursued by Clinpro White Varnish use (126.88 ±0.09), the control group (126.36 ±0.10) and the Duraphat varnish (124.14 ±0.08) in that order. Greater mean areas of remineralization were found with use of MI Varnish (92.40 ±0.09), pursued by the Duraphat varnish use (106.68 ±0.12), use of Clinpro White Varnish (112.36 ±0.08), and then the control group (123.08 ±0.18) in that order. Statistically significant differences were noted between the experimental groups employing the various fluoride varnishes (p <0.001).

CONCLUSION: The current research concluded that the MI Varnish group presented a superior protective potential in comparison with Duraphat varnish and Clinpro White Varnish groups.

CLINICAL SIGNIFICANCE: Mineral exchanges among teeth and saliva render incipient enamel lesions reversible. A 5% sodium fluoride varnish is the MI Varnish that is composed of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to provide an excellent fluoride varnish that makes available additional bioavailable fluoride, calcium, and phosphate. Therefore, it may be fruitfully utilized in remineralization of initial carious lesions. CPP-ACP may be employed in clinical practice for drawing back or ceasing initial carious lesions. Rani KBS, Ramanna PK, Mailankote S, et al. Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study. J Contemp Dent Pract 2021;22(7):774-777.

PMID:34615783

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Effect of Bone Graft on the Correlation between Clinical Bone Quality and CBCT-determined Bone Density: A Pilot Study

J Contemp Dent Pract. 2021 Jul 1;22(7):756-762.

ABSTRACT

AIM AND OBJECTIVE: The aim of this pilot study is to explore the possible correlation between radiographic bone density and clinical bone quality in edentulous implant sites with and without a history of bone grafting.

MATERIALS AND METHODS: A retrospective evaluation of 273 surgically placed dental implants with adequate preoperative cone-beam computed tomography (CBCT) between 2017 and 2019. Misch classification was used to assess the bone quality, and CBCT grayscale values, utilizing Hounsfield units (HU), were used for radiographic bone density assessment.

RESULTS: Sixty-six patients (mean age, 58 years; 43 [65%] female and 23 [35%] male) with 118 implant sites were included. A total of 38 sites with bone grafts were evaluated. Controlling for location, sites with previous bone graft had softer bone quality (p = 0.003) and greater bone density (p <0.001) compared to sites without previous bone grafts. A significant correlation existed between radiographic bone density and clinical bone quality (p ≤0.01). The magnitude of the relationship increased in the absence of bone graft (p <0.001) and became nonsignificant in sites with previous grafting. In sites with allograft, the relationship was not statistically different than those without bone graft (both p ≥0.07), while it was statistically different in sites with xenograft when sites assumed independent (p = 0.02).

CONCLUSION: CBCT-determined radiographic bone density was correlated to clinical bone quality in the absence of previous bone grafting, while in the presence of previous bone graft, the radiographic bone density of the edentulous sites seemed to be not associated with the clinical bone density, especially in sites with history of xenograft bone grafting.

CLINICAL SIGNIFICANCE: CBCT could be utilized to predict preoperative clinical bone quality in sites without previous bone grafting. When assessing sites with history of bone grafting, the CBCT should be interpreted with caution, especially if xenografts were used.

PMID:34615780

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Comparison of Apical Root Resorption in Patients Treated with Fixed Orthodontic Appliance and Clear Aligners: A Cone-beam Computed Tomography Study

J Contemp Dent Pract. 2021 Jul 1;22(7):763-768.

ABSTRACT

AIM AND OBJECTIVE: To carry out comparison of apical root resorption (ARR) in the fixed orthodontic appliance and clear aligners with the help of cone-beam computed tomography (CBCT) imaging.

METHODS AND MATERIALS: The study was conducted on 576 roots in 110 patients. These patients were divided into two groups such that each group consisted of 55 patients. A total of 288 roots were analyzed in each group. One group consisted of patients treated with the conventional fixed orthodontic appliance. Another group consisted of patients treated with clear aligners. Radiographic images were collected with the help of CBCT for each patient. One image was collected before treatment while another image was collected after treatment. The length of the root of the anterior tooth was measured with the help of CBCT images. The ARR was calculated for each tooth by obtaining the difference between the length of the root measured before orthodontic treatment and after orthodontic treatment. The data were recorded, and statistical analysis was carried out with the help of the paired t test and Chi-square test to compare ARR between the two groups.

