Comparative Evaluation of Dentinal Crack After Root Canal Preparation Using TruNatomy, Neoendo Flex, and Neoendo Neohybrid Files: An In Vitro Study

AIM

The objective of the study was to assess and compare the dentinal microcracks produced by TruNatomy, Neoendo Flex, and Neoendo Neohybrid files during root canal preparation.

MATERIAL AND METHODS

In this in vitro investigation, four groups of 25 samples each were assembled from 100 mandibular premolar teeth. Using TruNatomy, Neoendo Flex, and Neoendo Neohybrid files, or leaving the teeth unprepared (control), the teeth underwent root canal preparation. Horizontal sections were taken at different distances from the apex to analyze dentinal cracks. A stereomicroscope was used to assess the existence or lack of cracks, and chi-square tests were performed on the data.

RESULTS

In the control group, there were no cracks. TruNatomy files created fewer cracks compared to Neoendo Flex and Neoendo Neohybrid files.

CONCLUSIONS

This in vitro investigation demonstrates that the root surface might acquire dentinal cracks as a result of nickel-titanium instruments. Compared to Neoendo Flex and Neoendo Neohybrid files, TruNatomy showed a decreased incidence of cracks. However, it is important to note that these conclusions are limited to the scope of this study.

Distribution of Suicides in India: A Decadal Data Analysis (2011-2020)

Background

India accounts for a significant proportion of suicide deaths globally. As per the Global Burden of Disease Study, India’s share of global suicides from 1990 to 2016 increased from 25·3% to 36·6% among women and 18·7% to 24·3% among men. However, medical factors are not the sole contributors to the suicide burden.

Methods

I analyze decadal data (2011-2020) on suicides in India provided by National Crime Records Bureau. This data contains the distribution of suicidal deaths based on age groups, causes, professions, gender, and residence zones.

Results

The analysis suggests that individuals aged ‘15-29 years’ were most affected (35.05%) by suicides, followed by those aged ‘30-44 years’ (32.61%). Family problems contribute to the highest burden of suicides among both these age groups. Such deaths can be attributed to personal reasons. Suicides due to dowry disputes are exclusive to women. Also, women report the highest instances of suicides due to marriage-related issues. While suicides due to drug abuse, bankruptcy, unemployment, poverty, and property disputes were mainly reported among males. In 2020, the rise in annual suicide rate was found to be highest among business persons (29.43%), especially tradesmen (49.9%) and vendors (26.11%) against other businesses (12.13%). Other professions which witnessed a steep rise in annual suicide rates in 2020 were agricultural laborers (17.90%) and daily wage earners (15.76%). This increase in suicide rates may be linked to economic reasons post lockdown imposition during the Covid-19 outbreak in 2020.

Conclusions

Women commit suicide mainly due to marriage-related causes, while men are more vulnerable to suicide due to economic factors. Not all suicides can be traced back to diagnosed mental illnesses. A significant proportion of suicides are attributed to personal, economic, and social problems. The insights generated from this analysis can help identify the vulnerable groups and target the much-needed interventions.

Key messages

• Suicide is a multifaceted problem involving various personal, economic, cultural, and social factors, besides medical reasons.

• Multidimensional strategies targeted at vulnerable groups could be potentially effective in curbing suicide rate.

Patterns from dried drops as a characterisation and healthcare diagnosis technique, potential and challenges: A review

When particulate-laden droplets evaporate, they leave behind complex patterns on the substrate depending on their composition and the dynamics of their evaporation. Over the past two decades, there has been an increased interest in interpreting these patterns due to their numerous applications in biomedicine, forensics, food quality analysis and inkjet printing. The objective of this review is to investigate the use of patterns from dried drops as a characterisation and diagnosis technique. The patterns left behind by dried drops of various complex fluids are categorised. The potential applications of these patterns are presented, focussing primarily on healthcare, where the future impact could be greatest. A discussion on the limitations which must be overcome and prospective works that may be carried out to allow for widespread implementation of this technique is presented in conclusion.

