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IJCRR - 13(10), May, 2021

Pages: 57-61

Date of Publication: 19-May-2021


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Bio Ceramics: A Modern Approach to Cementsin Endodontics

Author: Kajol Relan, Manoj Chandak, Pradnya Nikhade, Pooja Chandak

Category: Healthcare

Abstract:There is an exponential growth in Endodontics due to various advances in materials used in Endodontics. Bioglass was a new material introduced in dentistry. Among them are Bioceramics that are biocompatible. They include 'alumina and zirconia, bioactive glass, glass ceramics, coatings and composites, Hydroxyapatite and resorbable calcium phosphate'. Bioceramic types of cement can be widely used for dentinal tubule closure. The voids between the dentinal walls and obturating material can be homogenously sealed by bioceramics. Bio ceramics have bioactivity that helps bone repair and neoformation due to their interaction with periapical tissues. Thorough knowledge of newer bioceramic materials is necessary to ensure the appropriate selection of material according to the clinical situation. The objective of this article is to review the various bioceramic materials and to choose the appropriate material for successful endodontic treatment.

Keywords: Bioceramics, Bioglass, Bio dentin, Calcium silicate-based types of cement, Calcium phosphate-based types of cement

Full Text:

INTRODUCTION

There is an exponential growth in Endodontics due to various advances in materials used in Endodontics. Bioglass was a new material introduced by L.L Hench and others in 1969. Various Glasses and Ceramics can bond to living bone was also observed by them.1 Earlier Calcium hydroxide was used. Calcium hydroxide is used in various pulp therapies. It is used as a pulp covering agent, in apexification, as an endodontic sealer, perforation repair material.2 The inorganic, non-metallic materials prepared by heating raw minerals at high temperatures are the Ceramics. Among them are the Bioceramics that are biocompatible.1 The brilliant biocompatibility is due to the resemblance to the biological procedure of forming Hydroxyapatite. This is also due to the ability to induce Regenerative response from periapical tissues.3 Bio ceramics are osteoinductive materials. During the bone healing process, after coming in contact they absorb osteoinductive materials. Currently, bone graft materials are used in extraction socket healing. This is because these materials are inert and also can induce healing.4 They include ‘alumina and zirconia, bioactive glass, glass ceramics, coatings and composites, Hydroxyapatite and resorbable calcium phosphate’. MTA became popular in Endodontics as the first generation bioceramic cement. There is the prevention of bacterial adhesion as bioceramics form porous powders that contain nanocrystals that having a diameter of 1-3 nm.5 Bioceramic cement can be widely used for dentinal tubule closure. The voids between the dentinal walls and obturating material can be homogenously sealed by bioceramics. Bioceramics have bioactivity that helps bone repair and neoformation due to their interaction with periapical tissues.

CLASSIFICATION

Bioceramics can be classified as6,7

  1. Bioinert: These materials do not interact with biological systems. eg: Alumina, Zirconium.

  2. Bioactive: These are tough tissues that are able of undergoing interfacial communications with the surrounding tissue. eg: ‘Bioactive glass, Hydroxyapatite, Bioactive glass ceramics, calcium silicates’.

  3. Biodegradable: They are soluble/ Resorbable. They are ultimately replaced or incorporated into the tissue. eg: Tricalcium phosphate, Bioactive glass.

BIOCERAMICS IN ENDODONTICS

  1. Calcium Silicate based : 

Types of cement: 

  • Portland Cement

  • Mineral Trioxide Aggregate (MTA).

  • Biodentin

 Sealers :

  • Endo CPM Sealer 

  • MTA Fillapex

  • BioRoot RCS

  • TechBiosealer

  1. Calcium Phosphate/ Tricalcium Phosphate/ Hydroxyapatite based

  2. The mixture of Calcium silicates and Calcium phosphates

  • iRoot BP

  • iRoot BP Plus

  • iRoot FS

  • Endosequence BC sealer

  • Bioaggregate

  • Tech Biosealer

  • Ceramicrete

PROPERTIES OF BIOCERAMICS8,9

Bio ceramics have excellent biocompatibility and is non-toxic. They do not shrink upon setting they expand a little after completion of setting. They do not produce any significant inflammatory response when used during obturation and in root repair. They form a chemical bond amid dentin and filling materials and form hydroxyapatite. They have a high pH (12.8) during the start of 24 hrs of setting. They are powerfully antibacterial, have hydrophilic nature, have outstanding sealing ability, sets fast ( 3 to 4 hrs), small particle size, easy to use. They have excellent physical properties and it has improved convenience and delivery method.

