Comparison of Residual Triple Antibiotic Paste, Propolis and Calcium Hydroxide on Root Canal Walls in Natural Open Apex Teeth: An In Vitro Study

Introduction: Endodontic therapy is challenging in open apex teeth. One of these problems is the residue of medicaments on root canal walls. The aim of this study was to evaluate the amount of residual materials on canal walls after the use as medicaments within natural open apex teeth. Methods and Materials: A total of 45 human extracted single-rooted premolars with open apices were selected. After cutting off the crowns, root canals were gently instrumented using #40 files and irrigated with 0.5% sodium hypochlorite. The samples were randomly divided into three groups: calcium hydroxide (CH), triple antibiotic paste (TAP) and propolis (PP). In these groups, CH, TAP, or PP were placed into the canals, respectively. The samples were then restored with temporary fillings. After one week, instrumentation was again performed as mentioned above. The samples were longitudinally cut and scanned and the remaining material in both halves was evaluated using computer software. One-way ANOVA was used to compare the average paste level remaining on the canal walls. Results: The residual amount of CH on the canal walls was significantly higher than that of PP (P=0.001). The residual amount of CH was higher than TAP but this difference was not significant (P=0.144); the residual amount of TAP was higher than PP but this difference was not significant, either (P=0.094). Conclusion: PP is superior to CH and TAP in terms of removability from the root canal system within open apex teeth.Keywords: Calcium Hydroxide; Intracanal Medicament; Open Apex; Propolis; Triple Antibiotic Past

Serum Fibroblast Growth Factor 21 in Patients with and without Pterygia

Purpose: Pterygium is a common fibro-vascular-related eye disease. The fibroblast growth factor 21 (FGF21) helps reduce neovascularization. Previous studies have shown that the serum level of FGF21 correlates with vascular eye diseases such as diabetic retinopathy and retinopathy of prematurity. In this study, the serum FGF21 is compared in patients with and without pterygium. Methods: This descriptive-analytical cross-sectional study examines individuals with pterygium who visited the Ophthalmology Clinic of Khatam-al-Anbia Hospital in Mashhad, Iran, during 2017–2018. Control subjects were selected from healthy people without pterygium disease. Patients with a history of acute illness, chronic liver and kidney disease, diabetes, cancer, malnutrition and drug use, women who were pregnant or breastfeeding, and subjects who were taking anticonvulsants or glucocorticoids were excluded as these may affect insulin and glycosuria levels. Sixty people (30 in each group) were chosen using the convenient sampling method. Intravenous blood samples were taken from all patients. After preparing the patients, the freeze was checked using the enzyme-linked immunosorbent assay (ELISA) method after samples had been taken. Data were analyzed by SPSS using an independent t-test, Mann–Whitney, Chi-square, Kruskal–Wallis, and Kolmogorov–Smirnov tests (α = 0.05).   Results: The serum FGF21 levels were 319.09 ± 246.93 pg/ml and 608.88 ± 449.81 pg/ml (P = 0.005) in the pterygium group and control subjects, respectively. The average serum FGF21 was 281.55 ± 40.74 pg/ml in males and 361.375 ± 10.298 pg/ml in females in the pterygium group. The difference was not statistically significant (P = 0.19).   Conclusion: Our study showed that FGF21 levels were lower in patients with pterygium than the control subjects to a statistically significant level

Autotransplantation of a mandibular third molar: A case report

Tooth autotransplantation defines as transition of one tooth from one position to another, in same individual. It is a biological procedure in which teeth have the potential to induce alveolar bone growth. It can be applied in patients before adolescence growth is finished. It significantly reduces time and cost compared to implants. Healing rapidly occurs and function is regained almost immediately. Our case was a 15-year-old male that his left mandibular third molar transplanted to the second molar sight after extraction of second molar because of unrestorable crown. During 9 month follow up transplanted tooth was asymptomatic, functional and responsive to sensibility tests. (Cold test, EPT)

Encapsulation of orange peel oil in biopolymeric nanocomposites to control its release under different conditions

Orange peel oil (OPO) is one of the most common flavorings used in the food industry, but it is volatile under environmental conditions (the presence of light, oxygen, humidity, and high temperatures). Encapsulation by biopolymer nanocomposites is a suitable and novel strategy to improve the bioavailability and stability of OPO and its controlled release. In this study, we investigated the release profile of OPO from freeze-dried optimized nanocomposite powders as a function of pH (3, 7, 11) and temperature (30, 60, and 90 °C), and within a simulated salivary system. Finally, its release kinetics modelling was performed using experimental models. The encapsulation efficiency of OPO within the powders, along with the morphology and size of the particles, were also evaluated by an atomic force microscopy (AFM) analysis. The results showed that the encapsulation efficiency was in the range of 70–88%, and the nanoscale size of the particles was confirmed by AFM. The release profile showed that the lowest and the highest release rates were observed at the temperatures of 30 and 90 °C and in the pH values of 3 and 11, respectively, for all three samples. The Higuchi model provided the best model fitting of the experimental data for the OPO release of all the samples. In general, the OPO encapsulates prepared in this study showed promising characteristics for food flavoring applications. These results suggest that the encapsulation of OPO may be useful for controlling its flavor release under different conditions and during cooking

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Fabrication of ZSM-5 Zeolite Dispersed Polyethylene Membranes via Thermally Induced Phase Separation Method

