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Virdee SS, Bashir NZ, Krstic M, Camilleri J, Grant MM, Cooper PR, Tomson PL. Periradicular tissue fluid-derived biomarkers for apical periodontitis: An in vitro methodological and in vivo cross-sectional study. Int Endod J 2023; 56:1222-1240. [PMID: 37464545 DOI: 10.1111/iej.13956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Periradicular tissue fluid (PTF) offers a source of diagnostic, prognostic and predictive biomarkers for endodontic disease. AIMS (1) To optimize basic parameters for PTF paper point sampling in vitro for subsequent in vivo application. (2) To compare proteomes of PTF from teeth with normal apical tissues (NAT) and asymptomatic apical periodontitis (AAP) using high-throughput panels. METHODOLOGY (1) To assess volume absorbance, paper points (n = 20) of multiple brands, sizes and sampling durations were inserted into PBS/1%BSA at several depths. Wetted lengths (mm) were measured against standard curves to determine volume absorbance (μL). To assess analyte recovery, paper points (n = 6) loaded with 2 μL recombinant IL-1β (15.6 ng/mL) were eluted into 250 μL: (i) PBS; (ii) PBS/1% BSA; (iii) PBS/0.1% Tween20; (iv) PBS/0.25 M NaCl. These then underwent: (i) vortexing; (ii) vortexing/centrifugation; (iii) centrifugation; (iv) incubation/vortexing/centrifugation. Sandwich-ELISAs determined analyte recovery (%) against positive controls. (2) Using optimized protocols, PTF was retrieved from permanent teeth with NAT or AAP after accessing root canals. Samples, normalized to total fluid volume (TFV), were analysed to determine proteomic profiles (pg/TFV) of NAT and AAP via O-link Target-48 panel. Correlations between AAP and diagnostic accuracy were explored using principal-component analysis (PCA) and area under receive-operating-characteristic curves (AUC [95% CI]), respectively. Statistical comparisons were made using Mann-Whitney U, anova and post hoc Bonferonni tests (α < .01). RESULTS (1) UnoDent's 'Classic' points facilitated maximum volume absorbance (p < .05), with no significant differences after 60 s (1.6 μL [1.30-1.73]), 1 mm depth and up to 40/0.02 (2.2 μL [1.98-2.20]). For elution, vortexing (89.3%) and PBS/1% BSA (86.9%) yielded the largest IL-1β recovery (p < .05). (2) 41 (NAT: 13; AAP: 31) PTF samples proceeded to analysis. The panel detected 18 analytes (CCL-2, -3, -4; CSF-1; CXCL-8, -9; HGF; IL-1β, -6, -17A, -18; MMP-1, -12; OLR-1; OSM; TNFSF-10, -12; VEGF-A) in ≥75% of AAP samples at statistically higher concentrations (p < .01). CXCL-8, IL-1β, OLR-1, OSM and TNFSF-12 were strongly correlated to AAP. 'Excellent' diagnostic performance was observed for TNFSF-12 (AUC: 0.94 [95% CI: 0.86-1.00]) and the PCA-derived cluster (AUC: 0.96 [95% CI: 0.89-1.00]). CONCLUSIONS Optimized PTF sampling parameters were identified in this study. When applied clinically, high-throughput proteomic analyses revealed complex interconnected networks of potential biomarkers. TNFSF-12 discriminated periradicular disease from health the greatest; however, clustering analytes further improved diagnostic accuracy. Additional independent investigations are required to validate these findings.
