An insight into the emergence of Acinetobacter baumannii as an oro-dental pathogen and its drug resistance gene profile - An in silico approach

Conventional Antimicrobial and Medicinal Plants from a Traditional Medicine Market in South Africa: An Interactive Antimicrobial and Toxicity Study

BACKGROUND

The World Health Organization (WHO) has proposed the use of integrative medicine to achieve extended healthcare coverage in developing countries facing high morbidity. Traditional remedies are frequently employed to prevent and treat infections among South Africans; however, the ways in which they interact with conventional antimicrobials are largely unknown. Therefore, this study aimed to explore the interactions between commonly traded medicinal plants at a traditional medicine market in KwaZulu-Natal (KZN), South Africa, and conventional antibiotics and antifungals.

METHODS

To determine the interactive antimicrobial profiles for plant/conventional antimicrobial combinations, minimum inhibitory concentration (MIC) assays were performed against ESKAPE pathogens and the yeasts Candida albicans and Candida glabrata. Calculated fractional inhibitory concentration (ΣFIC) values were used to identify synergism or antagonism, with synergistic interactions further tested in vitro for toxicity.

RESULTS

A total of 952 combinations were tested, of which 5.8% and 54.6% of the plant/antibiotic combinations were synergistic and antagonistic, respectively; additionally, 1.7% and 58.6% of the plant/antifungal combinations showed synergism or antagonism, respectively. The most toxic plant/antibiotic combination was Artemisia afra with doxycycline (71.1% mortality). The most toxic plant/antifungal combination was Acorus calamus with fluconazole (78.8% mortality).

CONCLUSIONS

When medicinal plants acquired from a traditional medicine market in South Africa are used in combination with conventional antibiotics and antifungals, more than half of the combinations exhibit antagonism, which is concerning.

Understanding the prevalence, antimicrobial resistance, and public health challenges of Acinetobacter baumannii in India and China

AIMS

Acinetobacter baumannii (A. baumannii) is a globally recognized notorious pathogen for its high levels of antibiotic resistance, posing severe challenges in healthcare settings, particularly in the most populated countries, India and China. This review compares its epidemiology, resistance patterns, and management strategies in both countries, highlighting its role in healthcare-associated infections and the ongoing challenges in controlling its spread.

METHODS AND RESULTS

A comprehensive review of recent literature was conducted, analyzing studies from both countries to assess the prevalence, resistance trends, and risk factors associated with A. baumannii infections. In India, A. baumannii was found to be responsible for 22.3% of hospital-acquired pneumonia cases, with carbapenem resistance rates exceeding 70%. The emergence of New Delhi Metallo-β-lactamase (NDM)-producing strains has intensified the challenge. Meanwhile, the prevalence of multidrug-resistant (MDR) strains has risen to 74.7%. In China, A. baumannii accounts for 35.7%-52.7% of hospital-acquired pneumonia cases, with carbapenem resistance rates exceeding 70% and MDR strains reaching up to 63.8%. Both China and other countries have witnessed a rise in extensively drug-resistant (XDR) strains, further complicating treatment options and contributing to increased morbidity and mortality rates.

CONCLUSIONS

The review emphasizes how important it is to implement focused treatments, antimicrobial stewardship initiatives, and international cooperation in order to fight A. baumannii.

3-Hydroxybenzoic acid inhibits the virulence attributes and disrupts biofilm production in clinical isolates of Acinetobacter baumannii

PURPOSE

Acinetobacter baumannii (A. baumannii) is an emerging global public health threat owing to its ability to form biofilms. Here, we evaluated 3-hydroxybenzoic acid (3-HBA), a promising organic compound, for its ability to disrupt biofilm formation and virulence attributes in clinical isolates of A. baumannii.

MATERIALS AND METHODS

The effect of 3-HBA on A. baumannii was assessed by determining the minimum inhibitory concentration (MIC) and certain other in vitro investigations viz., extracellular polymeric substance (EPS) estimation, crystal violet staining assay, motility assay, and the hydrogen peroxide (H2O2) assay to examine its impact on bacterial virulence. Biofilm formation was also evaluated at the air-liquid interface. In situ visualization investigations were employed to confirm biofilm dispersion at the lowest effective concentration. The cytotoxic effects of 3-HBA on MCF-7 cells were investigated using the MTT assay.

