bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Virtual Autism” and Excessive Screen Exposure in Children Aged 0-3 Years: A Cross-sectional Study in the Lebanese Context
Authors: Al Moussawi Issa , Bendak Lama , Ziab Hussein 
Published: December 2024

Background
Autism spectrum disorder (ASD), characterized by complex neurobiological traits, lacks specific biomarkers, necessitating an in-depth behavioral assessment. This study investigates the relationship between early ASD symptoms and excessive screen exposure in early childhood (0–3 years), introducing the concept of “Virtual Autism” by considering variables such as gender, age of exposure initiation, screen duration, and screen type. Moreover, the study seeks to provide insights into potential gender-specific differences in screen exposure effects and the necessity for targeted interventions.

Methods
A descriptive cross-sectional design is used, with 73 participants from the south of Lebanon. The study includes a comprehensive questionnaire incorporating behavioral characteristics derived from existing literature and the Early Childhood Autism Rating Scale. Participants were systematically selected based on eligibility criteria, and statistical analyses, including Pearson correlation and analysis of variance test, were utilized.

Results
Findings reveal significant correlations (p < 0.05) between screen exposure and ASD-like behaviors, emphasizing the critical role of early intervention. Gender-specific differences were observed, with males exhibiting higher susceptibility to autism-like features. The study underscores the need for cautious screen use during early childhood, considering variables such as age, duration, and type of exposure.

Conclusion
The study highlights the robust correlation between early and prolonged screen exposure and the emergence of ASD-like behaviors and other cognitive and sensory skills. Clinical implications emphasize tailored interventions and informed parenting practices, urging a cautious approach to screen exposure during the critical early years (0–3 years). Further research is needed to establish causal relationships and explore specific intervention strategies.
The Impact of Smoking on the Severity of COVID-19 and Risk Factors for Mortality: A Prospective Study in Hospitalized Patients
Authors: Ketfi Abdelbassat , Touahri Rama , Aissani Samia , Snouber Abdelmadjid 
Published: December 2024

ABSTRACT

Background:
Smoking has been linked to an increased risk of contracting many respiratory viral diseases and causes inflammation and damage to the lung epithelium. Smokers were found to have a higher likelihood of presenting with severe COVID-19.

Materials and Methods:
A 2-year single-center prospective study was conducted at the Pulmonology University Department of Rouiba Hospital. The clinical, biological, and imaging data, along with information on healing, death, or transfers to intensive care, were collected and analyzed for two patient groups: current or former smokers and nonsmokers.

Results:
There were 482 patients, including 206 men (42.7%), with an average age of 55.2 ± 15.2 years. Smoking tobacco consumption was found in only 14.21% of cases, with patients categorized into two groups: nonsmokers, accounting for 87.6% (422) of the total, and smokers, accounting for 12.4% (60). The smoking group also had a higher percentage of male subjects (93.3% vs. 35.5%) and a greater number of patients with chronic obstructive pulmonary disease (10.0% vs. 0.7%) (P < 0.0001). In addition, the smoking group had more patients with a history of tuberculosis (6.9% vs. 1.4%) (P = 0.0076). No difference was found in the duration of hospitalization between the two groups, but admission to intensive care was more common among smokers (16.7%) (P = 0.02). There were more nonsurvivors among patients who smoked compared to those who did not smoke (4.5% vs. 8.3%), although this difference was not statistically significant (P = 0.2026).

Conclusion:
Tobacco and COVID-19 are both factors that attack the lungs by causing inflammation that can surpass the body’s ability to control it. These two culprits can lead to irreversible damage to the respiratory system. Cigarette smokers are more susceptible to SARS-CoV-2 infection and have a higher risk of developing a severe form of COVID-19.
Acute spinal subdural hematoma following lumbar puncture in a pediatric leukemia patient
Authors: Abderraouf Kheirreddine Mohamed , Adel Khelifa , Fayçal Aichaoui , Abdelhalim Morsli 
Published: December 2024