RESULTS: The ARR was more in patients who were treated with fixed orthodontic treatment than in those patients who were treated with clear aligners. The mean value of ARR in fixed orthodontic appliances was 1.51 ± 1.34 mm, whereas the mean value of ARR in clear aligners was 1.12 ± 1.34 mm. The severity of ARR in the clear aligners group (on average) was significantly less than that in the fixed appliances group (on average). It was found that ARR in each individual’s tooth included in the study was more in case of the fixed orthodontic appliance as compared with clear aligners (p <0.001).

CONCLUSION: From the present study, it can be concluded that the amount of resorption at the root apex is less among patients who undergo treatment using clear aligners as compared with those treated with conventional fixed orthodontics appliances.

CLINICAL SIGNIFICANCE: ARR found in the orthodontic treatment is a process that causes loss of hard dental tissues such as dentine and cementum at the root apex. Fixed orthodontic appliances are most common method of orthodontic treatment. However, clear aligners are also used commonly for orthodontic treatment.

PMID:34615781

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A Comparative Study to Evaluate the Efficacy of Curcumin Lozenges (TurmNova®) and Intralesional Corticosteroids with Hyaluronidase in Management of Oral Submucous Fibrosis

J Contemp Dent Pract. 2021 Jul 1;22(7):751-755.

ABSTRACT

AIM AND OBJECTIVE: This study aims to compare the efficacy of TurmNova® lozenges and its active ingredient “curcumin” as a low-cost, safe, and noninvasive chemopreventive agent with intralesional corticosteroids (with hyaluronidase) in the management of oral submucous fibrosis (OSMF).

MATERIALS AND METHODS: A total of 80 patients with group III OSMF (Khanna JN and Andrade NN classification) visiting the dental outpatient clinic of the Department of Oral Medicine and Radiology Rama Dental College Hospital and Research Center, Kanpur, were selected for the study. A total of 80 patients were randomly divided into two groups (40 participants each): group A to whom TurmNova® lozenges containing turmeric extract 100 mg along with clove oil 10 mg three times daily for 3 months were given and group B to whom intralesional infiltration of 2 mL dexamethasone (4 mg/mL) + hyaluronidase 1500 IU dissolved in 0.5 mL of 2% lignocaine twice a week for 3 months was given. Data were analyzed using the IBM SPSS Statistics, version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, version 21.0. Armonk, New York: IBM Corp.) Results: Statistical analysis revealed that there was significant clinical improvement in mouth opening and subjective symptoms, like burning sensation/pain associated with the lesion and tongue protrusion in the group A as compared to group B.

CONCLUSION: Curcumin (100 mg) in an innovative delivery system of lozenge results in a higher level of plasma curcumin level. The aforementioned dosages prevent its biotransformation and inactivation by the liver enzymes. Because of these properties, curcumin lozenges are safer, low-cost, and effective alternative treatment in contrast to the present traditional treatment. Further long-term, prospective, large-scale studies need to be done.

CLINICAL SIGNIFICANCE: Curcumin has a role in the treatment of oral premalignant conditions and acts as a very effective chemopreventive agent in the prevention of cancer.

PMID:34615779

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A Statistical Model to Determine the Relationship between Employee Supervisor Characteristics and Overall Satisfaction in Dental Departments in Saudi Arabia

J Contemp Dent Pract. 2021 Jul 1;22(7):724-729.

ABSTRACT

AIM AND OBJECTIVE: An exploratory study was undertaken to determine the relationship between supervisor characteristics and overall satisfaction with supervisors as perceived by the employees of dental departments in hospitals in Saudi Arabia.

MATERIALS AND METHODS: We conducted a survey that included six questions designed to measure the overall performance of a supervisor, as well as questions that were related to specific activities involving interactions between supervisors and employees indental departments of 30 hospitals that were randomly selected. At least 35 employees and one supervisor in each dental department were interviewed. Initially, six questionnaire items were chosen as possible explanatory variables. There are two broad types of variables included in this study. Variables X1 (handles employee complaints), X2 (does not allow for special treatment), and X5 (too critical of poor performance) relate to direct interpersonal relationships, i.e., direct connection between the employee and supervisor, whereas variables X3 (opportunity to learn new things) and X4 (raises based on performance) are of a less personal nature and relate to the job as a whole, i.e., indirect relationship between employees and their supervisor. Variable X6 (rate of advancing to better jobs) is not a direct evaluation of the supervisor, but serves more as a general measure of how the employee perceives his or her own progress in the hospital.

RESULTS: Using regression analysis, we observed that only X1 (handles employee complaints) and X3 (opportunity to learn new things) have an impact on response Y (overall rating of job being done by supervisor). There is a strong positive relationship between X1 and Y and also between X3 and Y.

