A Clinical Decision Tree for Preserving versus Extracting a Compromised Tooth with Extensive Subgingival Caries or Crown Fractures

One of the most challenging issues in the field of dentistry is to decide whether to preserve or extract a compromised tooth with subgingival caries/crown fractures. Several patient-related factors (i.e. biological, behavioral, or financial factors), tooth-related factors (i.e. periodontal, endodontic, or restorative factors), and the role of the tooth in the overall treatment plan should be considered to make the most accurate decision. This article has focused on the decision-making process related to the management of compromised teeth with subgingival caries/crown fractures. Based on the current scientific evidence and clinical experience of the authors, an algorithm has been suggested to simplify this process of decision. In the first step, compromised teeth were classified as single-root or multi-root groups. “Crown-to-root ratio” (C/R ratio), and “apical extension of caries to the crestal bone” were considered the main clinical parameters in the decision-making process for single-root and multi-root teeth, respectively. We do not recommend restoring the compromised teeth if the C/R ratio is more than 1 (for single-root teeth) or if the extension of caries has reached the alveolar bone crest (for multi-root teeth). For maintainable single-root teeth, there are three treatment options to provide space for the re-establishment of supracrestal soft tissue attachment (previously named as biologic width) between the future restorative margin and underlying crestal bone. These approaches include: surgical crown lengthening (SCL), orthodontic forced eruption (OFE), and deep marginal elevation (DME). For multi-root teeth, SCL and DME are usually the procedures of choice. Multi-root teeth are not amenable to OFE due to the heavy orthodontic forces needed for extrusion. We also discussed the indications and limitations related to each treatment option. Further studies should be conducted to evaluate the external validity of this decision tree. Keywords: Decision trees; Decision making; Tooth fractures; Dental caries; Tooth extraction

Investigation of efficacy of asenapine on passive avoidance learning and memory and oxidative stress in animal model of seizure-induced with pentylenetetrazole

Asenapine (ASE) has been used for treatment of bipolar disorder. There is also evidence that it may be useful in the treatment of neurodegenerative disorders. In this regard, the efficacy of ASE in an experimental model of seizure and memory impairment caused by seizures in rats has been investigated in the present study. Seizures in male Wistar rats (200-250 g) were induced by pentylenetetrazole (PTZ, 60 mg/kg, intraperitoneally (i.p.)), and the anticonvulsant effect of ASE (0.5 and 1 mg/kg, i.p.) was evaluated. The effect on memory was assessed using passive avoidance (PA) test in a shuttle box apparatus. After behavioral tests, the animals underwent deep anesthesia and were euthanized painlessly. Serum was isolated for oxidative stress assays (nitric oxide (NO), and glutathione (GSH)). Intraperitoneal injection of ASE decreased the mean number of myoclonic jerks and duration of generalized tonic clonic seizures (GTCS) and increased the mean latency of myoclonic jerk and GTCS compared to the PTZ group. Moreover, in the PA test, ASE caused a significant increase in retention latency (RL) and total time spent in the light compartment (TLC) compared to the PTZ group. Biochemical tests showed that ASE was able to significantly increase GSH serum levels and significantly reduce NO serum levels compared to the PTZ group. Overall, this study suggests the potential neuroprotective effects of ASE in a model of memory impairment caused by seizures via the mechanism of inhibition of the oxidative stress pathway

