Assessment of knowledge and attitude about basic life support among dental interns and postgraduate students in Bangalore city,India

BACKGROUND: Life-threatening emergencies can occur at anytime, at anywhere and in anyone. Effective management of an emergency situation in the dental office is ultimately the dentist's responsibility. The lack of training and inability to cope with medical emergencies can lead to tragic consequences and sometimes legal complications. Therefore, health professionals including dentists must be well prepared to deal with medical emergencies. This study was undertaken to assess the knowledge about and attitude towards basic life support(BLS) among dental interns and postgraduate students in Bangalore city, India.METHODS: A cross sectional survey was conducted among dental interns and postgraduate students from May 2014 to June 2014 since few studies have been conducted in Bangalore city. A questionnaire with 17 questions regarding the knowledge about and attitude towards BLS was distributed to 202 study participants.RESULTS: The data analyzed using the Chi-square test showed that dental interns and postgraduate students had average knowledge about BLS. In the 201 participants, 121(59.9%) had a positive attitude and 81(40.1%) had a negative attitude towards BLS.CONCLUSIONS: Cardiopulmonary resuscitation should be considered as part of the dental curriculum. Workshops on a regular basis should be focused on skills of cardiopulmonary resuscitation for dental students.

Proteomic profiling of various human dental stem cells-a systematic review

BACKGROUND The proteomic signature or profile best describes the functional component of a cell during its routine metabolic and survival activities.Additional complexity in differentiation and maturation is observed in stem/progenitor cells.The role of functional proteins at the cellular level has long been attributed to anatomical niches,and stem cells do not deflect from this attribution.Human dental stem cells(hDSCs),on the whole,are a combination of mesenchymal and epithelial coordinates observed throughout craniofacial bones to pulp.AIM To specify the proteomic profile and compare each type of hDSC with other mesenchymal stem cells(MSCs)of various niches.Furthermore,we analyzed the characteristics of the microenvironment and preconditioning changes associated with the proteomic profile of hDSCs and their influence on committed lineage differentiation.METHODS Literature searches were performed in PubMed,EMBASE,Scopus,and Web of Science databases,from January 1990 to December 2018.An extra inquiry of the grey literature was completed on Google Scholar,ProQuest,and OpenGrey.Relevant MeSH terms(PubMed)and keywords related to dental stem cells were used independently and in combination.RESULTS The initial search resulted in 134 articles.Of the 134 full-texts assessed,96 articles were excluded and 38 articles that met the eligibility criteria were reviewed.The overall assessment of hDSCs and other MSCs suggests that differences in the proteomic profile can be due to stem cellular complexity acquired from varied tissue sources during embryonic development.However,our comparison of the proteomic profile suffered inconsistencies due to the heterogeneity of various hDSCs.We believe that the existence of a heterogeneous population of stem cells at a given niche determines the modalities of regeneration or tissue repair.Added prominences to the differences present between various hDSCs have been reasoned out.CONCLUSION Systematic review on proteomic studies of various hDSCs are promising as an eye-opener for revisiting the proteomic profile and in-depth analysis to elucidate more refined mechanisms of hDSC functionalities.

Smart scaffolds in bone tissue engineering: A systematic review of literature

AIM: To improve osteogenic differentiation and attachment of cells.METHODS: An electronic search was conducted inPub Med from January 2004 to December 2013. Studies which performed smart modifications on conventional bone scaffold materials were included. Scaffolds with controlled release or encapsulation of bioactive molecules were not included. Experiments which did not investigate response of cells toward the scaffold(cell attachment, proliferation or osteoblastic differentiation) were excluded. RESULTS: Among 1458 studies, 38 met the inclusion and exclusion criteria. The main scaffold varied extensively among the included studies. Smart modifications included addition of growth factors(group Ⅰ-11 studies), extracellular matrix-like molecules(group Ⅱ-13 studies) and nanoparticles(nano-HA)(group Ⅲ-17 studies). In all groups, surface coating was the most commonly applied approach for smart modification of scaffolds. In group I, bone morphogenetic proteins were mainly used as growth factor stabilized on polycaprolactone(PCL). In group Ⅱ, collagen 1 in combination with PCL, hydroxyapatite(HA) and tricalcium phosphate were the most frequent scaffolds used. In the third group, nano-HA with PCL and chitosan were used the most. As variable methods were used, a thorough and comprehensible compare between the results and approaches was unattainable.CONCLUSION: Regarding the variability in methodology of these in vitro studies it was demonstrated that smart modification of scaffolds can improve tissue properties.

