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Background and Objectives: Little information is available on the role of Vitamin D as a micro-nutrient deficiency with masticatory muscle efficiency and its effect on the function of removable prosthesis. The aim of this study was to evaluate the role of vitamin D on masticatory muscle activity among completely edentulous patients and its effect on the retention of removable complete dentures (RCDs). Materials and Methods: A non-randomized clinical control trial was conducted on completely edentulous patients (60.53 ± 7.01 years) in the Indian population between 2017 and 2019. Subjects were evaluated for temporomandibular disorders according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum Vitamin D (S Vit D) levels, Ultrasonography (USG), and surface Electromyography (sEMG) readings of the masseter muscle were recorded at enrolment (Level 0), after 3 months of Vitamin D therapy (Level 3), and after consecutive 3 months of maintenance therapy, i.e., after 6 months from baseline (Level 6). The fabrication of new RCDs was done for all after the enrolment, and the retention of RCDs was assessed by asking a question regarding denture retention and asking respondents to mark their satisfaction on a 5-point Likert scale. Data were analysed using ANOVA, Paired’-test and Pearson correlation coefficients. A p-value less than 0.05 indicated a statistically significant association. Results: Between enrolment and a six-month follow-up, S Vit D levels showed an increase from 16.03 ± 5.68 ng/mL to 31.35 ± 9.28 ng/mL, showing an increase of 15.32 ± 9.38 ng/mL (95.57% rise). Statistically significant values were observed for USG and sEMG. Conclusions: Results showed that S Vit D affects masticatory muscle activity by improving its thickness and boosting its tonicity. Healthy muscles assist in the retention of RCDs, consequently aiding in mastication, speech, and phonetics, hence improving patient satisfaction. Clinical implication: Acknowledging the fact that the prevalence of Vitamin D deficiency is worldwide. We suggest Vitamin D therapy as a nutritional intervention among the elderly completely edentulous population, following dietary counselling, and consider Vitamin D therapy to be an adjunct to nutritional counselling for improving masticatory muscle activity and efficiency, which aids in RCD retention and stability. Consequently, improving oral health-related quality of life for individuals.

Artificial intelligence (AI) is a contemporary, information-driven innovative technology. Prosthetic dentistry, also known as prosthodontics, is the restoration and reconstruction of missing teeth utilizing implants for permanent and removable prostheses. It enhances healthy soft and hard tissues, promoting oral health. This study examined the use of artificial intelligence in prosthodontics to diagnose abnormalities and create patient-specific prostheses. Two researchers searched Google Scholar, Scopus, PubMed/MEDLINE, EBSCO host, Science Direct, and Web of Science (MEDLINE, WOS, and KJD). Articles on AI in English were reviewed. We also collected the following broad article aspects: research and control groups, assessment methodology, outcomes, and quality rankings. This methodological study examined AI use in prosthodontics using the latest scientific findings. The findings were statistically evaluated using ANOVA. Titles and abstracts revealed 172 AI-related dentistry studies, which were analyzed in this research. Thirty-eight papers were eliminated. According to the evaluation, AI was found to have significantly increased in prosthodontics. Despite the vast number of studies documenting AI applications, the description of the data illustrated the latest breakthroughs in AI in prosthodontics, highlighting its use in automatically produced diagnostics, predicting analytics, and classification or verification tools.

