Medical Science: Recent Advances and Applications Vol. 12

A Comprehensive Review of Dental Ceramics: Evolution, Classification and Clinical Guidelines for Aesthetic and Restorative Applications

Ilhem Ben Othmen — 2025-10-25

Over the past two decades, dental ceramics have undergone remarkable evolution, particularly in the aesthetic zone where both visual appeal and mechanical performance are equally critical. This review explores their historical development and current clinical applications in anterior restorations, highlighting the central role of material selection in optimising outcomes. Dental ceramics are broadly classified into three categories: glass-matrix ceramics (feldspathic, leucite-reinforced, lithium disilicate), polycrystalline ceramics (zirconia), and hybrid ceramics (resin-matrix ceramics). Each category offers distinct advantages in terms of translucency, strength, optical properties, and fabrication techniques, making the choice highly dependent on case-specific requirements. Recent advances in bonding strategies and CAD/CAM technologies have further expanded the clinical indications of ceramics, enabling minimally invasive preparations and highly precise restorations. Hybrid ceramics, in particular, represent an emerging class that combines mechanical resilience with aesthetic fidelity, opening new perspectives for use in demanding clinical scenarios. Optimal ceramic selection requires careful evaluation of both biological and mechanical factors, as well as an understanding of the limitations of each system. By synthesising current evidence and offering practical guidelines, this work aims to support clinicians in achieving predictable, durable and aesthetically pleasing outcomes in anterior ceramic restorations.

Influence of Age, Body Mass Index, and Biochemical Parameters on Renal Function in a Rural Indian Cohort

Shilpa Rattan — 2025-10-25

Background: Chronic kidney disease (CKD) is a significant and growing global health concern, affecting approximately 9.1% of the world's population, with substantial variation across regions and populations. Renal function serves as a critical marker of systemic health, influenced by both physiological ageing and metabolic stress. Rural communities often exhibit unique risk factor profiles, including differences in diet, physical activity, healthcare access, and awareness, making it critical to generate localised evidence. However, limited data exist on how demographic and biochemical variables jointly impact kidney function in rural Indian populations.

Aim: The aim of this study is to assess the influence of age, body mass index (BMI), and key biochemical indices on renal function within a rural Indian cohort.

Methods: A cross-sectional study of 200 individuals was conducted, analysing estimated glomerular filtration rate (eGFR), serum creatinine, and blood urea nitrogen (BUN) across age groups. Data were collected using a structured, pre-tested questionnaire to gather demographic details, medical history, and lifestyle factors. Pearson’s correlation and multivariate linear regression were used to explore associations between renal function and demographic/biochemical predictors. Statistical analyses were performed using IBM SPSS Statistics Version 25.0 (IBM Corp., Armonk, NY, USA).

Results: The mean age was 59.7 ± 17.2 years, and the mean BMI was 24.5 ± 4.2 kg/m². A significant age-dependent decline in GFR was observed: from 131.2 mL/min in individuals <40 years to 62.1 mL/min in those >60 years. Strong negative correlations were found between age and GFR (r = - 0.71, p < 0.001) and between BMI and GFR (r = -0.35, p = 0.002), while BMI positively correlated with serum creatinine (r = 0.29, p = 0.006). Age also showed a strong positive correlation with BUN (r = 0.64, p < 0.001). In multivariate analysis, age (β = -0.56, p < 0.001), BMI (β = -0.28, p = 0.004), and bicarbonate levels (β = +0.31, p = 0.002) independently predicted GFR.

Conclusion: Age and BMI are strong, independent predictors of renal function decline in rural populations. Elevated bicarbonate levels appear to exert a protective effect. These findings underscore the need for age- and weight-adjusted screening protocols in low-resource settings to enable earlier intervention. Limitations of this study include its cross-sectional nature, which precludes causal inference, and potential confounders such as dietary habits and undiagnosed comorbidities that were not controlled. Future longitudinal studies with larger samples and inclusion of inflammatory markers are warranted to validate and extend these findings.

Platelet-Rich Plasma for the Management of Acne Scars

Sweta S Kumar — 2025-10-25

Acne vulgaris is one of the most common dermatological disorders, affecting approximately 80–85% of adolescents and young adults worldwide. Major complications of acne include scarring as well as psychosocial distress, which can persist long after the active lesions have resolved. Its onset in adolescence may add to the emotional and psychological challenges experienced during this developmental stage, potentially affecting body image, socialisation, and sexuality. Platelet-rich plasma (PRP) has emerged as a valuable tool in the management of acne scars, offering a safe, autologous, and minimally invasive option that harnesses the body’s regenerative potential. Its efficacy is most evident when used in combination with procedures such as microneedling, fractional CO₂ laser, and subcision. By promoting collagen remodelling, angiogenesis, and epidermal regeneration, PRP addresses the core pathophysiology of scarring.