Abstract
Acute spinal subdural hematoma (ASSDH) is a rare complication following intrathecal chemotherapy; however, it has the potential to cause significant morbidity. We present the case of a child treated with intrathecal chemotherapy for acute myeloid leukemia. The child presented with pain and acute paralysis in the lower limbs a few hours after lumbar puncture. Radiological findings confirmed the presence of ASSDH. The child was operated on after correcting severe thrombocytopenia. Postoperatively, the patient experienced relief from pain; however, there was no noticeable improvement in motor deficit immediately, and postoperative imaging confirmed total evacuation of the hematoma, and intensive rehabilitation was prescribed. ASSDH is a rare complication of lumbar puncture that physicians should consider, especially in leukemic patients, after correcting all hemostasis parameters; diagnosis is based on clinical presentation and radiological findings, and management requires neurosurgical intervention.
Comparative Evaluation of Salivary Flow Rate, pH, and Alkaline Phosphatase in Tobacco Users and Healthy Individuals: A Biomarker Study
Authors: Buktare Komal , Parikh Shilpa , Shah Jigna 
Published: December 2024

Abstract

Aims:
Saliva plays a vital role in maintaining oral health, and its composition can be significantly altered by tobacco use. The repeated exposure of saliva to tobacco has been associated with structural and functional changes in its parameters. This study aimed to evaluate salivary flow rate (SFR), salivary pH, and salivary alkaline phosphatase (S-ALP) levels in individuals using different forms of tobacco, including smokeless tobacco, smoking tobacco, combined tobacco use, and healthy controls.

Materials and Methods:
A total of 160 participants were randomly assigned to four groups: Group I (n = 40), smokeless tobacco users; Group II (n = 40), smoking tobacco users; Group III (n = 40), users of both smokeless and smoking tobacco; and Group IV (n = 40), healthy controls. Resting salivary flow was measured using Schirmer’s strip at 1, 2, and 3 minutes, and salivary pH was assessed using pH strips. A 3 mL sample of unstimulated saliva was collected, centrifuged, and analyzed for S-ALP levels using a biochemical analyzer. Statistical analyses were performed using the Kruskal–Wallis test for multiple group comparisons and the Mann–Whitney U test for pairwise comparisons, with a significance level set at P < 0.001.

Results:
A statistically significant reduction in mean SFR was observed in all tobacco-using groups compared to the control group (P < 0.001). Similarly, a significant decrease in salivary pH was noted in tobacco users compared to healthy controls (P < 0.001). The S-ALP levels were reduced in both smokeless and smoking tobacco users, while the combined tobacco group showed an increase in S-ALP levels compared to the healthy control group.

Conclusion:
Long-term tobacco use, whether smokeless, smoking, or a combination of both, can lead to significant changes in salivary parameters, including reduced salivary flow, altered pH, and fluctuations in S-ALP levels. These changes can contribute to adverse effects on oral mucosa and dental structures. Clinicians should consider tobacco use as a key factor when assessing oral health, as tobacco-related changes in salivary composition could increase the risk of oral diseases. Further research is needed to explore the underlying mechanisms by which tobacco affects salivary composition and to assess the potential for using these biomarkers in early detection of tobacco-related oral health issues.
Hydrogel-Based Intracanal Medicaments in Endodontics: A Systematic Review of Development and Antibacterial Efficacy
Authors: Piriyanga Rathna , Ranjan Manish , Sherwood Anand , Priyadharshini Swathi 
Published: December 2024

Abstract

Background and Aim:
Endodontic treatment necessitates the elimination of infectious pulp tissue and the disinfection of the root canal system to prevent reinfection and periradicular inflammation. Traditional intracanal medicaments, such as calcium hydroxide (Ca(OH)2), have limitations including limited drug diffusion, short retention time, and potential tooth discoloration. Hydrogels, due to their unique properties such as controlled drug release and biocompatibility, have emerged as promising carriers for intracanal medicaments. This systematic review aims to evaluate the development, antimicrobial efficacy, and clinical applications of hydrogel-based intracanal medicaments in endodontics. The primary objective is to assess the effectiveness of these medicaments compared to traditional in vitro intracanal medicament models or other drug delivery systems. The secondary objective is to evaluate the properties and characteristics of different hydrogel formulations used in endodontics.

Materials and Methods:
This systematic review was registered in PROSPERO (registration number: CRD42024525186). Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, experimental studies investigating hydrogel-based intracanal medicaments in simulated endodontic conditions were included. Eligibility criteria encompassed in vitro models, hydrogel-based interventions, and outcomes related to antimicrobial properties, drug release profiles, and other relevant in vitro outcomes. Data extraction and quality assessment were conducted by two independent reviewers.

