Effectiveness of Preoperative Alpha Wave Entrainment in Pediatric Dental Patients: A Randomized Controlled Trial.

Background Pediatric dental anxiety is a significant barrier to effective dental care, necessitating non-pharmacological interventions. Alpha wave entrainment has shown promise in adult studies for reducing procedural anxiety and pain perception, but its effectiveness in pediatric dental settings remains underexplored. Objective This study aims to evaluate the effectiveness of preoperative alpha wave entrainment in alleviating anxiety in gender-specific participants to the interventions. Methods We conducted a randomized controlled trial involving 252 pediatric patients (aged 7-12) with cooperative dispositions. Participants were randomly assigned to either an experimental group receiving alpha wave entrainment or a control group receiving conventional behavior management techniques. The experimental intervention involved 10-minute sessions of binaural beats with visual stimulation designed to induce alpha-wave synchronization. Anxiety levels were assessed using physiological measures (heart rate and blood pressure), both pre- and post-interventions. Results The intervention group demonstrated a significant reduction in heart rate and systolic blood pressure post-intervention compared to the control group. These changes indicate a decrease in anxiety levels, with no significant gender differences in the response to the intervention. Conclusion Alpha wave entrainment effectively reduces dental anxiety in pediatric patients, with similar efficacy observed across genders. This study supports the incorporation of alpha wave entrainment into pediatric dental practices as a viable alternative to traditional anxiety management techniques.

The Role of Low Mineral Water Consumption in Reducing the Mineral Density of Bones and Teeth: A Narrative Review.

Low mineral water has gained increasing attention due to its potential health implications concerning bone mineral density (BMD) and dental health. Reverse osmosis (RO) systems to purify water are in use extensively, and these systems, in addition to removing impurities from water, also remove 92-99% of beneficial minerals like calcium, lead, fluoride, magnesium, and iron. These minerals are essential for maintaining optimal mineral density of teeth and bones, thereby preserving bone and teeth health. Most of these mineral components are physically larger than water molecules and are trapped by the semi-permeable membrane of RO filters when drinking water is filtered through it. The resultant water is of very poor mineral content, and studies have shown that this water, when consumed, can absorb minerals from the body and eliminate the same through urine. The combined synergistic effect of consumption of low mineral water along with minerals being excreted has been shown to cause demineralization of bones and teeth, increasing the risk of osteoporosis and dental caries. This review tries to address the ill effects of consuming low mineral water along with preventive strategies to overcome its much-concealed adverse effects.

Synthesis and Characterization of Naringin Functionalized Nano-Hydroxyapatite for Bone Tissue Engineering.

Bone is a unique nanocomposite tissue composed of organic and inorganic materials. Bone grafting is a common surgical method used to improve bone regeneration in dentistry and orthopedic surgery. Because standard therapies have substantial drawbacks, nanomaterials provide alternative options for bone repair. Owing to its high bioactivity, osteoconductivity, biocompatibility, and topography that matches the architecture of real bone, hydroxyapatite nanoparticles (n-HA) are commonly used in bone treatment. We report here the synthesis and characterization of Naringin (NA) functionalized n-HA using HRTEM, FTIR, XRD, and UV-visible spectroscopy. The obtained results indicated that the n-HA can be functionalized with Naringin and they might be used as a bone regenerative material in medical and dental fields.

Nano-hydroxyapatite: A Driving Force for Bone Tissue Engineering.

Bone is an amazing nanocomposite tissue made of both organic (primarily collagen) and inorganic (primarily nano-hydroxyapatite [n-HA]) elements. Bone grafting is a widely used surgical technique in dental and orthopedic surgeries to enhance bone regeneration. In view of the significant drawbacks of traditional treatments, nanomaterials offer new strategies for bone regeneration. The HA with the chemical formula of Ca10(OH) 2(PO4) 6 is very identical to the inorganic portion of bone. Due to its high stability and minimal solubility, it is often used in orthopedic and dental procedures. Currently, n-HA, which facilitates the growth of new bone, has garnered considerable attention because of better bioactivity and bone integration ability when compared to porous HA. This review gives comprehensive insights related to n-HA structure, chemical composition, surface modification techniques, and their application in bone tissue engineering.

Comparative evaluation of three different glass ionomer cements.

