Dental Perspective on Mucormycosis in COVID-19: a Literature Review.

Purpose of Review: The purpose of this paper is to gain an understanding of existing knowledge and attain familiarity on mucormycosis for early diagnosis and treatment. It highlights the systematic factors, signs and symptoms, diagnostic tests and treatment procedure for mucormycosis from dentistry point of view. PubMed/ Medline, Scopus, Web of Science were the search engine used. Study selection encompassed systematic reviews, critical reviews and case reports related to mucormycosis in COVID-19 patients and only mucormycosis. 19 articles were selected between Years 2001 to 2021. Analysis was done based on patient's comorbidity, site of mucormycosis infection, use of steroids and its effect on people with COVID -19 infection. Recent Findings: Rhino-orbito-cerebral mucormycosis is the most common of all systemic manifestations of mucormycosis. Diabetes mellitus and long-term corticosteroid therapy are the leading risk factors with pre-existing diabetes mellitus accounting for almost 80% cases.  Elements that facilitate the growth of mucor in COVID-19 patients are the presence of low oxygen levels, high blood glucose levels, acidic media, high levels of iron, immunosuppression, and episodes of prolonged hospitalization. Mucormycosis is heterogenic in nature. Its management requires an individualized plan that considers the immunity status of the host, stage of the infection, systemic disease, early diagnosis and susceptibility to anti-fungal agents. Supervised use of corticosteroids and betadine gargle prevent the occurance of mucormycosis. Summary: The paper sheds some light on the warning signs and diagnostic tests that can help in early identification of infection by a dentist. This enables the timely implementation of therapy resulting in good prognosis of the treatment.

Can povidone iodine gargle/mouthrinse inactivate SARS-CoV-2 and decrease the risk of nosocomial and community transmission during the COVID-19 pandemic? An evidence-based update.

The Coronavirus disease in 2019 (COVID-19), also referred to as the novel 'CoV19 (nCov19)' is caused by a new coronavirus strain similar to Severe Acute Respiratory Syndrome (SARS-CoV-2). SARS-CoV-2 spreads via respiratory droplets, saliva, or direct contact. Therefore it is important to control the viral load in the saliva and respiratory secretions. One of the most simple and cost-effective measures that can be adopted by the public and healthcare professionals to prevent cross-contamination and community transmission, is the implementation of effective oral and throat hygiene. Recent evidence has confirmed that 0.5% povidone iodine (PVP-I) mouthrinse/gargle for 30 s can reduce SARS-CoV-2 virus infectivity to below detectable levels. PVP-I can even interrupt SARS-CoV-2 attachment to oral and nasopharyngeal tissues and lower the viral particles in the saliva and respiratory droplets. Thus, the use of PVP-I mouthrinse as a prophylactic measure has been advocated across the globe to reduce disease transmission. Although the efficacy of PVP-I against SARS-CoV-2 is proven, no review articles have yet discussed the evidence and mechanisms of PVP-I against the SARS-CoV-2. Thus, this paper highlights the rationale, safety, recommendations, and dosage of PVP-I gargle/mouthrinse as an effective method to decrease the viral loads during the pressing times of COVID-19.

Etiology and classification of food impaction around implants and implant-retained prosthesis.

BACKGROUND: Food impaction is a common risk factor for the initiation of peri-implant inflammation and failure of the osseointegrated implant. Although clinicians do acknowledge the presence of food impaction around implants and implant-retained prosthesis, no classification system has yet classified the food impaction around the implant and implant-retained prosthesis. PURPOSE: The present paper aims to identify and classify the plausible etiology of food impaction around implants and implant-related prosthesis. MATERIALS AND METHODS: The following search terms were utilized for data search: "Food Impaction" AND "Implants" AND "Food Impaction" AND "Perimplantitis" AND "Food Impaction" AND "Classification." Articles that were written in the English language in PubMed and Cochrane Library database from 1930 till September 2018 were scrutinized. A total of 24 articles were scrutinized, out of which only 15 articles were selected. RESULTS: Food impaction around implants is broadly classified into five categories based on the number of implants, nature of implants prosthesis involved for replacement and relation of the implant prosthesis to the adjacent tooth, restoration, or prosthesis. CONCLUSION: This is the first classification designed to classify food impaction around dental implants and implant-retained prosthesis. The classification can be used by clinicians for optimal diagnosis, interpretation, and treatment plan for patients.

