Antimicrobial Activity of Nanozirconium Oxide.

The goal behind this work is to prepare, characterize, and study the antimicrobial behavior of zirconia (ZrO2) nanoparticles (NPs). Various techniques, such as X-ray diffraction (XRD), were used for studying the mineralogical structure and crystal size. The microstructure and chemical composition of the prepared particles were analyzed using a scanning electron microscope attached with an energy-dispersive X-ray analysis (EDAX) unit. The antagonistic ability against several Gram-negative and Gram-positive bacteria, including Salmonella paratyphi, Pseudomonas aeruginosa, Alcaligenes aquatilis, Escherichia coli, Streptococcus pneumoniae, and Staphylococcus aureus, was assessed using the well diffusion method. The results of XRD and scanning electron microscopy (SEM) analyses revealed that the prepared material exhibited the phase of zirconium nanoparticles with particle sizes ranging between 40 and 75 nm. The antimicrobial test results demonstrated that the inhibitory effect increased with the increase of concentration. The inhibitory effect was more pronounced against Gram-positive bacteria, as indicated by the larger size of the inhibitory zone. At a 9% dimethyl sulfoxide (DMSO) concentration, the inhibitory zone had a diameter of 3.50 mm for S. aureus compared to a diameter of 3.40 mm for S. pneumoniae. The use of zirconium oxide nanoparticles reduced the diameter of the inhibitory zone when tested against S. aureus at a 3% DMSO concentration (0.50 mm diameter) and against S. pneumoniae (0.40 mm diameter). Zirconia nanoparticles were also evaluated for their antifungal activity against several species, including Aspergillus niger, Aspergillus flavus, and Penicillium sp. The size of the inhibitory zone indicated the susceptibility of microorganisms to nanozirconium oxide, resulting in a stronger inhibition of Penicillium sp. at a 100% DMSO concentration (4.50 mm diameter) compared to A. niger and A. flavus (3.00 mm diameter). The results for Penicillium sp. at a 3% DMSO concentration showed a diameter of the inhibitory zone of 0.90 mm, while for A. niger and A. flavus, the diameter was 0.80 mm. Thus, our findings demonstrate that the zirconium oxide nanoparticles possess the capability to reduce the inhibition zone effectively for both bacterial and fungal activities.

The Effect of Calcium Hydroxide, Triple Antibiotic Paste and Chlorhexidine on Pain in Teeth with Symptomatic Apical Periodontitis: A Randomised Controlled Trial.

BACKGROUND: One of the main reasons for post endodontic pain is the polymicrobial intracanal flora that may survive the initial disinfection. A single antimicrobial agent might not provide adequate disinfection, and an antimicrobial combination such as triple antibiotic paste was tested to achieve this goal. AIM: The study aimed to assess the efficacy of three intra-canal medicaments on post root canal preparation pain. MATERIALS AND METHODS: Eighty patients with single-rooted necrotic teeth and symptomatic apical periodontitis were randomly assigned to four treatment groups (n = 20). Their preoperative pain was recorded on Wong-Baker's FACES pain rating scale. After chemo-mechanical canal preparation, intracanal medications were applied to the groups (Group 1 (20% calcium hydroxide), Group 2 (2% chlorhexidine), Group 3 (tri-antibiotic paste), Group 4 (no medication (Control group)). Patients were instructed to record pain on the Wong-Baker FACES pain rating scale at 4, 48, 72 and 96 hrs, postoperatively. Pain scores were analyzed using a one-way ANOVA test and Tukey's post hoc test and, if significant, Dunn's test was used for pair-wise comparisons. The significance level was set at a p-value ≤ 0.05. RESULTS: Tukey's post hoc test revealed significantly lower pain scores in Group 3 compared with other groups at all follow up intervals. Dunnett's test showed significantly lower pain in Group 3 compared with the Control group at 48, 72 and 96 hrs, postoperatively. CONCLUSIONS: Triple-antibiotic paste showed effective pain control as an intracanal medication on necrotic teeth with symptomatic apical periodontitis.

