Single posterior implant-supported restorations fabricated using a scannable healing abutment versus a conventional scan body: A randomized controlled trial.

STATEMENT OF PROBLEM: The use of a scannable healing abutment is a convenient option for fabricating implant-supported restorations (ISRs) with a digital workflow; however, clinical studies evaluating prosthetic efficacy are lacking. PURPOSE: The purpose of this randomized controlled trial was to investigate the prosthetic efficacy of definitive posterior single ISRs fabricated after scanning using a scannable healing abutment-scan peg (SHA-SP) in comparison with a conventional scan body (CSB). The time for data acquisition, quality of proximal and occlusal contacts, and relative occlusal force of ISRs were measured. MATERIAL AND METHODS: Twenty-four participants eligible for single ISRs to replace the mandibular first molar with adjacent and antagonist teeth present were randomly allocated to either a study group (n=12) receiving ISRs after intraoral scanning using an SHA-SP or a control group (n=12) receiving ISRs after intraoral scanning using CSB. During the surgical procedure, a prefabricated contoured scannable healing abutment was screwed to the implant in the SHA-SP group, while a custom-made healing abutment was used in the CSB group. After a healing period of 3 months, an intraoral scan was made, and the duration of data acquisition was recorded. The ISRs were milled from zirconia and evaluated for the quality of proximal and occlusal contacts using dental floss and shim stock, respectively. The relative occlusal forces of the ISRs and their contralateral natural teeth were measured using a digital occlusal analyzer. Statistical analysis was done using an independent sample t test for quantitative variables and a Pearson chi-squared test for qualitative variables between the tested groups (α=.05). RESULTS: The direct digital workflow using SHA-SP was statistically less time consuming than the CSB (P<.001). The 2 groups were statistically similar regarding the quality of the proximal contacts (P=.281) or occlusal contacts (P=.307) and the relative occlusal forces of ISRs (P=.315). The relative occlusal forces of the ISRs in both groups were significantly lower than those of their contralateral natural teeth (P<.001). CONCLUSIONS: Direct digital workflow using SHA-SP was more rapid, saving clinical chairside time, and produced proximal and occlusal contacts of comparable quality with those obtained with CSB. The relative occlusal forces of ISRs in both workflows were lower than their contralateral natural teeth.

Piezosurgical Buccal Plate Repositioning Technique: A Modified Surgical Approach for the Horizontal Augmentation of Atrophied Mandibles.

PURPOSE: To demonstrate a modified surgical approach for horizontal ridge augmentation that allows for safe manipulation and predictable management of the buccal plate and avoids creation of a secondary surgical site. MATERIALS AND METHODS: This pilot randomized controlled clinical trial included 24 patients who required horizontal alveolar ridge augmentation. Patients were assigned to one of the three groups: Group A was treated with the buccal plate repositioning (BPR) technique and grafted with silica calcium phosphate nanocomposite (SCPC) graft, group B was similarly managed and grafted using demineralized freeze-dried bone allograft (DFDBA), and group C was augmented using mandibular ramus autogenous bone block graft (ABBG). The primary outcome was the coronal crest width, which was measured at 6 months using CBCT. RESULTS: The BPR technique resulted in horizontal augmentation with a mean of 4.30 ± 0.94 mm for group A, showing no significant difference from either group B (4.98 ± 1.13 mm) or group C (3.68 ± 0.27 mm). All augmented ridges allowed for successful implant placement with good primary stability. CONCLUSIONS: The BPR technique resulted in horizontal bone gain in extremely narrow alveolar ridges. It allowed for implant placement in a vascular cancellous bed protected by intact cortical plate. Different types of bone grafts, whether alloplast or allograft, resulted in successful augmentation comparable to that gained from autogenous block grafting.

Effect of curfew from the COVID-19 pandemic on amblyopia treatment in children in Saudi Arabia.