Results:
Fourteen studies were included, that used various hydrogel formulations such as methylcellulose, GelMA, poloxamer gel, alginate, chitosan-based hydrogel, and HPMC. Enterococcus aecalis was the most commonly evaluated microorganism. Evaluation methods included agar diffusion assay, colony count, and SEM. Most hydrogels demonstrated significant antimicrobial efficacy, controlled drug release, and favorable biocompatibility. Material characterization varied, with some studies evaluating mechanical properties, swelling behavior, and degradation rates.

Conclusion:
Hydrogel-based intracanal medicaments with active antimicrobial agents demonstrate promising potential in the improvement of endodontic treatment with their sustainability in the antimicrobial activity and enhanced biocompatibility. The interaction between the hydrogel carriers and their active ingredients thus represents a critical factor toward optimal therapeutic outcomes. However, the study has limitations, including a limited number of in vivo studies and variability in the formulations and evaluation methods across included studies. Further investigation into material properties and specific active agents is thus necessary to fully realize the benefits of these medicaments in endodontic therapy.
Effect of Irrigants on the Push-Out Bond Strength of Three Bioceramic Root Repair Materials: An In Vitro Comparative Analysis
Authors: Patri Gaurav , Lath Harshita , Jena Debkant , Agrawal Pratik , Bajoria Atul Anand , Banka Aanchal 
Published: December 2024

Abstract

Aims:
This study aims to comparatively assess the impact of root canal irrigants on the push-out bond strength (POBS) of mineral trioxide aggregate (MTA), biodentine, and EndoSequence root repair material (ERRM).

Materials and Methods:
In this in vitro study, the midroot dentin of human canine teeth was sectioned horizontally into slices of 1.5 mm thick. The canal lumen of each dentin slice was then enlarged to a diameter of 1.3 mm using a No. 5 GG drill. One hundred and twenty samples were then randomly split into three groups (n = 40), and the following materials were filled into the canal space, respectively: ProRoot MTA, biodentine, and ERRM putty. The samples were covered with damp gauze for 10 min. They were subsequently divided into four subgroups (n = 10) to be immersed in 3% sodium hypochlorite, saline, 2% chlorhexidine gluconate, and no irrigant (control), respectively. After incubation for 48 h, the POBS of the samples was determined using a universal testing machine. A stereomicroscopic examination of the samples was done to ascertain the nature of the bond failures. One-way ANOVA was employed to assess the differences in POBS among the three materials when exposed to different irrigants and pairwise comparison was done using post hoc Tukey test. The significance level was set to P < 0.05.

Results:
ERRM demonstrated the highest POBS of 6.83 ± 0.94 MPa when tested with normal saline and ProRoot MTA recorded the lowest POBS of 3.44 ± 0.47 MPa under chlorhexidine. Under saline, both ERRM and biodentine showed a significantly better (P < 0.05) POBS value than ProRoot MTA. With NaOCl, ERRM showed a significantly better (P < 0.05) POBS value than ProRoot MTA and biodentine. With chlorhexidine, both ERRM and biodentine showed significantly better results (P < 0.05) as compared to ProRoot MTA.

Conclusions:
ERRM showed the highest POBS value irrespective of the irrigant used, whereas ProRoot MTA showed the least. This suggests that ERRM may be the preferred choice for root repair, especially when using chlorhexidine as an irrigant.
Impact of Nanoparticles on Dental Composites: A Systematic Review and Meta-Analysis
Authors: Ahuja Dhruv , Akhila M. R. , Singh Ashish Kumar , Batra Puneet 
Published: December 2024

Abstract

Aims:
The focus of this review is to assess the mechanical characteristics of using nanoparticles (NPs) in dental composites (DCs) to enhance strength and toughness.

Materials and Methods:
The review protocol was registered on PROSPERO with registration ID: CRD42024573647. A systematic search for relevant articles published between 2018 and July 2024 was conducted across electronic databases including Scopus, PubMed, WoS, and EBSCOhost. Studies meeting pre-defined eligibility criteria were included and assessed for methodological quality. Data on the mechanical properties of NPs on DCs were extracted from included studies. Meta-analysis was performed to assess the mechanical flexure strength associated with NPs in DCs.

