Sardar Patel Post Graduate Institute of Dental and Medical Sciences

Alzheimer's disease (AD) is a progressive and complicated neurodegenerative disorder that mostly affects the elderly and is characterized by memory loss, cognitive dysfunction, accumulation of amyloid beta (Aβ) plaques, neurofibrillary tangles, and cholinergic deficits. Current therapies used for AD, such as acetylcholinesterase inhibitors and NMDA receptor antagonist memantine, can only provide temporary or symptomatic relief, but they do not stop or reverse the progression of the disease. Numerous pathogenic hypotheses have been proposed to explain this mechanism; however, the amyloid cascade hypothesis remains the most widely accepted theory, as it suggests that β-site amyloid precursor protein-cleaving enzyme 1 (BACE1) plays a critical role in the generation of Aβ peptides. Therefore, BACE1 may be a key therapeutic target. This review primarily focuses on the key role of BACE1 in AD pathogenesis and describes the development of its inhibitors over three generations, explaining their structure, design, and pharmacological properties. While the first generation lacked brain penetration, the second-generation improved potency but encountered clinical trial failures due to adverse effects. The third generation of these drugs was designed to achieve a balance between efficacy, selectivity, and safety. Additionally, we review the promising molecules currently under clinical investigation, highlighting both their therapeutic potential and the challenges that remain in developing effective disease-modifying therapies for AD treatment.

As global populations transition into an era of super-aging, implant therapy increasingly extends to older adults with multiple comorbidities and functional decline. Traditional reliance on chronological age as a determinant of treatment eligibility is gradually being replaced by a more holistic understanding of frailty, a multidimensional measure of biological resilience and vulnerability. Recognizing frailty as a dynamic continuum rather than a fixed state can reshape decision-making in implant dentistry, emphasizing patient-centered care over procedural ambition. Contemporary evidence suggests that while implant survival in older adults remains favorable, outcomes are significantly influenced by frailty status, systemic health, and the capacity for long-term maintenance. Incorporating brief frailty assessment tools such as the Clinical Frailty Scale (CFS) or Edmonton Frail Scale (EFS) into preoperative planning enables risk stratification, better communication with caregivers and physicians, and alignment of treatment goals with patient quality of life. This editorial advocates for a paradigm shift from age-based to frailty-based decision algorithms, promoting minimally invasive protocols, simplified prosthetic designs, and proactive maintenance strategies. Integrating geriatric principles into implant therapy not only enhances clinical predictability but also reinforces ethical stewardship in delivering personalized, sustainable care for the aging population.

BackgroundThe commonest multifactorial disease affecting mankind is dental caries. Oral pediatric liquid medications (PLMs) are the best line of treatment for young children, as they are available in the form of syrups, suspensions, and solutions. Extended use of liquid medicines has a deleterious effect on dentition in chronic asthmatic patients, sensitive respiratory problems, and epileptic patients, along with frequent sudden conditions such as sinusitis, allergic rhinitis, tonsillitis, and otitis media, and has a deleterious effect on the dentition of young adults.Materials and methodsThe study was performed in three phases on two antiasthmatic and two antiepileptic liquid medications. Phase I: cariogenic potential of the selected PLMs was assessed using endogenous pH determination, determination of total sugar, and Streptococcus mutans growth rate. Phase II: erosive capacity of the selected PLMs was assessed using determination of viscosity, titratable acidity, buffering properties, and total soluble solids content. Phase III: erosive capacity of selected liquid medications on permanent tooth surface was assessed by scanning electron microscope-electronic dispersion X-rays and microhardness.ResultsCariogenic and erosive potential was statistically significant in group B (antiasthmatic—omnacortil) and group C (antiepileptic—valparin).ConclusionIndividually, it would be feasible to educate youngsters and their parents about the importance of brushing their pearly whites after every medicine they take. On the contrary, producing medicines for kids without fermentable carbohydrates at minimal expense would be a desirable health improvement strategy.How to cite this articleGhosh R, Dhinsa K, Rai A, et al. An In Vitro Analysis of Erosive and Cariogenic Potential of Commonly Prescribed Antiasthmatic and Antiepileptic Liquid Medications on Permanent Teeth: An SEM-EDX Study. Int J Clin Pediatr Dent 2025;18(S-1):S40-S44.