Background: Amblyopia was defined as a reduction in the best-corrected visual acuity in one or both eyes with the presence of amblyogenic factors. Objective: The aim of this work was to investigate the effect of curfews resulting from the COVID-19 pandemic on amblyopia treatment in children. Design: A prospective longitudinal study. Methods: The study was conducted in pediatric ophthalmology clinics at a tertiary hospital in Riyadh, Saudi Arabia. Children aged 3-9 years who underwent amblyopia treatment from September 2020 to May 2021 were recruited. Visual acuity data were collected from the subjects' record files for the first visits prior to the curfew and from the clinics for the second visits after the curfew had ended. Results: A total of 97 children with amblyopia (strabismic, anisometropic, mixed, and visual deprivation) were included. In all, 15 children did not attend the clinic for follow-up visits after the outbreak of COVID-19. The follow-up visits for most of the participants took place 4-5 months after the first visit. No significant difference in visual acuity in the amblyopic eye was found between the first and second visits (p > 0.05). No significant correlation was noted between the baseline difference in visual acuity at the first and second visits and the duration of the amblyopia treatment between the two visits. The adjusted model shows a variation of 0.18% according to the duration between the two visits. Conclusion: The findings showed no significant difference in visual acuity in amblyopic eyes between the first and second visits (before and after the COVID-19 curfew), although visual acuity was clinically improved.

Vitamin C mesotherapy versus diode laser for the esthetic management of physiologic gingival hyperpigmentation: a randomized clinical trial.

BACKGROUND: Physiologic gingival hyperpigmentation is a common esthetic concern that affects individuals of various ethnicities, and can have a significant impact on individual's self-confidence and overall quality of life. Thus, this study aimed to clinically assess the effectiveness of intra-mucosal injection of vitamin C versus 980 nm diode laser for the management of physiologic gingival hyperpigmentation. METHODS: Twenty-six healthy non-smoker individuals with physiologic gingival hyperpigmentation were randomly assigned to two groups. Group I received intra-mucosal injection of vitamin C (L-Ascorbic acid 1000 mg/5 ml), and group II was managed using diode laser (980 nm, 1.5 W, continuous wave mode). Clinical evaluation of pigmentation intensity and distribution was performed preoperatively, and at 1, 2 and 3 months postoperatively using two different color assessment indices; Dummett-Gupta Oral Pigmentation Index (DOPI), and Gingival Pigmentation Index (GPI). Additionally, the study assessed pain intensity and patients' satisfaction. RESULTS: Pigmentation scores decreased significantly between pre-operative visit and different follow-up visits for both treatment modalities (p < 0.0001*). When compared to the vitamin C mesotherapy group, the laser group demonstrated significantly lower gingival pigmentation scores (p < 0.0001*). However, both treatment modalities were equally satisfying for the patients. CONCLUSIONS: Vitamin C mesotherapy and diode laser are both effective in the management of physiologic gingival hyperpigmentation. While diode laser yields better and earlier results, vitamin C mesotherapy offers a cost-effective, safe and minimally invasive approach that is equally satisfying for the patients seeking esthetic enhancements. TRIAL REGISTRATION: The study was registered on ClinicalTrials.gov (NCT05608057) on (01/11/2022).

Positional transfer accuracy of titanium base implant abutment provided by two different scan body designs: an invitro study.