RESULTS

At a sub-inhibitory concentration of 0.078 mg/mL, 3-HBA reduced biofilm formation in A. baumannii LSAB-04 and A. baumannii LSAB-06 by 61.22% and 59.21%, respectively, and decreased EPS production by 64% in LSAB-04 and 58.31% in LSAB-06. Microscopic examination confirmed significant biofilm dispersion. 3-HBA also significantly impaired swarming motility and increased their sensitivity to H2O2. The MTT assay showed a dose-dependent decrease in MCF-7 cell viability (43.67%) at a concentration of 0.078 mg/mL.

CONCLUSION

Our findings underscore the likely role of 3-HBA as a promising A. baumannii biofilm-disrupting agent. Further, by downplaying against the virulence factors of A. baumannii, 3-HBA could be a compelling alternative to conventional antibiotics that however requires to be investigated.

Microbiome interactions: Acinetobacter baumannii biofilms as a co-factor in oral cancer progression

Acinetobacter baumannii (A. baumannii) has long been recognized primarily as a hospital-acquired pathogen. However, recent studies have uncovered a potential link between this bacterium and oral cancer, necessitating a deeper exploration of this relationship. This review examines the relevance of A. baumannii biofilms in the context of oral cancer development. By synthesizing current knowledge, we seek to provide a comprehensive understanding of this emerging area of research and identify critical directions for future investigations. The review emphasizes the remarkable adaptability, environmental resilience, and antibiotic resistance of A. baumannii, delves into the molecular mechanisms of biofilm formation, and their potential connection to oral cancer progression. The review also evaluates how biofilm colonization on oral surfaces and medical devices, along with its role in chronic infections, inflammation, and increased antimicrobial resistance, could contribute to creating a microenvironment favourable for tumor development. This review underscores the broader healthcare implications of A. baumannii biofilms, evaluates current strategies for their prevention and eradication, and calls for interdisciplinary research in this emerging field. By shedding light on the complex interactions between A. baumannii biofilms and oral cancer, it aims to stimulate further research and guide the development of new diagnostic, preventive, and therapeutic strategies in both microbiology and oncology.

Comprehensive evaluation of the antibacterial and antibiofilm activities of NiTi orthodontic wires coated with silver nanoparticles and nanocomposites: an in vitro study

BACKGROUND

Fixed orthodontic appliances act as a niche for microbial growth and colonization. Coating orthodontic wires with antimicrobial silver nanoparticles (AgNPs) and nanocomposite was adopted in this study to augment the biological activity of these wires by increasing their antibacterial and antibiofilm properties and inhibiting bacterial infections that cause white spot lesions and lead to periodontal disease.

METHODS

Three concentrations of biologically synthesized AgNPs were used for coating NiTi wires. The shape, size, and charge of the AgNPs were determined. Six groups of 0.016 × 0.022-inch NiTi orthodontic wires, each with six wires, were used; and coated with AgNPs and nanocomposites. The antimicrobial and antibiofilm activities of these coated wires were tested against normal flora and multidrug-resistant bacteria (Gram-positive and Gram-negative bacterial isolates). The surface topography, roughness, elemental percentile, and ion release were characterized.

RESULTS

AgNPs and nanocomposite coated NiTi wires showed significant antimicrobial and antibiofilm activities. The chitosan-silver nanocomposite (CS-Ag) coated wires had the greatest bacterial growth inhibition against both Gram-positive and Gram-negative bacteria. The surface roughness of the coated wires was significantly reduced, impacting the surface topography and with recorded low Ni and Ag ion release rates.

CONCLUSIONS

NiTi orthodontic wires coated with AgNPs, and nanocomposites have shown increased antimicrobial and antibiofilm activities, with decreased surface roughness, friction resistance and limited- metal ion release.

The antimicrobial peptide Microcin C7 inhibits the growth of Porphyromonas gingivalis and improves the perodontal status in a rat model

AIMS

This study aimed to investigate the antibacterial and anti-inflammatory effects of the antimicrobial peptide Microcin C7 for Porphyromonas gingivalis-associated diseases.