Context: Newer glass ionomer cements with improved properties are constantly being developed. One such material is the novel Hybrid Glass-Ionomer cement (HGIC) with properties yet to be studied. Aims: The aim of this study was to compare the flexural strength, shear bond strength, wear resistance and fluoride release of Hybrid Glass Ionomer restorative with Conventional Glass Ionomer Cement (CGIC) and Resin modified Glass Ionomer Cement (RMGIC). Settings and Design: This was an in vitro study. Methods and Material: A total of 300 samples were tested in this study, with 100 samples per group and each group was further subdivided into 5 sub-groups with 20 samples each. Flexural and Shear bond strength values were determined by subjecting the specimens to a universal testing machine. For wear resistance, the specimens were assessed using a pin on the disc tribometer. For fluoride release, the test specimen suspended in 10 mL deionised water was tested at 24 h and 1 week. Statistical Analysis Used: One-way ANOVA. Results: RMGIC had the highest flexural and shear bond strength values followed by HGIC and CGIC. HGIC had the least wear rate followed by RMGIC and CGIC. At 24 h and 1 week, HGIC had the highest fluoride release among the study groups. Conclusions: HGIC exhibited the highest wear resistance and fluoride release among the cements studied. However, flexural and Shear bond strength values, of RMGIC, was comparatively higher.

A survey assessing the knowledge and perception of dental practitioners on the need for prophylactic endodontic treatment in abutment teeth for fixed partial dentures.

Background: Tooth preparation for fixed prosthodontic procedures often induces enough thermal or mechanical stresses on the pulp. The extent of pulpal injury and ability to repair depends on factors like amount of remaining dentin, extent of heat produced, and permeability of dentinal tubules. However, there is no infallible method to predict the pulpal response and so the treatment outcome. Aim: This survey tries to assess the knowledge and perception among dental practitioners on the need for prophylactic endodontic therapy in abutment teeth for fixed partial denture (FPD). Setting and Design: Questionnaire-based survey. Methodology: An observational study was then conducted among 303 dental practitioners in the state of Tamil Nadu and 250 participants responded. Statistical Analysis Used: Descriptive statistics and multiple linear regression analysis. Results and Conclusion: The survey further imparts light on the clinical outcomes that help minimize the incidence of biological failure underneath a FPD.

Gingival Fenestration Management: A Rarefied Case Entity and Literature Review.

Dehiscence and fenestration are commonly confronted alveolar defects. But the combined mucosal and alveolar fenestration is uncommonly reported in the literature as they less often cause pain, and in majority of the cases, only aesthetic complaint is present. This article highlights the case report of a 28-year-old female patient who presented with aesthetic concern about gingival/mucosal fenestration in her right lower central incisor. She had a history of surgical endodontic treatment in the same tooth. In this case, mucosal fenestration was treated with regenerative therapy using bioactive glass with platelet-rich fibrin and free connective tissue graft. The treatment resulted in excellent aesthetic outcome and satisfactory bone healing.

Clinical and Analytical Validation of a Novel Urine-Based Test for the Detection of Allograft Rejection in Renal Transplant Patients.

In this clinical validation study, we developed and validated a urinary Q-Score generated from the quantitative test QSant, formerly known as QiSant, for the detection of biopsy-confirmed acute rejection in kidney transplants. Using a cohort of 223 distinct urine samples collected from three independent sites and from both adult and pediatric renal transplant patients, we examined the diagnostic utility of the urinary Q-Score for detection of acute rejection in renal allografts. Statistical models based upon the measurements of the six QSant biomarkers (cell-free DNA, methylated-cell-free DNA, clusterin, CXCL10, creatinine, and total protein) generated a renal transplant Q-Score that reliably differentiated stable allografts from acute rejections in both adult and pediatric renal transplant patients. The composite Q-Score was able to detect both T cell-mediated rejection and antibody-mediated rejection patients and differentiate them from stable non-rejecting patients with a receiver-operator characteristic curve area under the curve of 99.8% and an accuracy of 98.2%. Q-Scores < 32 indicated the absence of active rejection and Q-Scores ≥ 32 indicated an increased risk of active rejection. At the Q-Score cutoff of 32, the overall sensitivity was 95.8% and specificity was 99.3%. At a prevalence of 25%, positive and negative predictive values for active rejection were 98.0% and 98.6%, respectively. The Q-Score also detected subclinical rejection in patients without an elevated serum creatinine level but identified by a protocol biopsy. This study confirms that QSant is an accurate and quantitative measurement suitable for routine monitoring of renal allograft status.

Evaluation of the Antibacterial Efficiency of a Combination of 1% Alexidine and Sodium Hypochlorite on Enterococcus faecalis Biofilm Models: An In Vitro Study.