Service-learning's impact on dental students' attitude to community service.

BACKGROUND: This study aimed to observe the impact of service learning on the attitude of senior dental students toward community service. METHODS: A cross-sectional survey-based was conducted and recruited a total of 120 senior students of Dentistry Taibah University that were enrolled in a clinical service-learning course using convenience sampling. The attitude of dental college students toward community service based on the model of helping behavior by Schwartz was evaluated through Community Service Attitude Scale (CSAS). The data was collected using the same questionnaires for the pre-test and post-test. Data were analyzed by using SPSS 25. A repeated-measures mixed-model ANOVA was used to test the changes across pre-and post-test. RESULTS: A total of 96 students completed the first survey, making a response rate of 80%, and 78 among them completed the second survey as well, making a response rate of 81%. Significant change (P < 0.0001) in ANOVA indicated that there was an overall change in attitude.  CONCLUSIONS: It can be concluded that community-based service-learning positively impacts the attitude of last year's dental students toward understanding needs at the community level and the attitude to help in providing dental care at the community level.

Root Canal Configuration and Its Relationship with Endodontic Technical Errors and Periapical Status in Premolar Teeth of a Saudi Sub-Population: A Cross-Sectional Observational CBCT Study.

Endodontic technical errors are the foremost cause of treatment failure. A thorough understanding of root canal configuration (RCC) is essential to prevent these iatrogenic errors. This study used CBCT images to determine the association between root canal configuration, endodontic technical errors, and periapical status. CBCT images of 101 patients, including total of 212 obturated premolars (256 canals) were assessed. RCCs were classified according to the Vertucci system. The presence of endodontic errors and periapical lesions associated with each RCC was noted. Presence or absence of coronal restoration and its association with periapical radiolucency was recorded. The most frequent RCC was Type I (199 cases; 77.73%), followed by Type II (26 cases; 10.15%), Type IV (22 cases; 8.59%), Type V (4 cases; 1.56%), Type III (4 cases; 1.56%), and Type VI (1 case; 0.39%). Under-filling and non-homogeneous filling were the most common technical errors. Prevalence of periapical radiolucency was 81% in the presence of technical errors. The absence of coronal restoration caused apical lesions in 93% of cases. The frequency of endodontic technical errors increased as the root canal configurations became more complex. Periapical lesions occurred more often in teeth with endodontic errors and/or absent coronal restoration.

Red-Complex Bacterial Levels in Pregnant Women With Preeclampsia and Chronic Periodontitis.

OBJECTIVES: The presence of red-complex bacteria (RCB) has been associated with the occurrence of not only periodontal disease but also other systemic diseases, thereby potentiating an oral-systemic relationship. This study aimed to explore the levels of periodontal RCB in pregnant preeclamptic women with periodontal disease, potentiating the pathophysiology of a bacterial association in both periodontitis and preeclampsia. METHODS: Six hundred pregnant women (aged 20 to 35 years) in their third trimester were selected and divided into 3 groups comprising a control group (systemically and periodontally healthy pregnant women), group A (preeclamptic women with chronic periodontitis), and group B (preeclamptic women without chronic periodontitis). Demographic variables and periodontal parameters were recorded. Other variables such as systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the urine protein content were also estimated. RCB, namely Porphyromonas gingivalis (Pg), Treponema denticola (Td), and Tenerella forsythia (Tf), were assessed in both subgingival plaque samples and placental samples of all the pregnant participants in the study. RESULTS: The mean weight, mean body mass index, mean SBP, mean DBP, and mean urine protein content were significantly elevated in group A and group B when compared to the control group. Preeclamptic women with chronic periodontitis (group A) had higher levels of plaque index, probing pocket depth, bleeding on probing, and clinical attachment level as compared with the other groups. The numbers of the RCB were found to be elevated in group A, out of which Pg was found to be more prevalent. CONCLUSIONS: Our findings indicate that the periodontal indices, blood pressure, and urine protein content were found to be higher in preeclamptic women with periodontitis. Hence, reducing the periodontal bacterial load in pregnant women via good oral hygiene maintenance would further reduce the putative risk of adverse pregnancy outcomes including preeclampsia in these women.