BACKGROUND: The variabilities in design and material of scan bodies have a major role in the positional transfer accuracy of implants. The purpose of this invitro study was to compare the 3D transfer accuracy (trueness and precision) of titanium base (TB) abutment position provided by 2 different scan bodies: one-piece scan body (SB) in comparison to two-piece healing abutment and scan peg (HA-SP). METHODS: A maxillary model with a dummy implant in the 2nd premolar (Proactive Tapered Implant; Neoss) was 3D printed and TB (Ti Neolink Mono; Neoss) was tightened on the implant and scanned by using a laboratory scanner (inEos X5; Dentsply Sirona) (reference scan). An SB (Elos Medtech) and an HA-SP (Neoss) were subsequently connected to the implant and were scanned 10 times each by using the same scanner (test scans). All the scans were exported as STL files and imported into CAD software where the TBs were formed. Test scans were superimposed on reference scans for transfer accuracy analysis using 3D metrology software (GOM Inspect; GOM GmbH) in terms of angular deviation in vertical and horizontal directions, linear deviation in each XYZ axis of TBs and total linear deviation in all axes. Statistical analysis was done using independent sample t test. When Levene's test for equality of variances was significant, Welch's t-test was used. (P value < 0.05) RESULTS: Significant differences were found amongst the tested groups in both angular and linear deviation in terms of trueness with less deviation values for the SB group (P < 0.001). For the precision, significant differences were found amongst the tested groups in angular deviation in vertical direction with less deviation value for the SB group compared to HA-SP group (P < 0.001). However, no significant difference was found between the tested groups regarding the angular deviation in horizontal direction (P = 1.000). Moreover, significant differences were found amongst the tested groups in linear deviations with less linear deviations in XYZ axes for SB compared to HA-SP group (P = 0.020, < 0.001, = 0.010 respectively). CONCLUSIONS: SB showed less angular and linear deviation values in the 3D positional transfer of TB than HA-SP indicating higher degree of accuracy of SB.

Fabrication and optimization of itraconazole-loaded zein-based nanoparticles in coated capsules as a promising colon-targeting approach pursuing opportunistic fungal infections.

Itraconazole (ITZ), a broad-spectrum antifungal drug, was formulated into colon-targeting system aiming to treat opportunistic colonic fungal infections that commonly infect chronic inflammatory bowel diseases (IBD) patients due to immunosuppressive therapy. Antisolvent precipitation technique was employed to formulate ITZ-loaded zein nanoparticles (ITZ-ZNPs) using various zein: drug and aqueous:organic phase ratios. Central composite face-centered design (CCFD) was used for statistical analysis and optimization. The optimized formulation was composed of 5.5:1 zein:drug ratio and 9.5:1 aqueous:organic phase ratio with its observed particle size, polydispersity index, zeta potential, and entrapment efficiency of 208 ± 4.29 nm, 0.35 ± 0.04, 35.7 ± 1.65 mV, and 66.78 ± 3.89%, respectively. ITZ-ZNPs were imaged by TEM that revealed spherical core-shell structure, and DSC proved ITZ transformation from crystalline to amorphous form. FT-IR showed coupling of zein NH group with ITZ carbonyl group without affecting ITZ antifungal activity as confirmed by antifungal activity test that showed enhanced activity of ITZ-ZNPs over the pure drug. Histopathological examination and cytotoxicity tests ensured biosafety and tolerance of ITZ-ZNPs to the colon tissue. The optimized formulation was then loaded into Eudragit S100-coated capsules and both in vitro release and in vivo X-ray imaging confirmed the success of such coated capsules in protecting ITZ from the release in stomach and intestine while targeting ITZ to the colon. The study proved that ITZ-ZNPs is promising and safe nanoparticulate system that can protect ITZ throughout the GIT and targeting its release to the colon with effectual focused local action for the treatment of colon fungal infections.

The precision of two alternative indirect workflows for digital model production: an illusion or a possibility?