AIM: The aim of the study was to assess the antibacterial efficiency of a combination of 1% alexidine (ALX) and 5.25% sodium hypochlorite (NaOCl) against E. faecalis biofilm using a confocal scanning electron microscopy. MATERIALS AND METHODS: An estimated 120 human root dentin disks were prepared, sterilized, and inoculated with E. faecalis strain (ATCC 29212) to develop a 3-weeks-old biofilm. The dentin discs were exposed to group I-control group: 5.25% sodium hypochlorite (NaOCl) (n = 20); group II-1% ALX + 5.25% NaOCl (n = 40); group III-1% alexidine (ALX) (n = 40) (Sigma-Aldrich, Mumbai, India); group IV-negative control: saline (n = 20). After exposure, the dentin disks were stained with the fluorescent live/dead dye and evaluated with a confocal scanning electron microscope to calculate the proportion of dead cells. Statistical analysis was done using the Kruskal-Wallis and Mann-Whitney U test (p < 0.05). RESULTS: The maximum proportion of dead cells were seen in the groups treated with the combination of 1% ALX + 5.25% NaOCl (94.89%) and in the control group 5.25% NaOCl (93.14%). The proportion of dead cells presented in the 1% ALX group (51.79%) and negative control group saline (15.10%) were comparatively less. CONCLUSION: The antibacterial efficiency of a combination of 1% ALX and 5.25% NaOCl was more effective when compared with 1% ALX alone. CLINICAL SIGNIFICANCE: Alexidine at 1% could be used as an alternative endodontic irrigant to chlorhexidine, as alexidine does not form any toxic precipitates with sodium hypochlorite. The disinfection regimen comprising a combination of 1% ALX and 5.25% NaOCl is effective in eliminating E. faecalis biofilms.

An In Vitro Evaluation of Fracture Resistance of Endodontically Treated Maxillary Central Incisor Restored with Custom-Made Cast Post and Core with Uniform and Nonuniform Core Ferrule Heights.

AIM: The aim of this study was to evaluate in vitro fracture resistance of endodontically treated teeth restored with custom-made cast post and core having uniform and nonuniform core ferrule heights. MATERIALS AND METHODS: Thirty-five freshly extracted human maxillary central incisors were included in this study. All teeth were subjected to standard root canal treatment. The teeth were randomly divided into five groups-Group 1: uniform ferrule (2 mm buccal, lingual, and proximal), Group 2: uniform ferrule (3 mm buccal, lingual, and proximal), Group 3: nonuniform ferrule (2 mm buccal, 3 mm lingual), Group 4: nonuniform ferrule (2 mm buccal, 4 mm lingual), and Group 5: no ferrule. The teeth were sectioned horizontally 4 mm above cementoenamel junction and post space preparation was performed maintaining 4 mm of apical gutta-percha. Ferrule was prepared according to dimension designated for each group. Custom-made cast post and core were fabricated and luted using zinc phosphate cement. Testing was conducted using universal testing machine with application of static load (Newton), and failure load was recorded. Data were analyzed by one-way analysis of variance and Tukey test. The mode of fracture was noted by visual inspection for all specimens. RESULT: Significant differences (P < 0.001) were found among mean fracture forces of test groups. Group 1: 1181.66 ± 68.29, Group 2: 1455.58 ± 173.11, Group 3: 1019.00 ± 52.55, Group 4: 971.58 ± 66.52, and Group 5: 888.00 ± 60.56. The presence of nonuniform ferrule height resulted in a significant decrease (P < 0.0001) in mean fracture strength compared to uniform 2- and 3-mm core ferrule height. CONCLUSION: The central incisors restored with cast post and core and crowns with 3-mm uniform core ferrule were more fracture resistant compared to central incisors with nonuniform core ferrule height. Both the uniform and nonuniform core ferrule groups were more fracture resistant than the group that lacked ferrule.

Endodontic Management of Teeth Juxtaposed to Haemangioma.

Vascular anomalies are localized defects in the vasculature that may or may not be present at birth. There are many types of vascular anomalies with different aetiology and clinical picture and, therefore, require the combined expertise of medical, radiological, and surgical specialities for its diagnosis and management. The term "haemangioma" is used as a common generic label to incorporate all types of vascular malformations. In this report, we describe a case of two maxillary premolars, requiring endodontic therapy, in close proximity to a haemangioma. The challenges encountered in the diagnosis and management of the case are discussed.