Introduction: Alveolar bone regeneration requires bioactive scaffolds that mimic the extracellular matrix (ECM) while providing therapeutic cues to promote healing and resist infection. We aimed to green-synthesize strontium nanoparticles (SrNps) using the horsetail plant (Equisetum) and incorporate the SrNps into alginate and chitosan nanofibers to characterize and evaluate the antimicrobial and cytotoxic activity of strontium (Sr)-incorporated alginate and chitosan nanofibers. Materials and Methods: SrNps were synthesized using Equisetum extract and electrospun with alginate/chitosan to fabricate the nanofibers. Alginate, chitosan, Sr-alginate, and Sr-chitosan nanofibers were tested for antimicrobial activity against common oral pathogens, Candida albicans, Streptococcus mutans, and Lactobacillus, using zone of inhibition and time-kill kinetic assays. Further, cytotoxicity was assessed using the brine shrimp lethality assay. High resolution Scanning electron microscopy analysis of the nanofibers was performed to characterize the nanofibers. FTIR spectroscopy was used to confirm the incorporation of SrNps into the polymer matrices. Results: FTIR confirmed successful incorporation of SrNps into alginate and chitosan polymers. HR SEM analysis characterized the Sr-incorporated nanofibers. Sr-chitosan exhibited significant antimicrobial activity, with ZOI against Lactobacillus ranging from 11.97 ± 0.17, 14.25 ± 0.29, and 18.00 ± 0.35 mm at 25, 50, and 100 μg/mL, respectively, and ZOI against S. mutans was observed to be 11.93 ± 0.02 and 18.85 ± 0.56 mm at 50 and 100 μg/mL, respectively. All test formulations exhibited no significant cytotoxicity up to a 50 µg/mL concentration for 48 h. Conclusion: Sr-incorporated alginate and chitosan nanofibers are biocompatible materials, with Sr-chitosan nanofibers exhibiting significant antimicrobial activity. Further cell-line and in vivo studies need to be carried out to underscore their potential as promising tissue regeneration scaffolds.
Introduction: Tobacco dependence is a chronic condition often requiring structured behavioral interventions. Conventional tobacco cessation counseling in dental settings largely relies on health education, which may not lead to sustained behavioral change. Cognitive dissonance (CD)-based strategies, which emphasize inconsistencies between beliefs and behaviors, may enhance motivation to quit. Materials and Methods: A two-arm, parallel-group randomized controlled trial was conducted among 128 current cigarette smokers aged 18–45 years attending two tertiary oral health care facilities. Participants were randomly allocated (1:1) to receive either standard 5A’s counseling (control) or the same counseling combined with a CD-based intervention. The CD intervention required participants to publicly advocate against smoking and highlight the benefits of quitting at each follow-up. Nicotine dependence was assessed using the Fagerström test for nicotine dependence (FTND) at baseline and 6 months, while gingival inflammation was measured using the gingival bleeding index (GBI) at baseline, 3 months, and 6 months. Results: Baseline characteristics were comparable between groups. At 6 months, the CD group showed significantly lower FTND scores than the control group (3.04 ± 1.90 versus 4.38 ± 1.25; P < 0.001) and greater dependence reduction (−2.01 versus −0.65; P < 0.001). GBI scores were significantly lower in the CD group at 3 and 6 months (P < 0.05). Participants in the test arm demonstrated significantly lower FTND scores at 6 months compared with the control group (adjusted mean difference = –1.42; 95% confidence interval (CI): −2.01 to −0.83; P < 0.001). Sensitivity analysis using multiple imputation yielded consistent estimates. Conclusion: Integrating CD induction into standard counseling was associated with greater reductions in nicotine dependence and gingival inflammation than counseling alone. While abstinence outcomes were not assessed, the findings highlight the potential of behaviorally driven interventions to promote gradual reductions in tobacco dependence.