Polymeric vs hydroxyapatite-based scaffolds on dental pulp stem cell proliferation and differentiation

AIM: To evaluate adhesion, proliferation and differentiation of human dental pulp stem cells(h DPSCs) on four commercially available scaffold biomaterials. METHODS: hD PSCs were isolated from human dental pulp tissues of extracted wisdom teeth and established in stem cell growth medium. h DPSCs at passage 3-5 were seeded on four commercially available scaffold biomaterials, SureO ss(Allograft), Cerabone(Xenograft), PLLA(Synthetic), and OSTEON Ⅱ Collagen(Composite), for 7 and 14 d in osteogenic medium. Cell adhesion and morphology to the scaffolds were evaluated by scanning electron microscopy(SEM). Cell proliferation and differentiation into osteogenic lineage were evaluated using DNA counting and alkaline phosphatase(ALP) activity assay, respectively. RESULTS: All scaffold biomaterials except Sure Oss(Allograft) supported h DPSC adhesion, proliferation and differentiation. hD PSCs seeded on PLLA(Synthetic) scaffold showed the highest cell proliferation and attachment as indicated with both SEM and DNA counting assay. Evaluating the osteogenic differentiation capability of hD PSCs on different scaffold biomaterials with ALP activity assay showed high level of ALP activity on cells cultured on PLLA(Synthetic) and OSTEON ⅡCollagen(Composite) scaffolds. SEM micrographs also showed that in the presence of Cerabone(Xenograft) and OSTEON Ⅱ Collagen(Composite) scaffolds, the h DPSCs demonstrated the fibroblastic phenotype with several cytoplasmic extension, while the cells on PLLA scaffold showed the osteoblastic-like morphology, round-like shape. CONCLUSION: PLLA scaffold supports adhesion, proliferation and osteogenic differentiation of hD PSCs. Hence, it may be useful in combination with hD PSCs for cell-based reconstructive therapy.

Pyoderma Gangrenosum with Oral Involvement–Case Report and Review of the Literature

Pyoderma gangrenosum （PG） is a rare, noninfectious neutrophilic dermatosis. Clinically, it begins with sterile pustules that rapidly progress into painful ulcers of variable depth and size with undermined violaceous borders. The diagnosis of PG is based on the history of an underlying disease, a typical clinical presentation, histopathology, and exclusion of other diseases. The peak incidence occurs between the ages of 20 to 50 years with women being more often affected than men. There have been very few reports of pyoderma gangrenosum with oral mucosal involvement. Oral lesions in previously reported cases have included ulcers of varying sizes from a few mm to several cm and have been reported to have been found on the tongue, soft and hard palate, buccal mucosa, and gingiva. Some of these oral lesions have been associated with ulcerative colitis, inflammatory bowel disease, and polycythemia rubra vera. A few cases were reported with biopsy findings, the histological picture being nonspecific, showing ulceration, and necrosis with inflam- matory cell infiltrate. A peculiar case of pyoderma gan- grenosum with an oral lesion is presented here, and the differential diagnosis is discussed.

Effect of Periodontal Infection on Birth Weight of Infants: A Clinical and Microbiological Study

