Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Research Protocol
Year : 2023 | Month : March | Volume : 17 | Issue : 3 | Page : ZK10 - ZK12 Full Version

Comparative Evaluation of Antimicrobial Efficacy of Simvastatin Paste and Aloe Vera Paste as a Pulpotomy Medicament-An In-vitro Study


Published: March 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/58659.17625
Sakshi Pravin Kabra, Nilima Thosar

1. Postgraduate, Department of Paediatric and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India. 2. Professor and Head, Department of Paediatric and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India.

Correspondence Address :
Sakshi Pravin Kabra,
Kabra House, Near Ratneshwar Mandir, Gujari Bazar Risod, Maharashtra, India.
E-mail: kabrasakshi2@gmail.com

Abstract

Introduction: Pulpotomy is the complete removal of the coronal part of the dental pulp, followed by the application of an appropriate dressing or medicament to promote healing and maintain the viability of the teeth in the dental arch. Aloe vera has anti-inflammatory, antibacterial properties which can be used as a pulpotomy medicament. Simvastatin, a lipid-lowering medication has recently emerged as a potential medicament in regenerative dentistry. It has an anti-inflammatory and antioxidant properties. Hence, it can be used as a pulpotomy medicament.

Need of the study: The present study can provide evidence regarding the use of Aloe vera and Simvastatin in pulpotomy with respect to their bactericidal activity, biocompatability and promoting root pulp healing.

Aim: To evaluate and compare the antimicrobial efficacy of Aloe Vera paste and Simvastatin paste as pulpotomy medicament against Pseudomonas aeruginosa and E. faecalis

Materials and Methods: An in-vitro study will be conducted in Department of Paediatric and Preventive Dentistry at Sharad Pawar Dental College, Wardha, Maharashtra, India, in which Aloe Vera paste and Simvastatin paste will be prepared in an aseptic environment. The antimicrobial activity of simvastatin paste and Aloe Vera paste against E.faecalis and pseudomonas will be assessed using the agar diffusion method. It will be cultured overnight in brain heart infusion broth. On blood agar media, pseudomonas aeruginosa will be inoculated. 4 mm wells will be punched out on plates with a puncher and will be instantly loaded with freshly customised test materials. The agar plates shall then be incubated in an incubator at 37°C for 24 hours and 72 hours before being analysed. Statistical analysis will be done using Chi-square test, ANOVA test and multiple comparision 2k test.

Keywords

Pulpotomy material, Regeneration, Statin

In pulpotomy coronal portion of the dental pulp is completely removed and the appropriate dressing or medicament is applied to hasten healing and maintain the health of teeth on dental arch. Several pulpotomy materials, including calcium hydroxide, ferric sulphate glutaraldehyde, formocresol enhanced mixture cement, and mineral trioxide aggregate have been studied in radiographic and clinical trials to determine their mechanism of action, clinical symptoms, and benefits (1). Properties of ideal pulpotomy material would be bactericidal and biocompatible, promote root pulp healing, and be compatible with root resorption physiological process. However, the appropriate pulpotomy medicament that meets all of the parameters has yet to be identified (2). Many natural products promise to have a major impact and appear to be a feasible alternative for formocresol, including Curcuma longa, turmeric, Nigella sativa, Thymus vulgaris, Honey, Allium sativum oil, Aloe Vera, and Acemannan (3).

Aloe Vera is a succulent, elongated tropical and subtropical plant with a shrubby appearance. Aloe Vera Barbadensis Miller is a member of the Liliaceae family, which is frequently utilised for therapeutic purposes (4). It has been used as a home cure for burn wounds for a long time. As a result, it’s known as the “burn plant.” Aloe Vera has a variety of dermatological uses, including inflammation treatment, wound healing, and antibacterial activity, particularly in the treatment of thermal burns, radiation burns, and frostbite. It promotes macrophage recruitment, collagen formation, and wound contraction, among other wound healing processes (4).