METHODS AND RESULTS

Reverse-phase high-performance liquid chromatography revealed that Microcin C7 could remain 25.5% at 12 h in saliva. At a concentration of <10 mg ml-1, Microcin C7 showed better cytocompatibility, as revealed by a hemolysis test and a subchronic systemic toxicity test. Moreover, the minimum inhibitory concentration and minimum bactericidal concentration of Microcin C7 were analyzed using a broth microdilution method, bacterial growth curve, scanning electron microscopy, and confocal laser microscopy and determined to be 0.16 and 5 mg ml-1, respectively. Finally, in a rat model, 5 mg ml-1 Microcin C7 showed better performance in decreasing the expression of inflammatory factors (IL-1β, IL-6, IL-8, and TNF-α) and alveolar bone resorption than other concentrations.

CONCLUSIONS

Microcin C7 demonstrated favorable biocompatibility, antibacterial activity, and anti-inflammatory effect, and could decrease the alveolar bone resorption in a rat model, indicating the promising potential for clinical translation and application on P. gingivalis-associated diseases.

Phytochemical Composition and Antimicrobial and Antibiofilm Effect of Myrciaria cauliflora Hydroethanolic Extract against Staphylococcus aureus and Acinetobacter baumannii

Staphylococcus aureus and Acinetobacter baumannii are opportunistic pathogens, and both are involved in different oral infections. This work aimed to analyze the phytochemical composition of Myrciaria cauliflora hydroethanolic extract and to evaluate its antimicrobial and antibiofilm action against Staphylococcus aureus (ATCC 6538) and Acinetobacter baumannii (ATCC 19606; multi-resistant clinical strains 58004, 50098, 566006, and H557). Myrciaria cauliflora hydroethanolic extract was prepared, and the content of soluble solids, flavonoids, and phenols was quantified. High-performance liquid chromatography (HPLC) was performed later. The minimum inhibitory concentration was determined using the broth microdilution method according to the Clinical and Laboratory Standards Institute, standard M7-A6, and subsequently, its minimum bactericidal concentration was determined. Then, the most effective concentrations were analyzed against biofilms. Statistical analysis was performed using the ANOVA method with Tukey's test. The soluble solids content in the prepared hydroethanolic extract of M. cauliflora was 2.22%. Additionally, the total flavonoid content, measured using the quercetin standard curve, was 0.040 mg/mL. Furthermore, the total phenol content, determined using the gallic acid standard curve, was 0.729 mg/mL. HPLC analysis presented peaks of gallic acid (11.80 m), p-coumaric acid (12.09 m), cinnamic acid derivative (19.02 m), and ellagic acid (29.83 m). The extract demonstrated antimicrobial and antibiofilm action against all tested strains. However, the most effective antibacterial concentration against all the tested bacteria was 5.55 mg/mL. Therefore, these chemical components justify that M. cauliflora hydroethanolic extract is effective in reducing biofilm formation in S. aureus (standard strain) and A. baumannii (standard and clinical strains).

The oral microbiome is associated with HPA axis response to a psychosocial stressor

Intense psychosocial stress during early life has a detrimental effect on health-disease balance in later life. Simultaneously, despite its sensitivity to stress, the developing microbiome contributes to long-term health. Following stress exposure, HPA-axis activation regulates the "fight or flight" response with the release of glucose and cortisol. Here, we investigated the interaction between the oral microbiome and the stress response. We used a cohort of 115 adults, mean age 24, who either experienced institutionalisation and adoption (n = 40) or were non-adopted controls (n = 75). Glucose and cortisol measurements were taken from participants following an extended socially evaluated cold pressor test (seCPT) at multiple time points. The cohort´s oral microbiome was profiled via 16S-V4 sequencing on microbial DNA from saliva and buccal samples. Using mixed-effect linear regressions, we identified 12 genera that exhibited an interaction with host's cortisol-glucose response to stress, strongly influencing intensity and clearance of cortisol and glucose following stress exposure. Particularly, the identified taxa influenced the glucose and cortisol release profiles and kinetics following seCPT exposure. In conclusion, our study provided evidence for the oral microbiome modifying the effect of stress on the HPA-axis and human metabolism, as shown in glucose-cortisol time series data.

Acinetobacter baumannii as an oro-dental pathogen: a red alert!!