OBJECTIVE: Despite the clear drive from both research and clinical dentistry toward digital transformation, there are limitations to implementing intra-oral scanning (IOS) into daily dental practice. This study aimed to compare the precision of digital models obtained from two alternative indirect workflows to direct IOS. MATERIAL AND METHODS: Two indirect digital workflows were evaluated in this study. In the IOS group (direct), IOS directly obtained digital impressions of participants' upper and lower dental arches, while in the Scan Impression (Scan Imp) group (indirect), a desktop scanner scanned silicone-based impressions of upper and lower whole arches that were taken with plastic trays. In the cone-beam computed tomography impression (CBCT Imp) group (indirect), a CBCT machine scanned the silicone-based impressions. Then, the precision of the entire arch and individual teeth for all digital impressions was virtually quantified. Following superimposition, differences between standard tessellation language (STL) files obtained from both-direct and indirect-methods were evaluated by color-mapping and measuring the surface distance between superimposed STL files. Furthermore, 18 linear measurements were taken from each digital model. ANOVA with repeated measures, Pearson coefficient, and intraclass correlation coefficient were used for intergroup comparisons. RESULTS: The digital models obtained from the two indirect workflows differed from the IOS in some dental and intra-arch measurements but were considered clinically acceptable. Ranked against IOS, CBCT Imp models had greater precision, followed by Scan Imp. CONCLUSION: Digital models obtained from two indirect, alternative workflows, desktop, and CBCT scanning of impression, have clinically acceptable accuracy and reliability of tooth size and intra-arch measurements, providing the use of proper methodologies. CLINICAL RELEVANCE: There are some limitations to implementing IOS in daily clinical practice. However, several alternative digital model production techniques might provide an affordable solution. Although they may insignificantly differ in accuracy, all can be applied clinically.

Exploiting itraconazole-loaded nanomixed micelles in coated capsules as efficient colon-targeted delivery system for improved antifungal and potential anticancer efficacy.

Chronic Inflammatory bowel diseases are usually accompanied by opportunistic colonic fungal infections. Itraconazole (ITZ), is a highly lipophilic broad-spectrum antifungal drug that is superiorly effective against several fungal species. Box-Behnken design was adopted to design ITZ-nanomixed micelles (ITZ-NMMs), aiming to enhance ITZ solubility, using various concentrations of Pluronic® L121, Cremophor EL, and with either sodium-deoxycholate or Pluronic® F68 through thin film hydration technique. Optimized formula composed of 90 % Pl-L121, 9.1% Cremophor EL, 3.127 % ITZ concentration and SDC as the hydrophilic surfactant and its particle size, Polydispersity index, zeta potential, entrapment efficiency, and release extent after 3 h were found to be 17.82 ± 0.189 nm, 0.26 ± 0.014, -6.72 ± 0.725 mV, 66 ± 7.4%, and 96.3 ± 7.22%, respectively. In vitro ITZ release study implied the ability of optimal ITZ-NMMs to enhance ITZ solubility in comparison to ITZ suspension. Also, augmented anti-fungal and anti-cancer activities were proven as ITZ-NMMs IC50 was 16.5 times that of pure ITZ. Afterwards, lyophilized optimal ITZ-NMMs formula was loaded into Eudragit S100-coated capsules where in vitro release and in vivo X-ray imaging ensured protection of ITZ release in either the stomach or intestine and targeting it to the colon. Such results suggested promising ITZ-NMMs system, capable of enhancing ITZ solubility in the intended target site, therefore, can be used not only in the treatment of colon fungal infections but also augments colon cancer therapy.

Outcomes of bio-esthetic single implant-supported restorations after peri-implant soft tissue conditioning with two prosthetic techniques: A 1-year randomized clinical trial.

STATEMENT OF PROBLEM: Providing a definitive restoration with an emergence profile matching that of the contralateral or extracted tooth should result in an esthetic peri-implant soft tissue contour. Whether a custom healing abutment improves the outcome of a bio-copied definitive restoration compared with a stock abutment is unclear. PURPOSE: The purpose of this 1-year randomized clinical trial was to evaluate the peri-implant soft and hard tissues related to bio-esthetic single implant-supported restorations having a contralateral tooth-matching restorative emergence profile after peri-implant soft tissue conditioning with either custom or stock healing abutment for patients indicated for immediate implant placement. MATERIAL AND METHODS: Twenty-four participants indicated for immediate implant placement in the maxillary esthetic zone received bio-esthetic single implant-supported restorations after peri-implant soft tissue conditioning with either a custom healing abutment (n=12) or a stock healing abutment (n=12). The pink and white esthetic score (PES-WES) was evaluated 6 and 12 months after implant placement. Peri-implant bone changes were measured with cone beam computed tomography (CBCT) scans at the same intervals. RESULTS: The PES-WES showed significant difference between the 2 groups at 6 and 12 months. The CBCT scans did not show significant difference between the 2 groups. CONCLUSIONS: The use of the bio-esthetic concept for immediate single implant placement achieved successful esthetic restorations after conditioning the peri-implant tissues using either custom or stock healing abutments. However, the use of custom healing abutments was associated with higher PES-WES values in comparison with the use of stock healing abutments.

