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   Table of Contents - Current issue
Coverpage
July-December 2019
Volume 14 | Issue 2
Page Nos. 57-161

Online since Thursday, December 26, 2019

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ORIGINAL ARTICLES: DENTAL MEDICINE  

Comparative study of diode lasers used for two time intervals for the treatment of teeth with vertical root fractures p. 57
Maram E Khallaf, Doaa M Saadony
DOI:10.4103/jasmr.jasmr_12_19  
Background/aim Vertical root fracture treatment is considered a challenge in endodontics. And no single approach up till now gives satisfactory results. The present study aimed to compare the effect of a 970 nm diode laser in a continuous wave at different time intervals with a resin-based sealer or a resin-based sealer only on sealing of vertical root fractures of extracted teeth. Materials and methods Thirty upper single-rooted teeth were sectioned below the cement enamel junction. A groove of 5 mm length and 1 mm width was done at the root surface. Specimens were divided into three groups (10 each). Group 1 using sealer only, group 2 using a 970 nm diode laser irradiation at a power of 1.5 W at continuous mode for 60 s, and group 3 using a 970 nm diode laser irradiation at a power of 1.5 W and at continuous mode for 90 s. In groups group 2 and group 3, the root fracture line was filled with a sealer followed by diode laser irradiation and the gap size was examined by scanning electron microscopy. Temperature rise at the root surface was also measured using a temperature meter. Statistical analysis was carried out using one-way analysis of variance and the Tukey test (P<0.05). Results The statistical analysis showed that using laser with a 1.5 W/90 s group 3 showed the statistically least fracture gap (1.22 μm) while group 1 showed a gap of 8.57 μm and group 2 a gap of 2.44 μm. Conclusion The present study concluded that the application of a 970 nm diode laser at 90 s decreased the gap between the sealer and the root surface at the fracture line in extracted teeth.
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The effect of salivary gland-derived stem cell transplantation on the regeneration of gamma-irradiated rat submandibular salivary glands: an immunohistochemical study p. 62
Reham A.A. Morsy, Effat A Abbas, Heba N Shalash, Ehab S.A. El-Hamid, Houry M Baghdadi
DOI:10.4103/jasmr.jasmr_13_19  
Background Hyposalivation could be a sequela of radiation impairment in patients with head and neck cancer. Regenerative approaches based on the reactivation of endogenous stem cells or the transplant of exogenous stem cells hold substantial promise in restoring the structure and function of these organs to improve patient quality of life. Recently, tissue-specific stem cell therapy has attracted public attention as a next-generation therapeutic reagent. The aim of this work is to assess the regenerative potential of salivary gland-derived stem cells transplantation in gamma-irradiated rat submandibular salivary glands (SMSGs). Materials and methods Forty-six adult male albino rats were used in this study. Both SMSGs were harvested from five healthy donor rats and used as a source of stem cells. Cells were cultured for 3 and 10 days. Characterization and assessment of stemness after isolation by flow cytometry was carried out using CD24 stem cell marker by fluorescent analysis cell sorting. The rats were grouped as follows: group I (normal untreated control), group II (irradiation group), and group III (irradiation and transplantation group). They were subjected to whole-body gamma radiation with a single dose of 6 Gy. Results Stem cells were successfully isolated from rat SMSGs with positively expressing CD24 and C-kit markers. The statistical analysis revealed significant increase in cell proliferation (proliferating cell nuclear antigen) in both groups II and III compared with the control group I (P˂0.05). Regarding caspase 3 results, the statistical analysis revealed highly significant increase in the mean values of groups II and subgroups III compared with the control group I (P˂0.05). Concerning C-kit expression, group III showed the highest statistically significant mean C-kit expression, followed by group II and group I (P˃0.05). At 2 weeks after transplantation, group II showed the highest statistically significant mean C-kit expression followed by III and control group I (P˃0.05). Conclusion Transplantation of these C-kit+ submandibular salivary gland stem cell (SMSGSCs) could result in amelioration of the severely reduced quality of life of surviving patients with cancer.