CONCLUSION: Therefore, when the supervisor listens and handles employee complaints and gives employees the opportunity to learn new things, the supervisor becomes favorable.

CLINICAL SIGNIFICANCE: The relationship between supervisor characteristics and overall satisfaction with supervisors as perceived by the employees of dental departments has not been studied. An understanding of this relationship is valuable to improve employee-supervisor relations, which can improve the overall functioning of hospitals.

PMID:34615774

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Microleakage Comparative Evaluation of RMGIC and Alkasite with and without Adhesive System in Class V Cavity: An In Vitro Study

J Contemp Dent Pract. 2021 Jul 1;22(7):735-738.

ABSTRACT

AIM AND OBJECTIVE: This study aimed to compare microleakage of resin-modified glass ionomer cement (RMGIC) and alkasite with and without adhesive system in class V cavity.

MATERIALS AND METHODS: Thirty class V cavities were prepared on the buccal surface. All prepared samples were randomly divided into three groups. Group I was restored with RMGIC, group II was restored with Cention N after the application of adhesive system, and group III was restored with alkasite. Samples were subjected to 200 thermocycles between temperature baths at 5ºC and 55ºC. Samples were stained with 2% methylene blue. The teeth were sectioned longitudinally, and the sections were then observed under stereomicroscope at a magnification of 20×.

RESULTS: Statistical analysis showed that there was less microleakage in Cention N using adhesive system in both occlusal margin and gingival margin.

CONCLUSION: There were significant differences between RMGIC, alkasite with adhesive system, and alkasite without adhesive system in class V cavity. Least microleakage at the occlusal margin and gingival margin was seen with Cention N using adhesive system and highest microleakage at the RMGIC.

CLINICAL SIGNIFICANCE: Cention N using the adhesive system affects the microleakage in the class V restoration. The study theorizes that the material restorations showed less microleakage in the occlusal margin than in the gingival margin.

PMID:34615776

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Mirror Cross-Exercise on a Kinetic Chain Approach Improves Throwing Performance in Professional Volleyball Athletes With Scapular Dyskinesis

J Sport Rehabil. 2021 Oct 6:1-9. doi: 10.1123/jsr.2021-0103. Online ahead of print.

ABSTRACT

CONTEXT: Volleyball players have shown to be at an increased risk of developing scapular dyskinesis. The kinetic chain exercise approach has gained a lot of attention because of its claims to provide an improved motor control and scapular kinematics. A form of cross exercise, known as mirror therapy, may enhance the effects of a kinetic chain exercise approach in throwing performance.

OBJECTIVE: To examine the effects of mirror cross exercise (MCE), based on a kinetic chain exercise approach in the throwing performance of volleyball athletes with scapular dyskinesis.

DESIGN: Randomized controlled trial.

SETTING: Biomechanics laboratory.

METHODS: 39 volleyball players with scapular dyskinesis were randomly allocated into 3 groups. The first group completed a 6-week kinetic chain approach (KCA group), the second group completed a kinetic chain exercise approach program in addition to MCE group, and the control group followed only their regular training program. Before and after delivering both interventions, throwing accuracy, speed, and force were determined while measuring the ground reaction forces of the drive leg during throwing. Two-way mixed analysis of variance investigated the effects of intervention and time and their interaction.

RESULTS: The results showed intervention × time statistically significant interactions for throwing accuracy, speed, and force for the MCE and the KCA groups. Over the 6-week training period, the MCE and the KCA groups showed significant improvements in throwing accuracy (P < .01) and speed (P < .01), while the ground reaction forces did not change (P > .05). Throwing force increased significantly in the MCE group (P = .01). Between-group comparison showed statistically significant improvements in the throwing accuracy for the MCE and KCA groups against the control group (P < .01) at posttesting. The MCE demonstrated superior results over the KCA in the aforementioned measures.

CONCLUSIONS: This study suggests that the addition of MCE in a KCA program enhances energy transfer throughout the distal and proximal segments, thus improving kinetic chain recruitment and potentially preventing shoulder pathology.

PMID:34615742 | DOI:10.1123/jsr.2021-0103

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Concepts and Treatment Strategies for Somatic Symptom Disorder and Relative Disorders

Brain Nerve. 2021 Oct;73(10):1139-1147. doi: 10.11477/mf.1416201904.