CAD-CAM custom healing abutments: A dental technique.

Custom healing abutments are important in establishing optimal esthetics for prosthesis-driven, implant-supported restorations. This report demonstrates a technique for constructing a custom healing abutment with computer-aided design and computer-aided manufacturing to save chairside time and provide predictable results.

Periodontal changes following distraction osteogenesis in patients with cleft lip and palate: a clinical trial.

OBJECTIVES: To evaluate inflammatory mediator levels and periodontal changes following distraction osteogenesis (DO) in patients with cleft lip and palate (CLP) using mid-maxillary distraction (MMD). MATERIALS AND METHODS: A total of 20 healthy patients with CLP with Class III malocclusion were included. Segmental forward advancement of the anterior maxilla from the second premolars on both sides using DO was performed. A custom-made, tooth-borne distractor connecting buccal molar segments to the anterior maxilla was used for 7 days with 0.5-mm distraction for the first 2 days and then increased to 1 mm daily until overcorrection. Crevicular interleukin IL-1ß and tumor necrosis factor TNF-α levels were measured during distraction. Periodontal clinical parameters and indices were recorded at baseline and 3 and 6 months postoperatively. Soft tissue healing was evaluated histologically at 2 and 4 weeks after distraction. RESULTS: The periodontal parameters remained stable during the follow-up periods. Insignificant increases in the level of inflammatory cytokines compared with the control were observed. Histological findings revealed mild inflammatory and structural changes in the gingiva immediately after distraction, whereas regeneration was noticed after 4 weeks. CONCLUSIONS: MMD was an effective technique in treating patients with CLP, leading to new bone and soft tissue formation without significant detrimental effect on the periodontium of the adjacent teeth.

Validation of the Arabic version of the quality of life impact of refractive correction questionnaire.

PURPOSE: To validate the Arabic version of the quality of life impact of refractive correction (QIRC) questionnaire. METHODS: This was a cross-sectional study included participants with refractive errors (myopia, hypermetropia, or astigmatism) aged between 19 and 40 years who were pre or postrefractive surgeries. Uncorrected distance visual acuity, refraction, and corneal topography were collected. The 20-item QIRC questionnaire was translated to the Arabic language and then back translated to the English language. Participants were asked to answer all items of the Arabic QIRC. The validity and reliability of the translated questionnaire were tested using Rasch analysis. RESULTS: A total of 145 participants with refractive errors participated in this study. The mean age ± standard deviation of participants was 26.29 ± 5.1 years. Person separation (2.01) and reliability (0.80) indicates good precision and stability of the Arabic QIRC questionnaire. Item infit was ranged between 0.82 and 1.23; and item outfit was range between 0.76 and 1.32. The items were well targeted to the persons with a mean difference of 0.30. Skew and kurtosis values were within the normal limits (-2.00 to + 2.00). Cronbach's α for the scale was 0.79, which indicates good reliability of the Arabic 20-item QIRC. CONCLUSION: The Arabic 20-item QIRC questionnaire is a valid tool to assess the impact of refractive correction on Arabian participants' quality of life.

Fabrication of a CAD-CAM custom healing abutment guided by a conventional dental radiograph for delayed loaded dental implants: A dental technique.