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Evaluation of two-body wear rate and roughness of polyetheretherketone and zirconia opposing enamel structure: an in-vitro study p. 73
Ghada E Hamza, Haidy N Salem, Muhammad A Samman
DOI:10.4103/jasmr.jasmr_14_19  
Background/aim Investigation of polyetheretherketone (PEEK), a new synthetic thermoplastic polymer, as an alternative for zirconia for veneering frameworks, to be used with weakened abutment teeth, as in cases of patients with parafunctional habits. This study aimed to investigate the two-body wear rate and roughness of PEEK and zirconia by itself and against human enamel. Materials and methods A total of six disc-shaped zirconia (n=6) and six disc-shaped PEEK specimens (n=6) (10 mm in diameter with a thickness of 2 mm) were prepared. Human enamel antagonists were produced by sectioning of 12 premolars. The two-body wear testing was performed using chewing simulator. Weight loss was assessed by electronic analytical balance. The optical profilometry was used for roughness evaluation. Results The findings of this study revealed that PEEK showed a comparable effect upon comparison with zirconia, although there was a statistically nonsignificant difference between weight changes recorded for wear in both PEEK and zirconia groups, tested alone or with enamel antagonists, as indicated by the unpaired t test. Moreover, the optical profilometer revealed that, the difference between surface roughness changes recorded for both groups, tested alone or with enamel antagonists, was statistically nonsignificant as indicated by the unpaired t test. Conclusion PEEK showed a promising effect in terms of antagonistic tooth wear and roughness upon comparison with zirconia. However, the results were not significant between both materials.
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The odontogenic performance of human dental pulp stem cell in 3-dimensional chitosan and nano-bioactive glass-based scaffold material with different pores size p. 82
Reham A.A. Morsy, Hanan Beherei, Marwa Ellithy, Heba E Tarek, Mostafa Mabrouk
DOI:10.4103/jasmr.jasmr_18_19  
Background This study focused on the development of biocompatible and biodegradable homoporous chitosan scaffolds containing nano-bioactive glass 58S for dental tissue regeneration. For this aim, we developed a new chemical route to obtain homoporous scaffolds that mimic cancellous bone by utilizing H2O2. Materials and methods Different properties of the prepared powder of 58S were analyzed by transmission electron microscopy, thermogravimetric analysis (TGA)/differential scanning colometric (DSC), X-ray diffraction, and Fourier transform infrared spectroscopy. The developed scaffolds were analyzed by X-ray diffraction, Fourier transform infrared spectroscopy, and scanning electron microscope in comparison with heteroporous scaffolds prepared in the absence of H2O2. Stem cells from dental pulp were seeded onto the prepared scaffolds for different periods of time. The ability to differentiate toward an odontogenic lineage was studied for the loaded cells with the prepared scaffolds. Results The size of the prepared nano-bioglass 58S nanoparticles was in the range of 23.9–98.18 nm. The scaffolds prepared using H2O2 exhibited homogenous porous scaffolds in the range of 250–450 μm size when compared with scaffold synthesized in the absence of H2O2, which demonstrated heterogeneous scaffolds in the range of 350–700 μm. The cell studies showed better cell growth and biomineralization with the heterogeneous scaffolds compared with homogenous microarchitecture. Conclusion The microarchitecture of heterogeneous scaffolds plays a significant role in dental pulp stem cell differentiation and calcified tissue development as well as provides new possibilities for dental tissue engineering.
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Candida albicans colonization on different polymeric denture base materials in controlled type II diabetic patients p. 95
Eman M Ahmed, Ahmed M Esmat, Hoda G Hassan
DOI:10.4103/jasmr.jasmr_20_19  
Background/aim Growth of the immunosuppressed population has provoked increased incidence of oral candidiasis infections. This study was conducted to evaluate colonization of Candida albicans upon the fitting surfaces of three different polymeric denture base materials in patients with controlled type II diabetes mellitus. The investigated resin denture base materials were the conventional heat-cured methacrylate and two types of commercially available flexible denture base materials. Materials and methods A total of 30 completely edentulous patients with controlled type II diabetes mellitus were included in the study, and they were divided into three equal groups (10 each), where group I patients received upper and lower complete dentures fabricated from conventional heat-cured acrylic resin, group II patients received a flexible versacryl upper complete denture and a lower heat-cured acrylic resin denture, and group III patients received a thermoplastic nylon upper complete denture and a heat-cured acrylic resin lower denture. Samples of C. albicans culture swabs were taken after 1 month and after 3 months of dentures insertion. Culture swab was obtained by scrubbing the fitting surface of all upper dentures at tuberosity area. At each time interval, three swab samples were collected from each patient and were inoculated in three individual culture media. Results of the study were statistically analyzed to evaluate the fungal colonization in each of the three investigated groups. Results The present results indicated that mean number of C. albicans colonies upon heat-cure acrylic resin denture base material at 1 month was 45±6.86, whereas at 3 months, it was 97±12.02. The mean number of fungal colonies for versacryl denture base material after 1 month was 12.80±4.80, and at 3 months, it was 22.50±6.16. The mean number of C. albicans colonies for nylon-based denture base at 1 month was 7.00±2.30, and at 3 months, it was 13.50±3.02. Conclusion Within the limitation of the study, flexible polymeric denture base materials showed lesser Candida adherence upon upper denture fitting surface than that of conventional heat-cured acrylic resin. In addition, nylon-based denture showed less colonization to Candida than versacryl denture material. Flexible dentures seem to be promising owing to their minimum microbial colonization and relatively healthier biological tissue reactions in comparison with the heat-cured acrylic resin.