OBJECTIVES

This review highlights the existence and association of Acinetobacter baumannii with the oro-dental diseases, transforming this systemic pathogen into an oral pathogen. The review also hypothesizes possible reasons for the categorization of this pathogen as code blue due to its stealthy entry into the oral cavity.

METHODOLOGY

Study data were retrieved from various search engines reporting specifically on the association of A. baumannii in dental diseases and tray set-ups. Articles were also examined regarding obtained outcomes on A. baumannii biofilm formation, iron acquisitions, magnitude of antimicrobial resistance, and its role in the oral cancers.

RESULTS

A. baumannii is associated with the oro-dental diseases and various virulence factors attribute for the establishment and progression of oro-mucosal infections. Its presence in the oral cavity is frequent in oral microbiomes, conditions of impaired host immunity, age related illnesses, and hospitalized individuals. Many sources also contribute for its prevalence in the dental health care environment and the presence of drug resistant traits is also observed. Its association with oral cancers and oral squamous cell carcinoma is also evident.

CONCLUSIONS

The review calls for awareness on the emergence of A. baumannii in dental clinics and for the need for educational programs to monitor and control the sudden outbreaks of such virulent and resistant traits in the dental health care settings.

Predictions of Immunodominant Epitope Peptides From the AsaA Type VI Secretion System in Acinetobacter baumannii: A Computational Approach

Introduction Acinetobacter baumannii, designated as a priority pathogen by the World Health Organization (WHO), is responsible for recalcitrant infections in immunocompromised patients. The type VI secretion system (T6SS) is a class of macromolecular secretion machines, contributing to its virulence. The aim of this study is thus to predict the immune-dominant epitope peptides from the Acinetobacter T6SS-associated protein of A. baumannii (AsaA). Methods AsaA protein retrieval from the bacteria was carried out using computational platforms and the evaluation of antigenicity and allergenicity was performed. The T-cell epitopes of major histocompatibility complex class II binders were identified followed by molecular docking of the immune-dominant epitopes with human leukocyte antigen alleles using the ClusterPro server (https://cluspro.org/help.php). Additionally, the B-cell epitopes were predicted. Results Immune-informatic analysis showed immune-dominant peptides in the most favored regions with promising interactions with HLA alleles DP, DQ, DR, and toll-like receptor showing high binding capacity. Conclusion In the present investigation, epitope 1 (LILFLIGNY) was found to be a promising candidate for the synthesis of vaccines. However, it requires further experimentation for its immunological memory and response.

Antidiabetic activity of Kabasura Kudineer Chooranam

One of the traditional plants used in Siddha medicine is Kabasura Kudineer Chooranam. It is said to possess antiaging, life-strengthening, and disease-preventing activities that have an enormous influence on health care. It has significant therapeutic potential and ethnobotanical significance. The aim of this study is to investigate the antidiabetic activity of Kabasura Kudineer Chooranam. The antidiabetic potential of Kabasura Kudineer Chooranam was determined in vitro using established methods such as alpha-amylase and alpha-glucosidase activity. We used one-way ANOVA to see the statistical difference among the groups. The significance thresholds were considered at the P < 0.05 level. In comparison with the healthy group, the extract showed a significant antidiabetic effect. The proportion of inhibition increased as the concentrations increased. Previous studies established the antiviral, anti-inflammatory, analgesic, antifungal, antioxidant, antibacterial, hepatoprotective, antiasthmatic, immunomodulatory, and antipyretic effects of Kabasura Kudineer or Choornam. The current findings demonstrated that the Chooranam has good antidiabetic action at a significant concentration. Plant-based products have recently proven to be effective and economical antidiabetic items.

Effect of disinfectants on the tear strength of addition silicone impression material - An in vitro study

Addition silicone is a newer type of silicone impression material which has high dimensional stability, accuracy, and flexibility. They are mostly used for fixed restorations such as crowns and bridges. They have high tear strength; however, this strength may be altered upon disinfection. Disinfection of addition silicone prior use is important to reduce the microbial load. The aim of this study is to check whether there is any change in tear strength of addition silicone on disinfection with two commercially available disinfectants. Zhermack Elite HD + Putty material was tested in this study. Base and catalyst material was mixed and the material was cut into strips of dimension 70 mm × 10 mm × 2 mm. Five strips were immersed in sterillium and five strips were immersed in glutaraldehyde solution. These strips were then tested for their tear strength using Instron E3000 Universal Testing Machine. The values obtained were recorded in SPSS software version 22 (IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp.) for analysis and the P was obtained. The mean tear strength of Group 1, addition silicone immersed in sterillium disinfecting solution was found to be 7.148 ± 2.654 kN/m. The mean tear strength of Group 2, addition silicone immersed in glutaraldehyde disinfectant solution was found to be 7.326 ± 4.062 kN/m. An unpaired Student's t-test was done and P was found to be 0.235. The tear strength values between the groups was statistically not significant. Hence the tear strength of addition silicone was found to be greater in the glutaraldehyde disinfectant solution group.