ABSTRACTBackground:The research was carried out for the evaluation of serum metal ion concentrations in dental implant subjects.Material and Methods:The study comprised 50 individuals, with 26 being male and 24 being female. Before inserting the implant, serum samples had been taken from every individual to determine the initial amounts of titanium and aluminum ions. Each patient had 10 milliliters of blood extracted into sterile vacutainers, without the addition of any anticoagulant. The blood had been permitted to coagulate precisely for 20 minutes at room temperature, and thereafter subjected to centrifugation to get serum. Prolonged incubation could potentially lead to the introduction of external contaminants. Inductively coupled plasma optical emission spectrometry (ICP-OES) was employed to evaluate the samples for titanium and aluminum. Subsequently, implants were inserted via a flapless approach. Serum samples were obtained on follow-up and results were assessed.Results:Mean titanium amounts prior to placement of dental implants were 3.24 mg/dl. The mean titanium levels at six weeks, three months, and six months following implant placement were 3.26 mg/dl, 3.29 mg/dl, and 3.31 mg/dl, respectively. Mean aluminum levels before placement of dental implants were 4.21 mg/dl. The mean titanium levels at six weeks, three months, and six months following implant placement were 4.25 mg/dl, 4.27 mg/dl, and 4.3 mg/dl, respectively.Conclusion:No effect in serum titanium and aluminum levels occurs after dental implant placement.

This case report outlines the successful management of a large, chronic oroantral fistula (OAF) using a three-layer closure technique in a 55-year-old male who reported nasal fluid leakage several months after maxillary molar extraction. Imaging confirmed a large communication between the oral cavity and maxillary sinus. Surgical closure was performed under general anesthesia using nasal intubation. A cortical bone graft from the chin reconstructed the bony defect, followed by the placement of a buccal fat pad (BFP) and coverage with a buccal advancement flap. Platelet-rich plasma (PRP) was applied over the graft and soft tissue layers to accelerate healing and enhance tissue regeneration. Postoperative recovery was smooth, with complete resolution of symptoms and no complications noted during follow-up. This case emphasizes the effectiveness of combining autologous bone grafting, soft tissue coverage, and PRP application in managing large chronic fistulas, providing stable outcomes and improved healing in complex clinical scenarios.

Emerging bio-intelligent dental prostheses mark a paradigm shift from passive tissue replacements to interactive, adaptive systems. Traditional dentures and fixed prostheses restore function and esthetics but remain static within a dynamic oral environment. Recent advances in materials science, sensor technology, nanotechnology, and artificial intelligence (AI) are redefining prosthodontics by enabling prostheses to monitor, respond, and integrate with biological processes. Biosensor-embedded implants and smart dentures can track peri-implant tissue health, detect oral dryness, or provide real-time temperature data, while AI systems interpret inputs for predictive and preventive care. These innovations expand prosthodontics into a partner discipline of systemic healthcare. However, challenges remain, including device durability, power supply, data security, regulatory frameworks, and equitable access. This editorial explores the emerging concept of bio-intelligent prostheses, highlighting their potential applications, limitations, and implications for future prosthodontic education, practice, and interdisciplinary collaboration. Such systems position prostheses not as inert replacements but as intelligent health interfaces shaping the future of dental medicine.

Prosthodontics plays a vital role in improving the oral health-related quality of life of patients, yet its contribution in the context of palliative care remains underexplored. Individuals receiving palliative care often suffer from oral complications such as xerostomia, mucosal ulceration, prosthesis-related trauma, and impaired mastication or speech. These conditions not only compromise nutrition and communication but also aggravate broader symptoms such as pain, dyspnea, and fatigue. For instance, poorly fitting prostheses can cause persistent oral pain, limiting food intake and thereby worsening fatigue. Difficulty in mastication and swallowing may contribute to aspiration risk, exacerbating dyspnea. By addressing these oral challenges, prosthodontic interventions can directly support comfort, reduce symptom burden, and preserve dignity in end-of-life care, complementing systemic medical management. Prosthodontic interventions, ranging from the use of soft liners and tissue conditioners to lightweight interim prostheses and modified obturators, can provide substantial relief in this setting. Despite the availability of simple and cost-effective strategies, awareness and integration of prosthodontics into palliative care pathways remain limited. This editorial highlights the urgent need to reframe prosthodontics as a discipline not confined to restorative excellence but as one that directly contributes to alleviating suffering. By emphasizing patient-centered goals, prosthodontists can enhance nutrition, communication, and psychosocial well-being for terminally ill patients. Greater collaboration between prosthodontists, oncologists, and palliative care providers is essential to ensure comprehensive oral comfort management. Addressing these gaps will not only improve patient outcomes but also align prosthodontics more closely with the core mission of palliative care, optimizing quality of life in its final stages.