Background: Maternal periodontal infection has been proposed to influence pre-term delivery and low birth weight infants through mechanisms involving inflammatory mediators or direct bacterial assault on the amnion. Thus, the aim of the present study was to assess the presence of periodontal pathogens in maternal periodontal infection and their effect on the birth weight of infants. Materials and Methods: The case-control study included 30 mothers with a singleton gestation and gestational age of >37 weeks. Data regarding the periodontal status, pregnancy outcome variables, hemoglobin levels (Hb%) and other factors that may influence adverse pregnancy outcomes were collected. A qualitative analysis of the predominant anaerobic organisms was conducted. The data was analysed using one-way ANOVA test and Scheffe’s test. Results: The microbiological results showed that prevalent colonies of organisms isolated from the experimental groups were of Bacteroides spp. (n = 3), Fusobacterium spp. (n = 3) and Peptostreptococcus spp. (n = 9). In the control group, Peptostreptococcus spp. (n = 15) were predominant. In the experimental group, it was seen that Bacteroides spp. (p = 0.003) and Fusobacterium spp. (p = 0.050) were statistically significant with the birth weight of the infant. The one-way ANOVA test showed that the birth weight of the infant was inversely proportionate with increase in severity of the periodontal disease. Scheffe’s test showed that presence of a periodontal pocket showed most significance to the birth weight of an infant as compared to presence of local factors or bleeding on probing. Conclusion: The study revealed that the gram negative organisms, Bacteroides spp. and Fusobacterium spp. were significantly associated with the low birth weight (LBW) of the infants, although there was not a significant difference in the clinical periodontal status between the experimental groups and the controls. It could be proposed that specific groups of pathogens may have a contributory role in the risk of LBW.

Kimura’s Disease—A Rare Cause of Head and Neck Swelling

Kimura’s disease (KD) is a chronic inflammatory disorder with unknown etiology, most commonly manifesting as painless unilateral cervical lymphadenopathy or subcutaneous masses in the head or neck region. The disease is characterized by a triad of painless subcutaneous masses in the head or neck region, blood and tissue eosinophilia, and markedly elevated serum immunoglobulin E levels. Kimura’s disease is an unusual vascular tumor that typically occurs at 20 to 30 years of age. There has been no documented case of malignant transformation;however, recurrence rates after excision may be as high as 25%. Surgery and medical therapy are useful for treatment. We present a 14 years old male developed a unilateral cervical mass associated with KD. It was a recurrence of disease. As a complete excisional resection of the mass already done 1 year back at some other centre, we decided to give medical treatment for Kimura’s disease.

Cone beam computed tomographic evaluation of pharyngeal airway in North Indian children with different skeletal patterns

BACKGROUND In growing patients with skeletal discrepancies,early assessment of functional factors can be vital for the restoration of normal craniofacial growth.AIM To compare airway volumes in patients with mandibular retrognathism with the normal anteroposterior skeletal relationship,thereby assessing the association between cephalometric variables and airway morphology.METHODS Cone-beam computed tomography volume scans,and lateral cephalograms,3-dimensional airway volume and cross-sectional areas of 120 healthy children(54 boys and 66 girls mean age 15.19±1.28)which were done for orthodontic assessment were evaluated.The subjects were divided into 2 groups based on the angle formed between point A,Nasion and point B(ANB)values and cephalometric variables(such as anterior and posterior facial height,gonial angle etc.)airway volumes,and cross-sectional measurements were compared using independent t tests.Pearson’s correlation coefficient test was used to detect any relationship of different parts of the airway and between airway volume and 2-dimensional cephalometric variables.RESULTS Means and standard deviations for cephalometric,cross-sectional,and volumetric variables were compared.ANB,mandibular body length and facial convexity were statistically highly significant(P<0.01)whereas condylion to point A,nasal airway and total airway volume(P<0.05)were statistically significant.The nasal airway volume and the superior pharyngeal airway volume had a positive correlation(P<0.01),nasal airway was correlated to middle(P<0.05)and total airway superior had a relation with middle(P<0.05),inferior and total airway(P<0.05),middle was related to all other airways;inferior was also related to all the airways except nasal.Lateral cephalometric values were positively correlated with the airway volume with Frankfurt Mandibular Plane Angle and facial convexity showed significant correlations with total airway volume(P<0.05).Additionally,ANB angle was significantly correlated with total airway volume and superior airway(P<0.05).CONCLUSION The mean total airway volume in patients with retrognathic mandible was significantly smaller than that of patients with a normal mandible.