Awareness of Vitamin and mineral supplements among college students

A Vitamin or mineral supplement is a kind of adjunct that aims to supplement the diet and it comprises a wide range of Vitamins, minerals, herbs, etc., that amplifies different nutrient levels. People intake such supplements for protection against health illnesses such as stress, cold, flu, osteoporosis, heart attacks, tooth decay, cancer, and neural tube defects in infants, etc. Anyhow, intake of large amounts without proper medical consideration can have severe negative consequences. This study aimed to assess the awareness on Vitamin and mineral supplements among College students. An online cross-sectional questionnaire was made using Google Forms and distributed among 100 College students. The data collected were analyzed using SPSS software. Descriptive analysis and Chi-square tests were done. Results showed that the majority of 63.43% of UG students and 21.64% of PG students believed that its consumption was beneficial and in general awareness was more among UG students. When asked about the Vitamin that should be avoided during pregnancy, a majority of 20.30% of UG students opted for Vitamin E and 7.52% of PG students opted for Vitamin A which shows that both were feasible options as they were fat-soluble vitamins capable of causing congenital defects. The most probable issue related with the use of dietary supplements is that the people who include them in their diet might see it as a substitute, in lieu of a supplement, thus, more people should be made aware of the proper consumption and side effects of Vitamin and mineral supplements.

Assessment of independent variables of periodontal disease among selected South Indian population

Periodontal diseases are chronic diseases that affect the surrounding tissues of the teeth and the alveolar bone. As the disease progresses, it can lead to tooth loss. Several risk factors may increase the risk of periodontal disease. The objective of the study was to assess the independent variables of periodontal disease among the few of the Southern population of India. The current study was done on 155 patients who visited Saveetha Dental College and Hospitals. Data of demographic details (age, gender, educational status) and periodontal status (clinically healthy gingiva, gingivitis, and periodontitis) were recorded. The demographic and the periodontal parameters were associated using Chi-square test (SPSS Software, Version 23.0). 20-30-year-old patients were mostly affected with gingivitis (25.8%) and 51-60-year-old patients were affected with periodontitis (22.58%). This showed statistical significance (P < 0.05). More males were affected with periodontal diseases than females and were statistically insignificant (P > 0.05). Periodontitis was more common among illiterates (26.45%) and was statistically significant (P < 0.05). The study shows that periodontitis was predominantly seen among males of 51-60 years of age and illiterates. The results of the study reveal a positive association between age, gender, and educational status of patients with their periodontal health.

Effect of herbal and nonherbal dentifrice on gingival health - A clinical study

The main causative factor for periodontal diseases is dental plaque. The most effective way to remove plaque is tooth brushing using dentifrice. Recently, due to the side effects of commercially available chemical dentifrices, herbal toothpaste is gaining popularity. This study aimed to evaluate the impact of herbal and nonherbal toothpaste on gingival health. The current study involved 100 outpatients reported to Saveetha Dental College and Hospitals. Each patient received oral prophylaxis and for 3 days, they were told not to use any other oral hygiene products. The subjects were assigned randomly into the test group (Colgate Herbal) and control group (Colgate). Thirty days later, the plaque and gingival indices were recorded and compared with the baseline using an unpaired t-test (SPSS software, version 23). The mean plaque index at baseline was 1.4 ± 0.6 (herbal) and 1.3 ± 0.7 (nonherbal), and after 30 days, the scores were 1.0 ± 0.5 and 0.9 ± 0.3, respectively. The mean gingival index score for herbal and nonherbal dentifrice at baseline was 1.19 ± 0.5 and 0.9 ± 0.2, and at 30^th day, it was 1.1 ± 0.4 and 1.0 ± 0.4, respectively. However, there was no statistically significant difference between the groups. Herbal dentifrices are just as effective as nonherbal dentifrices at reducing plaque and improving gingival health.