CALCIUM SILICATE BASED BIO CERAMICS

Portland Cement

Joseph Aspdin, in 1824 introduced a material Portland cement (PC) and patented it. It was obtained from a calcining mixture of limestones from Portland in England and silicon argillaceous materials.10 It is an easily available material and cheap. As MTA, it is available as grey and white.11 

Discolouration:- Grey PC shows discolouration compared to white PC.

Solubility:- PC showed little solubility and improved washout resistance

comparing to MTA.

Bioactivity:- PC showed lesser bioactivity as compared to MTA. Calcium ion release and hydroxyapatite crystal formation are there with grey as well as white PC.

Antibacterial properties:- PC has powerful action against bacteria and fungi against E. faecalis, Micrococcus luteus, Staph aureus, staph epidermidis, Pseudomonas aeruginosa, Candida albicans.12

Sealing ability:- As perforation repair material, when checked by protein leakage method, white PC has better sealing when compared to white and grey MTA.

Limitations:- PC releases a high quantity of lead and arsenic, hence the safety of PC is questionable. The seal of restoration can be jeopardized because of its high solubility. Crack formation in the tooth occurs due to excessive setting expansion.

Mineral trioxide aggregate (MTA)

MTA had been the 1st bioceramic material effectively used in endodontics. It was introduced by Dr. Mahmoud Torabinejad in 1993. The development of this cement was founded on Portland cement, in Loma Linda University – California. It has osteoconductive, osteoinductive, and biocompatible properties. MTA was used as ‘retrograde filling material and perforation closing’. The material contents, physical and chemical properties of PC and MTA are comparable. Portland cement, contains ‘Tricalcium silicate (3CaO?SiO2), dicalcium silicate (2CaO?SiO2), tricalcium aluminate (3CaO?Al2O3) and calcium sulfate (2CaSO4?H2O)’. MTA is adding has bismuth oxide – it is a nonsoluble substance to give the material radiopacity. MTA – a calcium silicate cement has ‘tricalcium silicate, dicalcium silicate, and tricalcium aluminate’. Material has two forms – grey and white. Grey coloured MTA was available up to 2002. In the same year, WMTA was presented as ProRoot MTA. This was introduced to overcome the disadvantage of discolouration caused by GMTA.11

Properties of MTA

Compressive strength: It is ~ 40 MPa in 24 hrs and ~ 67 MPa in 21 days.

Setting reaction: The setting reaction of MTA is exothermic. It requires hydration of the powder resulting in a paste that matures over time. The Tricalcium silicate and dicalcium silicate reacting with water and producing calcium silicate hydrates (C-S-H) and calcium hydroxide [Ca (OH) 2].

2[3CaO.SiO2] + 6H2O ---->3CaO.2SiO2.3H2O + 3Ca(OH)2

 2[2CaO.SiO2] + 4H2O ---->3CaO.2SiO2.3H2O + Ca(OH)2

 7Ca(OH)2 + 3Ca(H2PO4)2 ----> Ca10(PO4)6(OH)2 + 12H2O

Accelerator in setting is Calcium chloride. Retarder in setting is Sodium hypochlorite. these affect the formation of calcium hydroxide.13

Setting time: The powder liquid ratio for MTA is 3:1. As noted by Torabinejad et al, the setting time of grey ProRoot MTA is 2 hrs 45 min. As noted by Islam et al the setting time for White MTA is 2 hrs 20 min and for grey, MTA is 2 hrs 55 min.11

pH: Initial pH of hydrated MTA is 10.2. The pH 3 hrs after mixing rises up to 12.5.

Pushout bond strength and Flexural strength: Push-out bond strength of MTA as noted by Aggarwal V et al. After 24 hours is ~5.2 ± 0.4 MPa. After 7 days, the set cement had a strength that increased to 9.0 ± 0.9 MPa.14. After placing moist cotton pellet on the MTA during setting for 24 hrs, Walker et al noted increased flexural strength as ~14.27±1.96MPa.15

Porosity and Microhardness: The porosity depends on the amount of water added for paste, bubble entrapment, or pH value. MTA microhardness is affected adversely by low pH, less humidity, more condensation pressure.

Sealing ability, Particle size, and Biocompatibility: MTA materials have low microleakage compared to traditional materials while using as an apical restoration and when 3mm of MTA remained after root-end resection. Reducing the thickness of MTA causes microleakage. The particle size of MTA affects the handling characteristics of MTA. Small particle size increases the contact with the liquid. This results in increased early strength and ease of handling. Grey MTA has a larger particle size than white MTA. MTA is not mutagenic, is not neurotoxic, and does not produce side effects on microcirculation. MTA also has an anti-inflammatory effect on pulp. MTA also has osteoconductive, cementoconductive, cementoinductive effects.