Suppression of Tumorigenicity 2 Pro-Inflammatory Biomarker Linking Diabetes Mellitus and Periodontitis: A Pilot Study.

BACKGROUND Suppression of tumorigenicity 2 (ST2) is a member of the interleukin (IL)-1 family and has 2 isoforms: ST2L, a transmembrane form, and ST2, a soluble form. IL-33 can act as an immune system alarm signal when released by damaged cells, which in turn activates other cells expressing the ST2 receptor. This can cause inflammatory cytokines to be released and produced, as well as trigger osteoclastogenesis. This study aimed to investigate the levels of soluble ST2 in gingival samples. MATERIAL AND METHODS The study population consisted of 30 individuals. The participants were divided into 3 groups: healthy participants, patients with periodontitis, and patients with periodontitis and diabetes mellitus. Periodontitis was determined using probing depth, clinical attachment loss, and gingival index. Patients with stage 2 to 4 periodontitis met the inclusion criteria. Gingival crevicular fluid (GCF) was collected for quantification of samples for ST2 levels by using an enzyme immunoassay. RESULTS The mean±standard deviation of ST2 GCF concentrations was relatively high (558.87±68.99) in the group with periodontitis and diabetes mellitus, compared with that of the periodontitis group (452.06±54.18) and healthy group (252.82±87.9). CONCLUSIONS GCF ST2 values were found to be a marker of inflammatory activities. Thus, GCF ST2 could be a potential biomarker for the diagnosis of periodontitis as well as systemic diseases, such as diabetes mellitus. This pilot study was limited by a small number of participants. To confirm the associations, more large-scale investigations should be conducted.

Evaluation of Mesiodistal Root Angulation of Permanent Incisors, Canines, and First Pre-Molars by Orthopantomogram Dental Imaging Findings in 296 Children Aged 6-14 Years.

BACKGROUND Early pre-eruptive inclination changes of the first premolar (FP) and its associative changes with canine (C) inclination are important to predict canine impaction. This study aimed to evaluate the mesiodistal root angulation of permanent lateral incisors (LI), canines, and first molars by orthopantomogram dental imaging in 296 children ages 6-14 years at a single center in India. MATERIAL AND METHODS The total number of participants was 296, with equal numbers of boys and girls divided into 4 age groups: 6-8 years, 8-10 years, 10-12 years, and 12-14 years. Angles between lateral incisor, erupting canine, and first pre-premolar with midline were measured on an orthopantomogram (dental imaging which includes all the teeth with TMJ). The angle between the erupting C with LI and erupting C with FP was measured. Pearson's correlation was also evaluated between the movement of the erupting canine with lateral incisor and erupting canine with erupting first premolar. RESULTS There was a significant difference in the angular values of different age groups (P≤0.05). The movements between LI, C, and FP were moderately correlated boys and girls aged 6-12 years. CONCLUSIONS The findings from this study showed that in boys and girls aged 6-14 years, eruption of the upper canine tooth was synchronized with eruption of the LI and FP.

Marginal and Internal Gap of Metal Copings Fabricated Using Three Types of Resin Patterns with Subtractive and Additive Technology: An In Vitro Comparison.