Simultaneous increase in the permeance coefficient and mechanical strength and decrease in membrane fouling pose a challenge to polymeric membrane researchers. In this work, polyethylene (PE) polymer membranes, to which ZSM-5 zeolite particles have been added, were fabricated via thermally induced phase separation (TIPS) method. The fabrication of membranes is done in two steps; in the first step, in a constant coagulating bath temperature, the ratio of zeolite to polymer varies within 0-30% range and the changes in the pure water permeance and mechanical strength were assessed. The results are indicative of 60% increase in pure water permeancy, 300% increase in the mechanical strength and 400% increase in the ultimate tensile strength in pure water permeancy test in the membrane containing 30 wt% of zeolite. In the second step of optimization of the membrane’s structure and performance, the experimental design and response surface methodology (RSM) is applied to measure the individual and mutual effects of zeolite concentration, membrane’s thickness and bath temperature parameters on the water permeancy and mechanical strength. The results indicated that the water permeancy improved with any increase in the zeolite concentration and coagulation bath temperature while the membrane’s thickness scarcely affected the water permeancy. The interesting point was that any increase in the membrane thickness improved mechanical strength. Finally, the performance of membranes was evaluated using the collagen solution. The results showed that the membranes containing zeolites were more fouling resistant and the degree of resistance increased by increasing the zeolite content

Revascularization procedure in an open apex tooth with external root resorption: A case report

External inflammatory root resorption (EIR) represents a challenge in endodontic practice. EIR commonly occurs after dental trauma that results in periodontal ligament injury, pulp necrosis and subsequent infection.  Treatment of EIR is based on disinfecting the root canal system through chemomechanical procedures and then filling it with calcium hydroxide or triple antibiotic paste. Dental trauma commonly occurs in young patients whose teeth are not fully formed and have thin dentinal walls and open apices. Revascularization therapy has proven to be suitable for treatment of root canals of teeth with pulp necrosis and open apices. This case report presents successful revascularization treatment of a permanent immature tooth with external root resorption and chronic apical periodontitis. The tooth was treated by the protocol suggested by the American Association of Endodontics (AAE), consisted of disinfecting the root canal system, filling it with blood clot and sealing the root canal with mineral trioxide aggregate followed by bonded resin restoration. The symptoms disappeared, the size of the periapical lesion reduced and the tooth was asymptomatic during the 12 month follow up period

Alginate Microcapsules as Nutrient Suppliers : An In-vitro Study

Objective Alginate, known as a group of anionic polysaccharides extracted from seaweeds, has attracted the attention of researchers because of its biocompatibility and degradability properties. Alginate has shown beneficial effects on wound healing as it has similar function as extracellular matrix. Alginate microcapsules (AM) that are used in tissue engineering as well as Dulbecco’s modified Eagle’s medium (DMEM) contain nutrients required for cell viability. The purpose of this research was introducing AM in medium and nutrient reagent cells and making a comparison with control group cells that have been normally cultured in long term. Materials and Methods In this experimental study, AM were shaped in distilled water, it was dropped at 5 mL/hours through a flat 25G5/8 sterile needle into a crosslinking bath containing 0.1 M calcium chloride to produce calcium alginate microspheres. Then, the size of microcapsules (300-350 µm) were confirmed by Scanning Electron Microscopy (SEM) images after the filtration for selection of the best size. Next, DMEM was injected into AM. Afterward, adipose- derived mesenchymal stem cells (ADSCs) and Ringer’s serum were added. Then, MTT and DAPI assays were used for cell viability and nucleus staining, respectively. Also, morphology of microcapsules was determined under invert microscopy. Results Evaluation of the cells performed for spatial media/microcapsules at the volume of 40 µl, showed ADSCs after 1-day cell culture. Also, MTT assay results showed a significant difference in the viability of sustained-release media injected to microcapsules (P<0.05). DAPI staining revealed living cells on the microcapsules after 1 to 7-day cell culture. Conclusion According to the results, AM had a positive effect on cell viability in scaffolds and tissue engineering and provide nutrients needed in cell therapy

CRISPR/Cas9-mediated TGFβRII disruption enhances anti-tumor efficacy of human chimeric antigen receptor T cells in vitro

Background!#!CAR T-cell therapy has been recently unveiled as one of the most promising cancer therapies in hematological malignancies. However, solid tumors mount a profound line of defense to escape immunosurveillance by CAR T-cells. Among them, cytokines with an inhibitory impact on the immune system such as IL-10 and TGFβ are of great importance: TGFβ is a pleiotropic cytokine, which potently suppresses the immune system and is secreted by a couple of TME resident and tumor cells.!##!Methods!#!In this study, we hypothesized that knocking out the TGFβ receptor II gene, could improve CAR T-cell functions in vitro and in vivo. Hereby, we used the CRISPR/Cas9 system, to knockout the TGFβRII gene in T-cells and could monitor the efficient gene knock out by genome analysis techniques. Next, Mesothelin or Claudin 6 specific CAR constructs were overexpressed via IVT-RNA electroporation or retroviral transduction and the poly-functionality of these TGFβRII KO CAR T-cells in terms of proliferation, cytokine secretion and cytotoxicity were assessed and compared with parental CAR T-cells.!##!Results!#!Our experiments demonstrated that TGFβRII KO CAR T-cells fully retained their capabilities in killing tumor antigen positive target cells and more intriguingly, could resist the anti-proliferative effect of exogenous TGFβ in vitro outperforming wild type CAR T-cells. Noteworthy, no antigen or growth factor-independent proliferation of these TGFβRII KO CAR T-cells has been recorded. TGFβRII KO CAR T-cells also resisted the suppressive effect of induced regulatory T-cells in vitro to a larger extent. Repetitive antigen stimulation demonstrated that these TGFβRII KO CAR T-cells will experience less activation induced exhaustion in comparison to the WT counterpart.!##!Conclusion!#!The TGFβRII KO approach may become an indispensable tool in immunotherapy of solid tumors, as it may surmount one of the key negative regulatory signaling pathways in T-cells