Cytotoxicity and estrogenicity in simulated dental wastewater after grinding of resin-based materials

OBJECTIVE

This study evaluated the cytotoxic and estrogenic effects of dust and eluates released into simulated wastewater after grinding of dental resin-based materials.

METHODS

Four materials were used: ceram.x® universal, Filtek™ Supreme XTE, Lava™ Ultimate and Core-X™ flow. From each composite material, samples (5 × 2 mm, n = 50) were prepared according to the manufacturers' instructions. Lava™ Ultimate was used as blocks. All samples were ground to dust with a diamond bur (106 μm) and suspended in distilled water at 60 mg/mL. After storage for 72 h, the suspensions were separated into a soluble (eluate) and a particulate (dust) fraction. Eluates and dusts were evaluated for inhibition of Vibrio fischeri bioluminescence and cytotoxicity on human A549 lung cells (WST-1-Assay). The estrogenic activity was assessed by YES-Assay using Saccharomyces cerevisiae. Additionally, dental monomers (BisGMA, BisEMA, UDMA, TEGDMA, HEMA) and Bisphenol A were investigated.

RESULTS

All eluates showed inhibition of V. fischeri bioluminescence at concentrations above 1.1 mg/mL (p < 0.05). The activity of the eluates of ceram.x® universal and Filtek™ Supreme XTE was significantly higher than Lava™ Ultimate and Core-X™ flow (p < 0.05). In the WST-1-Assay, all materials induced cytotoxic effects at concentrations of 0.1 mg/mL (p < 0.05), while no significant differences were detected among them. The tested materials revealed no estrogenic activity. All dental monomers and Bisphenol A showed concentration dependent cytotoxic effects (p < 0.05), whereas only Bisphenol A induced an estrogenic effect (p < 0.01).

SIGNIFICANCE

Dust and eluates of resin-based dental materials released into wastewater exert bactericidal and cytotoxic effects in vitro. However, they reveal no estrogenic effect.

Preprocedural Pool Testing Strategy for Dentistry during the COVID-19 Pandemic

INTRODUCTION

Aerosol-generating procedures (AGPs) put the dental health care professionals (DHCPs) at a greater risk for acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In late June 2020, the Centers for Disease Control and Prevention advised elective dental procedures provision to asymptomatic patients while mandating strict infection control protocol and suggested the use of preprocedural testing as an adjunct. A cost-effective method for mass preprocedural testing is pool testing, which has specificity and sensitivity similar to polymerase chain reaction. This article aims to assess the outcomes and utility of incorporating preprocedural testing protocol for SARS-CoV-2 in dental clinics before providing AGPs.

METHOD

The patients who were recommended AGPs where rubber dam placement was not possible were advised to undergo preprocedural testing for SARS-CoV-2. Pool testing strategy was employed, and patients were asked to get tested 48 h before the day of the procedure.

RESULTS

Out of a total of 1,000 patients, who presented from June 2020 to late July 2020, 464 were recommended dental procedures. In 194 of 464, AGPs could not be performed under rubber dam isolation; therefore, the patients were advised to get a preprocedural pool test. In total, 111 patients deferred the procedure and testing. Out of 83 who got tested, 7 were positive for SARS-CoV-2, 5 of whom were tested in early June 2020 and 2 in late July 2020.

CONCLUSION

Pool testing within its limitations can be a useful preprocedure test in asymptomatic low-risk patients for AGP in dentistry, especially when the disease prevalence is low or moderate (<10%). It has the potential of reducing testing costs significantly while conserving reagent and other resources. Preprocedure testing, however, also gives rise to certain ethical concerns that also need to be addressed.

KNOWLEDGE TRANSFER STATEMENT

The results of this study can be used by clinicians when deciding which preprocedure testing approach they wish to use when performing aerosol-generating procedures in asymptomatic patients with consideration of cost sensitivity and specificity values.