This study analyzes the evidence of the marginal discrepancy and internal adaptation of copings fabricated using three types of resin patterns with subtractive (milling) and additive technology (3D printing), as it is not widely reported. Working casts (n = 15) were scanned and patterns were completed using computer-aided designing (CAD). Resin patterns were fabricated using the designed data and divided into three groups according to the method of fabrication of patterns: subtractive technology-CAD milled polymethyl methacrylate resin (Group-PMMA), additive technology [digital light processing (DLP) technique]-acrylonitrile-butadiene-styrene (ABS) patterns (Group-ABS), and polylactic acid (PLA) patterns (Group-PLA). Resin patterns were casted with Cobalt-Chromium (Co-Cr) alloy (lost wax technique). Internal and marginal gaps of the metal copings were analyzed with the replica technique under optical microscope. The Kruskal-Wallis test was used to compare values among the groups, and post hoc multiple tests confirmed the specific differences within the groups. The median marginal gap was least for CAD milled resin patterns, followed by PLA printed resin patterns and ABS printed resin patterns. There were significant differences between Group-PMMA and Group-PLA and Group-ABS (p = 0.0001). There was no significant difference between Group-PLA and Group-ABS (p = 0.899). The median internal gap was least for metal copings fabricated from Group-PLA, followed by Group-ABS and Group-PMMA. The differences were not statistically significant (p = 0.638) for the internal gap. Full metal Co-Cr copings fabricated from the milled PMMA group had a better marginal fit, followed by the PLA and ABS printed groups. Copings fabricated with the PLA printed group had the best internal fit, though the values were statistically insignificant between the groups.

Comparative Evaluation of Microleakage of Flowable Composite Resin Using Etch and Rinse, Self-Etch Adhesive Systems, and Self-Adhesive Flowable Composite Resin in Class V Cavities: Confocal Laser Microscopic Study.

The essential factor in determining the preservation of restoration is the marginal seal. Restoring cervical lesions with a resin composite has always been a challenge. Composite resins with various viscosities and different bonding systems are being researched to reduce the microleakage. Confocal laser scanning microscopy (CLSM) is the latest non-destructive technique for visualizing the microleakage. Objectives: To evaluate and compare the microleakage of Universal Flo composite resin (G-aenial) using etch and rinse adhesive system ER-2 steps (Adper Single Bond 2), self-etch adhesive system SE-1 step (G-Bond), and self-adhesive flowable composite resin (Constic) in Class V cavities using a confocal laser scanning microscope. Materials and Method: Class V cavities were prepared on 27 caries-free human extracted premolar teeth on the buccal and lingual surfaces with standardized dimensions of 2 mm height, width 4 mm, and a depth of 2 mm. After the cavity preparation, all teeth were randomly divided into three groups, namely Group-I: G-aenial Universal Flo with Single Bond 2 (n = 9 teeth); Group-II: G- aenial Universal Flo with G-Bond (n = 9 teeth), and Group-III: Constic (n = 9 teeth). The prepared and restored specimens were then subjected to thermocycling for 500 cycles in a water bath at 5 °C and 55 °C with a dwelling time of 30 s. The specimens were placed in 0.6% aqueous rhodamine dye for 48 h. Sectioning was carried out bucco-lingually and specimens were evaluated for microleakage under a confocal laser scanning microscope. Results: There was a significant difference (p = 0.009) in microleakage when comparing total etch and rinse, specifically between Adper Single Bond 2 ER-2 steps (fifth generation) and self-adhesive flowable composite resin, which is Constic. There was more microleakage in the self-etch bonding agent, particularly G-Bond, SE-1 step (seventh generation), when compared to ER-2 steps (fifth generation bonding agent); however, the results were not statistically significant (p = 0.468). The self-adhesive flowable composite resin showed more microleakage than SE-1 step and ER-2 steps. Conclusions: None of the adhesive systems tested were free from microleakage. However, less microleakage was observed in the total etch and rinse, especially Adper Single Bond 2 (ER-2 steps), than the self-etch adhesive system SE-1 step and self-adhesive flowable composite resin. Clinical significance: Constant research and technological advancements are taking place in dentin adhesives to improve the marginal seal. This has led to the evolution of total acid-etching dentin bonding agents termed as etch and rinse (ER)-2 steps (fifth generation dentin bonding agents) and self-etching (SE) 2 steps, and SE-1 step dentin bonding agents termed as the sixth and seventh generation bonding agents, respectively.