In Dentistry, Aloe Vera plays a major role in the treatment of oral lichen planus, oral submucous fibrosis, recurrent aphthous stomatitis, alveolar osteitis, periodontitis etc., (4). In Paediatric Dentistry Kriplani R et al., performed an in-vitro experiment using Aloe Vera in powdered form and proved that Aloe Vera with sterile water has superior antimicrobial activity as a root canal filling material (4). Aloe Vera has anti-inflammatory, antibacterial, immunomodulatory, antiviral, and pain-relieving activities in nature (5).

Simvastatin, a strong lipid-lowering medication (3hydroxy, 3methylglutaryl co-enzyme) A (HMG CoA) reductase inhibitor, has recently emerged as a potential medicament in regenerative dentistry (2). Statin enhances bone formation by improving osteoblast function and suppressing osteoclast function via the Bone Morphogenic Protein (BMP)-2 pathway. As a result, statins may help odontoblasts function efficiently, resulting in better dentin production (6). It has been proven to have regenerative impacts on dental pulp stem cell, odontoblastic differentiation and the generation of reparative dentin [7,8]. Statins play a vital role in oral cancer by inhibiting the growth, metastasis, invasion etc. It helps in wound healing, periodontal treatment and pulpotomy treatment. Simvastatin has anti-inflammatory, antioxidant properties, immunomodulatory action, antifungal, antiviral and antithrombotic properties (9). Aripirala M et al., performed an in-vivo study on diode laser and Simvastatin gel as a pulpotomy material (2). Whitaker EJ and Alshammari A, performed an in-vitro study on bacteriostatic effects of simvastatin solution against Streptococcus and prove that simvastatin inhibits the growth of the test organisms (10).

Aloe Vera and Simvastatin has antimicrobial properties. Simvastatin has not been studied in the paste form as a pulpotomy material in literature. In past studies there is only one literature which has evaluated clinically the efficacy of pure simvastatin as a pulpotomy agent in gel form (2). Instead of simvastatin in gel form simvastatin in paste form will show good results because gel form might get displaced from its place in the tooth (2). So, the aim of this study is to evaluate and compare the antimicrobial efficacy of Aloe Vera paste and Simvastatin paste as a pulpotomy medicament against Pseudomonas aeruginosa and E. faecalis.

The objectives of the study are to evaluate the antimicrobial efficacy of Aloe Vera and Simvastatin paste as pulpotomy medicament against Pseudomonas aeruginosa and E. faecalis. Second, to compare the antimicrobial efficacy of Aloe Vera and Simvastatin paste as pulpotomy medicament against Pseudomonas aeruginosa and E. faecalis. Third is to evaluate the antimicrobial efficacy of Aloe vera and Simvastatin paste with calcium hydroxide against Pseudomonas aeruginosa and E.faecalis. And last objective is to compare the antimicrobial efficacy of Aloe vera and Simvastatin paste with calcium hydroxide against Pseudomonas aeruginosa and E.faecalis.

REVIEW OF LITERATURE

The main cause of pulpal and periradicular diseases are microorganisms and their by-products (11). The major goal of pulpotomy treatment is to remove the infected coronal portion of the pulp and thereby decreasing the microbial load in the affected tooth (4). The mucilaginous gel produced by the parenchymatous cells in the leaf pulp of Aloe Vera has been utilised for a variety of medicinal applications since ancient times. Aloe Vera materials have been suggested to have a direct antimicrobial effect. It has been demonstrated to have anti-inflammatory, regenerative, nutritional, and antibacterial effects, among other medicinal characteristics (12). Gala-Garcia A et al., conducted one investigation on the effects of Aloe Vera on rat pulpal tissue (13). Aloe Vera which is 4 years grown is taken in the study. Pulpal tissue was manually treated with Aloe Vera 1-7 days after therapy the Aloe Vera-treated group displayed a noticeable acute-moderate inflammatory infiltration. When compared to Ca(OH)2 therapy, pulp tissue returned to normal after 14-30 days; both treatment groups triggered reparative dentin and the establishment of a full bridge (13).