Anesthetic management of parturients with Arnold Chiari malformation-I: a multicenter retrospective study

BACKGROUND

Consensus regarding the safest mode of delivery and anesthetic management for parturients with Arnold Chiari malformation-I (ACM-I) remains controversial. This study assessed their anesthetic management and reported anesthetic complications during hospitalization for delivery.

METHODS

This was a multicenter, retrospective, cohort study of patients with ACM-I undergoing vaginal or cesarean delivery. Data were obtained from the electronic databases of four United States academic institutions using International Classification of Diseases (ICD) codes from 2007-2017 at three sites and 2004-2017 at one site. The primary outcome was anesthetic complications.

RESULTS

Data were analyzed for 185 deliveries in 148 patients. Diagnosis of ACM-I was made prior to delivery in 147 (80%) cases. Pre-delivery neurosurgical consultation for management of ACM-I was performed in 53 (36%) patients. Pre-existing symptoms were recorded for 89 (48%) of the deliveries. Vaginal deliveries occurred in 80 (43%) cases, and 62 women (78%) received neuraxial labor analgesia. Cesarean delivery was performed in 105 (57%) cases, of which 70 women (67%) had neuraxial anesthesia and 34 (32%) received general anesthesia. Post-dural puncture headache was reported in three (2%) patients who had neuraxial anesthesia, and in two (12%) patients with syringomyelia. There was one (3%) reported case of aspiration pneumonia with general anesthesia.

CONCLUSIONS

The findings suggest that anesthetic complications occur infrequently in patients with ACM-I regardless of the anesthetic management. Although institutional preference in anesthetic and obstetric care appears to drive patient management, the findings suggest that an individualized approach has favorable outcomes in this population.

Microanatomy of the digestive tract, hooves and some visceral organs of addax antelope (Addax nasomaculatus) following a concentrate or forage feeding regime

Subacute ruminal acidosis is a common disease in captive non-domesticated ruminants and is mainly diagnosed by rumen fluid pH and rumen histology. Furthermore, differences in ruminant gastrointestinal histology have been hypothesized to correlate with the browser-grazer continuum. Twelve surplus addax antelope (Addax nasomaculatus) were divided into two groups, fed either their usual diet, consisting of a concentrate feed with a limited amount of hay, or a diet of unlimited hay only, for 3 months. After culling, descriptive and morphometric histology and pH measurements were compared between groups. Significant variations in cellular subpopulations were noted between groups, with roughage-fed individuals presenting primarily with balloon cells of the Stratum corneum and living layer cell vacuolization, whereas parakeratosis and intermediate-type cells were more frequent in the concentrate-fed group. Lesions typical of subacute ruminal acidosis were significantly more pronounced in concentrate-fed individuals. Ruminal pH measurements did not differ significantly, but were more consistent in forage-fed individuals, indicating a more stable reticuloruminal environment. The results indicate that ruminal histology may be more appropriate in assessing ruminal health compared to a single post-mortem pH measurement. It is proposed that Stratum corneum balloon cells may indicate cell maturation and not, as previously assumed, hyperfunction. Concentrate-fed individuals scored higher on the presence of inflammatory cells on hoof corium histology. The study further emphasizes the adaptability of ruminant digestive tract microanatomy in adult animals even after a short period of time and the positive effects an increased roughage diet may have in populations of captive grazing ruminants.

Genetic diversity of functional food species Spinacia oleracea L. by protein markers

Exploration of genetic diversity contributes primarily towards crop improvement. Spinaciaoleracea L. is a functional food species but unfortunately the genetic diversity of this vegetable is still unexplored. Therefore, this research was planned to explore the genetic diversity of S. oleracea by using morphological and protein markers. Protein profile of 25 accessions was generated on sodium dodecyl sulphate polyacrylamide gel. Total allelic variation of 27 bands was found. Out of these, 20 were polymorphic and the rest of the bands were monomorphic. Molecular weights of the bands ranged from 12.6 to 91.2 kDa. Major genetic differences were observed in accession 20541 (Peshawar) followed by 20180 (Lahore) and 19902 (AVRDC). Significant differences exist in the protein banding pattern. This variation can further be studied by advanced molecular techniques, including two-dimensional electrophoresis and DNA markers.