Effect of Erosive Agents on Surface Characteristics of Nano-Fluorapatite Ceramic: An In-Vitro Study.

Erosive beverages cause dissolution of natural teeth and intra-oral restorations, resulting in surface characteristic changes, particularly roughness and degradation. The purpose of this study was to evaluate the surface roughness and topography of a dental ceramic following immersion in locally available erosive solutions. A total of 160 disc specimens of a nano-fluorapatite type ceramic (12 mm diameter and 2 mm thickness) were fabricated and equally distributed into two groups (n = 80) and then evenly distributed among the following five testing groups (n = 16): lemon juice, citrate buffer solution, 4% acetic acid, soft cola drink, and distilled water which served as a control. The surface roughness (Ra) and topography were evaluated using a profilometer and scanning electron microscope at baseline, 24 h, 96 h, and 168 h respectively. Data were analyzed using ANOVA and Tukey's multiple comparisons (p ≤ 0.05). Surface changes were observed upon exposure to all acidic beverages except distilled water. Amongst all immersion media, 4% acetic acid produced the most severe surface roughness across all time periods (i.e., baseline, 24 h, 96 h, and 168 h). A statistically significant difference in the surface roughness values between all immersion media and across all four time intervals was observed. Erosive agents had a negative effect on the surface roughness and topography of the tested ceramic. The surface roughness increased with increased storage time intervals.

Evaluating the Effect of Tideglusib-Loaded Bioactive Glass Nanoparticles as a Potential Dentine Regenerative Material.

Dental pulp treatment is the least intrusive procedure currently available for preserving the vitality of the pulp. Several studies are underway to improve the bioactivity of pulp capping materials. Tideglusib isa potent anti-inflammatory, antioxidant, and a regenerative drug developed against Alzheimer's disease and has been shown to be effective in the treatment of dental cavities. However, its bioactive properties encapsulated within the nanoparticles as a component of pulp capping material are largely unknown. In this study, tideglusib-loaded bioactive glass nanoparticles were synthesized (tideglusib-BgNPs) and mixed at various concentrations into the calcium silicate cement to testits physiomechanical and bioactivitiescompared with biodentine (control). The calcium silicate cement with 10wgt% tideglusib-BgNPs showed comparable physiomechanical properties to that of biodentine. Additionally, the assessment of cytotoxicity and bioactivity (cell proliferation, wound healing, and cell migration assays) showed increased bioactivity in terms of better wound healing, increased proliferation, and better migration of human dental pulp stem cells than biodentine. These findings suggest new opportunities to use tideglusib-BgNPs in pulp therapy.

The Anticariogenic Efficacy of Nano Silver Fluoride.

Dental caries is a common chronic disease, and anyone can be at threat of it throughout their lifespan. In school-aged children, dental caries is the most frequent disease related with oral health. Contemporary dental caries management focuses on non-restorative, non-invasive, and micro-invasive therapeutic techniques that effectively eliminate the caries progression at the lesion level and decrease the loss of healthy tooth structure. One of these strategies is to use caries apprehending agents with antibacterial and remineralizing characteristics. Due to recent regulatory approval in the United States, the use of silver diamine fluoride (SDF) for the therapy of dental caries has received substantial interest. SDF has successfully prevented and reversed both primary tooth caries and permanent teeth root caries. Even though SDF is an effective anti-caries agent, but it is associated with certain drawbacks like gum irritation, metallic taste, and irreversible dark stains on applying on cavities. As an alternative agent Nano Silver Fluoride (NSF) is preferable because it performs like SDF without tooth staining. It has comparable preventive and antibacterial activities as SDF. Further, it is ergonomic, economic and safe in children and adults. The current article aims to highlight the superior properties of NSF as a better anti-caries agent outstripping the limitations of discoloration of SDF.