However, the lack of standardised preparation protocols, variability in outcomes, and limited large-scale randomised trials remain challenges. Future advances in biologically enhanced PRP formulations, integration with regenerative medicine, and development of standardised guidelines are likely to strengthen its role in aesthetic dermatology. For now, PRP represents a promising adjunctive modality that bridges the gap between conventional procedures and next-generation regenerative therapies for acne scars. This review briefly discusses the role of PRP in the management of acne scars.

Prevalence of Coronary Mineralised Pulp Nodules in Molars Using Cone Beam Computerised Tomography in a Brazilian Subpopulation

Ana Maria Veiga Vasques — 2025-10-25

Background: Pulp nodules, also known as Pulp stones, are a complex biological phenomenon characterised by the abnormal accumulation of mineralised tissue within the dental pulp. Only nodules larger than 200 μm in diameter are radiographically visible. Due to the variation in previous results and the limitations of earlier studies based on conventional radiographs, there is a need for more accurate diagnostic tools.

Aims: The aim of the study is to evaluate the prevalence of mineralised coronary pulp nodules by cone beam computerised tomography (CBCT) and explore any potential correlation between the occurrence of pulp nodules with gender, age, tooth, arches, and condition of the dental crown.

Methodology: CBCT scans of 300 patients, totalling 631 molars, were assessed. CBCT scans were collected from a private radiology clinic in Brazil between August 2017 and July 2018. All maxillary and mandibular molars were analysed in the sagittal, axial and coronal planes, and, when present, pulp nodules were identified as a round or oval hyperdense mass. Statistical analysis was conducted using chi-square tests, with a significance level set at 5% through Sigma Plot software (version 12.0).

Results: Of a total of 300 patients, pulp nodules were identified in 35% of subjects and in 25.5% of molars. The presence of pulp nodules was most frequently found in females (41.1%) than in males (27.7%) and in individuals aged over 60 years. The first upper molars showed the highest incidence of pulp nodules. No significant difference was observed when maxillary and mandibular arches were compared, either side. The presence of pulp nodules was higher in restored molars when compared to intact teeth (P<0.05). Within the observed teeth with pulp stones, 70 molars had a round-shaped nodule, while 91 were oval-shaped.

Conclusion: CBCT is an efficient resource for the diagnosis and location of pulp nodules and may be used to assist clinicians in planning the safest endodontic approach. Understanding the prevalence and distribution of pulp nodules regarding gender and type of teeth is paramount for the proper design of root canal treatment. The main limitation of the study is its single-centre data evaluation, highlighting the need for future multicenter studies from different regions of the country, with larger sample sizes and greater population diversity.

Intra-Arterial Therapy with 90Y for Hepatic Tumour Lesions: A Review

Adrine Silveira da Silva — 2025-10-25

Aim: The objective of this integrative review study was to identify existing studies in the literature that provide information on the advances associated with the therapeutic technique of radioembolization with 90Y-labelled microspheres and its relationship within radiology, from the perspective of expanding the culture of radiological protection.

Methodology: Through an integrative literature review, the advances associated with the therapeutic technique of radioembolization with yttrium-90 (90Y) microspheres were analysed, highlighting the reduction of radiation dose in medical and occupational exposures, as well as evaluating the role of intra-arterial radionuclides in terms of survival benefit, progression-free survival, and quality of life.

Results: The results showed that therapeutic association with radioembolization using 90Y microspheres was effective in the treatment of liver tumours, but further studies are still required to determine ideal administration protocols and combination with radionuclide therapy.

Conclusion: Moreover, additional research is needed to establish the absorbed dose delivered to the tumour, taking into account its specific radiosensitivity and the desired final mass of the treated lesion.

Recent Developments in Open Mesh-Based Inguinal Hernia Repair: A Review

Kumar H.R. — 2025-10-25

Open mesh-based techniques have emerged as the leading approach for inguinal hernia repair, replacing traditional suture-based methods. Among these techniques, the Lichtenstein repair is the most utilised due to its short learning curve and its feasibility under local anaesthesia. Irving Lichtenstein introduced this tension-free repair in 1984, whereby after reduction of the hernia and ligation of the sac, a mesh was inserted and reinforced on the posterior wall of the inguinal canal, and it was fixed to the inguinal ligament and conjoint tendon with nonabsorbable sutures and under no tension. This method is associated with reduced postoperative morbidity and exhibits the lowest recurrence rate. Other open mesh-based techniques include the Plug and Patch repair and the Prolene hernia system, both of which are viable options for open inguinal hernia repair. This review explores the Lichtenstein repair, the Plug and Patch repair, and the Prolene hernia system, with a focus on their indications and potential complications. Furthermore, a comparative analysis of these procedures was conducted concerning their postoperative complications and recurrence rates.

