The Effect of Premedication with Curcumin on Post-Operative Pain in Single Visit Endodontic Treatment of Acute Pulpitis in Mandibular Molars: A Randomized Controlled Trial

Objective: The purpose of this randomized double-blind clinical trial was to compare the effect of a single pretreatment dose of Curcumin and placebo on post-operative pain for patients diagnosed with symptomatic irreversible pulpitis in mandibular molars treated in single visit. Methods: Forty-four patients with severe to moderate pain randomly received either Curcumin (400mg +20 mg pepper) or placebo (420 mg Starch) one hour before starting root canal treatment (n = 22 per group). Participants rated their pain using visual analogue pain scale (VAS): preoperatively and at 5 time points: immediately post-operative, 8, 12, 24 and 48 hours postoperative. Patients also stated emergency analgesic intake. The need for supplemental anesthesia during treatment was recorded. Mann-Whitney U-test compared the two groups at each time point, while Repeated-Measure ANOVA and Wilcoxon Signed Rank test compared time points within each group. A p-value <0.05 was considered statistically significant. Results: Baseline characteristics of both groups showed non-significant differences (P > 05). Curcumin group at 8, 12 and 24 hours revealed statistically significantly less VAS values (44.2, 26.7, 19.1) than the placebo (58.5, 43.3, 30.3), respectively, (P > 05). All patients in Curcumin group did not need emergency analgesics. Curcumin group revealed statistically significantly lower percentages for the need of supplemental anesthesia (27.3%) compared to placebo (68.2%), (P < 05). Conclusion: Single preoperative oral dose of Curcumin proved to be an effective premedication that reduced post-operative pain as well as the need of supplemental anesthesia for patients diagnosed with symptomatic irreversible pulpitis of mandibular molars.

Abutment and Orthodontics for Endurance of Dental Crowns

The split-increment horizontal placement (SHP) is the popular technique being used, along with other therapeutic modus operandi. As more than adequate, SHP methods are being enhanced in barricade cavities for reducing the shrinkage stress that were generated during light polymerization. Such stress, if released unrestrained, may redress within the composite, tooth or at the adhesive contact .

Treatment with Oral Appliances in Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a disorder caused by a number of factors like an obstruction of the upper airway during sleep because of insufficient motor tone of the tongue and/or airway dilator muscles or inadequate growth of the maxillary jaw bone etc. Oral appliances (OAs) are commonly used as a non-invasive treatment for obstructive sleep apnea syndrome. The primary oral appliance (OA) used in obstructive sleep apnea (OSA) treatment is the mandibular advancement device (MAD). Tongue-retaining devices or tongue-stabilizing devices (TSDs) are a second type of OA, which displace the tongue anteriorly and may be customized or come in different stock sizes. This review article aims to examine the best in class on this particular subject of treatment of OSA with oral appliances, explaining acceptability of an appliance in patients on the basis of its construction and results, while providing enough cognizance regarding the diagnosis, management and causes of discontinuation.

What do Patients Use for Treating Their Oral Ulcers? And How do these Treatments Affect Their Quality of Life?

Objectives: Oral ulceration forms a major category of oral lesions. Due to its effect on the quality of life, the patients seek treatment using various substances. This study investigated the types of treatments used by a sample of patients having all types of oral ulcers and its positive and negative effects on the patients' lives. Methods: This cross-sectional study included patients having different types of oral ulcers. Participants provided information about their previous treatments, the source of recommendation of its use and side effects linked to them. They filled the oral health impact profile-14 questionnaire to report the change in their quality of life after treatment. The patients' educational and social levels were tested as predictors for the use of non-conventional treatments. Results: Correct pharmaceutical treatments were administered y 34% of the participants; the most effective of which were systemic and topical steroids by ulcerative oral lichen planus patients; and vitamin supplements in recurrent aphthous stomatitis patients. The majority (64.2%) of the previously treated patients used non-conventional treatments, the most widely used of which was Tahini. Half of the patients using non-conventional treatments suffered side effects. The source of information of the self-medication was attributed mainly to the patients themselves, followed by friends and family members. Conclusion: This study reflects the widely spread habit of self-medication in our sample of patients having oral ulcers. It highlights the negative influence of these remedies.

Does the Use of Botulinum Toxin Reduce the Intensity of Myofascial Pain in Adult Patients? A Systematic Review and Meta-Analysis

Objective: A systematic review was performed to evaluate if the use of botulinum toxin was able to reduce the intensity of myofascial pain compared to other treatments in adult patients. Material and Methods: A comprehensive search was carried out in the MEDLINE via Pub-Meb, Scopus, Web of Science, LILACS, BBO and Cochrane Library. In addition, the gray literature was also researched. The risk of bias tool from the Cochrane Collaboration was used by two independent reviewers for quality assessment of the studies. Results: A total of 4372 studies were identified, 9 remained in qualitative study, 8 of these studies were considered at “unclear” risk of bias and just one study was “low” risk of bias in the key domains. Only two studies presented similar data to be included in the meta-analysis. Both studies evaluated the pain relief used the botulinum toxin (BTX-A) versus saline solution. The meta-analysis demonstrated that after 3 months follow-up the pain relief was 15.70 (95 % confidence interval [CI] = 0.80 to 30.61; p = 0.04). Conclusion: The BTX-A reduced the intensity of myofascial pain compared to saline solution in adults after 3 months. However, further studies should be conducted to corroborate this finding.