Introduction: Antimicrobial resistance (AMR) is a major global health challenge, with dentistry contributing 7–10% of antibiotic prescriptions worldwide. Inappropriate prescribing, rising resistance in oral pathogens, and limited stewardship interventions underscore the need for consolidated evidence. To synthesize evidence from systematic reviews and meta-analyses on AMR and stewardship in dentistry, and to critically appraise their methodological quality using a measurement tool to assess systematic Reviews 2 (AMSTAR-2). Materials and Methods: An umbrella review was conducted in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 and Joanna Briggs Institute methodology. PubMed, Scopus, Embase, Web of Science, and Cochrane Library were searched for systematic reviews and meta-analyses published between January 2020 and March 2025. Eligible reviews reported on AMR prevalence, prescribing practices, prophylaxis, stewardship interventions, or oral microbiota resistance. Methodological quality was assessed using AMSTAR-2. A narrative synthesis was performed due to heterogeneity. Results: Thirteen systematic reviews and meta-analyses were included. Key themes identified were the following: (1) antibiotic prophylaxis—single-dose preoperative prophylaxis reduced implant failures, while prolonged regimens showed no added benefit; (2) prescribing patterns and misuse—high rates of inappropriate prescribing and self-medication were reported, especially in low- and middle-income countries; (3) AMR in oral pathogens—widespread resistance to penicillin, amoxicillin, metronidazole, and clindamycin was observed, with oral biofilms harboring diverse resistance genes; and (4) stewardship interventions—audit and feedback with education were most effective, while guideline dissemination alone was insufficient. Methodological quality varied, with several reviews rated as critically low due to a lack of protocol registration and limited bias assessment. Conclusion: Dentistry contributes significantly to the AMR burden through inappropriate prescribing and pathogen resistance. Evidence supports single-dose prophylaxis and active stewardship strategies. Dentistry must be integrated into national and global AMR action plans to strengthen antimicrobial stewardship and safeguard antibiotic effectiveness.
Introduction: Accurate dental age estimation is pivotal in forensic, legal, and clinical contexts, particularly in countries like India, where official birth records may be unreliable or missing. Given the cultural, genetic, and environmental diversity within South India, a unified dental age estimation model may not adequately represent regional variations. Although a population-specific regression model was recently proposed for South Indian children, its generalizability across different states had not been evaluated. Materials and Methods: A cross-sectional study was conducted using 2000 digital orthopantomographs (OPGs) of children aged 5 to 16 years from six South Indian states and one Union Territory. The seven left permanent mandibular teeth were assessed for dental maturity using the normalized open apices method. Age was estimated using the population-specific regression equation developed by Prabhu et al. To evaluate regional variation, five state-specific regression models were derived and compared with the population model using adjusted R2 values and interaction terms involving state dummy variables. Results: Regression analysis showed that the state-specific dummy variables were statistically nonsignificant. The adjusted R2 values for the state-specific models showed only marginal differences (range: −0.46 to 0.45) from the population model (adjusted R2 = 73.4%). Minor variation in the influence of the “sum” variable was observed between Karnataka and Andhra Pradesh, but this did not translate into meaningful improvements in predictive performance. Conclusion: The study concludes that a single, population-specific regression equation developed by Prabhu et al. is sufficient for accurate dental age estimation in South Indian children. The development of separate equations for individual states is unnecessary, making this model suitable for broad forensic and legal use across South India.
Introduction: Salivary diagnostics, based on approaches in omics data, are increasingly applicable in the diagnosis of systemic and oral pathologies. Saliva, an easily analyzable, collectible oral secretion, is evaluated for this purpose and serves as a predictor for multiple disease scenarios. In the decade when nonsmoking forms of tobacco are silent killers in South East Asia, it is the right time to look at the usefulness of saliva in assessing tobacco-associated lesions. This study analyzes parameters such as total antioxidant activity and the presence or absence of cotinine among tobacco chewers and nonchewers. The study aims to assess the salivary cotinine and antioxidant activity in the saliva of nonsmoking tobacco users and normal individuals. Materials and Methods: N = 50 adults were categorized as Group 1 (n = 25), without tobacco chewing habits, and Group 2 (n = 25), with tobacco chewing habits, selected based on their tobacco chewing habits. Saliva was passively collected and analyzed for antioxidant levels using the α-diphenyl-β-picrylhydrazyl assay and cotinine levels using commercially available cotinine detection strips. Results: A significant drop in antioxidant activity of tobacco chewers as compared to normal was noted on t-test. Cotinine levels were significantly above the detection limits in all tobacco chewers, confirming the presence of tobacco-associated chemicals in saliva. Their complete absence in the nonchewers makes it a useful marker. Conclusion: The presence of cotinine and a significant decline in antioxidant activity in saliva increase the susceptibility of the oral cavity to tobacco-associated lesions. Habit relapse in reported cases can be monitored for appropriate counseling by using salivary samples.