Periodontal Treatment for Chronic Periodontitis With Rheumatoid Arthritis.

BACKGROUND: History of rheumatoid arthritis (RA) increases risk of periodontal diseases. A pro-inflammatory condition noted in periodontitis is considered a trigger for RA. Thus, periodontal treatment aimed at attenuating the pro-inflammatory state could aid in potentially reducing the risk of RA. AIMS: The objective of this research was to assess the effect of periodontal therapy on rheumatoid factor, Disease Activity Score-28, anti-citrullinated protein antibody, and C-reactive protein levels in patients with chronic periodontitis (CP) and RA. MATERIALS AND METHODS: The sample consisted of 28 patients with CP and RA. The study was designed to be a double-blind, randomised controlled clinical study. The samples were randomly categorised to either the treatment group (n = 13) or the control group (n = 15). CP status (plaque index, bleeding on probing, probing pocket depth, clinical attachment loss), clinical rheumatologic status (Disease Activity Score), and biochemical status (C-reactive protein, anti-citrullinated protein antibody, and rheumatoid factor) were assessed at baseline and at follow-up at 8 to 12 weeks. RESULTS: The treatment group showed a highly statistically significant reduction in bleeding on probing (P < .005), probing pocket depth (P < .001), plaque index (P < .001), and C-reactive protein (P < .001); a gain in the clinical attachment loss (P < .001) and an improvement in Disease Activity Score-28 (P = .001) were observed at reassessment following nonsurgical periodontal treatment as compared to the control group. However, blood serum anti-citrullinated protein antibody (P = .002) and rheumatoid factor levels (P = .351) were found to increase from baseline to 8 to 12 weeks following subgingival scaling and root planing. CONCLUSIONS: Reduction of inflammation in the periodontium by nonsurgical periodontal therapy did not reduce anti-citrullinated protein antibody and rheumatoid factor levels. However, it has shown improvement in periodontal conditions, and remarkable changes were observed in the clinical Disease Activity Score and C-reactive protein levels of individuals with RA.

Alternate Special Stains for the Detection of Mycotic Organisms in Oral Cyto-Smears-A Histomorphometric Study.

In the wake of the COVID-19 pandemic, fungal infections of the maxillofacial region have become prevalent, making their accurate diagnosis vital. Histopathological staining remains a simple, cost-effective technique for differentiation and diagnosis of the causative fungal organisms. The present study aims to evaluate the staining efficacy of Periodic Acid-Schiff (PAS), Alcian Blue, Safranin-O and Gomori's Methenamine Silver (GMS) on fungal smears. This research work also attempts to study the morphometric characteristics of Candida albicans, Aspergillus flavus, Rhizopus oryzae. Candida albicans, Aspergillus flavus and Rhizopus oryzae, 10 smears each, were stained using PAS, Alcian Blue, Safranin-O and GMS. The morphological characteristics and staining efficacy were examined, and semi-quantitative scoring was performed. Candida albicans, Aspergillus flavus and Rhizopus oryzae were stained for the first time with Safranin-O. The morphometric traits were then analyzed using an image analysis software. Safranin-O provided the most reliable staining efficacy amongst the stains and optimum morphological definition for all three organisms. Safranin-O was found to be superior to PAS and GMS, ensuring detection of even the most minute mycotic colonies. The hyphae of Aspergillus flavus to be the largest, and the spores and fruiting body of Rhizopus oryzae were found to be the largest amongst the three organisms compared. Early and accurate diagnosis of fungal infections can significantly reduce morbidity in orofacial fungal infections.

Evaluation and Comparison of Genomic DNA Extraction Methods and PCR Optimization on Archival Formalin-Fixed and Paraffin-Embedded Tissues of Oral Squamous Cell Carcinoma.

