Conservative Management of the Horizontal Root Fracture in the Middle Third using Fiber Post as an Intraradicular Splint

BACKGROUND: Root fractures are uncommon injuries in permanent teeth and account for only 0.5–7% of dental trauma. It occurs more frequently in fully erupted permanent teeth, in which the completely formed root with closed apices is solidly supported in the bone and periodontium. This may lead to complex consequences due to the combined damage to the pulp, dentine, cementum, bone, and periodontium. They are transverse to oblique in direction and result from a horizontal impact. Their incidence is more in the middle third of the root than at the cervical and apical thirds. CASE REPORT: This paper describes a case of complicated horizontal root fracture at the middle third of the maxillary right central incisor. After receiving an endodontic treatment, the fractured root fragments of the maxillary right central incisors were united with the help of a glass fibre post. Eventually, the incisor was restored with a zirconia crown. CONCLUSION: Follow-up after a year revealed a well-stabilized assembly of the root fragments and the post. &nbsp

Confocal Laser Scanning Microscopic Evaluation of Sealer Penetration in Root Canals of Teeth with the butterfly and Non-butterfly Effect: An In vitro Study

AIM: The study aimed to investigate the penetration depth of calcium hydroxide-based root canal sealer into buccolingual and mesiodistal aspects of roots with and without the butterfly effect at coronal and middle root sections. METHODS AND MATERIALS: Twenty single-rooted maxillary premolars were decoronated at the cementoenamel junction and viewed under a light microscope and grouped as Group 1 – butterfly (B) and Group 2 – non-butterfly according to the presence or absence of the effect. Canals were prepared till working length followed with copious irrigation. Canals were finally rinsed with 5 ml of 17% ethylenediaminetetraacetic acid solution and activated using EndoActivator followed by obturation using gutta-percha (warm vertical compaction technique) with Sealapex sealer. To provide fluorescence for confocal laser scanning microscopy (CLSM), the Sealapex was mixed with rhodamine B dye. Root sectioning yielded coronal and middle sections. CLSM was used to assess the penetration of the sealer. STATISTICAL ANALYSIS: Shapiro–Wilk test, unpaired “t-test.” RESULTS: Teeth with the butterfly effect had greater mean penetration buccolingually (905.2 μm) than mesiodistally (182.1 μm; p < 0.001). Coronal sections had greater penetration (517.4 μm) compared with the middle (354.6 μm). CONCLUSION: Sealapex sealer exhibited maximum tubular penetration in teeth with butterfly effect in buccolingual direction at the coronal third level

Review on the Scale-Up Methods for the Preparation of Solid Lipid Nanoparticles

Solid lipid nanoparticles (SLNs) are an alternate carrier system to liposomes, polymeric nanoparticles, and inorganic carriers. SLNs have attracted increasing attention in recent years for delivering drugs, nucleic acids, proteins, peptides, nutraceuticals, and cosmetics. These nanocarriers have attracted industrial attention due to their ease of preparation, physicochemical stability, and scalability. These characteristics make SLNs attractive for manufacture on a large scale. Currently, several products with SLNs are in clinical trials, and there is a high possibility that SLN carriers will quickly increase their presence in the market. A large-scale manufacturing unit is required for commercial applications to prepare enough formulations for clinical studies. Furthermore, continuous processing is becoming more popular in the pharmaceutical sector to reduce product batch-to-batch differences. This review paper discusses some conventional methods and the rationale for large-scale production. It further covers recent progress in scale-up methods for the synthesis of SLNs, including high-pressure homogenization (HPH), hot melt extrusion coupled with HPH, microchannels, nanoprecipitation using static mixers, and microemulsion-based methods. These scale-up technologies enable the possibility of commercialization of SLNs. Furthermore, ongoing studies indicate that these technologies will eventually reach the pharmaceutical market

Cardiopulmonary exercise test in myocardial ischemia detection

Exercise electrocardiography has low sensitivity for detection of myocardial ischemia. However, when combined with cardiopulmonary exercise testing (CPEX), the sensitivity and specificity of ischemia detection improves significantly. CPEX offers unique advantages over imaging techniques in tricky situations such as balanced ischemia. Early abnormal oxygen uptake would point toward profound coronary stenosis that could be missed in perfusion imaging. CPEX could be an invaluable tool in asymptomatic left bundle branch block pattern, without exposing patients to the risks of computerized tomography or invasive coronary angiography. Normal oxygen uptake curves would rule out significant coronary stenosis as the cause of left bundle branch block pattern. Elseways, abnormal oxygen uptake in patients with normal coronary arteries could indicate microvascular angina. Furthermore, exercise capacity is an excellent predictor of cardiovascular risk in those with and without heart disease. Using two clinical cases we introduce the concept of gas-exchange and hemodynamic changes encountered in ischemic heart disease

Liver Injury in Acute Fatty Liver of Pregnancy: Possible Link to Placental Mitochondrial Dysfunction and Oxidative Stress

