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Aerobic and facultative anaerobic bacteria are most commonly found in failed root canal cases. Among those, is the most resistant intracanal microbe. Hence, the antibacterial effectiveness of various intracanal medicaments (ICMs) is primarily tested against . To eliminate such resistant bacteria from the entire root canal system, various contemporary intracanal medicaments (ICMs) with an effective antibacterial action are evaluated. The purpose of the study is to compare the antimicrobial efficacy of intracanal medications, Phytosphingosine nano-emulsion (PHSN), Chitosan nano-emulsion (CHN), and Triple Antibiotic Paste (TAP) against in endodontics. Assuming the Minimum Inhibitory Concentration (MIC) of 15.93 and SD 1.53 with estimated error of 1, 80% power, and 5% alpha error, the sample size was calculated as 9. All three ICMs were prepared following the standard protocols. These ICMs were categorised into 3 groups as follows: Group I: PHSN; Group II: CHN; Group III: TAP. The antibacterial property of these ICMs was evaluated using MIC and disk diffusion methods. ANOVA and post hoc Tukey's tests. The minimum inhibitory concentration (MIC) was found to be 1 μg/mL for PHSN, 32 μg/mL for CHN, and 4.0 μL/mL for TAP against . PHSN showed the largest zone of inhibition (38.3 ± 1.48), followed by CHN (8.16 ± 0.966), and TAP (6.30 ± 1.71). Thus, PHSN showed significantly higher antimicrobial efficiency compared to CHN and TAP (p < 0.05). Although CHN showed a higher zone of inhibition than the TAP, the difference between them was statistically nonsignificant. Phytosphingosine nano-emulsion (PHSN) has maximum efficacy against , and it can hinder its growth with a minimum inhibitory concentration of 1μg/mL. Chitosan nano-emulsion (CHN) shows slightly more efficacy than Triple Antibiotic Paste (TAP), but without any statistical significance.

Background: In the past few decades focus of research has been toward herbal medicines because of growing bacterial resistance and side effects of antimicrobial agents. The extract derived from the plants may increase the efficacy of antibiotics when used in combination against pathogenic bacteria. In the current study, the synergistic antibacterial efficacy of plant extracts in combination with antibiotics has been assessed on selected periodontal pathogens. Methods: Ethanolic extracts were prepared from Salvadora persica (Miswak) and Cinnamomum zeylanicum (Ceylon cinnamon), by the soxhalate method. Plaque samples were collected from clinical periodontitis patients to isolate and grow the periodontal pathobionts under favorable conditions. Susceptibility of bacteria to the extracts was assessed by gauging the diameter of the inhibition zones. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of plant extracts were determined against each bacterium. Synergistic activity of plants extract in combination with antibiotics against the bacteria was also assessed by measuring the diameter of the inhibition zones. Results: Ethanolic extract of both the plants showed an inhibitory effect on the proliferation and growth of all four strains of periodontal pathobionts. Maximum antibacterial activity was exhibited by C. zeylanicum against Tannerella forsythia (MIC = 1.56 ± 0.24 mg/mL, MBC = 6.25 ± 0.68 mg/mL), whereas among all the studied groups the minimum activity was reported by C. zeylanicum against Aggregatibacter actinomycetemcomitans the (MIC = 12.5 ± 3.25 mg/mL, MBC = 75 ± 8.23 mg/mL). Combination of herbal extracts with different antibiotics revealed a synergistic antibacterial effect. The best synergism was exhibited by S. persica with metronidazole against A. actinomycetemcomitans (27 ± 1.78). Conclusions: Current in vitro study showed variable antibacterial activity by experimented herbal extracts against periodontal pathobionts. The synergistic test showed significant antibacterial activity when plant extracts were combined with antibiotics.

Objective This systematic review and meta-analysis aimed to evaluate the efficacy of regenerative endodontic procedures compared with conventional root canal treatment procedures in mature permanent teeth with periapical lesions. Methods This systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials that were included in the study compared regenerative endodontic procedures with traditional root canal treatment procedures in mature permanent teeth with irreversible pulpitis. The Risk of Bias 2 tool was used for quality assessment, and the certainty of the evidence was evaluated using the GRADE approach. Meta-analysis was performed using the RevMan Web software, using odds ratios for dichotomous outcomes and mean differences for continuous outcomes, with a random-effects model applied. Heterogeneity was assessed using the I2 statistic, and publication bias was evaluated using funnel plots and Egger's test. Results The analysis included five studies encompassing diverse regenerative strategies. Overall, regenerative endodontic procedures demonstrated comparable or superior clinical and radiographic healing outcomes relative to conventional treatments. Notably, certain regenerative approaches showed greater potential for restoring pulp vitality and reducing early postoperative pain. However, the quality of evidence was moderate, constrained by small sample sizes, methodological heterogeneity, and blinding challenges. Conclusion Current evidence suggests that regenerative endodontic procedures are promising alternatives to conventional root canal treatment procedures for mature teeth with periapical lesions. Despite these encouraging findings, further high-quality, multicenter trials with standardized protocols and extended follow-up periods are necessary to confirm the results and establish the long-term benefits and cost-effectiveness of regenerative endodontics.