Berry as an adjunct to nonsurgical periodontal therapy: A clinical trial

Periodontal disease, a persistent inflammatory condition affecting the tissues around the teeth, is brought on by an imbalance between dental biofilm and the host's reaction, with the potential for tooth loss. Periodontal disease has been linked to an excess of free radicals induced by oxidative stress or antioxidant deficiency. There is a notable oxidative process early in the course of periodontal disease, especially in periodontitis. The objective of the study is to assess if berry supplements can be used as a supplement to nonsurgical periodontal therapy. Forty individuals with chronic periodontitis in total were divided into two groups for this study. Group A received scaling and root planing (SRP), whereas Group B received SRP plus berry supplements. At baseline and on the 28^th day, both groups had their probing pocket depth (PPD) and clinical attachment level (CAL) assessed. After then, the data from both time periods were compared. The SPSS software was used to examine the data (Version 23.0). Using an unpaired t-test, the mean PPD and CAL values were compared between the groups. The mean PPD in Group A decreased on day 28 from 4.18 ± 0.12 to 3.06 ± 0.02 while in Group B reduced from 4.21 ± 0.13 to 2.05 ± 0.08. The CAL in Group A improved from 5.05 ± 0.09 to 3.04 ± 0.11 and in Group B from 4.52 ± 0.17 to 2.02 ± 0.08. There was evidence of a statistically significant difference between two groups in terms of mean pocket depth and clinical attachment degree (P < 0.05). Therefore, berries may be an effective treatment for chronic periodontitis when used in conjunction with SRP.

Comparative analysis of pink and white esthetics of anterior full veneer crown: Indian scenario

A goal of modern dentistry is to make an esthetic outcome as one of the major modalities in dental treatment. In recent years, more emphasis has been given to esthetic parameters, especially in the anterior regions. The aim of this study was to evaluate the presence of change in pink and white esthetics scores after giving crowns in a single tooth. Subjects for this retrospective study were chosen by randomization from June 2019 to May 2020. A total of 120 subjects were selected which were equally divided with respect to age and gender. The analysis was done with a photographic assessment. The study test was done using paired t-test, and the correlation was evaluated using the Chi-square test. In this study, we observed that there is an increase in pink and white esthetic scores (WES) after the prosthesis is delivered. There was a clinical and statistically significant difference seen with the WES and total score, whereas only clinical but no statistical difference was seen with the pink esthetic score. After giving crowns, there is an increase in overall esthetic score. It is important to have certain standardized indices to score esthetics by which the overall esthetic outcomes can be improved. One such popular index is the pink and white esthetic index, which scores the soft and hard tissue.

Knowledge and awareness about Bowen's disease among dental students

The study aimed to assess the awareness and knowledge about Bowen's disease among dental students. Bowen disease is an infrequent skin disorder and is also referred to as squamous cell carcinoma in situ. It is a noninvasive form of intraepidermal squamous cell carcinoma with flat or slightly raised lesions. An online survey was conducted among 300 dental students between the age group of 18-30 years in the Chennai district based on Bowen's disease. This is the best approach to data collection due to the large population of the city of Chennai and is also appropriate in the current situation where people need to avoid gatherings and close contact. About 78.21% were BDS students and 21.79% were MDS students. In the age group of 10-20 years, 8.97% responded heard about Bowen disease and 3.85% responded not heard. Within the 21-30 years age group, 44.02% responded that Bowen disease is invasive and 20.09% responded noninvasive. Studies showed that the exact occurrence of Bowen's disease is not known. It is found to be more common in men than in women. To conclude, about 65% of participants were aware of Bowen's disease. Nevertheless, patients with Bowen's disease seem to be at an abnormal risk of internal malignancies, and they need to be educated about the various treatments available to prevent the cause as soon as possible.