Toxoplasmosis and anti-Toxoplasma effects of medicinal plant extracts-A mini-review

Toxoplasmosis is a globally diwstributed parasitic protozoan disease,caused by Toxoplasma gondii.The infection can result in more severe symptoms with potentially life-threatening in case of immunocompromised individuals.Sulfadiazine and pyrimethamine are the two drugs used as a part of standard therapy for toxoplasmosis.Researchers have demonstrated the therapeutic effects of medicinal plants for toxoplasmosis,which can be used as an alternative to standard drug therapy with reduced side effects.Traditional herbal plants are used by people to cure a large number of parasitic disorders.This review provides new insights into various medicinal plants that are used traditionally for the treatment of toxoplasmosis and other parasitic infections,which can be useful as an alternative treatment option for Toxoplasma gondii infections.

A rare case of intraoral lipoma in a six year-old child:a case report

One type of soft tissue lesions of the oral cavity is lipoma, which is a kind of benign tumor composed of mature lipid cells. Although the lipoma presents as one of the most common mesenchymal neoplasms, most tend to develop on the trunk and proximal portions of the extremities. However, lipomas in the oral and maxillofacial region are much less frequent. Here we present a case of an intraoral lipoma in a six year-old child.

Health from the Hive: Potential Uses of Propolis in General Health

The health industry has always used natural products as an alternative, to the conventional allopathic formulations available for the treatment of various afflictions. Propolis, a natural antibiotic is a resinous yellow brown to dark brown substance that honey bees (Apis mellifera) collect from tree buds, sapflows, shrubs or other botanical sources to seal unwanted open spaces in the hive, protecting it from outside contaminants. The main chemical classes present in propolis are flavonoids, phenolics and other various aromatic compounds. Flavonoids are well known plant compounds that have antibacterial, antifungal, antiviral, antioxidant and anti-inflammatory properties. Propolis has been used in general for various purposes and has a promising role in future medicine as well as in dentistry. This paper is an attempt to review various applications of this compound in medicine.

Comprehensive management of malocclusion in maxillary fibrous dysplasia:A case report

BACKGROUND Fibrous dysplasia(FD)is a developmental hamartomatous bone disease characterized by a blend of fibrous and osseous entities.Though rarely malignant,the tumor can vary from being small and asymptomatic,to a fairly large sized lesion,progressing gradually,compromising occlusion and facial esthetics.Treatment approach depends on the stage of skeletal maturity.It primarily involves surgical management for stabilizing the disease process.Post-surgical comprehensive dental treatment is necessary for restoring form and function of the jaws and teeth.This article describes comprehensive orthodontic management of severe malocclusion in a surgically operated case of FD maxilla.CASE SUMMARY A 19-year female presented with a chief complaint of excessive gingival display when smiling.Dental history included swelling of gums around the upper right front teeth,diagnosed at the age of 15 as FD of the right anterior maxillary segment and treated with surgical recontouring of the dysplastic bone.The clinical and radiological examinations showed adequate post-surgical healing.The surgically treated dysplastic area presented with right canting of the maxillary anterior occlusal plane.The maxillary teeth were torqued palatally,with the root of the right maxillary canine exposed clinically.We discuss sequential management of the associated malocclusion with comprehensive fixed orthodontics,along with special precautions taken to prevent reactivation of the quiescent and healed lesion.CONCLUSION The adequate healing of fibro-dysplastic bone post-surgery must be allowed before initiating orthodontic tooth movement in the dysplastic bone.Periodic follow-ups are needed to monitor stability of occlusion and any relapse of the lesion.

Periodontal surgery in a stage Ⅱ Parkinson's disease patient:Report of a case with special considerations

Parkinson's disease(PD) is an idiopathic progressive neurological disorder characterised by resting tremor, restrictions in mobility and muscular rigidity that can lead to problems in maintaining oral health. Here we report a case where crown lengthening surgeries were successfully performed in a PD patient for complete oral rehabilitation. Certain special considerations that are required before and during periodontal surgery in such patients are also elucidated. Often dentists and PD patients are reluctant to embark on complex dental procedures resulting in a compromised outcome. However, early intervention along with proper education and motivation of these patients can aid in achieving satisfactory results.