Mucormycosis is a group of infections, caused by multiple fungal species, which affect many human organs and is lethal in immunocompromised patients. During the COVID-19 pandemic, the current wave of mucormycosis is a challenge to medical professionals as its effects are multiplied because of the severity of COVID-19 infection. The variant of concern, Omicron, has been linked to fatal mucormycosis infections in the US and Asia. Consequently, current postdiagnostic treatments of mucormycosis have been rendered unsatisfactory. In this hour of need, a preinfection cure is needed that may prevent lethal infections in immunocompromised individuals. This study proposes a potential vaccine construct targeting mucor and rhizopus species responsible for mucormycosis infections, providing immunoprotection to immunocompromised patients. The vaccine construct, with an antigenicity score of 0.75 covering, on average, 92–98% of the world population, was designed using an immunoinformatics approach. Molecular interactions with major histocompatibility complex-1 (MHC-I), Toll-like receptors-2 (TLR2), and glucose-regulated protein 78 (GRP78), with scores of −896.0, −948.4, and −925.0, respectively, demonstrated its potential to bind with the human immune receptors. It elicited a strong predicted innate and adaptive immune response in the form of helper T (Th) cells, cytotoxic T (TC) cells, B cells, natural killer (NK) cells, and macrophages. The vaccine cloned in the pBR322 vector showed positive amplification, further solidifying its stability and potential. The proposed construct holds a promising approach as the first step towards an antimucormycosis vaccine and may contribute to minimizing postdiagnostic burdens and failures.

Aim This research aimed to use an extra-oral 3D scanner for conducting volumetric analysis after caries excavation using caries-detecting dyes and chemomechanical caries removal agents in individuals with occlusal and proximal carious lesions. Methods Patients with occlusal (A1, A2, A3) and proximal carious lesions (B1, B2, B3) were treated with the conventional rotary technique, caries detecting dyes (CDD) and chemomechanical caries removal (CMCR) method on 90 teeth ( n  = 45 for each). Group A1, B1: Excavation was performed using diamond points. Group A2, B2: CDD (Sable Seek™ caries indicator, Ultradent) was applied and left for 10 s, and then the cavity was rinsed and dried. For caries removal, diamond points or excavators were used. Group A3 and B3: BRIX3000 papain gel was applied with a micro-brush for 20 s and was activated for 2 min, and then the carious tissue was removed with a sharp spoon excavator. Post-excavation cavity volume analysis was performed using a 3D scanner. The time required and the verbal pain score (VPS) for pain were scored during excavation. Post-restoration evaluation was performed at 1, 3, and 6 months FDI (Federation Dentaire Internationale) criteria. Results Comparison of age, time and volume with study groups were made using Independent Sample’ t’ test and one-way analysis of variance (ANOVA) for two and more than two groups, respectively. Using Cohen’s Kappa Statistics, evaluators 1 and 2 agreed on caries removal status aesthetic, functional and biological properties at different follow-ups. The chi-square test revealed that the rotary groups [A1(2.5 ± 0.4 min) B1(4.0 ± 0.4 min)] had significantly less ( p  = 0.000) mean procedural time than CDD [A2(4.5 ± 0.4 min) B2(5.7 ± 0.4 min)] and CMCR [A3(5.4 ± 0.7 min) B3(6.2 ± 0.6 min)] groups. The CMCR group showed better patient acceptance and less pain during caries excavation than the rotary and CDD groups. CMCR group showed significantly less mean caries excavated volume( p  = 0.000). Evaluation of restoration after 1-, 3-, and 6-month intervals was acceptable for all the groups. Conclusion Brix3000 helps effectively remove denatured teeth with less pain or sensitivity. The time required for caries removal was lowest in the rotary method and highest in the brix3000 group, while the volume of caries removed was the lowest for brix3000 and highest for the rotary group.

Air-writing is a widely used technique for writing arbitrary characters or numbers in the air. In this study, a data collection technique was developed to collect hand motion data for Bengali air-writing, and a motion sensor-based data set was prepared. The feature set as then utilized to determine the most effective machine learning (ML) model among the existing well-known supervised machine learning models to classify Bengali characters from air-written data. Our results showed that medium Gaussian SVM had the highest accuracy (96.5%) in the classification of Bengali character from air writing data. In addition, the proposed system achieved over 81% accuracy in real-time classification. The comparison with other studies showed that the existing supervised ML models predicted the created data set more accurately than many other models that have been suggested for other languages.