Microbiological study which is conducted by Kriplani R et al., in which Aloe Vera was compared to several root canal materials like calcium hydroxide Zinc Oxide Eugenol (ZOE) calcium hydroxide with idoform etc., As a result, Aloe Vera had a high inhibitory effect on aerobic gram-positive microbes and a moderate inhibitory effect on aerobic gram negative microorganisms. ZOE+Aloe Vera had a moderate inhibitory effect on both groups of test microorganisms, whereas ZOE had a moderate inhibitory effect on both groups of test microorganisms. As a result, incorporating Aloe Vera into ZOE improves the antibacterial properties of the ZOE-Aloe Vera combination when compared to ZOE alone (4). As mentioned in Kriplani R et al., Aloe Vera will be used in present study but, it will be in paste form.

In the present study, Aloe Vera harvested after 3 years of growth will be taken because of increase in effectiveness of the plant, while after 12 years of Aloe Vera growth it loses some of its nutritional potency (4). Therefore, in the present study, Aloe Vera after 12 years of growth will be excluded from the study. Statins have distinct anti-inflammatory, angiogenesis-inducing, osteoblastic, and odontoblastic differentiation capabilities. Simvastatin improves osteoblast function and suppresses osteoclastic activity, resulting in bone growth when applied locally (14). Stein D et al., investigated a scientific study on effects of simvastatin on growth and inflammation of mandibular bone. Female rats were given different doses of simvastatin (0.1, 0.5, 1.0, 1.5, or 2.2 mg) through methyalcellulose gel in a polylactic acid membrane on the lateral side of the jaw. When 0.5 mg simvastatin was used instead of gel, bone area 11increased by 45 percent, and clinical inflammation was minimised when compared to the high simvastatin dose. The 0.1 mg dose of simvastatin did not result in considerable bone development. As a result, Simvastatin was lowered from 2.2-0.5 mg, which decreased swelling to a clinically manageable level without affecting bone development potential (15). Present study will use the similar simvastatin material which is mentioned in the study of Stein D et al., but it will convert into paste form (15).

A randomised clinical experiment was conducted by Aripirala M et al., to assess and compare the clinical and radiographic efficacy of the diode laser and simvastatin gel in pulpotomy of carious primary molars. The study was performed on 90 patients 45 with diode laser and 45 with simvastatin gel. Clinical and radiological follow-up evaluations were done at 3 and 12 months. In results, abscess was diagnosed in 9 molars of the diode laser group and 8 molars of the simvastatin gel group after 3 months. Two more molars in the diode laser group and 1 more in the simvastatin gel group had abscess at 12 months. Simvastatin gel shows more clinical success rate than diaode laser pulpotomy. Author concluded that simvatatin gel can be recommended as a potential pulpotomy medicament in primary molars (2). As efficacy of simvastatin gel is proven, present study will try to prove its efficacy in paste form.

Material and Methods

This study will be conducted in Department of Paediatric and Preventive Dentistry at Sharad Pawar Dental College, Wardha, Maharashtra, India. Ethical approval for the study was obtained from the Institutional Ethics Committee (IEC ref no. DMIMS(DU)/IEC/2022/755).

Inclusion criteria: The inclusion criteria consists of natural extract of Aloe Vera from the Liliaceae family harvested after 3 years of growth, from botanical garden, 97% pure simvastatin powder from sigma Aldrich company and Pseudomonas aeruginosa and E.faecalis strain.

Exclusion criteria: Aloe Vera plant which is older than 12 years will be excluded from the study.