Effect of westernization on oral health among college students of Udaipur City,India

Background:There is overwhelming evidence that periodontal disease and dental caries affect the majority of populations and that western culture and lifestyle may have a profound influence on oral health,especially in adults.The present study was performed to determine the effect of westernization on the oral health of college students of Udaipur City,Rajasthan.Methods:A descriptive cross-sectional study was conducted among students attending various professional and non-professional bachelor's degree colleges of Udaipur City,Rajasthan,India,from March 2013 to May 2013.Eight hundred students were selected based on a two-stage random sampling procedure.Westernization was assessed by a self-administered structured questionnaire.Periodontal status,dental caries status and malocclusion were assessed according to World Health Organization(WHO) criteria(1997).Statistical analysis was performed using Chi-square and Multivariate logistic regression.The confidence level and level of significance were set at 95% and 5%,respectively.Results:The present study suggested that adverse habits,listening to English music and preferring English food had a significant association with dental caries and periodontal diseases.Malocclusion also showed a significant relationship with consuming English food for snacks and desserts.Multivariate analysis revealed a significantly greater odds ratio(OR) for periodontal disease and dental caries among those who preferred English food for lunch.Conclusion:Based on the results of the present study,there is an association between westernization and oral health.

Unraveling the role of epidermal growth factor receptor in oral lesions: Key to non surgical treatment modes

Epidermal growth factor receptor(EGFR) is a transmembrane receptor with tyrosine kinase activity,mediating actions of various growth factors including EGF, transforming growth factor-α, and neuregulins.Protein binding to ligand induces receptor modification,tyrosine autophosphorylation leading to cell signaling resulting in cellular proliferation. This receptor playsdiverse roles in maintaining homeostasis and recent molecular advances identify that EGFR mutations are linked to several carcinomas. EGFR plays important roles in the development and maintenance of various oral structures, tooth development, eruption and morphogenesis. EGFR expression has also been studied in diverse oral pathologies like squamous cell carcinomas, potentially malignant lesions, lichen planus, salivary gland tumors and odontogenic cysts and tumours. The present review delves into the various general features of EGFR with an insight into its physiological and pathological role in the oral cavity. The clinical implications and upcoming role of EGFR inhibitors in the nonsurgical treatment of oral lesions has also been discussed.

Enhanced osseointegration of drug eluting nanotubular dental implants: An in vitro and in vivo study

Faster and predictable osseointegration is crucial for the success of dental implants, especially in patients with compromised local or systemic conditions. Despite various surface modifications on the commercially available Titanium (Ti) dental implants, the bioactivity of Ti is still low. Thus, to achieve both biological and therapeutic activity on titanium surfaces, surface modification techniques such as titanium nanotubes have been studied as nanotube surfaces can hold therapeutic drugs and molecules. The main aim of the present research work is to study the early osseointegration around the novel Simvastatin drug eluting nanotubular dental implant. In the present research, the titanium nanotubes were fabricated on the screw-shaped dental implant surface and the Simvastatin drug was loaded into the nanotubes using the ultrasonication dip method. In vitro and In vivo studies were carried out on the modified dental implants. In vitro cell culture study reported enhanced osteogenic activity on the drug-loaded nanotube surface implants. The in vivo animal studies were evaluated by micro-CT, histopathology, and reverse torque removal analysis methods. The test results showed faster osseointegration with the strong interface on the Simvastatin drug-loaded implant surface at 4 weeks of healing as compared to the control implants.

Biomarkers in triple negative breast cancer:A review

Breast cancer is an intrinsically heterogeneous disease. In the world about 1 million cases of breast cancer are diagnosed annually and more than 170000 are triplenegative. Characteristic feature of triple negative breast cancer(TNBC) is that it lacks expression of oestrogen,progesterone and human epidermal growth factor receptor-2/neu receptors. They comprise 15%-20% of all breast cancers. We did a systematic review of Pub Med and conference databases to identify studies published on biomarkers in TNBC. We included studies with biomarkers including: Epidermal growth factor receptor,vascular endothelial growth factor,c-Myc,C-kit and basal cytokeratins,Poly(ADP-ribose) polymerase-1,p53,tyrosinase kinases,m-TOR,heat and shock proteins and TOP-2A in TNBC. We also looked for studies published on synthetic lethality and inhibition of angiogenesis,growth,and survival pathways. TNBC is a complex disease subtype with many subclasses. Majority TNBC have a basal-like molecular phenotype by gene expression profiling. Their clinical and pathologic features overlap with hereditary BRCA1 related breast cancers. Management of these tumours is a challenge to the clinician because of its aggressive behaviour,poor outcome,and absence of targeted therapies. As the complexity of this disease is being simplified over time new targets are also being discovered for the treatment of this disease. There are many biomarkers in TNBC being used in clinical practice. Biomarkers may be useful as prognostic or predictive indicators as well as suggest possible targets for novel therapies. Many targeted agents are being studied for treatment of TNBC.