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Osteogenic potential of human dental pulp-derived mesenchymal stem cells in bone regeneration of rabbit p. 102
Eman E.A. Mohammed, Mohamed El-Zawahry, Abdel Razik H Farrag, Nahla N Abdel Aziz, Nourhan Abou-Shahba, Marwa Mahmoud, Wael A El-Mohandes, Mahmoud A El-Farmawy, Alice K Abdel Aleem
DOI:10.4103/jasmr.jasmr_21_19  
Background/aim Human dental pulp-derived mesenchymal stem cells (hDP-MSCs) offer a promising source of progenitor cells for regenerative medicine and bone tissue engineering. Cranial defects are common complications that can arise secondary to trauma, surgery, or infection. This study aimed to evaluate the osteogenic differentiation potential of hMSCs isolated from dental pulp of third molar teeth in vitro cultures and the bone regenerative capacity of hDP-MSCs transplanted into induced temporomandibular joint (TMJ) defect in rabbits. Patients and methods hDP-MSCs were isolated from third molar teeth and cultured. Alizarin staining was performed to assess the osteogenic differentiation at the 14th and 28th days. The therapeutic potential of hDP-MSCs in craniofacial bone defects was investigated in the left side of the rabbits’ TMJ. The transplanted cells involved three groups: the osteogenic differentiated DP-MSCs (O), undifferentiated MSCs (M), and control group (cell-free matrix) (C). Cells were loaded on gel foam. Eighteen rabbits were used and sacrificed at subsequent three time points, 4, 6, and 9 weeks, after transplantation, with six rabbits/each time point and two rabbits/each cell group. Histopathological studies were applied to evaluate the healing potential of hDP-MSCs in the induced rabbit TMJ defect. Results hDP-MSCs showed a high proliferative potential and osteogenic differentiation in vitro. Histological results demonstrated a timely correlated mandibular defects’ repair in all the experimental groups, including the control group, with more enhanced bone healing effect for the osteogenic differentiated DP-MSCs. Conclusion hDP-MSCs possess high proliferation capacity and osteogenic differentiation potential in vitro. Histological observations revealed the osteogenic differentiated DP-MSCs have higher bone healing potential than the undifferentiated DP-MSCs at 9 weeks after transplantation, and gel foam promotes bone formation in the control group. The bone regenerative potential of osteogenic differentiated DP-MSCs revealed a significant capacity when implanted in rabbit TMJ defect. Hence, hDP-MSCs could be a promising source for craniofacial bone regeneration.
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Effect of surface treatment of milled cobalt–chromium alloy on shear bond strength to porcelain p. 113
Ghada E Hamza, Hanaa Sallam, Elzahraa Eldwakhly
DOI:10.4103/jasmr.jasmr_24_19  
Background/aim Strong bond between metal and porcelain is essential for success and longevity of porcelain-fused-to-metal restorations. Therefore, the present study aimed to evaluate shear bond strength (SBS) between porcelain and CAD/CAM milled cobalt–chromium (Co–Cr) alloy treated by sandblasting, oxidation, and laser etching in comparison with cast alloy treatment. Materials and methods Co–Cr alloys were used for fabrication of sixty discs (2.5 mm thickness×10 mm diameters), which were split into half (n=30 each): group A, milled discs, and group B, conventional casting discs. Both groups were split into thirds (n=10) according to Co–Cr surface treatment: subgroup S, sandblasting (control); subgroup O, oxidation; and subgroup L, laser etching. Surface morphology of the samples was examined before and after surface treatments by scanning electron microscope. Feldspathic porcelain (3 mm thickness×5 mm diameter) was added to the Co–Cr discs (opaque, dentin, and enamel) and fired. SBS test (MPa) was carried out using material testing machine at crosshead speed of 0.5 mm/min till failure. The modes of failure were evaluated by scanning electron microscope and digital microscope. Statistics were performed by two-way analysis of variance (ANOVA), one-way ANOVA, Tukey post-hoc test, and t-test (P<0.05). Results Two-way ANOVA results indicated insignificant differences in SBS among Co–Cr fabrication techniques (P=0.259). In contrast, significant differences were demonstrated between the different surface treatments (P<0.001), where laser etching showed the least SBS mean values with both fabrication techniques. Regardless of the fabrication technique, all subgroups exhibited cohesive failure within the porcelain, except for the laser etching subgroups, which showed mixed failure mode. Conclusion Bond between surface treated Co–Cr alloys and porcelain is independent of the fabrication technique. Laser etching recorded the least SBS among the tested surface treatments irrespective of the fabrication technique. All SBS values recorded in the present study were clinically acceptable.