Advantages : 

  • Calcium hydroxide is in such a way which gives calcium ions for cell attachment and proliferation.

  • High pH affects bacteria.

  • Cytokine production modulation.

  • Hard tissue migration and differentiation occur.

  • Provides biological seal by forming hydroxyapatite on MTA surface.

Limitations : 

  • Prolonged sitting time.

  • High cost and difficulty in handling.

  • No known solvent is there for the material.

  • Once placed it is difficult to remove.

Biodentin

Biodentin was commercially available in 2009 ( Septodont, Saint Maur des Fosses, France). It is based on calcium silicate cement. Biodentin is prepared using MTA based technology with better physical and handling properties than MTA. Biodentin is fast setting than MTA hence reduces bacterial contamination.

Properties of Biodentin :

Setting reaction: Setting reaction is the same as MTA that results in the formation of Calcium silicate hydrogel (C–S–H) and Ca(OH)2. The nucleation site for calcium silicate hydrogel is provided by Calcium carbonate. Hence the induction period is reduced and it causes the cement to set fast, It also improves the microstructure. The polymer formed is hydrosoluble that improves handling and there is a reduction in viscosity of cement.16

Setting time: Biodentin has a working time of 6 minutes. Its start setting time is 9-12 minutes and the completed setting time is 45 minutes. By adding Calcium chloride the setting time of biodentin is accelerated.16

Compressive strength and elastic modulus: Compressive strength reaches up to 100 MPa in 1st  hour. The strength keeps on increasing up to 200 MPa at 24 hrs. This value is more than that for the Glass ionomer cement. The strength reaches 300 MPa after 1 month. At this time the value stabilizes that is comparable to natural dentin ( 297 MPa). The Elastic Modulus of Biodentin is 22 GPa that is similar to dentin which is 18.5 GPa.16

Pushout bond strength and Flexural strength: Biodentin has more pushout bond strength than MTA at 24 hrs. Contamination with bleeding does not affect the pushout bond strength whereas it does in the case of MTA. The flexural strength of Biodentin after 2 hrs was 34 MPa.16

Microhardness and sealing ability: Microhardness of Biodentin was 51 VHN after 2 hrs. The value reached 69 VHN after 1 month. Natural dentin has a hardness value of 60-90 VHN. Biodentin creates a stable anchorage along with bacteria tight effect.16

Antibacterial activity, pH, and Biocompatibility: pH of Biodentin is 12.5 that is bacteriostatic, and disinfect the dentin. Biodentin has no toxic and adverse effects on cell function. TGF – B1 ( growth factor) is secreted from pulp cells due to biodentin. This causes angiogenesis, progenitor cell recruitment, cell differentiation, and mineralization.16

Endo CPM sealer (EGO SRL, Buenos Aires, Argentina)

It is an MTA based calcium silicate cement. It has the same or improved physical, chemical, and biological properties compared to MTA. It has the same composition as that of MTA, calcium carbonate is added for reducing the pH to 10 of the complete set cement. This limits the surface necrosis of the nearby tissue and allows the alkaline phosphatase action. It has ‘satisfactory radiopacity, hydroxyl and calcium ion release, antibacterial activity, biocompatibility ( stimulation of mineralization), no cytotoxicity’. However, the microleakage of the sealer is more than that of MTA.11

MTA Fillapex (Angelus, Brazil)

It is an MTA based salicylate resin root canal sealer. It contains 13.2 % MTA. It has a higher radiopacity. It releases calcium ions that help in bone healing and tissue regeneration. It has a higher flow and low film thickness. This helps easy penetration into the lateral and accessory canals. It can be simply removed if retreatment is essential. It has less solubility hence outstanding seal inside the canal is maintained.17

EXPERIMENTAL CALCIUM ALUMINO-SILICATES

EndoBinder (Binderware, São Carlos, SP, Brazil): It is a new calcium aluminate based endodontic cement. It is produced by conserving the properties and clinical applications of MTA and elimination of traces of ‘Magnesium oxide (MgO), and Calcium oxide (CaO) and ferric oxide (FeO)’. These elements result in the expansion of material that is not desired. Ferric oxide (FeO) is accountable for discolouration.17

Generex A (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA): It is based on calcium silicate material. It has little resemblances to ProRoot MTA but is mixed with unique gels in place of water that is used for MTA. However, it is difficult in handling as compared to MTA. It is used mostly for perforation repair and retrograde fillings.17

Capasio (Primus Consulting, Bradenton, FL, USA): It is made up of ‘bismuth oxide, dental glass and calcium alumino-silicate with a silica and polyvinyl acetate-based gel’. Capasio as well as MTA promoted apatite deposition after exposing it to synthetic tissue fluid hence can be concluded that it has mineralizing property. It can penetrate dentinal tubules when used as root-end filling material.17

Calcium Phosphate based Ceramics: They were developed by  Hench in 1971. He developed Bioglass that was a Ca and P containing glass-ceramic. He also showed that it bonded chemically with host bone via a CaP rich layer.17

Compressive strength: For porous ceramics, it was 30-170 MPa. For dense ceramics, it was 120-917 MPa.