Results:
A range of NPs including silicon dioxide, zirconium dioxide, titanium dioxide, graphene oxide, core–shell chlorhexidine/amorphous calcium phosphate, zinc-doped mesoporous silica NPs, silver NPs, farnesol-loaded halloysite nanotube, calcium hydrogen phosphate dihydrate, niobium pentoxide, and chitosan were examined for incorporation into DCs. The use of organic and inorganic NPs has shown a significant boost in the mechanical characteristics of DCs. The forest plot demonstrated a significant increase in mechanical characteristics in DCs infused with NPs.

Conclusion:
It can be concluded that incorporating NPs in restorative dentistry holds promise for enhancing their mechanical properties and increasing strength and toughness.
Inflammatory Status of Patients with Dental Implants of Different Microgeometry using ELISA: A Prospective Clinical Study
Authors: Gnanajothi Janani , Rajasekar Arvina 
Published: December 2024

Abstract

Aims:
Interleukin-1 beta (IL-1β), one of the most potent proinflammatory cytokines, plays a crucial role in bone resorption and inflammation. Its concentrations are pivotal in assessing the inflammatory responses around dental implants. This study aimed to conduct a comparative analysis of IL-1β levels in peri-implant crevicular fluid (PICF) among patients with dental implants of different microgeometries.

Materials and Methods:
A total of 78 patients who underwent dental implant placement in the mandibular first molar region between September 2020 and January 2021 were enrolled in this prospective study, following rigorous inclusion and exclusion criteria. Participants were categorized into three groups based on implant surface treatment: sandblasted acid-etched implants (SLA, n = 27; Group 1), SLActive implants (n = 26; Group 2), and TiUnite implants (n = 25; Group 3). IL-1β levels in the PICF were measured by enzyme-linked immunosorbent assay (ELISA) at the third month and first year post-implantation. Statistical analyses, including analysis of variance (ANOVA) and paired t-tests, were performed, with a P-value of less than 0.05 indicating statistical significance.

Results:
IL-1β levels in the PICF were significantly higher in Group 3 (TiUnite implants) compared to Groups 1 (SLA) and 2 (SLActive) (P < 0.05). Pairwise comparisons at the third month (P < 0.05) and first year (P < 0.05) showed significant differences between the groups. Additionally, intragroup analysis revealed a significant increase in IL-1β levels from the third month to the first year within each group (P < 0.05)

Conclusion:
IL-1β concentrations in PICF were notably higher in patients with anodized implants (TiUnite), compared to those with sandblasted acid-etched implants (SLA and SLActive). These findings highlight the potential influence of implant surface treatment on peri-implant inflammation and bone resorption. Clinicians should consider implant surface treatment as a factor in managing inflammatory responses and ensuring long-term implant success. Future studies could explore the underlying mechanisms contributing to elevated IL-1β levels in anodized implants, and investigate the long-term effects of these surface treatments on bone healing and implant stability.
Evaluation of Effect of Poloxamer on Smear Layer Removal Using Apical Negative Pressure: An In Vitro Scanning Electron Microscopy Study
Authors: Prabha Chandra , Shetty Chitharanjan , Shetty Aditya 
Published: December 2024

Abstract

Aims:
The aim of this study was to assess the smear layer removal efficacy of sodium hypochlorite (NaOCl) and ethylene diamine tetraacetic acid (EDTA), with and without the addition of poloxamer, in an in vitro model.

Materials and Methods:
In this in vitro study, 60 human premolars were randomly selected and decoronated to standardize the root length to 15 mm. The working length was set 1 mm short of the apex. The canals were instrumented to size F3 using the Protaper file system, with irrigation using NaOCl and saline between instrumentations. The samples were randomly divided into four groups based on the final irrigation protocol: Group 1 (n = 15) - 3% NaOCl with poloxamer, Group 2 (n = 15) - 17% EDTA with poloxamer, Group 3 (n = 15) - 3% NaOCl without poloxamer, and Group 4 (n = 15) - 17% EDTA without poloxamer. All samples were irrigated using an apical negative pressure system, and smear layer removal was analyzed using scanning electron microscopy (SEM). A five-graded scoring system was used to assess smear layer removal. Data were statistically analyzed using the Kruskal–Wallis test.

