NAFLD and nutraceuticals: a review of completed phase III and IV clinical trials

BackgroundNonalcoholic Fatty Liver Disease (NAFLD) has become a significant public health concern, affecting approximately one-fourth of the population. Despite its prevalence, no FDA-approved drug treatments specifically target NAFLD.AimTo provide a review of clinical trials investigating the use of herbal remedies and dietary supplements in NAFLD management, utilizing the ClinicalTrials.gov database.MethodsThis review evaluates the current evidence by examining completed phase III and IV clinical trials registered on ClinicalTrials.gov. An exhaustive search was performed on April 17, 2023, using the terms “Nonalcoholic Fatty Liver Disease” and “NAFLD.” Two independent reviewers appraised eligible trials based on pre-defined inclusion and exclusion criteria.ResultsAn initial search yielded 1,226 clinical trials, with 12 meeting the inclusion criteria after filtration. The majority of trials focused on Omega-3 fatty acids (20.0%) and vitamin D (26.7%), followed by caffeine, chlorogenic acid, ginger, phosphatidylcholine, Trigonella Foenum-graecum seed extract, vitamin C, and vitamin E (each 6.7%). Most studies were Phase 3 (75.0%) and used a parallel assignment model (91.7%). Quadruple masking was the most prevalent technique (58.3%), and Iran was the leading country in terms of trial locations (25.0%). These interventions constitute two herbal interventions and nine supplement interventions.ConclusionThis reveals a diverse range of nutraceuticals, with Omega-3 fatty acids and vitamin D being predominant in the management of NAFLD. The global distribution of trials highlights the widespread interest in these therapeutics. However, more rigorous, large-scale trials are needed to establish safety, efficacy, and optimal dosages

In Vitro Assessment of Artificial Aging on the Antifungal Activity of PMMA Denture Base Material Modified with ZrO2 Nanoparticles

The antifungal effect of zirconium dioxide nanoparticles (ZrO2NPs) incorporated into denture base material has been inadequately investigated; additionally, to the authors’ knowledge, no studies have assessed the influence of artificial aging on the antifungal activity of these particles. Methodology. Heat-polymerized acrylic resin disks were fabricated and divided into four groups (0%, 1%, 2.5%, and 5% ZrO2NPs by weight). Antifungal activity was assessed using the direct culture and disk diffusion methods. Surface roughness and contact angles were measured using a profilometer and a goniometer, respectively. The artificial aging procedure was performed by repeating all tests at 7, 14, and 30 days following 2 rounds of thermocycling. Data were analyzed using ANOVA and Tukey’s post-hoc test (p<0.05). Results. The addition of ZrO2NPs significantly decreased the adhesion of Candida albicans with and without artificial aging procedures (p<0.001), while the disk diffusion methods did not reveal inhibition zones. ZrO2NP-modified specimens displayed significantly higher surface roughness compared to specimens in the control group (p<0.05) and showed the same behaviors with artificial aging procedures. The contact angle was significantly decreased in all modified groups in comparison to the control group (p<0.05). Conclusion. The addition of ZrO2NPs to polymethylmethacrylate denture base material reduced the adhesion of Candida albicans with a long-term antifungal effect. With the addition of ZrO2NPs, contact angles were decreased and surface roughness was increased; 1% was the most appropriate concentration. Clinical significance. The addition of ZrO2NPs to denture base material confers a long-term antifungal effect and could be used as a possible method for preventing and treating denture stomatitis

Effect of treated zirconium dioxide nanoparticles on the flexural properties of autopolymerized resin for interim fixed restorations: An in vitro study.

STATEMENT OF PROBLEM Fractures of interim fixed restorations are a common complication. The autopolymerized polymethyl methacrylate resin materials used for interim fixed restorations have limited mechanical properties, but whether adding treated zirconium dioxide nanoparticles improves mechanical properties is unclear. PURPOSE The purpose of this in vitro study was to evaluate the effect of treated zirconium dioxide nanoparticles on the flexural strength and elastic modulus of autopolymerized polymethyl methacrylate resin. MATERIAL AND METHODS A split-metal mold (60×10×3.3 mm) was used to fabricate 40 autopolymerized acrylic resin specimens. The specimens were divided into 4 groups (n=10) according to zirconium dioxide nanoparticle concentration: control (unmodified resin) and zirconium dioxide nanoparticle contents of 1, 2.5, and 5 wt%. The specimens were mixed and polymerized according to the manufacturer's instructions and stored in distilled water for 48 ±2 hours at 37 °C. The flexural strength and elastic modulus were evaluated based on the 3-point bend test where data were analyzed by using 1-way analysis of variance and Tukey post hoc tests (α=.05). RESULTS The flexural strength of the 1-wt% zirconium dioxide nanoparticle specimens was significantly higher than that of the control group (P.05). Elastic modulus significantly decreased with 2.5-wt% zirconium dioxide nanoparticles (P=.019), while no significant changes were found with other test groups (P>.05). CONCLUSIONS The addition of treated zirconium dioxide nanoparticles at low concentrations increased the flexural strength of autopolymerized polymethyl methacrylate resins used in fixed interim restorations