Introduction: Peritoneal fibrosis (PF) results in technique failure in peritoneal dialysis (PD) patients. Peritoneal fibroblasts are characterized by increase in the ACTA2 gene, responsible for alpha smooth muscle actin (α−SΜΑ), extracellular matrix (ECM) production, and inflammatory cytokines production, which are the are key mediators in the pathogenesis of PF. 5-hydroxytryptamine (5-HT; serotonin) induces ECM synthesis in fibroblasts in a transforming growth factor-beta 1 (TGF-β1) dependent manner. The purpose of our study was to identify the potential mechanism and role of sildenafil and 5HT 2B receptor inhibitor (SB204741) combination in attenuating PD-associated peritoneal fibrosis. Methods: Studies were performed to determine the effect of TGF-β1, sildenafil, and SB204741 on human peritoneal fibroblasts (HPFBs) isolated from the parietal peritoneum of patients in long-term PD patients (n = 6) and controls (n = 6). HPFBs were incubated with TGF-β1 (10 ng/mL) for 1 h and later with TGF-β1 (10 ng/mL)/[sildenafil (10 µM) or SB204741 (1 µM)] and their combination for 24 h (post-treatment strategy). In the pre-treatment strategy, HPFBs were pre-treated with sildenafil (10 µM) or SB204741 (1 µM) and a combination of the two for 1 h and later with only TGF-β1 (10 ng/mL) for 24 h. Results: The anti-fibrotic effects of the combination of sildenafil and SB204741 were greater than that of each drug alone. In TGF-β1-stimulated HPFBs, pro-fibrotic genes ( COL1A1, COL1A2, ACTA2, CTGF , FN1, and TGFB1 ) exhibited higher expression than in controls, which are crucial targets of sildenafil and SB204741 against peritoneal fibrosis. The synergistic approach played an anti-fibrotic role by regulating the pro- and anti-fibrotic gene responses as well as inflammatory cytokine responses. The combination treatment significantly attenuated peritoneal fibrosis, as evident by the almost complete amelioration of ACTA2 expression, restoration of anti-fibrotic genes ( MMP2/TIMP1 ), and, at least, by reducing the expression of pro-inflammatory cytokines (IFN-γ, IL-4, IL-17, IL-1β, IL-6, TNF-α, and TGF-β1) along with an increase in IL-10 levels. Discussion: Taken together, the above research evidences that the combination of sildenafil and SB204741 may have therapeutic potential in suppressing peritoneal fibrosis due to peritoneal dialysis.

To assess utility of neutrophilCD64 (nCD64) expression in differentiating bacterial infection from inflammation in patients with severe alcoholic hepatitis (SAH) fulfilling systemic inflammatory response syndrome criteria. Patients with SAH and infection (n = 58), SAH without infection (n = 70), and healthy controls (n = 20) were included. Neutrophil CD64 expression by flowcytometry, serum Procalcitonin (ELISA) and C-reactive protein (Nephelometry) and neutrophil–lymphocyte ratio (NLR) were studied. Percentage of neutrophils with CD64 expression (nCD64%) was significantly higher in patients with SAH and infection than in those without infection and controls [76.2% (56.9–86.5) vs. 16% (12.6–23.1) vs. 7.05% (1.4–9.5), p  < 0.05], as was their mean fluorescence intensity [MFI; 1431 (229–1828) vs. 853 (20–968) vs. 99.5 (54.7–140.7), p  < 0.05]. Using a cut-off of 27%, the sensitivity and specificity of nCD64% to diagnose bacterial infection was 94% and 81%, respectively, with area under curve (AUC) of 0.95. At a cut-off value of 0.261 ng/ml, the sensitivity and specificity of serum procalcitonin was 83% and 72%, respectively, with AUC of 0.86. Serum CRP, total leukocyte count, NLR had AUCs of 0.78, 0.63 and 0.64, respectively. Quantitative measurement of nCD64 can better distinguish systemic bacterial infection and inflammation in SAH as compared to traditional biomarkers.

Background Nowadays dental implants are commonly used and to fulfil esthetic demands, zirconia has been suggested as an implant material as an alternative to titanium. Many researchers and systematic reviews are documented on it, but the results have been often inconsistent. This overview of systematic reviews aimed to report on the factors that influence the clinical effectiveness of zirconia (Zi) versus titanium (Ti) dental implants in anterior region. Methods This overview of systematic reviews (Registration Number CRD42023396206) is in accordance with the Transparent Reporting of Systematic Reviews and Meta-analyses. PubMed, Cochrane, Scopus, Embase and Google Scholar databases were sourced for systematic review and meta-analyses. Joanna Briggs Institute (JBI) criteria and Measurement Tool to Assess systematic Reviews” (AMSTAR-2), evaluated the quality. The PICO-focused question of this overview of systematic reviews was “What are the various factors influencing the clinical performance of Zi versus Ti implants in the anterior area?”, Evaluations were assessed by two assessors. In case there was any uncertainty or dispute among the reviewers, the work was included for further screening. Using Cohen's kappa, the inter-reviewer reliability was evaluated. Results Six reviews were chosen from 57 suitable reviews for this data analysis. Although the survival and effectiveness rates backed titanium implants, there was no conclusive proof of marginal bone loss. Zirconium implants performed better in terms of aesthetics. Conclusion Clinical performance of zirconia could be considered at par with titanium implants in the anterior area. Titanium has exhibited greater mechanical performance but no significant difference between two recorded. In future, studies with improved design are needed to identify biological and technical factors that affect implant’s efficacy. Novelty and relevance This is the first overview of systematic reviews focusing specifically on the anterior region, evaluates both aesthetic and biomechanical performance of Zi and Ti Implants, offers detailed insight into material-specific advantages and limitations. In the present clinical scenario it addresses a critical gap by comparing the performance of Zi and Ti implants and evaluates patient-centred priorities, particularly in the highly visible anterior region.