Results:
The group irrigated with EDTA and poloxamer showed the most effective smear layer removal, with a median score of 2 in both the middle and apical thirds of the canal. The NaOCl with poloxamer group showed a median score of 3, while the NaOCl-only group had a median score of 5, indicating less efficient removal of the smear layer.

Conclusion:
The study concluded that the addition of poloxamer to NaOCl and EDTA improved smear layer removal by lowering the surface tension of the irrigants. The combination of EDTA with poloxamer exhibited the best smear layer removal, followed by NaOCl with poloxamer. The NaOCl-only group showed the least effectiveness. This enhanced smear layer removal improves irrigant penetration, particularly for NaOCl, and may also enhance its antimicrobial efficacy. Furthermore, poloxamer’s surfactant properties suggest its potential as a drug delivery agent for intracanal medicaments. The results suggest that incorporating poloxamer into root canal irrigation protocols can significantly improve the efficacy of smear layer removal, leading to better irrigation outcomes and improved penetration of medicaments. This could enhance the overall success of endodontic treatments, particularly by improving antimicrobial activity and facilitating more effective drug delivery to the root canal system. Future research could explore the long-term clinical effects of using poloxamer-enhanced irrigants in various root canal systems, as well as investigate its potential as a carrier for additional intracanal medicaments. Further studies should also examine the impact of poloxamer on the mechanical properties of the root canal dentin and its compatibility with other commonly used irrigants.
Assessment of Patient Satisfaction and Acceptance of Acupuncture as an Alternative Therapy in Dental Practice
Authors: Sarkar Tapas K. , Pandya Divya , Sharma Mohit , Kulavi Sandip , Dausage Priyanka , Banerjee Anwesha 
Published: December 2024

ABSTRACT

Objective:
To evaluate patient satisfaction and acceptance of acupuncture in dental practice.

Methods:
This randomized controlled study involved 30 participants (15 males, 15 females, mean age 38.2 years) requiring mandibular third molar extraction. Patients were randomly assigned to receive either real or placebo acupuncture. Pain intensity was assessed using a 4-point scale, and patients’ acceptance of and satisfaction with acupuncture were measured. The study was conducted at an oral and maxillofacial surgery clinic.

Results:
Toothache was the most common dental issue (16.7%). Participants showed moderate to high levels of acceptance toward acupuncture (mean score of 3.37 on a 4-point scale) and satisfaction with the treatment (mean score of 3.50).

Conclusion:
The study demonstrates a positive reception of acupuncture in dental settings, with moderate to high levels of patient acceptance and satisfaction. These findings suggest that acupuncture could be a valuable adjunctive therapy in comprehensive dental care, particularly for pain management and anxiety reduction. However, further research is needed to fully establish its efficacy across various dental procedures.
The Impact of Periodontal Therapy on Systemic Inflammatory Markers and Cardiovascular Disease Risk in Patients with Chronic Periodontitis
Authors: Shrivastava Deepti , Alanazi Abdullah R. F. , Altimani Zayed M. A. , Alsalem Abdullah M. , Alam Mohammad K. , Srivastava Kumar C. 
Published: December 2024

ABSTRACT

Background:
A common inflammatory condition that damages the tissues that support teeth, chronic periodontitis has become more closely associated with systemic health conditions, especially cardiovascular disease (CVD).

Materials and Methods:
In this randomized controlled experiment, 100 individuals with a diagnosis of chronic periodontitis were included. Two groups of participants were created: a treatment group (n = 50) that received scaling and root planning as well as other non-surgical periodontal care, and a control group (n = 50) that did not receive any treatment. Measurements were taken at baseline and 6 months after therapy for systemic inflammatory markers, including as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). The Framingham Risk Score (FRS) was used at the same intervals to evaluate the risk of CVD.

Results:
At 6 months after therapy, patients in the treatment group had substantial reductions in all measured inflammatory markers: CRP was down 30% (P < 0.01), IL-6 was down 25% (P < 0.05), and TNF-α was down 28% (P < 0.01). In the therapy group, the Framingham Risk Score dropped by 15% (P < 0.05), suggesting a lower chance of cardiovascular disease. There were no noteworthy alterations noted in the group under control.

Conclusion:
In individuals with persistent periodontitis, non-surgical periodontal treatment may minimize the risk of cardiovascular disease and considerably reduce systemic inflammatory indicators.