This article describes a technique for fabricating a custom anatomic healing abutment for delayed loaded implants by using the computer-aided design and computer-aided manufacturing (CAD-CAM) technology from a polymethyl methacrylate (PMMA) blank. The dimensions of the custom healing abutment are measured from a conventional dental radiograph and diagnostic casts. The healing abutment is used in the second surgical stage to guide soft tissue healing. The resulting soft tissue contour guides the design of the mucosal part of the custom implant abutment.

Evaluation of immediately loaded mandibular four vertical versus tilted posterior implants supporting fixed detachable restorations without versus with posterior cantilevers.

BACKGROUND: Distally inclining posterior implants may be technically challenging in certain situations. The presence of a posterior cantilever can also exert unfavorable forces on supporting implants. The aim of the present study was to evaluate and compare peri-implant soft and hard tissues around 4 mandibular interforaminal implants having tilted posterior implants with posterior cantilevers, versus vertical implants, 2 in the interforaminal region and 2 in the first molar regions, without posterior cantilevers. All implants supported full-arch fixed detachable restorations opposing complete dentures. MATERIAL AND METHODS: A total of 80 implants were placed flapless in the mandibles of 20 edentulous participants. Four implants were placed for every participant, who were randomly assigned into 2 equal groups. Axial group implants were vertically aligned, with 2 implants in the interforaminal area and 2 in the molar area. Tilted group implants have 2 anterior axial and 2 posterior distally inclined implants. Interim screw-retained prostheses converted from pre-existing dentures were immediately fabricated and loaded on the same day of surgery. After awaiting period of 3 months, all participants received fixed detachable metal acrylic resin definitive restorations. A follow-up protocol of 3, 6, and 12 months was scheduled to assess the modified gingival index, modified plaque index, peri-implant probing depth, implant stability, and marginal bone level and bone density changes. RESULTS: No statistically significant differences (P > .05) were found in the modified gingival index, modified plaque index, peri-implant probing depth, implant stability, bone density, and marginal bone level between the axial and tilted implant groups after the 1-year follow-up period. CONCLUSION: Placing 4 flapless immediately loaded implants in mandibular edentulous patients that supported full-arch fixed restorations provided high implant and prosthodontic success rates whether posterior implants were tilted with posterior cantilevers or vertically aligned without posterior cantilevers. TRIAL REGISTRATION: Pan African Clinical Trial Registry database, PACTR201907776166846. Registered 3 July 2019, www.pactr.org .

Visual outcomes and quality of life before and after photorefractive keratectomy.

PURPOSE: To compare visual outcomes and vision-related quality of life (VRQoL) between subjects before and after photorefractive keratotomy (PRK) and controls. In addition, VRQoL was compared between subjects at different periods of PRK surgery. METHODS: This was a cross-sectional study that included subjects with refractive errors aged 19-40 years and age-matched controls. Subjects were divided into three groups: pre-, post-PRK, and control. Subjects in the post-PRK group were divided into three subgroups (1-week, <6-month, and >6-month follow-up visits). Measurements including uncorrected distance visual acuity (UCVA), corrected distance visual acuity (CDVA), spherical equivalent (SE) of manifest refraction, and corneal topography were obtained for all participants. The Quality of Life Impact of Refractive Correction (QIRC) questionnaire was administered to compare VRQOL between groups and between post-refractive surgery subgroups. RESULTS: A total of 145 participants were included in this study. The mean age ± standard deviation (SD) of all participants was 26.29 ± 5.1 years. There was a significant difference (P < 0.001) in total QIRC scores between groups. The total QIRC score was better in the post-PRK group than in the pre-PRK and control groups. The scores of items included in the convenience, well-being, and health concern domains were significantly higher in the post-PRK group than in the pre-PRK and control groups. Within the post-PRK group, significant differences (P < 0.001) were found in UCVA and SE between the post-PRK subgroups. Uncorrected VA and SE were better in the post-PRK groups who were followed up in the < 6 and > 6 months subgroups than in the 1-week follow-up subgroup (P < 0.0001). CONCLUSION: A significant improvement in visual outcomes and VRQoL occurred after PRK surgery. Subjects enjoyed their VRQoL after refractive surgery.