Acute fatty liver of pregnancy (AFLP) is a rare disorder which is fatal if not recognized and treated early. Delivery of the feto-placental unit results in dramatic improvement in maternal liver function, suggesting a role for the placenta. However, the mechanisms by which defects in the fetus or placenta lead to maternal liver damage are not well understood and form the focus of this study. Placenta and serum were obtained at delivery from patients with AFLP, and placental mitochondria and peroxisomes were isolated. Placental mitochondrial function, oxidative stress, and fatty acid composition as well asserumantioxidants, oxidativeandnitrosative stress markers,andfatty acid analysis were carried out. Hepatocytes in culture were used to evaluate cell death, mitochondrial function, and lipid accumulation on exposure to fatty acids. Oxidative stress was evident in placental mitochondria and peroxisomes of patients with AFLP, accompanied by compromised mitochondrial function. Increased levels of arachidonic acid were also seen inAFLPplacenta when compared to control. Patients with AFLP also had a significant increase in oxidative and nitrosative stress markers in serum, along with decreased antioxidant levels and elevated levels of arachidonic acid. These levels of arachidonic acid were capable of inducing oxidative stress in hepatocyte mitochondria accompanied by induction of apoptosis. Exposure to arachidonic acid also resulted in increased lipid deposition in hepatocytes. Conclusion: Oxidative stress in placental mitochondria and peroxisomes is accompanied by accumulation of toxic mediators such as arachidonic acid, which may play a causative role in maternal liver damage seen in AFLP

The Contribution of Indian Endodontists in Rotary Endodontics to Pubmed Database, from 2000-2017

AIM: This study aimed at assessing the trends of publications of Indian Endodontists in the field of rotary Endodontics in the PubMed database from 2000-2017. METHODS: The date of publication was set from 1st January 2000 to 31st December 2017, wherein keywords entered in the advanced search were “Indian†AND “Dental†AND “Rotary Endodonticsâ€. From the collected articles the following criteria were noted: year of publication, the name of the journal, status of the journal, name of the first author, state of origin and the rotary Endodontic file system used. RESULTS: All data was subjected for statistical analysis by SPSS software version 16. The data were subjected to chi-square test, and a statistically significant difference (p < 0.001) was obtained in the inter-6 yearly interval starting from 2000-2017; in the status of the journal; the state of origin and in the generation of rotary files which were published during the study period. CONCLUSION: The plethora of publications by Indian Conservative Dentists and Endodontists is on the rise, and with the advent of better technology a greater interest in the mechanics and properties of these rotary file systems has invoked greater research work

Site-directed mutations in the C-terminal extension of human aB-Crystalline affect chaperone function and block amyloid fibril formation

Copyright: 2007 Treweek et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background. Alzheimer’s, Parkinson’s and Creutzfeldt-Jakob disease are associated with inappropriate protein deposition and ordered amyloid fibril assembly. Molecular chaperones, including aB-crystallin, play a role in the prevention of protein deposition. Methodology/Principal Findings. A series of site-directed mutants of the human molecular chaperone, aBcrystallin, were constructed which focused on the flexible C-terminal extension of the protein. We investigated the structural role of this region as well as its role in the chaperone function of aB-crystallin under different types of protein aggregation, i.e. disordered amorphous aggregation and ordered amyloid fibril assembly. It was found that mutation of lysine and glutamic acid residues in the C-terminal extension of aB-crystallin resulted in proteins that had improved chaperone activity against amyloid fibril forming target proteins compared to the wild-type protein. Conclusions/Significance. Together, our results highlight the important role of the C-terminal region of aB-crystallin in regulating its secondary, tertiary and quaternary structure and conferring thermostability to the protein. The capacity to genetically modify aB-crystallin for improved ability to block amyloid fibril formation provides a platform for the future use of such engineered molecules in treatment of diseases caused by amyloid fibril formation

Cataract-Causing Defect of a Mutant γ-Crystallin Proceeds through an Aggregation Pathway Which Bypasses Recognition by the α-Crystallin Chaperone

Background: The transparency of the eye lens depends upon maintenance of the native state of the γ- and β-crystallins, which is aided by the abundant chaperones αA- and αB-crystallin. Mature onset cataract, the leading cause of blindness worldwide, involves the polymerization of covalently damaged or partially unfolded crystallins into light-scattering aggregates. A number of single amino acid substitutions and truncations of γ-crystallins result in congenital cataract in both humans and mice, though in many cases the coupling between the protein alterations and the accumulation of aggregates is poorly defined. Methodology/Principal Findings: We have studied the aggregation properties and chaperone interactions of human γD-crystallin carrying substitutions of two buried core mutants, I90F and V75D, which cause congenital cataract in mice. The in vitro aggregation pathway competing with productive refolding was not altered by either substitution. Furthermore, this aggregation pathway for both mutant proteins–originating from a partially folded intermediate–was efficiently suppressed by αB-crystallin. Thus the cataract pathology was unlikely to be associated with a direct folding defect. The native state of wild-type human γD-crystallin exhibited no tendency to aggregate under physiological conditions. However both I90F and V75D native-like proteins exhibited slow (days) aggregation to high molecular weight aggregates under physiological conditions. The perturbed conformation of I90F was recognized and bound by both αA and αB chaperones. In contrast, the aggregation derived from the perturbed state of V75D was not suppressed by either chaperone, and the aggregating species were not bound by the chaperone. Conclusions/Significance: The cataract phenotype of I90F in mice may be due to premature saturation of the finite α- crystallin pool. The V75D aggregation pathway and its escape from chaperone surveillance and aggregation suppression can account for the congenital cataract pathology of this mutant. Failure of chaperone recognition may be an important source of pathology for many other protein folding defects.National Eye Institute (Grant no. EY015834 )National Institutes of Health (U.S.) (Grant no. GM17980