Water Sorption, Solubility, and Translucency of 3D-Printed Denture Base Resins

This study aimed to evaluate the water sorption, solubility, and translucency of 3D-printed denture base resins (NextDent, FormLabs, and Asiga), compare them to heat-polymerized acrylic denture base resins, and assess their performance under the effects of thermal cycling. A total of 80 acrylic disc specimens were used in the current study, categorized into four groups (n = 10); in one group, the samples were fabricated conventionally with a heat-polymerizing process (control), while the other three groups were fabricated digitally from different 3D-printed reins (NextDent, FormLabs, and Asiga). Specimens were fabricated according to the manufacturers&rsquo; recommendations and immersed in distilled water for 48 h at 37 &deg;C. Data on water sorption, solubility, and translucency measurements (T1) were obtained. All the specimens were subjected to 5000 thermal cycles, and then the measures were repeated using the same method (T2). Data analysis was attained via ANOVA and the post hoc Tukey test (&alpha; = 0.05). The type of resin significantly affected the values of water sorption, solubility, and translucency (p &lt; 0.001). The water sorption of 3D-printed resins was increased significantly in comparison to control with or without a thermal cycling effect. In terms of solubility, a significant increase in 3D-printed resins before thermocycling was observed; however, after thermocycling, Asiga had a significantly low value compared to the other groups (p &lt; 0.001). Thermal cycling increased the water sorption and solubility of all tested materials. In comparison to control, the translucency of the 3D-printed resins was significantly decreased (p &lt; 0.001). The translucency was significantly decreased per material in terms of the thermal cycling effect (before and after). NextDent showed significantly low translucency values (p &lt; 0.001) compared to the other groups. All 3D-printed resin groups had higher water sorption and solubility and lower translucency values in comparison to the heat-polymerized resin group. Regardless of resin types, thermal cycling adversely affected all tested properties

Influence of Different Conditioning Treatments on the Bond Integrity of Root Dentin to rGO Infiltrated Dentin Adhesive. SEM, EDX, FTIR and MicroRaman Study

The present study aimed to synthesize and equate the mechanical properties and dentin interaction of two adhesives; experimental adhesive (EA) and 5 wt.% reduced graphene oxide rGO) containing adhesive. Scanning electron microscopy (SEM)-Energy-dispersive X-ray spectroscopy (EDX), Micro-Raman spectroscopy, push-out bond strength test, and Fourier Transform Infrared (FTIR) spectroscopy were employed to study nano-bond strength, degree of conversion (DC), and adhesive-dentin interaction. The EA was prepared, and rGO particles were added to produce two adhesive groups, EA-rGO-0% (control) and rGO-5%. The canals of sixty roots were shaped and prepared, and fiber posts were cemented. The specimens were further alienated into groups based on the root canal disinfection technique, including 2.5% sodium hypochlorite (NaOCl), Photodynamic therapy (PDT), and ER-CR-YSGG laser (ECYL). The rGO nanoparticles were flake-shaped, and EDX confirmed the presence of carbon (C). Micro-Raman spectroscopy revealed distinct peaks for graphene. Push-out bond strength test demonstrated highest values for the EA-rGO-0% group after NaOCl and PDT conditioning whereas, rGO-5% showed higher values after ECYL conditioning. EA-rGO-0% presented greater DC than rGO-5% adhesive. The rGO-5% adhesive demonstrated comparable push-out bond strength and rheological properties to the controls. The rGO-5% demonstrated acceptable DC (although lower than control group), appropriate dentin interaction, and resin tag establishment

Influence of Different Conditioning Treatments on the Bond Integrity of Root Dentin to rGO Infiltrated Dentin Adhesive. SEM, EDX, FTIR and MicroRaman Study