ABSTRACT

Somatic Symptom Disorder is a specific disorder that is extensively defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5). Although the diagnostic criteria for somatic symptom disorder has archived breakaway from mind-body dualism and simplification for physicians, it remains vague and universally unapplicable. Moreover, despite the DSM-5 removing etiology in diagnosis, there is still a need to determine the etiology for individualized patient treatment. In particular, patients with somatic symptom disorder and relative disorders have psychological pathologies, such as somatization and anxiety about illness, all of which require psychiatric treatment. However, these patients initially visit physicians, not psychiatrists, since their symptoms are somatic, and they are anxious about the possibility of a physical disease. As such, supportive attitude and continuous treatment are important, as they can be performed even without a psychiatric consultation. Furthermore, while the effectiveness of pharmacotherapy is limited for these disorders, psychotherapy has the possibility to bring about a fundamental resolution. Particularly, cognitive behavior therapy or psychoanalytic psychotherapy has been found to be effective; however, they require high motivation and take up much time from the patients. Fortunately, the Morita therapy is especially effective for patients who pay excessive attention to somatic symptoms or are hypochondriacal, which is applicable for outpatients using a comparatively short interview that can even be performed in nonpsychiatric clinical settings.

PMID:34615750 | DOI:10.11477/mf.1416201904

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Distant residues modulate conformational opening in SARS-CoV-2 spike protein

Proc Natl Acad Sci U S A. 2021 Oct 26;118(43):e2100943118. doi: 10.1073/pnas.2100943118. Epub 2021 Oct 6.

ABSTRACT

Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) involves the attachment of the receptor-binding domain (RBD) of its spike proteins to the ACE2 receptors on the peripheral membrane of host cells. Binding is initiated by a down-to-up conformational change in the spike protein, the change that presents the RBD to the receptor. To date, computational and experimental studies that search for therapeutics have concentrated, for good reason, on the RBD. However, the RBD region is highly prone to mutations, and is therefore a hotspot for drug resistance. In contrast, we here focus on the correlations between the RBD and residues distant to it in the spike protein. This allows for a deeper understanding of the underlying molecular recognition events and prediction of the highest-effect key mutations in distant, allosteric sites, with implications for therapeutics. Also, these sites can appear in emerging mutants with possibly higher transmissibility and virulence, and preidentifying them can give clues for designing pan-coronavirus vaccines against future outbreaks. Our model, based on time-lagged independent component analysis (tICA) and protein graph connectivity network, is able to identify multiple residues that exhibit long-distance coupling with the RBD opening. Residues involved in the most ubiquitous D614G mutation and the A570D mutation of the highly contagious UK SARS-CoV-2 variant are predicted ab initio from our model. Conversely, broad-spectrum therapeutics like drugs and monoclonal antibodies can target these key distant-but-conserved regions of the spike protein.

PMID:34615730 | DOI:10.1073/pnas.2100943118

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Gluteal Activity During Gait in Patients With Chronic Ankle Instability Following Rehabilitation: A Randomized Controlled Trial

J Sport Rehabil. 2021 Oct 6:1-7. doi: 10.1123/jsr.2021-0148. Online ahead of print.

ABSTRACT

CONTEXT: Ankle positioning gait biofeedback (GBF) has improved ankle inversion for patients with chronic ankle instability. However, the effects on proximal deficits remain unknown. The purpose of this study was to determine the effects of impairment-based rehabilitation with GBF and without biofeedback on gluteal activity during walking in patients with chronic ankle instability.

DESIGN: Randomized controlled trial.

METHODS: Eighteen patients with chronic ankle instability (14 women and 4 men; age 22 [4] y; height 171 [10] cm; mass 71.6 [13.8] kg) were recruited from a university setting, following International Ankle Consortium guidelines. Patients were randomly allocated to GBF or without biofeedback groups (N = 9 per group). Both groups performed 4 weeks of exercises and treadmill walking. The GBF group alone received feedback on frontal ankle positioning at initial contact during walking. Ultrasound videos of the gluteus maximus and medius were recorded during walking at baseline and follow-up by a blinded clinician. Gluteal activity ratios were obtained at each 10% of the gait cycle. Statistical parametric mapping repeated-measures analysis of variance were used to compare groups and time points.

RESULTS: Both groups demonstrated significantly increased gluteus medius activity across the gait cycle compared with baseline (P < .01, mean differences: 0.13-0.21, Hedge g: 0.97-1.89); however, there were no significant between-group differences. There were no statistically significant changes noted for the gluteus maximus. No adverse events were observed.

CONCLUSIONS: Impairment-based rehabilitation led to increased gluteus medius activity, but GBF did not provide any additional improvement to this parameter. Clinicians may consider implementing impairment-based strengthening interventions to improve gluteus medius function during gait for patients with CAI.

PMID:34615741 | DOI:10.1123/jsr.2021-0148