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ORIGINAL ARTICLE: BIOCHEMISTRY Top

Brain-derived neurotrophic factor and coenzyme Q10 levels in blood of children with learning disorder p. 124
Mohamed E Elhadidy, Ola H Gebril, Adel Hashish, Ayman Kilany, Neveen H Nashaat, Ehab R Abdelraouf
DOI:10.4103/jasmr.jasmr_15_19  
Background Learning disorder (LD) is manifested by significant difficulties in the acquisition and use of reasoning, reading, writing, or mathematical abilities, despite average intelligence and proper education. Its etiological factors were suggested to be related to neurodevelopmental alterations. Measurement of the levels of brain-derived neurotrophic factor (BDNF) and coenzyme Q10 (CoQ10) was targeted in children with LD in comparison with typically developing (TD) ones. Materials and methods This study included 82 Egyptian Arabic-speaking children matched for age and sex and socioeconomic status, comprising 42 with specific LD (group I) and 40 TD children (group II). All participants were subjected to clinical and full neurological examination after reporting a full medical history. Furthermore, LD group was subjected to Stanford–Binet intelligence scale, dyslexia assessment test, and phonological awareness test, which evaluates cognitive and learning aptitudes. The levels of BDNF and CoQ10 were determined in serum by enzyme-linked immunosorbent assay. Results All children with LD obtained a score of 1 or more as at-risk quotient by the dyslexia assessment test, which indicated a specific reading disorder. The BDNF and CoQ10 levels in the LD group were significantly less than those in the TD group. No correlations were found between the measured markers and each other or between them and the measured factors of the used tests. Conclusion The detected low levels of BDNF and CoQ10 in children with specific LD with impairment in reading would be suspected to be related to etiological or exaggerating factors for the deficits in such children.
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ORIGINAL ARTICLE: OPTHALMOLOGY Top

The combined effect of photobiomodulation therapy and chia seeds supplementation for the treatment of diabetic retinopathy in experimental rats p. 130
Salwa Abdelkawi, Amal E Ibrahim, Dina F Ghoneim, Aziza A Hassan, Maha S.A. Eldaiem
DOI:10.4103/jasmr.jasmr_16_19  
Background Photobiomodulation (PBM) plays an essential role in accelerating wound healing and in the recovery of the retinal function. This study aimed to evaluate the efficacy of PBM therapy in combination with chia seeds as an antioxidant in the treatment of experimental diabetic retinopathy (DR). Materials and methods A total of 80 Wistar rats were divided into two groups: group 1 control (n=8 rat), and group 2 streptozotocin (STZ)-induced DR group (72 rats), which were injected intraperitoneally with 55 mg/kg of STZ. After 6 weeks, the rats were examined for DR and divided into three subgroups (each 24 rats): (2a) STZ-induced DR group, (2b) STZ-induced DR group exposed to 670-nm diode laser for 6 successive weeks, and (2c) STZ-induced DR group was exposed to 670-nm diode laser and supplemented with 250 mg/kg of chia seeds for 2 weeks before induction of diabetes and continued till the end of the experiment. Electroretinogram (ERG), total protein concentration in retina, and Fourier transform infrared spectrum were assessed after 1, 2, 4, and 6 weeks (six rats each). Results DR group showed a progressive decrease (P<0.05) in a-wave and b-wave of the ERG and retinal protein, in addition to distinct change in the amide I region during 6 weeks, whereas treatment with PBM showed improvement in ERG (a-wave and b-wave, P<0.05), protein content (P<0.05), and in the amide I region (P<0.05). However, the group treated with PBM and chia seeds showed better improvement in the a/b ratio of ERG, retinal protein, and in structural component of amide I region compared with the control (α-helix: 37 vs. 34.3%, β-sheet first peak was 12.6 vs. 14.39%, and β-sheet second peak was 20 vs. 20.36%). Conclusion Chia seeds with PBM has more beneficial effects in the treatment of DR than by PBM alone.