Combination therapy using advanced biomaterials in the management of mandibular Grade II furcation defect

Periodontitis is a multifactorial disease. Even though plaque is a primary etiological factor; there are so many aggravating factors such as calculus, genetics, lifestyle habits, systemic health, and occlusal trauma. Trauma from occlusion is caused by occlusal force that surpasses the periodontium's adaptive capacity, causing injury to periodontal structures. This case highlights the management of a furcation defect of Grade II which was induced by occlusal trauma. The patient presented with periodontal abscess in relation to 36 and on radiographic examination, bone loss and high points were evident in relation to endodontically treated 36. A full-thickness mucoperiosteal flap was elevated and after debridement injectable platelet-rich fibrin (iPRF), osseograft, and guided tissue regeneration (GTR) membrane were placed. The patient was recalled after 3 months for re-evaluation. On re-evaluation, the radiograph showed adequate bone fill which suggested that using iPRF, bone graft, and GTR may enhance periodontal regeneration in Grade II furcation defects. Therapy using iPRF, bone graft, and GTR may enhance in Grade II furcation problems, and periodontal regeneration is possible.

Management of inadequate width of attached gingiva using mucograft

Attached gingiva around the teeth is crucial in preserving periodontal health. Plaque development and soft-tissue recession are both prevented by adequate attached gingiva. The processes for harvesting soft-tissue grafts are frequently accompanied by some level of morbidity which results in commercially available xenogeneic collagen matrices. The blood clot is more effectively stabilized by this collagen matrix, which also promotes vascularization. Furthermore, this biomaterial enhances root coverage and keratinized gingiva regeneration in both width and thickness. The purpose of the case report is to increase the width of attached gingiva using Mucograft^®. This case report highlights a case scenario where a patient presented with probing depth of 6-8 mm in relation to 24, 25, 26, 27, and 28, Grade I mobility in relation to 25.26, and 1 mm of the width of attached gingiva in relation to 25, 26, and 27. Flap surgery was done and simultaneously vestibular deepening was done in relation to 25, 26, and 27, and mucograft was placed and stabilized. On a 3-month follow-up, probing pocket depth was 3 mm and 4 mm of width of the attached gingiva was seen in 25, 26, and 27. The Mucograft^® was beneficial in this clinical case for the purpose of extending the width of the associated gingiva, making it a feasible treatment option for soft-tissue augmentation.

Knowledge, attitude, and practice of ultrasonics in endodontic treatment: A Survey among general practitioners and endodontists

The use of ultrasonics (US) has greatly expanded in the field of dentistry. Over the past few decades, the application of US has increased substantially in endodontics owing to the predictable prognosis and ease of operation. The objective of this survey was to determine the knowledge, practice, and attitude of US in endodontics among the general practitioners, postgraduates, and endodontists. An electronic questionnaire containing 16 questions regarding the knowledge, attitude, and practice of US in endodontics was circulated among the general dentists, postgraduates, and endodontists and the responses were collected online. Data were statistically examined using IBM SPSS software. A total of 202 dentists (general dentists = 92, endodontists = 77, and postgraduates = 33) participated in the survey. Eighty-nine percent of them were aware of the use of US in endodontics, 36.1% of them preferred using US in the removal of pulp chamber calcifications, pulp stones, access refinement, and troughing hidden canals, and 61.4% chose <3% sodium hypochlorite for root canal irrigation with US. The cost of the ultrasonic unit and heat generation during procedures were considered the greatest limitation in using the US. The majority of the dentists were well aware of the use of US and its advantages in various endodontic procedures but they did not use it routinely in their practice. The use of US has been reported to have greatly increased the predictability of endodontic treatment.

Protein targets in red complex pathogens for catechin

The development of antimicrobial drug resistance has encouraged scientists to develop alternate methods to combat infectious pathogens associated with dental diseases. Therefore, it is of interest to predict interactions for catechin (a plant derived compound) with protein targets in the red complex pathogens using computer aided network tools. However, in vitro and in vivo studies are warranted to confirm the antimicrobial effect of catechin (gallocatechin, epicatechin, epigallactocatechin (EGC) and gallolyl catechins) on the dental pathogens.

Genistein binding protein targets in dental pathogens

Oral pathogens have created a menace in recent years due to biofilm formation and antimicrobial drug resistance. The current treatment strategy works well with antibiotics. However, constant use of antibiotics creates a selective pressure, which increases adaptability of the pathogens. Therefore, it is of interest to analyze the potential targets of genistein in dental pathogens using computer aided prediction tools.