Background and objectives: This study aimed to evaluate the synergistic antimicrobial activity of extracts obtained from Salvadora persica (Miswak), Commiphora molmol (myrrh) and Azadirachta indica (neem) in combination with commercially available antimicrobial agents: penicillin, tetracycline, ofloxacin and fluconazole on endodontic pathogens such as Enterococcus faecalis, Streptococcus mitis,Actinomyces naeslundii and Candida albicans. Materials and Methods: Microbiological samples from the root canals of the teeth undergoing retreatment were taken using sterile paper points kept at full length in the canal for 30 s. The disc diffusion method was used to check the susceptibility of microbes to the plant extracts and antimicrobials by measuring the diameter of the inhibition zones. Against the microbes, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)/minimum fungicidal concentration (MFC) of the plant extracts were assessed. The fractional inhibitory concentration index (FICI) was used to estimate the synergistic effect of plant extracts combined with antimicrobials against the resistant endodontic microbes. Results: The findings clearly indicate the effectiveness of all the three plant extracts, Commiphora molmol, Azadirachta indica, Salvadora persica, against all the experimental pathogenic microorganisms except for the ineffectiveness of Azadirachta indica, Salvadora persica against Candidaalbicans. Maximum antimicrobial activity was displayed by Azadirachta indica against Enterococcusfaecalis (MIC = 0.09 ± 1.2 mg/mL, MBC = 0.78 ± 1.25 mg/mL) and the minimum antimicrobial activity was displayed by Commiphora molmol against Actinomyces naeslundii (MIC = 12.5 ± 3.25 mg/mL, MBC = 100 ± 3.75 mg/mL). The best synergy was displayed by Commiphora molmol with fluconazole against Candidaalbicans (FICI = 0.45). Conclusions: The current study delineates the variable antimicrobial activity of plant extracts against the experimental endodontic pathogenic microorganisms. Plant extracts in conjunction with various antimicrobials can be valuable aids in combating relatively resistant endodontic microorganisms that have been the cause of worry in recent years, leading to failure even in treatment procedures following all required protocols.

Iron oxide nanoparticles are produced using simple auto combustion methods with honey as a metal-stabilizing and -reducing agent. Herein, α-Fe2O3 nanoparticles are produced using an iron nitrate precursor. These prepared samples are analyzed by an X-ray diffractometer (XRD), FTIR spectroscopy, UV-DRS, and a field-emission scanning electron microscope (FESEM) combined with energy-dispersive spectroscopy and a vibrating sample magnetometer (VSM). The XRD results confirm a rhombohedral structure with an R3c¯ space group single-phase formation of α-Fe2O3 in all samples. FESEM images reveal the different morphologies for the entire three samples. TEM analysis exhibits spherical shapes and their distribution on the surfaces. XPS spectroscopy confirms the Fe-2p and O-1s state and their valency. The VSM study shows strong ferromagnetic behavior. The prepared α-Fe2O3 nanoparticles exhibit exceptional charge carriers and radical production. The prepared sample retains excellent photocatalytic, antifungal and antibacterial activity.

Background: Periapical extrusion is frequently observed during endodontic therapy. It can lead to acute injury of periapical tissues, resulting in interappointment pain or swelling. The effect is pronounced in teeth with immature apex, which are more susceptible to the extrusion of irrigant. The aim of this study was to evaluate the effect of gravity on the apical extrusion of irrigating solution with different irrigation protocols in single-rooted premolars. Methodology: A total number of 80 permanent single-rooted teeth (premolars) with same working length (WL) were divided into two main groups: Group A: Penetration depth of irrigation syringe to 2 mm from the WL and Group B: Penetration depth of irrigation syringe to 4 mm from the WL. Each group was subdivided into four subgroups. (n = 10). The extruded debris and irrigants were weighed, and the data were statistically analyzed by the analysis of variance and the Tukey test. Results: Irrespective of the irrigation technique used, the amount of irrigant extruded from the apex showed a statistically significant difference related to the effect of gravity (P < 0.05). There was no statistically significant difference observed between irrigation methods (P > 0.05). Conclusion: The degree of apical extrusion of irrigant was dependent on the type of irrigation technique and gravity. Greater caution should be taken during irrigation to prevent postoperative pain.

We report the results of staged flexor tendon reconstruction in 12 patients (12 fingers) with neglected or failed primary repair of flexor tendon injuries in zone II. Injuries involved both flexor digitorum profundus (FDP) and flexor digitorum sublimis (FDS), with poor prognosis (Boyes grades II-IV). The procedure included placing a silicone rod and creating a loop between the FDP and FDS in the first stage and reflecting the latter as a pedicled graft through the pseudosheath created around the silicone rod in the second stage. At a mean follow-up of 18 months (range 12-30 months), results were assessed by clinical examination and questionnaire. The mean total active motion of these fingers was 188°. The mean power grip was 80.0% and pinch grip was 76% of the contralateral hand. The rate of excellent and good results was 75% according to the Buck-Gramcko scale. These results were better than the subjective scores given by the patients. Complications included postoperative hematoma in two, infection in one, silicone synovitis in one (after stage I) and three flexion contractures after stage II. This study confirmed the usefulness of two-stage flexor tendon reconstruction using the combined technique as a salvage procedure to restore flexor tendon function with a few complications.