PEEK as a Potential Material for Dental Implants and its Biomechanical Properties and Osteoblast Cell Response

Proper osseointegration is crucial for the success of dental and orthopedic implants. Titanium-6Aluminum-4Vanadium (TAV) is one of the most popular implant materials; however, polyetheretherketone (PEEK) has gained the interest of implant researchers and manufacturers over the past several years due to its lower modulus of elasticity compared to metallic implant materials. Porosity and patterned surface morphologies are thought to improve mechanical interlocking and play an important role in the differentiation of pre-osteoblasts into mature osteoblasts. This study aimed to determine the effects a macro patterned PEEK surface has on the material’s mechanical properties and the proliferation, differentiation, and maturation of pre-osteoblasts. Mechanical testing data indicated that the macro patterning improved the mechanical interlocking and has no detrimental effect on compression strength. DNA data and live/dead imaging showed that pre-osteoblasts on solid PEEK specimens did not readily differentiate but instead encouraged proliferation only. However, ALP data in comparison to the DNA data showed that cells on patterned PEEK specimens more readily entered the differentiation pathway to mineralization. This is further confirmed by the patterned PEEK specimens showing an overall higher amount of cell mineralization. Clinical significance: This study concludes that surface macro patterning of PEEK material increases the mechanical interlocking and enhances the osseointegration capability without diminishing mechanical properties.

Periodontitis Risk in Patients With and Without Systemic Lupus Erythematosus: A Retrospective Study

Objectives: Systemic lupus erythematosus is a systemic, long-term autoimmune condition that has chronic inflammatory effects in connective tissue throughout the body. There are numerous studies that have examined the association between systemic lupus erythematosus and chronic periodontitis, with varying conclusions. The purpose of this cross-sectional study is to evaluate and compare the risk for periodontitis in patients with SLE to patients without SLE. Materials and Methods: Medical and dental records were retrospectively reviewed for patients that had been admitted to the Temple University School of Dentistry from 2010 to 2018. A roster of 22 SLE positive patients were generated from the Temple University patient database and matched to a control population of 22 patients without SLE. Periodontal probing depths were then documented and used to evaluate periodontal statuses in both test and control groups. Sites with probing depths ≥ 5 mm were considered to be at increased risk for periodontal breakdown. Prevalence was defined as the percentage of individuals having at least one site with a ≥ 5 mm probing depth, and extent was defined as the average percentage of sites with increased periodontitis risk. The number of missing teeth in patients from each group were also recorded as a secondary outcome. Results: The prevalence of ≥ 5 mm probing depths in SLE and control groups was 50 % (10/20) and 40.9 % (9/22), respectively. Calculations of relative risk (1.22) and odds ratio (1.44) were not statistically significant between the two populations (p > 0.05). The extent of ≥ 5 mm probing depths was 1.5 % in SLE patients and 3.7 % in healthy patients, which was also not significant between groups (p > 0.05). SLE patients were missing an average of 9.6 teeth per individual compared to 3.8 in healthy patients (p < 0.05). Conclusions: The results of the present study indicate that patients with SLE do not have an increased risk for periodontitis when compared to patients without SLE. Risk analysis on the prevalence and the extent of deeper probing depths were not statistically different between SLE and control groups. Further studies with a larger sample size and elimination of unseen confounders are needed in order to validate our results. An interesting observation was the finding that SLE patients have a significantly greater number of missing teeth. The exact mechanism through which SLE patients experience periodontal breakdown and increased tooth loss is an avenue that warrants future research. Keywords: systemic lupus erythematosus (SLE); chronic periodontitis Abbreviations: SLE: Systemic Lupus Erythematosus, CP: Chronic Periodontitis, SLEDAI: Systemic Lupus Erythematosus Disease Activity Index, BOP: Bleeding on Probing, CAL: Clinical Attachment Level.

New Manifestation of Covid-19 in Oral Region, a Potential Faster Diagnosis Approach, a Mini Review

Introduction: The pandemic of COVID-19 continues to shatter the world by high rate of mortalities. The poorest prognosis of COVID-19 is among patients with comorbidities. Exploring new ways to predict and diagnose the infection at early stages will probably reduce the fatality and prevent further damages. Identifying unexampled or additional clinical symptoms may provide opportunities for earlier diagnosis and prevention of severe cases of COVID-19. Material and method: A methodical search was conducted through PubMed, Google and Google scholar databases to analyze the published or in press literature. The keywords were words “novel Coronavirus”, “SARS-Cov-2 (CoV)” and “COVID-19”, searched by at least two or more independent individuals. A total of 88 related items were picked based on the keywords. While the majority of materials were based on one-case reports (66 cases), a combination of multiple case studies as well as full research papers was investigated. Results: There were several unexampled manifestations including cutaneous symptoms and oral lesions by which early diagnosis, prevention and even more effective treatment may be achieved for COVID-19 patients. Conclusion: The most striking novel clinical presentation was intraoral painful blisters or mouth ulcers mostly seen on the cheek mucosa as per the revelation of the reported cases in the literature review. Leaving out a daily intraoral examination might have been the reason why intraoral lesions have been connived as effective predictive, prognostic and even preventive manifestations of COVID-19. The outcomes of these current studies suggest that intraoral lesions may offer a very new approach, using preventive, predictive and personalized medicine (PPP) concept to provide a rapid diagnosis and more effective therapeutic modality in patients with COVID-19. Keywords: COVID-19; Oral lesions; SARS-CoV-2; PPP; Preventive; coronavirus; Personalized Abbreviations: PPP: preventive predictive and personalized medicine, SARS: Severe Acute Respiratory Syndrome, COVID: corona virus disease.