ObjectivesThis study set out to compare the mechanical behavior of graphene and zirconia in the context of their potential use in fixed dental prostheses. Specifically, we evaluated three critical properties: Rockwell hardness, to understand surface durability; compressive strength, to assess resistance to biting forces; and flexural strength, to examine performance under bending stress. To approximate real-world conditions, all samples were subjected to thermocycling, simulating the thermal changes typical of the oral cavity. The goal was to explore whether graphene could serve as a viable alternative to zirconia in restorative applications.MethodsA systematic in vitro protocol was followed. Standardized specimens of graphene and zirconia were fabricated and subjected to 30,000 thermocycles between 5°C and 55°C. Mechanical tests were conducted using a universal testing machine. Rockwell hardness was measured using a standard durometer, while compressive and flexural strengths were evaluated through load-to-failure testing. Data were statistically analyzed using independent-sample t-tests, with significance defined at p<0.05.ResultsZirconia showed markedly higher compressive strength compared to graphene, making it better suited for high-load areas of the mouth. Interestingly, the two materials performed similarly in Rockwell hardness, suggesting comparable surface durability. Flexural strength results were also close, with no significant difference, indicating that graphene may perform well under bending or tensile forces. These outcomes reaffirm zirconia's status as a robust material for prosthodontics while also opening the door for graphene as a lightweight, structurally capable alternative.ConclusionWhile zirconia continues to outperform in terms of compressive strength, graphene demonstrates meaningful potential due to its comparable flexural strength and hardness, along with the added advantage of being significantly lighter. These findings support further investigation into graphene's role in restorative dentistry, especially in cases where weight, design complexity, or aesthetics demand alternative materials. Future research should explore its biocompatibility, long-term performance, and integration with current dental systems.

Introduction: Sediment cytology, initially applied in urinary diagnostics, has expanded to formalin-fixed biopsy specimens, evaluating exfoliated cells suspended in formalin fixative. Though traditionally discarded, this sediment contains diagnostic material, especially in friable or malignant tissues. It offers a rapid, cost-effective, preliminary diagnostic tool when histopathology is delayed, such as in bone lesions requiring decalcification. This systematic review aimed to comprehensively assess the diagnostic accuracy, applicability, and limitations of sediment cytology across diverse anatomical sites. Methods: This systematic review followed PRISMA guidelines, and an electronic search was conducted across PubMed, Scopus, and Google Scholar databases until January 1, 2025, without year restrictions. Keywords included “Sediment cytology,” “oral neoplasms,” “bone lesions,” and related terms. Articles in English reporting sediment cytology on formalin-fixed biopsies with cytological-histological correlation were included. Results: Nine eligible studies were identified, involving various lesions including oral squamous cell carcinoma (OSCC), oral potentially malignant disorders (OPMDs), bone lesions, GIT, and cervical and ovarian neoplasms. Pooled sensitivity and specificity were 73.3% and 92.1%, respectively. Subgroup analysis revealed excellent concordance for OSCC and bone malignancies. Sensitivity was lower in benign lesions and OPMDs, attributed to poor cellularity and exfoliation. Methodological heterogeneity was noted, though overall bias remained low. Conclusion: Sediment cytology shows valuable diagnostic potential as a preliminary adjunct to histopathology, particularly for malignancies, warranting further standardized multicenter studies.

This case report presents a rare occurrence of congenital oral mucosal synechiae in a 5-day-old neonate with a cleft palate, leading to feeding difficulties. The infant exhibited a soft fibrous band restricting oral mobility, which was successfully excised using electrocautery. Immediate postsurgical improvements included restored mouth opening and the ability to breastfeed. Histopathological analysis confirmed connective tissue composition. This case highlights the importance of recognizing mucosal synechiae in neonates and its associated cleft and other craniofacial anomalies, contributing to the limited literature on this rare presentation and guiding future clinical management strategies, offering valuable insights for clinicians handling similar presentations.