Uses :

  • Bone substitute.

  • Bone graft material.

  • Pulp capping materials.

  • Active restorative materials with ACP as filler

Limitations :

  • less strength.

  • caused fatigue fracture.

  • failure in load-bearing situations.

MIXTURE OF CALCIUM SILICATES AND CALCIUM PHOSPHATES

Bio aggregate (Verio Dental Co. Ltd., Vancouver, Canada): Biaggregate is made up of nanoparticles of ‘tricalcium silicate, calcium phosphate, silicon dioxide. This shows increased performance than MTA. Tantalum oxide is added that acts as a radiopacifier and it does not contain aluminium. Tricalcium silicate is the main component. Bioaggregate has no aluminium and contains additives like ‘calcium oxide and silicon dioxide. It has greater calcium release as compared to MTA. It is more biocompatible, has a better sealing ability, higher fracture resistance, and acid resistance than MTA. It has a better ability for inducing odontoblastic differentiation and mineralization than MTA in pulp capping.11

Setting reaction: Calcium silicate hydrate and calcium oxide are produced by the hydration of tricalcium silicate. ‘Calcium silicate hydrate’ gets deposited around cement grains. Calcium oxide is reacted with silicon dioxide and forms extra calcium silicate hydrate. Hence calcium hydroxide is reduced in aged cement. While in MTA angelus, no additions were done but still, calcium hydroxide was present in aged cement.18

Endosequence BC sealer [Brasseler USA]: It is not soluble, radiopaque, and aluminium free material. It is based on calcium silicate cement. It has ‘Zirconium oxide, calcium silicates, calcium phosphate monobasic, calcium hydroxide, filler, and thickening agents. It requires the presence of water to set and harden.18

Setting reaction : The hydration reaction of calcium silicates is as follows

2[3CaO-SiO2] + 6H2O   →3CaO2SiO2-3H2O+ 3Ca(OH)2

 2[2CaO-SiO2] + 4H2O  → 3CaO2SiO2-3H2O+ Ca(OH)2

The precipitation reaction (C) of calcium phosphate apatite is as follows:

7Ca(OH)2 + 3Ca(H2PO4)2   →Ca10(PO4)6(OH)2 + 12H2O                                                                                                                      

No mixing is required and can be applied straight into the root canal. The working time can be more than 4 hrs at room temperature. However, in very dry root canals, it can be greater than  10 hrs.18

EndoSequence Root Repair Material/IrootSP/ IrootBP (ERRM; Brasseler, Savannah, GA)

It mainly consists of ‘calcium silicate, monobasic calcium phosphate, zirconium oxide, tantalum oxide, and filler agents’. Paste form is marketed in already loaded syringes. Also marketed in a putty form that can be moulded. The time of working for cement is 30 min. The reaction starts in presence of moisture. The final set is achieved after 4 hrs. However, it has a lesser sealing ability than MTA. The antibacterial property of this cement is similar to that of MTA. ERRM has no cytotoxic effect.18 As compared to MTA and Biodentin, ERRM is considered to have superior sealing ability for furcation repair.19

Endodontic and Restorative uses of Bioceramics

  • Bio ceramics are used as sealers along with Gutta-percha.

  • They are effective as pulp capping agents and dentin substitute.

  • They can be used during apexification and regenerative endodontics.

  • They are used as a retrograde filling material and repairing perforation.

  • They can be used as a canal locator owing to their excellent flowability and radiopacity.

  • They can be used in resorption.

  • They can be used in dentin hypersensitivity and dentin remineralization.

CONCLUSION

Bio ceramics are not currently used materials for endodontic use. They present various advantages as compared to conventional cement. Bio ceramics have a wide range of applications in restorative dentistry and endodontics. Thorough knowledge of newer bioceramic materials is necessary to ensure the appropriate selection of material according to the clinical situation. The tricalcium silicate-based materials have various biological advantages and have increasing use in endodontic therapy in the future.