Ocular parameters alterations after hemodialysis in patients with chronic kidney diseases.

PURPOSE: To evaluate the effects of hemodialysis (HD) on visual acuity (VA), central corneal thickness (CCT), intraocular pressure (IOP), and macular thickness (MT) in chronic kidney disease (CKD) patients and also to investigate the relationship between the ocular parameters and blood biochemical parameters such as serum albumin, creatinine, sodium, and urea levels. METHODS: A prospective cohort study including a total of 24 CKD patients of both genders (above 18 years old) undergoing HD in XXX was conducted. The participants were divided into three sub-groups based on the primary cause of renal failure, group 1: Hypertensive kidney disease, group 2: Diabetic kidney disease, group 3: Other causes. All subjects underwent full ophthalmological examinations including measurement of VA using LogMAR, IOP, CCT, and CMT. Comparisons between different ocular parameters during pre- and post-HD sessions were done using the paired t-test. The relationship between changes in ophthalmologic and blood biochemical parameters was calculated using Pearson correlation coefficient. RESULTS: HD did not significantly alter any ocular parameter within and between CKD groups. Spherical equivalent changes were found to be significantly correlated with serum K (r = -0.315; P = 0.038), and IOP results were positively correlated with serum creatinine (r = 0.330; P = 0.029) and negatively correlated with hemoglobin (r = -0.349; P = 0.020). Bodyweight alterations were significantly correlated with CCT (r = -0.03; P = 0.0001). However, no correlation between ocular parameters and duration of HD was detected. CONCLUSION: Following a single HD session, ocular parameters did not alter significantly.

Controlled diabetes amends oxidative stress as mechanism related to severity of diabetic retinopathy.

Oxidative stress is a well-accepted etiological mechanism that contributes to neuronal dysfunction. Role of oxidative stress as a mechanism of retinopathy in controlled type 2 diabetic patients was evaluated. Participants were divided into three groups: Group 1 as 30 normal eyes of 15 subjects, Group 2 comprised 24 eyes of 12 diabetic patients without retinopathy and Group 3 comprised 23 eyes of 12 diabetic patients with different grades of retinopathy (8 eyes with maculopathy). A complete ophthalmological examination was performed. Oxidative stress markers were measured in blood. Macular thickness was different in all quadrants among all groups and showed a tendency to increase in Group 3 due to diabetic retinopathy with insignificant changes in parapapillary retinal nerve fiber layer thickness although thinning was noted also with retinopathy. Non-significant differences in GST and lipid peroxide levels were observed between the three studied groups, whereas vitamin C and GSH levels were higher in diabetic patients when compared to those in controls. As oxidative stress, hyperglycemia and local inflammation are involved in the pathogenesis of DR, the present study proved that the progressive damage can be retarded in controlled type 2 diabetic patients using different treatment modalities that abated oxidative stress.

The protective effect of Moringa oleifera plant extract against glutamate-induced DNA damage and reduced cell viability in a primary retinal ganglion cell line.

BACKGROUND: Glutamate excitotoxicity can cause DNA damage and is linked to many retinal and neurological disorders. In mammals, the visual signal from the eyes to the brain is conducted only by retinal ganglion cells (RGCs), which can be damaged by overstimulation of glutamate receptors. METHODOLOGY: We examined the protective effects of Moringa oleifera seed extract against glutamate-induced DNA damage in RGCs. RGCs cells were treated with 5, 10, 50, or 100 µg/ml of M. oleifera seed extract and glutamate separately and then assessed for DNA damage using the comet assay. We also evaluated the viability of the RGCs after both treatments using the MTT test. Additionally, RGCs were pretreated with M. oleifera seed extract (50 or 100 µg/ml) for 2 h before glutamate treatment (100 µg/ml) to determine the potential protective effects of M. oleifera. We performed a phytochemical analysis of the M. oleifera seed extract using standard reactions. RESULTS: The M. oleifera seed extract was found to be rich in many phytochemicals. We observed a significant dose-dependent elevation in all comet assay variables in glutamate-treated RGCs, whereas M. oleifera seed extract treatments did not show any significant change in DNA integrity. CONCLUSION: M. oleifera seed extract demonstrates neuroprotective effects, which suggests it may help to prevent the development of many neurodegenerative disorders.