Recovery and amplification of nucleic acids from archived formalin-fixed tissue samples is the most developing field in retrospective genetic studies. We compared different deparaffinization methods and DNA isolation techniques, and intergroup comparisons were performed to evaluate the effectiveness of different storing methods for archival OSCC samples based on obtained mean DNA quantity, quality, and PCR amplification of the P53 gene. The study comprised 75 archival histologically diagnosed OSCC samples which were divided into Group I: Formalin-fixed paraffin-embedded tissue blocks and Group II: Long-term formalin-fixed tissue. A comparison of different deparaffinization methods showed that xylene deparaffinization is an efficient method to obtain suitable DNA. Comparing different DNA isolation techniques illustrated that the conventional phenol-chloroform method gives better integrity to DNA in contrast with the kit method. Comparison between FFPET and long-term FFT samples demonstrated that samples fixed in formalin overnight and embedded in wax yield better quality and quantity DNA in comparison with long-term samples fixed in formalin. To obtain suitable integrity of DNA, tissue samples should be stored by fixing in formalin overnight followed by preparation of paraffin tissue blocks, deparaffinization by xylene, and subjecting them to the conventional phenol-chloroform DNA isolation protocol.

Dental Caries and Oral Health Status of Psychoactive Substance Abusers.

Substance-abuse disorders are universally associated with comorbid illness. Tobacco is a widely abused substance across the globe and presents a critical public health problem. The precise correlation between tobacco use and dental caries remains unclear. Thus, the present study aimed to evaluate the correlation between tobacco use and dental caries. METHODOLOGY: Based on selection criteria, a total of 270 (age 20-50 years) participants were included in the study, and were categorized as group A (n = 135), consisting of tobacco users, and group B (n = 135), comprising healthy controls (non-users). The Decayed, Missing, and Filled index (DMFT) was used to measure caries status. The Simplified Oral Hygiene index was used to evaluate oral health. RESULTS: The tobacco group reported the use of cigarettes; smokeless tobacco in indigenous forms, such as gutka (areca nut, tobacco, and slaked lime), betel nut chewing; and a combination. Individuals with tobacco habits had a higher prevalence of dental caries (Mean DMFT 4.73 ± 4.32) compared to the non-habit group (Mean DMFT 3.17 ± 3.11 (p = 0.001). The Oral Hygiene index was significantly higher (indicating bad/poor oral hygiene) in tobacco abusers than those of non-users (p = 0.0001). Duration and frequency of tobacco use were correlated with the levels of moderate and severe caries (p = 0.001). CONCLUSION: Psychoactive substance abuse, such as smoking/smokeless tobacco consumption, is associated with higher prevalence of dental caries.

Biocompatibility and Antibacterial Action of Salvadora persica Extract as Intracanal Medication (In Vitro and Ex Vivo Experiment).

This study aimed to test the biocompatibility and antibacterial properties of Salvadora persica (S. persica) extract, a natural product, as an intracanal medication in comparison with calcium hydroxide (Metapaste, META BIOMED, Cheongju, Korea). The pH values of both materials were tested. The biocompatibility of S. persica extract and Metapaste was determined using light microscopy and MTT assays. The antibacterial action was tested using the zone of bacterial inhibition on four common bacterial species. In addition, intracanal medication was administered using 68 extracted single-rooted teeth contaminated with Enterococcus faecalis (E. faecalis), and the percentage reduction in colony count (% RCC) at 1, 3, and 7 days was measured. The extension of activity for both materials was assessed using histological sections and scanning electron microscopy. S. persica was found to be acidic in nature. Both materials showed significantly lower cell viability than the positive control cells on days 1 and 3 but not on day 7. S. persica showed better antibacterial effects against E. faecalis and S. mutans. S. persica extract showed 97.6%, 98.9%, and 99.3% RCC values at 1, 3, and 7 days, respectively, which are comparable to those of Metapaste. S. persica herbal extract is a promising material that can be utilized as an intracanal medication, but its use requires further research.