The present study aimed to synthesize and equate the mechanical properties and dentin interaction of two adhesives; experimental adhesive (EA) and 5 wt.% reduced graphene oxide rGO) containing adhesive. Scanning electron microscopy (SEM)-Energy-dispersive X-ray spectroscopy (EDX), Micro-Raman spectroscopy, push-out bond strength test, and Fourier Transform Infrared (FTIR) spectroscopy were employed to study nano-bond strength, degree of conversion (DC), and adhesive-dentin interaction. The EA was prepared, and rGO particles were added to produce two adhesive groups, EA-rGO-0% (control) and rGO-5%. The canals of sixty roots were shaped and prepared, and fiber posts were cemented. The specimens were further alienated into groups based on the root canal disinfection technique, including 2.5% sodium hypochlorite (NaOCl), Photodynamic therapy (PDT), and ER-CR-YSGG laser (ECYL). The rGO nanoparticles were flake-shaped, and EDX confirmed the presence of carbon (C). Micro-Raman spectroscopy revealed distinct peaks for graphene. Push-out bond strength test demonstrated highest values for the EA-rGO-0% group after NaOCl and PDT conditioning whereas, rGO-5% showed higher values after ECYL conditioning. EA-rGO-0% presented greater DC than rGO-5% adhesive. The rGO-5% adhesive demonstrated comparable push-out bond strength and rheological properties to the controls. The rGO-5% demonstrated acceptable DC (although lower than control group), appropriate dentin interaction, and resin tag establishment

Influence of Denture Cleansers on the Retention Loss of Attachment Systems Retained Implant Overdenture

Background. This study aimed to evaluate the effects of different denture cleansing solutions (DCSs) on the retention of Locator and Locator R-Tx attachment systems of implant retained overdentures (IRO). Methods. Two part acrylic resin blocks were fabricated, upper part contained metal housing and plastic inserts and lower part contained implant analogs and abutments. Eighty pink plastic inserts (40/attachment, 10/solution) were immersed in Corega, Fittydent, sodium hypochlorite, and water for a time simulating upto 1-year of clinical usage. Acrylic blocks were held on a universal testing machine for a pull-out test to record the dislodgement force. Measurements were conducted after 6 months (T1) and 12 months (T2). One-way ANOVA followed by Tukey’s HSD test was used to analyze the results (α = 0.05). Results. For both attachments, retention significantly decreased after immersion in different solutions at T2 P<0.001. Locator R-Tx attachment in NaOCl showed a significant decrease in retention compared with other solutions at T1. At T2, there was a significant decrease in retention for all DCS compared with water P<0.001. Locator R-TX showed higher retention values per solution compared to Locator attachment P<0.001. In terms of retention loss %, NaOCl recorded the highest (61.87%) loss, followed by Corega (55.54%) and Fittydent (43.13%), whereas water demonstrated the best retention (16.13%) in both groups. Conclusion. Locator R-TX has better retention with different DCS immersion. The loss of retention varied with different types of DCS and NaOCl recorded the highest retention loss. Therefore, denture cleanser selection must be guided by the type of IRO attachment

Impact of Smokeless Tobacco on the Color Stability of Zirconia, Zirconia-Reinforced Lithium Silicate and Feldspathic CAD/CAM Restorative Materials: An In Vitro Study

WHO estimates that the global number of tobacco users exceeds 1.3 billion people. Few studies have examined the effect of locally made smokeless tobacco (ST) products on the color changes of material used in dental prosthetics. Bearing the recent advances in CAD/CAM ceramic restorations material in mind, this study aimed to assess ST influence on mean color change (&#8710;E*) values among selected CAD/CAM ceramic types: multilayer zirconia (Ceramill Zolid PS), zirconia-reinforced lithium silicate ceramic (Vita Suprinity), and feldspathic (Vita TriLuxe) restorative materials. The color changes of the ceramics were compared to VITA classical and VITA 3D-MASTER shade guides. Sixty CAD/CAM ceramic specimens (20 samples each) were fabricated from Ceramill Zolid PS, Vita TriLuxe Forte, and VITA Suprinity. Specimens were prepared and divided into two groups according to the ST type and immersed for two weeks. Basic VITA classical and VITA 3D-MASTER colors were recorded at a baseline of one week and two weeks. The highest &#8710;E* values were recorded in the black ST for Vita Suprinity (4.77) in the first week, followed by Vita TriLuxe (4.07) in the second week. For white ST, Vita TriLuxe (4.87), and Vita Suprinity (4.42) showed extensive color change after two weeks and one week, respectively. The color change was least in zirconia for black and white ST after one week. CAD/CAM ceramic materials showed no significant difference after 1 and 2 weeks for the tested ST types. The effects of ST on CAD/CAM ceramic material (&#8710;E* values) were high but did not reach clinically unacceptable values. Zirconia showed the least amount of color change among all the tested materials