Lepidium sativum as candidate against excitotoxicity in retinal ganglion cells.

Glutamate excitotoxicity is considered one of the major causes of retinal ganglion cell death in many retinal diseases. Retinal ganglion cell degeneration causes severe blindness since visual signals from the eye to the brain are conducted only through retinal ganglion cells. OBJECTIVE: We aimed to explore the potential ameliorative effects of L. sativum against glutamate excitotoxicity-induced retinal ganglion cell damage. METHODS: Pure retinal ganglion cells were divided into a control group (untreated); L. sativum-treated groups in which retinal ganglion cells were treated with 5, 10, 50, or 100 µg/mL L. sativum seed extract for 2 h; glutamate-treated groups in which cells were treated with 5, 10, 50, or 100 µM glutamate for 48 h; and L. sativum/glutamate groups [pretreatment with L. sativum for 2 h (50 or 100 µg/mL) before glutamate treatment at 100 µM for 48 h]. Cell damage was assessed by comet assay and cell viability was by MTT test. RESULTS: Tailed DNA, tail length, and tail moment of the 50 and 100 mM glutamate-treated groups were significantly greater than those of the blank control group, while the L. sativum-treated groups demonstrated nonsignificantly different tailed DNA, tail length, and tail moment compared with the blank control group, but significantly lower values compared with the glutamate-treated groups. CONCLUSION: L. sativum ameliorated the cell viability in retinal ganglion cells after high-concentration glutamate exposure. L. sativum seed extracts were efficient anti-excitotoxic and antioxidant agent that might improve the clinical presentation of many neurological disorders.

Green Nanotechnology in the Formulation of a Novel Solid Dispersed Multilayered Core-Sheath Raloxifene-Loaded Nanofibrous Buccal Film; In Vitro and In Vivo Characterization.

Green nanotechnology utilizes the principles of green chemistry to formulate eco-friendly nanocarrier systems to mitigate patients and environment hazards. Raloxifene (RLX) demonstrates poor aqueous solubility (BCS class II) and low bioavailability, only 2% (extensive first-pass metabolism). The aim of this study is to enhance RLX solubility and bioavailability via development of novel solid dispersed multilayered core-sheath RLX-loaded nanofibers (RLX-NFs) without the involvement of organic solvents. A modified emulsion electrospinning technique was developed. Electrospinning of an RLX-nanoemulsion (RLX-NE) with polymer solution (poly vinyl alcohol (PVA), hydroxypropyl methylcellulose (HPMC), and chitosan (CS) in different volume ratios (1:9, 2:8, and 4:6) using D-optimal response surface methodology was adopted. In vitro characterization of RLX-loaded NFs was performed; scanning electron microscope (SEM), thermal analysis, drug content, release studies, and bioadhesion potential. The optimum NFs formula was evaluated for morphology using high-resolution transmission electron microscopy (HRTEM), and ex vivo drug permeation. The superiority of E2 (comprising RLX-NE and PVA (2:8)) over other NF formulae was statistically observed with respect to Q60 (56.048%), Q240 (94.612%), fiber size (594.678 nm), mucoadhesion time 24 h, flux (5.51 µg/cm2/h), and enhancement ratio (2.12). RLX pharmacokinetics parameters were evaluated in rabbits following buccal application of NF formula E2, relative to RLX oral dispersion. E2 showed significantly higher Cmax (53.18 ± 4.56 ng/mL), and relative bioavailability (≈2.29-fold).