Objectives Evaluation of dynamic occlusal parameters can help dentists to understand the association of occlusion with the preferred chewing side (PCS) and enable optimal restoration of masticatory efficiency. This study evaluated the association between PCS and dynamic occlusal parameters. Methods One hundred participants (50 each, right and left PCS) were included in this study. PCS was determined by the visual spot-checking method, and occlusal analysis was conducted by T Scan. Occlusal parameters evaluated included initial contact, center of force, tooth contact area, occlusal interferences, and occlusal time. Data were assessed by chi-squared test and eta correlation coefficient. Results Initial contact towards the PCS was observed in 68% and 70% of right and left unilateral chewers, respectively. Likewise, center of force towards the PCS was present in 72% and 66% of right and left unilateral chewers, respectively. A larger area of tooth contact was predominant towards the PCS in 70% and 72% of right and left unilateral chewers, respectively. Chi-squared analysis showed a strong positive correlation between PCS and occlusal parameters at maximum intercuspation. Eta correlation coefficients between PCS and occlusal interferences, as well as centric and eccentric occlusion, revealed negligible associations. Conclusion Dynamic occlusal parameters may be associated with PCS.

Steroid remains the keystone therapy for Idiopathic Nephrotic Syndrome (NS). Besides genetic factors and histological changes, pharmacogenomic factors also affect the steroid response. The upregulation of P-glycoprotein (P-gp) and Multidrug resistance-associated protein 1 (MRP-1) modulate the pharmacokinetics of steroids and may contribute to steroid resistance. Flow-cytometric analysis of P-gp, MRP-1 expression and functional activity on peripheral blood mononuclear cells (PBMCs) was carried out in steroid-sensitive nephrotic syndrome (SSNS) (n = 171, male 103, mean age = 8.54 ± 4.3); and steroid-resistant nephrotic syndrome (SRNS) (n = 83, male 43, mean age = 7.43 ± 4.6) patients. The genotypings of MDR-1 gene were carried out using PCR-RFLP. We observed that the percentage expression of P-gp (10.01 ± 2.09 and 3.79 ± 1.13, p < 0.001); and MRP-1 (15.91 ± 3.99 and 7.40 ± 2.33, p < 0.001) on lymphocyte gated population were significantly higher in SRNS than that of SSNS. The functional activity of P-gp and MRP-1 was also significantly escalated in SRNS as compared to SSNS (68.10 ± 13.35 and 28.93 ± 7.57, p < 0.001); (72.13 ± 8.34 and 31.56 ± 8.65, p < 0.001) respectively. AUC-ROC curve analysis revealed that P-gp and MRP-1 expression with a cut-off value of 7.13% and 9.62% predicted SRNS with the sensitivity of 90% and 80.7%; and specificity 90% and 80%, respectively. Moreover, MDR-1 homozygous mutant TT+AA for G2677T/A (rs2032582) was significantly associated with SRNS (p = 0.025, OR = 2.86 CI = 1.14–7.14). The expression of P-gp (9.68 ± 4.99 v/s 5.88 ± 3.38, p = 0.002) was significantly higher in the patients of homozygous mutant alleles compared to wildtype GG. The increased expression and functionality of P-gp and MRP-1 contribute to steroid resistance, and MDR-1 homozygous mutant G2677T/A promotes steroid resistance by inducing P-gp expression in NS.