Microbial Contamination of the Outer Surface of X-ray Films

Objectives Infection control is one of the most important aspects of dentistry. Since intraoral radiographic films are directly in contact with the oral environment, microbial contamination may transmit infectious diseases. The purpose of this study was to investigate the frequency of microbial contamination of intraoral radiographic films and compare the probable microbial contamination of two intraoral radiographic film brands available in the Iranian market. Methods in this in vitro, experimental study, 900 radiographic films of two commercial brands, i.e. Intra X-ray and Carestream films were placed in aerobic, anaerobic, and fungal culture media immediately after removal from the packaging in sterile conditions. The samples were transferred to the respective culture media after incubation. The cultured bacteria were Gram-stained, and microscopically observed. The percentage of the contaminated intraoral radiographic films and the type of microbial contamination were reported. Data were analyzed using the Chi-square test. Results Of all, 32.6% of the Carestream films and 44.6% of Intra X-ray films were infected by aerobic microorganisms, mostly Bacillus. In the anaerobic culture, the turbidity of the medium indicated the possible presence of microorganisms. In the fungal culture, no fungal hyphae were observed microscopically. Conclusion The results of this study showed that intraoral films cannot be considered sterile. Intra X-ray radiographic films were significantly more contaminated than Care stream radiographic films

Berberine Supplement and Resistance Training May Ameliorate Diazinon Induced Neural Toxicity in Rat Hippocampus Via the Activation of the TrkB and ERK Signaling Pathway

Background: Diazinon is an organophosphate pesticide that is broadly applied to control insectswhich causes oxidative damages in hippocampus tissue. We aimed to examine whether resistancetraining and berberine supplementation can protect the hippocampus against berberine-inducedneural toxicity.Methods: Fifty-six male Wistar rats were assigned randomly into eight groups of seven including:Control (Ctrl), Sham (normal saline), T1 (diazinon + berberine chloride (2 mg/kg) + resistancetraining), T2 (diazinon + berberine chloride [15 mg/kg] + resistance training), T3 (diazinon), T4(diazinon +resistance training), T5 (diazinon + berberine chloride [2 mg/kg]), and T6 (diazinon+ berberine chloride [15 mg/kg]). In the experimental groups, diazinon was intraperitoneallyadministered at a dose of 1.5 mg/kg. In the training groups, rats were trained every three days for sixweeks and 8-12 dynamic movements (repetitions) during each climb (six climbs for two sets). Theexpression of hippocampus PI3K and CDK genes and TrkB and ERK protein levels were evaluated inthe brain of diazinon-treated rats.Results: The protein expression of ERK and TrkB were increased following the treatment of diazinonintoxicated rats with berberine and resistance training (P=0.001). The administration of berberineat a dose of 15 mg/kg in combination with resistance training significantly (P=0.001) decreasedthe cell death rate in the hippocampus. Diazinon treatment caused extensive apoptosis in thehippocampus region of the rats’ brain (P=0.001). The gene expression of PI3K and CDK wassignificantly increased and the cell death rate significantly decreased (P=0.001) in the hippocampusfollowing the treatment of rats with berberine and resistance training.Conclusion: Six weeks of resistance training in combination with berberine treatment significantlyreduced apoptosis in the hippocampus region of diazinon-intoxicated rats. It seems theneuroprotection effects of berberine and resistance training are mediated by the stimulation of theexpression of enzymes responsible for the antioxidant defense within neuronal cell

Preparation and Investigation of Poly (N-isopropylacrylamide-acrylamide) Membranes in Temperature Responsive Drug Delivery

Objective(s)Physiological changes in the body may be utilized as potential triggers for controlled drug delivery. Based on these mechanisms, stimulus–responsive drug delivery has been developed.Materials and MethodsIn this study, a kind of poly (N-isopropylacrylamide-acrylamide) membrane was prepared by radical copolymerization. Changes in swelling ratios and diameters of the membrane were investigated in terms of temperature. On-off regulation of drug permeation through the membrane was then studied at temperatures below and above the phase transition temperature of the membrane. Two drugs, vitamin B12 and acetaminophen were chosen as models of high and low molecular weights here, respectively. ResultsIt was indicated that at temperatures below the phase transition temperature of the membrane, copolymer was in a swollen state. Above the phase transition temperature, water was partially expelled from the functional groups of the copolymer. Permeation of high molecular weight drug models such as vitamin B12 was shown to be much more distinct at temperatures below the phase transition temperature when the copolymer was in a swollen state. At higher temperatures when the copolymer was shrunken, drug permeation through the membrane was substantially decreased. However for acetaminophen, such a big change in drug permeation around the phase transition temperature of the membrane was not observed. ConclusionAccording to the pore mechanism of drug transport through hydrogels, permeability of solutes decreased with increasing molecular size. As a result, the relative permeability, around the phase transition temperature of the copolymer, was higher for solutes of high molecular weight