Gut Microbiota as a Modulator of Insulin Resistance: A Review

Noor Ali Hussein — 2025-10-25

Insulin resistance is the pivotal pathogenic component of many metabolic diseases, including type 2 diabetes mellitus, and is defined as a state of reduced responsiveness of insulin-targeting tissues to physiological levels of insulin. Recent studies have progressively uncovered aspects of the gut microbiota and how it contributes to the metabolism of key nutrients during IR. The purpose of this review is to examine the role of gut microbiota as a modulator of insulin resistance. Growing evidence indicates that dysbiosis, marked by reduced microbial diversity and an imbalance between beneficial and harmful species, contributes to metabolic dysfunction. Key findings show that a higher Firmicutes-to-Bacteroidetes ratio, the inflammatory action of lipopolysaccharide (LPS), and the beneficial effects of short-chain fatty acids (SCFAs) are central to understanding the link between microbiota and host metabolism. Protective taxa such as Akkermansia muciniphila and Faecalibacterium prausnitzii support metabolic stability, while endotoxin elevation worsens inflammation and insulin resistance. Current therapeutic strategies—including diet modification, physical activity, prebiotics, probiotics, and faecal microbiota transplantation (FMT)—demonstrate potential in restoring microbial balance. Despite these advances, challenges such as interindividual variability and the need for standardised, long-term trials remain. In conclusion, gut microbiota should be regarded not as a passive indicator but as an active therapeutic modulator with strong potential in the prevention and management of insulin resistance.

Applied and Clinical Anatomy of Sacrum

Rajani Singh — 2025-10-25

The sacrum is a triangular bone formed by the fusion of five sacral vertebrae. It forms the postero-superior part of the bony pelvis. Sacrum is subjected to various disorders like dysmorphism, fractures and tumours. To manage different types of disorders related to sacrum, S1 and S2 pedicle screws, Sacro-iliac screws, iliac screws, S2 AIar screws and instrumentation are very often used. But the sacrum is related to various viscera, blood vessels and nerves. To avoid injury to structures in the pelvis and to prevent intra- and post-operative complications, detailed knowledge of the normal and varied anatomy of the sacrum is essential. The aim of this chapter is to elaborate on the normal and applied anatomy of the sacrum. The information will be of utmost use to clinicians while dealing with the sacrum and its disorders.

Breast Cancer: Epidemiology, Pathophysiology and Diagnostic Modalities

Kurupatha Menatha Jayasree — 2025-10-25

Background: Breast cancer is a leading cause of cancer-related mortality worldwide. HER2-enriched and triple-negative—that differ in receptor status (ER, PR, HER2), prognosis, and treatment options. Disease risk arises from a mix of non-modifiable factors (age, genetics, reproductive history), modifiable factors (lifestyle, hormonal exposures), and strong environmental and hormonal influences. Early detection and characterisation of tumours—including imaging and biopsy to establish molecular subtype—are critical for guiding therapy.

Methods: This review synthesises existing literature on breast cancer epidemiology, risk factors, pathophysiology, diagnostic modalities, and treatment strategies. Sources include peer-reviewed studies on genetic mutations (e.g. BRCA1/2, TP53), hormonal and reproductive risk studies, lifestyle and environmental exposure reports, and clinical trials of therapies such as HER2-directed treatments. Diagnostic and surgical & radiation therapy approaches are compared in the context of evidence for outcomes and side effect profiles.

Results: Molecular subtype classification has proven essential: Genetic mutations such as BRCA1/2 significantly increase risk and are associated with more aggressive disease in some subtypes. Modifiable risk factors—such as obesity, alcohol use, late first childbirth, and hormone replacement therapy—also substantially impact incidence. Diagnostic imaging modalities (mammography, ultrasound, MRI) and biopsy allow earlier detection. Treatments combining surgery, radiation, and systemic (targeted, hormonal, or chemotherapy) therapies improve survival and reduce recurrence, especially when matched to the specific subtype. However, aggressive subtypes and late diagnosis continue to challenge outcomes.

Conclusions: Breast cancer is not a single disease but rather a collection of subtypes with distinct biology, risks, and treatment responses. Advances in molecular understanding and diagnostics have enabled more personalised treatment. Still, substantial work remains: reducing incidence via prevention, improving early detection in all populations, and developing more effective therapies for aggressive subtypes. Overall, integrating genetic, lifestyle, and clinical data is key to reducing the burden of breast cancer globally.