Nasopalatine Canal Revisited: An Insight to Anterior Maxillary Implants

Purpose: The study was performed to evaluate variability in nasopalatine canal using cone beam computed tomography (CBCT) in relation to age and gender. The study also provides an insight while considering anterior maxillary implants. Materials and Methods: The study included 200 subjects aged between 19 and 67 years who were divided into the following 3 groups: 1) 19 - 34 years old;2) 35 - 49 years old;3) >50 years old. The male and female subjects were 104 and 96 respectively. After obtaining a prior consent, CBCT was performed using a standard exposure and patient positioning protocol. The CBCT volume was sliced in three planes (X, Y, and Z) and was sequentially analyzed for the location, morphology and morphometric dimensions of the nasopalatine canal. The correlation of age and gender with all the variables were evaluated. Results: The present study revealed statistically significant differences in the length of the nasopalatine canal based on the age group. The slanted and the cylindrical variety of the nasopalatine canal were commonly observed in the study. However, no statistical differences were noted in the other variables such as number of openings at the nasal fossa, diameter of the incisive fossa, angulation of the canal as viewed in the sagittal sections and antero-posterior dimensions of the canal in the sagittal sections. Conclusion: The present study demonstrates the variability observed in the anatomy and morphology of the nasopalatine canal which is an important landmark for placing dental implants in the anterior maxillary region.

Factors Associated with Orthodontic Tooth Movement in Periodontally Compromised Patients

There is no consistent relationship between malocclusion and periodontal disease but certain characteristics of malocclusion can promote a pathologic environment conducive to periodontal disease. One of the dramatic means available to improve the local environmental factors is through orthodontic tooth movement. The pretreatment periodontal conditions can include excessive tooth mobility, advanced crestal bone loss, infrabony defects, tipped molars, furcation involvement, and hard and soft tissue dehiscences. Movement of teeth in the presence of periodontal inflammation can result in an increased loss of attachment and irreversible crestal loss. Although absolute reduction in bone and attachment levels does not contraindicate orthodontic correction, it does increase the difficulty of delivering controlled orthodontic mechanics that would potentially minimize further bone loss. The present review article discusses the various factors that are associated with orthodontic tooth movement in periodontally compromised patients namely: 1) tooth movement into infrabony pockets;2) tooth movement into compromised bone areas;3) tooth movement through cortical bone;4) extrusion (eruption);5) intrusion;6) tipping.

Morphologic,Radiographic,and Stereomicroscopic Evaluation of Teeth Subjected to High Temperatures:An In vitro Forensic Study

Background:To evaluate morphologic,radiographic,and stereomicroscopic changes of teeth when subjected to specific high temperatures in both direct heat and gradual heat and to compare the changes among two heat groups and also among different types of teeth.Materials and Methods:An in vitro study was conducted on 90 healthy extracted human teeth,in which the teeth were divided into two groups.Group 1(45)was subjected to direct heat and Group 2(45)was subjected to gradual heat.Group 1 and Group 2 were further subdivided into three subgroups(A)anteriors,(B)premolars,and(C)molars each consisting of 15 teeth.Teeth were subjected to temperatures of 200°C,400°C,600°C,800°C,and 1000°C in a muffle electric furnace.The color changes were noted using the Revised Munsell soil color chart and the radiographic and stereomicroscopic changes were evaluated.The results obtained were subjected to statistical analysis.Results:Teeth in direct heat showed more destructive changes at lower temperatures,i.e.,400°C and 600°C when compared to gradual heat where changes are observed at 600°C and 800°C.Among different types of teeth,anteriors and premolars showed more changes when compared to molars.Interpretation and Conclusion:It can be concluded that dental evidence may provide clues to solve the mystery in fire investigations as dental structures are the last to be destroyed under extreme conditions,whether temperature,acid,or putrefaction.