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Affiliation(s)
- Satnam S Virdee
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | | | - Milan Krstic
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | - Josette Camilleri
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | - Melissa M Grant
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
| | - Paul R Cooper
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Phillip L Tomson
- Institute of Clinical Sciences, School of Dentistry & Birmingham Dental Hospital, University of Birmingham, Birmingham, UK
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Virdee SS, Albaaj FS, Grant MM, Walmsley D, Camilleri J, Cooper PR, Tomson PL. Antimicrobial Efficacy of Different Irrigant Solutions Using a Novel Biofilm Model: An In Vitro Confocal Laser Scanning Microscopy Experiment. Eur J Prosthodont Restor Dent 2023; 31:50-58. [PMID: 35857530 DOI: 10.1922/ejprd_2419virdee09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/15/2022] [Indexed: 03/03/2023]
Abstract
AIM To determine the ability of different irrigation solutions to biomechanically remove Enterococcus faecalis biofilm from a novel artificial root canal model during chemomechanical preparation. METHODS High resolution micro-computer-tomography scans of a mandibular molar's mesial root were used to produce 50 identical 3D-printed resin root canal models. These were cultured with E.faecalis over seven days to generate biofilm and subjected to chemomechanical preparation using: saline; 17% ethylenediaminetetraacetic acid (EDTA) or 2% sodium hypochlorite (NaOCl) alongside positive/negative controls (n = 10). Canals were prepared to 40/.06 taper, with 1 mL irrigation between instruments, followed by 5 mL penultimate rinse, 30 s ultrasonic activation and 5 mL final rinse. Residual biofilm volume (pixels) was determined following immunofluorescent staining and confocal-laser-scanning-microscopy imaging. Statistical comparisons were made using Kruskal-Wallis with post-hoc Dunn's tests (α ⟨0.05). RESULTS In all canal thirds, the greatest biofilm removal was observed with NaOCl, followed by EDTA and saline. The latter had significantly higher E.faecalis counts than NaOCl and EDTA (P ⟨0.01). However, no statistical differences were found between EDTA and NaOCl or saline and positive controls (P ⟩0.05). CONCLUSIONS Within limitations of this model, 17% EDTA was found to be as effective as 2% NaOCl at eradicating E.faecalis biofilm following chemomechanical preparation. Further investigations with multi-species biofilms are encouraged.
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Affiliation(s)
- S S Virdee
- Department of Restorative Dentistry, School of Dentistry, Birmingham, UK
| | - F S Albaaj
- Department of Conservative Dentistry, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
| | - M M Grant
- Department of Restorative Dentistry, School of Dentistry, Birmingham, UK
| | - D Walmsley
- Department of Restorative Dentistry, School of Dentistry, Birmingham, UK
| | - J Camilleri
- Department of Restorative Dentistry, School of Dentistry, Birmingham, UK
| | - P R Cooper
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - P L Tomson
- Department of Restorative Dentistry, School of Dentistry, Birmingham, UK
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Singh H, Bashir NZ, Virdee SS. Evaluation of the Quality of Undergraduate Full Veneer Crown Preparations at a UK Dental Teaching Hospital. Eur J Prosthodont Restor Dent 2023; 31:31-39. [PMID: 35852161 DOI: 10.1922/ejprd_2396singh09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/05/2022] [Indexed: 03/03/2023]
Abstract
OBJECTIVES To determine the quality of full veneer crown preparations produced by supervised undergraduate students at a UK dental teaching hospital. METHODS One hundred and eighty-five scanned digital dies between October 2019 and March 2021 were obtained. Using cross-sections in four planes, the total angle of convergence, abutment height, margin design and margin depth were evaluated. Statistical comparisons were made by plane, location, material-type, tooth-type, and inter- and intra-arch positions. RESULTS Across all preparations the mean total angle of convergence was 24.8° ± 11.7°. and mean abutment height was 3.6 mm ± 1.0 mm. Mandibular and molar teeth were significantly more tapered (P ⟨0.001) and exhibited significantly shorter abutment heights (P ⟨0.001). Chamfer margins were the most frequently observed and mean margin depths ranged from 0.49-1.06 mm. The compliance to recommended taught parameters were 28.1%, 42.7%, 34.1% and 6.5% for total angle of convergence, abutment height, margin design and margin depth, respectively. CONCLUSIONS The findings from this study suggest that compliance to taught parameters is poor, especially for molar teeth, and demonstrates the use of digital software in guiding future research and teaching.