Juvenile hormone stimulated tyrosine kinase-mediated protein phosphorylation in the CNS of the silk worm, Bombyx mori

In vitro studies with the larval CNS of the silkworm, Bombyx mori revealed the phosphorylation of a 48-kDa protein, which was not dependent on cyclic nucleotides. Studies also revealed modest phosphorylation of this protein by a calcium-dependent but calmodulin-independent mechanism. However, phosphorylation of this protein was greatly enhanced in the presence of juvenile hormone (JH) I by a calcium-independent mechanism. This stimulatory effect of JH was seen in both homogenates as well as in intact CNS of Bombyx. Immunoblotting studies revealed the cross-reaction of this 48-kDa protein with phosphotyrosine monoclonal antibody and the phosphorylation of this protein was inhibited by genistein. This study suggests that the 48-kDa protein is a substrate for tyrosine kinase. The phosphorylation of this protein was also observed in other larval tissues such as salivary gland, fat body, and epidermis of Bombyx.

A study of aplastic anemia at the Department of Child Health, School of Medicine University of North Sumatera/Dr. Pirngadi Hospital, Medan

A study of aplastic anemia in children in a period of June 1980 to June 1989 was done to evaluate the pattern of aplastic anemia in children. The cases consisted of 55 children, 30 males (54.55%) and 25 females (45.45%). Most of the patients (47.27%) were found in the age group of 10 to 15 years. The complaints were paleness (90.91%), fever (56.45%) and bleeding (52.72%). The hemoglobin concentration was 4.25 +/- 1.17 g/dl (mean +/- SD), and the thrombocytopenia was generally severe. Prednisone or combination of prednisone and oxymethalone was given in addition to blood transfusions, antibiotics and vitamins. The outcome was difficult to evaluate because of the irregularity of treatments. Of the 55 children, 9 (18.02%) contracted leukemia after 1-5 months.

Complications of caustic ingestion

The use of steroid and antibiotic prophylaxis no longer is tenable on the basis of recent studies showing their inability to favorably influence the outcome of caustic injuries. The need for early endoscopic and radiologic assessment if not gastroesophagectomy for severe injuries now is the management of choice. Further efforts to identify high-risk populations and efforts to educate them of the dangers must continue.

Drug abuse and prevention programs in 29 countries

In this paper, drug prevention programs in 29 countries are reviewed and summarized. The material was gathered from the reports that each country had prepared for the World Health Organization project on Guidelines for Drug Abuse Prevention. Each report provided a detailed schedule of background data on drug abuse and prevention programs in that country. The sophistication of prevention programs varies considerably from one country to another and depends on the degree and nature of the problem. An analysis of this material indicates that the seriousness of the drug problem is well recognized in some countries but not in others. In some of the latter countries it is obvious that no real problem exists, while in others little is known about the extent of the problem and little effort is spent in this area.

Nomenclature and classification of drug- and alcohol-related problems: a WHO Memorandum

Earlier work in this field is reviewed and present concepts and terminologies are examined in detail. A revised way of dealing with ideas implicit in the terms "drug abuse" or "drug misuse" is proposed; the term "neuroadaptive state" is suggested as an alternative to "physical dependence"; a profile is given of the elements that constitute a "drug dependence syndrome"; and the need to differentiate conceptually between "dependence" and "drug related disability" is stressed. A model of dependence is outlined in which dependence is considered as a psycho-physiological-social syndrome determined and kept going by a complex system of reinforcements. The association between substance use and mental illness is discussed with emphasis on possible two-way relationships. The need for population studies and in particular for longitudinal studies is emphasized. The bearing of all the fore-going considerations on work towards the revision of relevant classification systems is considered, and, in the final section, several recommendations on nomenclature are brought together and suggestions are made for research that might lead to refinement of classification and diagnostic systems.