Background Accurate vertical dimension of rest (VDR) is critical in complete denture fabrication. Along with conventional phonetic and electromyographic (EMG) methods; cephalometric angular reconstruction (CAR) has recently been proposed as a reliable approach that minimizes reliance on patient dexterity. This in-vivo study aimed to determine the effectiveness of the CAR method by comparing it with conventional and electromyographic methods in determining VDR in edentulous subjects. Materials and methods Twenty completely edentulous patients were enrolled. For each patient, VDR was measured using phonetic, CAR, and EMG methods. Data were analyzed with SPSS version 23 using one-way ANOVA and independent t -tests. A sample size of 20 provided 80% power with an effect size of 0.8 at a significance level of 0.05. One month after denture insertion, patient satisfaction was assessed with a structured questionnaire. Results The mean VDR (cm) was 5.36 ± 0.61 for the conventional method, 5.35 ± 0.74 for CAR, and 5.64 ± 0.62 for EMG. Although the EMG method yielded slightly higher values, independent t -tests revealed no statistically significant differences between conventional and CAR ( p  = 0.962), conventional and EMG ( p  = 0.181), or CAR and EMG ( p  = 0.167). Patient satisfaction scores indicated favorable outcomes across all groups. Conclusion There was no statistically significant difference among the three methods, confirming that CAR can serve as a viable alternative to conventional and EMG approaches. Clinical implications The CAR method may be particularly useful for patients with neuromuscular issues, psychological challenges, or limited cooperation during traditional VDR recording.

Peritoneal Dialysis (PD) requires a healthy and functional peritoneal membrane for adequate ultrafiltration and fluid balance, making it a vital treatment for patients with end-stage renal disease (ESRD). The spectrum of PD-associated peritoneal fibrosis encompasses a diverse range of collective mechanisms: peritoneal fibrogenesis, epithelial to mesenchymal transition (EMT), peritonitis, angiogenesis, sub-mesothelial immune cells infiltration, and collagen deposition in the sub-mesothelial compact zone of the membrane that accompany deteriorating membrane function. In this narrative review, we summarize the repertoire of current knowledge about the structure, function, and pathophysiology of the peritoneal membrane, focusing on biomolecular mechanisms and signalling pathways that potentiate the development and progression of peritoneal fibrosis. The article suggests future directions that could enhance our comprehension of the relationship between peritoneal membrane dysfunction and its fibrosis to elucidate the promising targets for therapeutic interventions. A thorough understanding of early events in pathophysiology closely associated with the inflammatory events in peritoneal fibrosis is the logical starting point for identifying new targets rather than concentrating on more downstream effects. Biomarkers are essential for monitoring the progression of peritoneal fibrosis and evaluating the effectiveness of therapeutic interventions. Biomarkers are evolving in concert with new targets and novel agents, and biomarker outcomes offer a means of monitoring the peritoneal membrane’s health. Recent approaches to reducing the etiologies of peritoneal membrane dysfunction, the impact of fibroblast switch, and peritoneal membrane events perturbing fibroblast function are explored and suggest using unique, effective therapeutic strategies to target peritoneal fibrosis and associated complications.

Reusing of alloy has become a need of time due to the increasing demand, depletion of resources, and substantial increase in their price. The alloys used require a long-term stay in the oral cavity exposed to a wet environment, so they must have good wear resistance, biocompatibility, and mechanically good strength. In this study, the vertical marginal discrepancy, surface roughness, and microhardness of the new and recast nickel–chromium (base metal) alloys were evaluated. 125 wax patterns were fabricated from a customized stainless steel master die with a heavy chamfer cervical margin divided into 5 groups. Each group had 25 samples. Group A: 25 wax patterns were cast using 100% by weight of new alloy, Group B: the casting was done by using 75% new alloy and 25% alloy by weight, Group C: wax patterns were cast using 50% new alloy and 50% alloy, Group D: 25% new alloy and 75% alloy and Group E: 100% recast alloy. The vertical marginal discrepancy was measured by an analytical scanning microscope, microhardness was tested on a universal testing machine, and surface roughness was on a tester of surface roughness. Castings produced using new alloys were better than those obtained with reused alloys. Alloys can be reused till 50% by weight along with the new alloy and accelerated casting technique can be used to save the lab time to fabricate castings with acceptable vertical marginal discrepancy, microhardness, and surface roughness. This indicated that 50% recasting of (Ni–Cr) can be used as a good alternative for the new alloy from an economical point of view.