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Affiliation(s)
- H Singh
- School of Dentistry, University of Birmingham, Birmingham, B5 7SA, United Kingdom
| | - N Z Bashir
- School of Oral and Dental Sciences, University of Bristol, Bristol, United Kingdom
| | - S S Virdee
- School of Dentistry, University of Birmingham, Birmingham, B5 7SA, United Kingdom
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Virdee SS, Lynch CD, Sadaghiani L, Addy LD, Gilmour ASM, Blum IR, Wilson NHF. Contemporary teaching of bridges (fixed partial dentures) in Ireland and United Kingdom dental schools. Br Dent J 2018; 224:741-745. [PMID: 29747193 DOI: 10.1038/sj.bdj.2018.312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 11/09/2022]
Affiliation(s)
- S S Virdee
- Clinical Lecturer & Honorary Specialty Registrar in Restorative Dentistry, School of Dentistry, University of Birmingham
| | - C D Lynch
- Professor/Consultant in Restorative Dentistry, University Dental School & Hospital, University College Cork, Wilton, Cork, Ireland
| | - L Sadaghiani
- Senior Lecturer/Consultant in Restorative Dentistry, School of Dentistry, Heath Park, Cardiff
| | - L D Addy
- Consultant in Restorative Dentistry, School of Dentistry, Heath Park, Cardiff
| | - A S M Gilmour
- Professor/Consultant in Restorative Dentistry, School of Dentistry, Heath Park, Cardiff
| | - I R Blum
- Director, King's College Maurice Wohl Dental Centre,Consultant/Senior Lecturer in Restorative Dentistry, King's College, London
| | - N H F Wilson
- Emeritus Professor of Dentistry, King's College, London
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Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J 2017; 51:605-621. [PMID: 29178166 DOI: 10.1111/iej.12877] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/16/2017] [Indexed: 12/21/2022]
Abstract
AIMS To establish whether irrigant activation techniques (IATs) result in greater intracanal smear layer and debris removal than conventional needle irrigation (CNI). METHODOLOGY Six electronic databases were searched to identify scanning electron microscopy studies evaluating smear layer and/or debris removal following the use of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), sonic irrigation (SI) or apical negative pressure (ANP) IATs in mature permanent teeth. Meta-analyses were performed for each canal segment (coronal, middle, apical and apical 1 mm) in addition to subgroup analyses for individual IATs with respect to CNI. Outcomes were presented as standardized mean differences (SMD) alongside 95% confidence intervals (95% CI) and chi-squared analysis. RESULTS From 252 citations, 16 studies were identified. The meta-analyses demonstrated significant improvements in coronal (SMD: 1.15, 95% CI: 0.72-1.57 / SMD: 0.54, 95% CI: 0.29-0.80), middle (SMD: 1.30, 95% CI: 0.59-2.53 / SMD: 0.8, 95% CI: 0.58-1.13) and apical thirds (SMD: 1.22, 95% CI: 0.83-1.62 / SMD: 1.86, 95% CI: 0.76-2.96) for smear layer and debris removal, respectively. In the apical 1 mm IATs improved cleanliness; however, differences were insignificant (SMD: 1.15, 95% CI: -0.47-2.77). Chi-squared analysis revealed heterogeneity scores of 79.3-92.8% and 0.0-93.5% for smear layer and debris removal, respectively. CONCLUSIONS IATs improve intracanal cleanliness across a substantial portion of the canal, and therefore, their use is recommended throughout root canal preparation. However, current data is too heterogeneous to compare and identify superiority of an individual technique highlighting the need to standardize experimental protocols and develop a more representative research model to investigate the in vivo impact of IATs on clinical outcomes and periapical healing following root canal treatment.