Healthcare Providers' Vaccination Against COVID-19: Safety Concerns

This study examined parameters that may affect the severity and type of side effects associated with COVID-19 vaccine administration at Imam Khomeini Hospital in Ardabil, Iran. Based on a reliable and valid questionnaire, data were collected from 149 hospital employees at random. 77.2% of the study participants were women, and 52% were between the ages of 30-39. Approximately 50% of the participants had a healthy body mass index. Of the participants, 76.5% had no underlying disease. The prevalence of complications after injection of the first dose (regardless of vaccine type) included fever (45%), chills (28.3%), injection site complications (34.9%), myalgia (46.3%), weakness and fatigue (43%), headache (24.2%), thrombocytopenia (1.3%), cough (4%), nausea (6.7%), diarrhea (6.7%), and other complications (5.4%). After receiving a second dose, the most frequently reported adverse reactions were fatigue and weakness. This pattern was repeated for third dose. Injection of the first dose of vaccine induced the most severe side effects. The results demonstrated a significant relationship between severity and duration of side effects and participants' age, sex, body mass index, diet quality, physical activity, and complementary medicines. Participants with underlying health conditions and those using corticosteroids had higher adverse effects incidences. A significant positive correlation (0.878%) was observed between fever severity and chills. SputnikV and AstraZeneca vaccines were associated with more side effects. In general, the rate and severity of side effects after vaccination are directly related to female gender, low body mass index, previous infection, and young age

Evaluation of the association between KIR polymorphisms and systemic sclerosis : a meta-analysis

Background: The results of investigations on the association between killer cell immunoglobulin-like receptor (KIR) gene polymorphisms and the risk of systemic sclerosis (SSc) are inconsistent. To comprehensively evaluate the influence of KIR polymorphisms on the risk of SSc, this meta-analysis was performed. Methods: A systematic literature search was performed in electronic databases including Scopus and PubMed/ MEDLINE to find all available studies involving KIR gene family polymorphisms and SSc risk prior to July 2019. Pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were measured to detect associations between KIR gene family polymorphisms and SSc risk. Results: Five articles, comprising 571 patients and 796 healthy participants, evaluating the KIR gene family polymorphisms were included in the final meta-analysis according to the inclusion and exclusion criteria, and 16 KIR genes were assessed. None of the KIR genes were significantly associated with the risk of SSc. Conclusions: The current meta-analysis provides evidence that KIR genes might not be potential risk factors for SSc risk

Microhardness change of human dental enamel due to power bleaching with different gels

Aim: Since the introduction of bleaching treatments in the office, different lights have been suggested to accelerate the bleaching reaction. This study aimed to evaluate the microhardness of tooth enamel after office bleaching using different materials.Materials nd methods: Thirty-three sound human upper premolars were randomly divided into 3 groups as follows (n=11): Group 1: Whitesmile HP40% gel with R&B LED light source with 3 W power output; Group 2: HP 35% Dr Smile gel with a 980 nm diode laser, 2 W power and continuous wavelength; Group 3: HP 40% Ultra boost gel according to factory instructions. Enamel surface microhardness was measured before and after the bleaching procedure in each group using the Vickers microhardness test. One-way ANOVA and Tukey post hoc tests were used for statistical analysis. We used a SEM microscope to examine the surface of one sample from each group and one sample as a negative control.Results: In group 1, enamel microhardness increased remarkably (p=0.013) whereas in group 2 and group 3 enamel microhardness decreased. Enamel microhardness decreased in group 3 significantly (p=0.00) but its reduction in group 2 was not significant (p=0.833). SEM examination of the enamel surfaces after bleaching revealed erosion and surface porosities in group 1, enamel structure melting, and shallow porosities in group 2, and enamel prism exposure and etching in group 3.Conclusions: Due to the limitations of the present study, power bleaching with HP40% Whitesmile gel with LED Monitex increases microhardness, so it can have better results for treatment in the clinic. Additionally, using Dr Smile gel with a 980 nm diode laser does not reduce surface microhardness