Conflict of Interest:- None

Acknowledgement:- Authors would like to thank Dr Nikhil Mankar for his valuable support.

Funding support:- Nil.

References:

1. Hench LL. The story of bioglass. J Mater Sci Mater Med. 2006;17: 967–978.

2. Chandak MG, Modi RR, Rathi BJ, Gogiya RJ, Bhutada P. In vitro comparative assessment of diffusion of ion from calcium hydroxide with three different phytomedicine pastes through dentin. Wor J Dent 2018; 9(5):377-371.

3. Damas BA, Wheater MA, Bringas JS, Hoen MM.Cytotoxicity comparison of mineral trioxide aggregates and EndoSequence bioceramic root repair materials. J Endod 2011;37:372-375.

4. Shilpa BS, Dhadse PV, Bhongade ML, Puri K,  Nandanwar J. Evaluation of the effectiveness of platelet-rich fibrin for ridge preservation after atraumatic extraction. Adv Dent Res 2017;4:294-300.

5. Hermansson L. Nanostructural bioceramics: Advances in Chemically Bonded Bioceramics. CRC Press 2014.

6. Best SM, Porter AE, Thian ES, Huang J. Bioceramics: Past, present and for the future. J Eur Ceram Soc 2008;23:1319–1327.

7. Hickman K. Bioceramics. Internet (Overview) April 1999. http://www.csa.com/discoveryguides/ archives/bceramics.php.

8. Prati C, Gandolfi MG. Calcium silicate bioactive cement: Biological perspectives and clinical applications. Dent Mater 2015;31(4):351-370.

9. Utneja S, Nawal RR, Talwar S, Verma M. Current perspectives of bio-ceramic technology in endodontics: Calcium enriched mixture cement - review of its composition, properties and applications. Restore Dent Endod 2015;40(1):1-13.

10. Viola NV, Tanomaru Filho M, Cerri PS. MTA versus portland cement: Review of the literature. Rev Sul-bras Odontol 2011;8(4):446-452.

11. Parirokh M, Torabinejad M. Calcium silicate-based cements in mineral trioxide aggregate: Properties and clinical applications. Hoboken, NJ, USA: John Wiley & Sons, 2014.

12. Parirokh M, Torabinejad M. Mineral trioxide aggregate: A comprehensive literature review--part i: Chemical, physical, and antibacterial properties. J Endod 2010;36(1):16-27.

13. Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide aggregate material use in endodontic treatment: A review of the literature. Dent Mater 2008;24(2):149-164.

14. Aggarwal V, Singla M, Miglani S, Kohli S. Comparative evaluation of push-out bond strength of proroot mta, biodentine, and mta plus in furcation perforation repair. J Conserv Dent 2013;16(5):462465.

15. Walker MP, Diliberto A, Lee C. Effect of setting conditions on mineral trioxide aggregate flexural strength. J Endod 2006;32(4):334-336.

16. Malkondu O, Karapinar Kazandag M, Kazazoglu E. A review on biodentine, a contemporary dentine replacement and repair material. Biomed Res Int 2014;2014:160951.

17. Saxena P, Gupta SK, Newaskar V. Biocompatibility of root-end filling materials: Recent update. Restore Dent Endod 2013;38(3):119-127.

18. LeGeros RZ. Calcium phosphate materials in restorative dentistry: A review. Adv Dent Res 1988;2(1):164-180.

19. Duraivel D, Fayeez A, Poorni S, Diana D, Srinivasan MR. Management of Non-Vital Teeth with Open Apex Using Endosequence Root Repair Material, Mineral Trioxide Aggregate and Biodentin-A Case Series. Int J Curr Res Rev 2017;9(22):26.

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Dr. Pramod Kumar Manjhi joined Editor-in-Chief since July 2021 onwards

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A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
A Study by Chandran Anand et al. entitled "A Prospective Study on Assessment of Quality of Life of Patients Receiving Sorafenib for Hepatocellular Carcinoma" is awarded Best article for Vol 13 issue 15
A Study by Rosa PS et al. entitled "Emotional State Due to the Covid – 19 Pandemic in People Residing in a Vulnerable Area in North Lima" is awarded Best Article for Vol 13 issue 14
A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13
A Study by Mona Isam Eldin Osman et al. entitled "Psychological Impact and Risk Factors of Sexual Abuse on Sudanese Children in Khartoum State" is awarded Best Article for Vol 13 issue 12
A Study by Khaw Ming Sheng & Sathiapriya Ramiah entitled "Web Based Suicide Prevention Application for Patients Suffering from Depression" is awarded Best Article for Vol 13 issue 11
A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10
A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

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