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Affiliation(s)
- S S Virdee
- Department of Restorative Dentistry, Birmingham Dental Hospital, Birmingham, UK
| | - D W Seymour
- Department of Restorative Dentistry, York Hospital, York, UK
| | - D Farnell
- Department of Dentistry, Cardiff University School of Dentistry, Cardiff, UK
| | - G Bhamra
- Department of Restorative Dentistry, Cardiff University Dental Hospital, Cardiff, UK
| | - S Bhakta
- Department of Restorative Dentistry, Leeds Dental Institute, Leeds, UK
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Virdee SS, Wang FC, Xu H, Jin ZM. Elastohydrodynamic lubrication analysis of a functionally graded layered bearing surface, with particular reference to 'cushion form bearings' for artificial knee joints. Proc Inst Mech Eng H 2003; 217:191-8. [PMID: 12807159 DOI: 10.1243/095441103765212686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Elastohydrodynamic lubrication of a functionally graded layered (FGL) bearing surface, whose elastic modulus increases with depth from the bearing surface, was investigated in this study. The finite difference method was employed to solve the Reynolds equation, simultaneously with the elasticity equation of the bearing surface, under circular point contacts. The finite element method was adopted to solve the elasticity equation for the FGL bearing surface. The displacement coefficients thus obtained were used to calculate the elastic deformation of the bearing surface, required for the elastohydrodynamic lubrication analysis. Good agreement of the predicted film thickness and pressure distribution was obtained, between the present method and a previous study for a single layered bearing surface with a uniform elastic modulus. The general numerical methodology was then applied to an FGL bearing surface with both linear and exponential variations in elastic modulus, with particular reference to the 'cushion form bearing' for artificial knee joints. The predicted film thickness and pressure distribution were shown to be quite close to those obtained for a single layer under typical operating conditions representative of artificial knee joints, provided that the elastic modulus of the single layer was chosen to be the average elastic modulus of the graded layer.
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Affiliation(s)
- S S Virdee
- School of Engineering, Design and Technology, University of Bradford, Bradford, UK
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McLaughlin GE, Virdee SS, Schleien CL, Holzman BH, Scott GB. Effect of corticosteroids on survival of children with acquired immunodeficiency syndrome and Pneumocystis carinii-related respiratory failure. J Pediatr 1995; 126:821-4. [PMID: 7752016 DOI: 10.1016/s0022-3476(95)70421-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The medical records of patients with acquired immunodeficiency syndrome were reviewed to evaluate the effect of our adoption to the pediatric population of the National Institutes of Health recommendation for adjunctive corticosteroid therapy in adults with Pneumocystis carinii pneumonia. In 21 episodes of P. carinii-related respiratory failure, only adjunctive corticosteroids were associated with a significant improvement in survival to successful removal of the tracheal tube, from a historical rate of 11% to 91%.
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Affiliation(s)
- G E McLaughlin
- Department of Pediatrics, University of Miami School of Medicine, Florida 33101, USA
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Banerjee A, Virdee SS, Deo SI. Alcoholic liver disease among ethnic Asians and non-Asians. J R Soc Health 1988; 108:211-2. [PMID: 3150455 DOI: 10.1177/146642408810800609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Dowsett M, Attree SL, Virdee SS, Jeffcoate SL. Oestrogen-related changes in sex hormone binding globulin levels during normal and gonadotrophin-stimulated menstrual cycles. Clin Endocrinol (Oxf) 1985; 23:303-12. [PMID: 4075539 DOI: 10.1111/j.1365-2265.1985.tb00228.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Previous studies have identified no consistent change in sex hormone binding globulin (SHBG) levels during normal menstrual cycles. This is despite marked cyclical changes in plasma oestradiol concentration, and the observation that SHBG level increases in pregnancy, and after administration of exogenous gonadotrophin or synthetic oestrogens. The level of SHBG was measured in 19 normal females at 2 d intervals from day -8 to +10 where the preovulatory peak of oestradiol was designated as occurring on day 0. SHBG levels increased by a mean 15% +/- 4 (SEM) between the follicular and luteal phases (P less than 0.001) and this was due entirely to an increment between day 0 and +2. The change in SHBG levels was correlated with the change in oestradiol levels between days -8 and 0 (P less than 0.001). Fifty-six infertile patients were also studied. Twenty-seven received Pergonal alone whilst the other 29 received Pergonal after a preceding 5 d on Clomid. In both groups peak preovulatory oestradiol levels were greater than 3 times higher than in normal cycles. SHBG levels showed no change in the follicular phase but rose markedly during the luteal phase. These increases were significantly correlated with peak preovulatory oestradiol concentration but showed no relationship with mid-luteal progesterone concentration. We conclude that supranormal levels of oestradiol cause marked increases in SHBG binding capacity and increases in SHBG level of a lower order occur shortly after the preovulatory peak of oestradiol in the normal menstrual cycle.
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