Association Between Single Nucleotide Polymorphisms of the Interleukin-4 Gene and Atopic Dermatitis

ABSTRACT Atopic dermatitis (AD) is an inflammatory skin disease in which both genetic and environmental factors seem to be involved. Several studies investigated the association of certain genetic factors with AD in different ethnic groups, but conflicting data were obtained. This study was performed to check the possible association between single nucleotide polymorphisms (SNPs) of interleukin 4 (IL-4) and the IL-4 receptor α chain (IL-4Rα) and AD in a group of Iranian patients. The allele and genotype frequencies of genes encoding for IL-4 and IL-4Rα were investigated in 89 patients with AD in comparison with 139 healthy controls, using methods based on polymerase chain reaction sequence-specific primers. The most frequent alleles of IL-4 in patients were T at -1098 (P&lt;0.001, odds ratio (OR)=2.35), C at -590 (P&lt;0.001, OR=4.84) and C at -33 (P=0.002, OR=2.08). The most frequent genotypes of IL-4 in patients were TT, CC, and CC at positions -1098 (P&lt;0.001, OR=3.59), -590 (P&lt;0.001, OR=31.25) and -33 (P&lt;0.001, OR=3.46), respectively. We found a significant lower frequency of GT at -1098 GT, TC at -590, and TC at -33 in patients. There were no statistically significant differences in the frequency of alleles and genotypes of IL-4Rα gene at position +1902. A strong positive association was seen between TCC haplotype and AD (68% in patients vs. 23.4% in controls, P&lt;0.001, OR=8.91). We detected a significantly lower frequency of TTC, GCC, and TTT haplotypes (P&lt;0.001, OR=0.02, P&lt;0.001, OR=0.40, P&lt;0.001, OR=0.39, respectively) in patients compared to controls. A significant association between the polymorphisms of the IL-4 gene promoter at positions -1098, -590, and -33 and AD was detected in the Iranian population. Key words: atopic dermatitis; polymorphism, single nucleotide; interleukin-4 gene</p

Filaggrin Single Nucleotide Polymorphisms in Atopic Dermatitis

Atopic Dermatitis (AD) is a relapsing chronic pruritic inflammatory disease of skin in which no monogenic cause has been identified so far. Meanwhile Filaggrin (FLG) gene is considered as the most important gene associated with predisposition to the disease.One hundred and six patients with AD and 105 healthy individuals were enrolled in this study. Real time polymerase chain reaction was performed to determine frequencies of alleles and genotype in six variants of FLG gene.Atopic dermatitis (AD) is a relapsing chronic pruritic inflammatory disease of skin for which no monogenic cause has been identified so far. Meanwhile, the filaggrin (FLG) gene is considered as the most important gene associated with predisposition to the disease.One hundred and six patients with AD and 105 healthy individuals were enrolled in this study. Real time polymerase chain reaction was performed to determine frequencies of alleles and genotype in six variants of the FLG gene. The frequencies of allele A in variants of rs3126065, rs2786680, and rs1933063 as well as allele C in variant rs3814300 were 100%. There was no significant difference between allele frequencies in variants rs2485518 and rs3814299. The only genotypes in variants of rs3814299 and rs2485518 were GG and CC, respectively, with no significant difference between the patients and controls. This study demonstrated that there was no significant association between polymorphisms of FLG gene variants and AD.</p