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ORIGINAL ARTICLE: PHYSIOLOGY Top

Comparative study of the cardioprotective effect of probiotics and symbiotics in 5/6th nephrectomized rats p. 140
Bataa M El-Kafoury, Dalia A Saad
DOI:10.4103/jasmr.jasmr_17_19  
Background Chronic kidney disease (CKD) is a well-known world health problem. Patients with CKD rapidly progress to end-stage renal disease with cardiovascular complications. CKD is characterized by retention of toxic substances that contribute to progression of uremia. Indoxyl sulfate is a known toxin that increases in the blood in patients with CKD and is related to uremic cardiomyopathy. Probiotics and prebiotics are reported to have health benefits to the host when supplemented in an adequate amount. We aimed to explore the pathogenesis of uremic cardiomyopathy and the possible protective effects of probiotics and symbiotic. Materials and methods A total of 48 white albino rats were divided into six groups: sham group (group 1), 5/6th nephrectomy group (group 2), probiotic-treated 5/6th nephrectomy rats (group 3 and group 4), and symbiotic-treated 5/6th nephrectomy rats (group 5 and group 6). Treatments were initiated either immediately or 2 weeks after the performed operation. Heart was exposed to 30-min ischemia followed by 30-min reperfusion. Systolic and diastolic functions and myocardial flow rate were measured at 15 and 30 min of reperfusion. Blood pressure measurement was done 1 day before killing. Biochemical studies including serum levels of creatinine, urea, and indoxyl sulfate, and transforming growth factor-β1 (TGF-β1) and NADPH oxidase in heart tissue were done. Results Creatinine, urea, TGF-β1, and NADPH oxidase were significantly elevated in all groups compared with sham group. In symbiotic-treated groups, these parameters significantly decreased compared with nephrectomized rats. Systolic and diastolic functions of the heart at 30-min reperfusion were decreased in nephrectomized rats compared with sham one, whereas these functions were attenuated in treated rats. Blood pressure was increased significantly in nephrectomized rats but decreased significantly in symbiotic-treated rats. Conclusion Use of symbiotic and not probiotic is cardioprotective in CKD rats. Symbiotics protect the heart by decreasing uremic toxins and oxidative stress and improve internal milieu.
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ORIGINAL ARTICLE: PATHOLOGY Top

Immunohistochemical expression of CD4+ and CD8+ tumor-infiltrating lymphocytes in colorectal carcinoma p. 153
Wafaa E Abdelaal, Naglaa F Abbas, Sonia L El-Sharkawy, Noha A.H. Helmy, Manal A Badawi, Dalia M Abouelfadl, Noha N Yassen, Marwa E Shabana, Ahmed S.A. Soliman, Ola R Oda
DOI:10.4103/jasmr.jasmr_22_19  
Background/aim Colorectal cancer (CRC) is one of the most common causes of cancer-related deaths in the world. The potential influences of tumor-infiltrating lymphocytes (TILs) in various neoplasms including CRC have been reported to reflect the antitumor immunity of the host. The aim of this study was to evaluate the expression of CD4+ and CD8+ TILs in CRC and to correlate their expression with patients’ clinicopathological parameters. Materials and methods Paraffin blocks and clinicopathological data of 130 patients with CRC were obtained from private laboratories. The density of CD4 and CD8 tumor TILs was assessed immunohistochemically and evaluated by image analysis in 130 specimens of CRC. The CD4+and CD8+ cell tumor infiltrate was classified into scanty, moderate, and abundant expression. Results Of the 130 CRC cases, 68 (66.2%) were adenocarcinoma and 44 (33.8%) were mucinous carcinoma, 114 (87.7%) were of grade II and 16 (12.3%) were of tumor grade III. CD4+ T cells expression was significantly correlated with the histopathological grade and Duke’s classification. CD8+ T cells expression was significantly correlated with the Duke’s classification. Conclusion Cancer colon progression is influenced by host immune response and the presence of TILs CD4+ and CD8+. Further studies are recommended to assess implication of these cells in CRC prognosis.
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