Study Procedure

The study will consist of four groups. The first group will contain pure Aloe Vera paste, for which Aloe Vera leaves will be collected and freeze-dried. After drying the powder, it will be mixed with 1.5 mL saline water and converted into paste form. For the second group, Aloe Vera paste with 1 mL propylene glycol shall be mixed with 0.17 g of Calcium hydroxide (4). For preparing simvastatin paste, pure simvastatin (97 percent pure) (10) will be procured in powder form mixed with distilled water and converted into paste form. Third group will consist of Simvastatin paste which will be prepared under an aseptic environment using a vortex unit to combine 0.03 mg simvastatin powder with 10 mL distilled water and a carrier paste; and for group four, 0.03 mg of calcium hydroxide shall be added to the above-mentioned simvastatin paste (2). All the groups shall be tested against Pseudomonas and E.faecalis.

In the microbial assay, the antimicrobial activity of simvastatin paste and Aloe Vera paste against E.faecalis and pseudomonas will be assessed using the agar diffusion method. E.faecalis will be obtained as a bacterial stock culture, and will be cultured overnight in brain heart infusion broth. Pseudomonas aeruginosa will be inoculated on blood agar media. Wells of 4 mm will be punched out on 12 plates with a puncher under an aseptic environment, according to the manufacturer’s specifications, and instantly loaded with freshly customised test materials. The Agar plates will then be incubated in an incubator at 37°C for 24 hours and 72 hours before being analysed. By using digital calliper, the diameter of microbial inhibition zones, of this pulp capping material around each well to the nearest size in mm will be measured at 24 hours and 72 hours to assess their antimicrobial efficacy against E.faecalis and pseudomonas (16). The obtained data will be tabulated and analysed statistically.

Primary outcome: Simvastatin paste and Aloe Vera paste will prove to be more efficient as pulpotomy medicament and will able to provide Antimicrobial efficacy against Pseudomonas aeruginosa and E.faecalis.

Statistical Analysis

Statistical analysis will be done using software SPSS Version 27.0 and Graph pad Prism 7.0 version where, (p<0.05) will be considered as level of significance. The findings will be analysed statistically using Chi-square test ANOVA test and multiple comparison 2k test.

References

1.
Bhat S, Bhagat R. Evaluation of anti-bacterial efficiency of different pulp capping materials method against E. faecalis and S. mutans: An in-vitro study. Int J Appl Dent Sci. 2019;5(3):13-15.
2.
Aripirala M, Bansal K, Mathur VP, Tewari N, Gupta P, Logani A. Comparative evaluation of diode laser and simvastatin gel in pulpotomy of primary molars: A randomised clinical trial. J Indian Soc Pedod Prev Dent. 2021;39:303-09.
3.
Jha S, Goel N, Dash BP, Sarangal H, Garg I, Namdev R. An update on newer pulpotomy agents in primary teeth: A literature review. J Pharm Bioallied Sci. 2021;13(Suppl 1):S57. [crossref] [PubMed]
4.
Kriplani R, Thosar N, Baliga MS, Kulkarni P, Shah N, Yeluri R. Comparative evaluation of anti-microbial efficacy of various root canal filling materials along with aloevera used in primary teeth: A microbiological study. J Clin Pediatr Dent. 2013;37:257-62. [crossref] [PubMed]
5.
Mangaiyarkarasi SP, Manigandan T, Elumalai M, Cholan PK, Kaur RP. Benefits of Aloe Vera in dentistry. J Pharm Bioallied Sci. 2015;7(Suppl 1):S255. [crossref] [PubMed]
6.
Reynolds T, Dweck AC. Aloe Vera leaf gel: A review update. J Ethnopharmacol. 1999;68(1-3):03-07. [crossref] [PubMed]
7.
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DOI and Others

DOI: 10.7860/JCDR/2023/58659.17625

Date of Submission: Jun 24, 2022
Date of Peer Review: Aug 22, 2022
Date of Acceptance: Nov 02, 2022
Date of Publishing: Mar 01, 2023

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? No
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 30, 2022
• Manual Googling: Aug 20, 2022
• iThenticate Software: Nov 01, 2022 (14%)

ETYMOLOGY: Author Origin

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