Is zirconia a viable alternative to titanium for oral implant? A critical review.

PURPOSE: Titanium based implant systems, though considered as the gold standard for rehabilitation of edentulous spaces, have been criticized for many inherent flaws. The onset of hypersensitivity reactions, biocompatibility issues, and an unaesthetic gray hue have raised demands for more aesthetic and tissue compatible material for implant fabrication. Zirconia is emerging as a promising alternative to conventional Titanium based implant systems for oral rehabilitation with superior biological, aesthetics, mechanical and optical properties. This review aims to critically analyze and review the credibility of Zirconia implants as an alternative to Titanium for prosthetic rehabilitation. STUDY SELECTION: The literature search for articles written in the English language in PubMed and Cochrane Library database from 1990 till December 2016. The following search terms were utilized for data search: "zirconia implants" NOT "abutment", "zirconia implants" AND "titanium implants" AND "osseointegration", "zirconia implants" AND compatibility. RESULTS: The number of potential relevant articles selected were 47. All the human in vivo clinical, in vitro, animals' studies were included and discussed under the following subheadings: Chemical composition, structure and phases; Physical and mechanical properties; Aesthetic and optical properties; Osseointegration and biocompatibility; Surface modifications; Peri-implant tissue compatibility, inflammation and soft tissue healing, and long-term prognosis. CONCLUSIONS: Zirconia implants are a promising alternative to titanium with a superior soft-tissue response, biocompatibility, and aesthetics with comparable osseointegration. However, further long-term longitudinal and comparative clinical trials are required to validate zirconia as a viable alternative to the titanium implant.

Comparison of the effect of different surface treatments on the bond strength of different cements with nickel chromium metal alloy: An in vitro study.

BACKGROUND: For success of any indirect metal restoration, a strong bond between cement and the intaglio surface of metal is imperative. The aim of this study is to evaluate and compare the effect of different surface treatment on the tensile and shear bond strength of different cements with nickel-chromium alloy. MATERIAL AND METHODS: 120 premolars were sectioned horizontally parallel to the occlusal surface to expose the dentin. Wax patterns were fabricated for individual tooth followed by casting them in nickel chromium alloy. 60 samples were tested for tensile bond strength, and the remaining 60 for shear bond strength. The samples were divided into three groups (of 20 samples each) as per the following surface treatment: oxidation only, oxidation and sandblasting, or oxidation, sandblasting followed by application of alloy primer. Each group was subdivided into 2 subgroups of 10 samples each, according to the bonding cement i.e RM-GIC and resin cement. Samples were subjected to thermocycling procedure followed by evaluation of bond strength. RESULTS: Two-way analyses of variance (ANOVA) was performed to compare the means of tensile and shear bond strength across type of surface treatment and cement, followed by post hoc parametric analysis. For all tests 'p' value of less than 0.05 was considered statistically significant. CONCLUSIONS: The surface treatment of oxidation and sandblasting followed by application of alloy primer offered the maximum tensile and shear bond strength for both RM GIC and resin cement. Resin cement exhibited greater tensile and shear bond strength than RM-GIC for all the three surface treatment methods. Key words:Resin cement, resin modified glass ionomer cement, oxidation, sandblasting, alloy primer, tensile bond strength, shear bond strength, universal testing machine.

In Vitro Comparative Evaluation of Different Types of Impression Trays and Impression Materials on the Accuracy of Open Tray Implant Impressions: A Pilot Study.

Purpose. For a precise fit of multiple implant framework, having an accurate definitive cast is imperative. The present study evaluated dimensional accuracy of master casts obtained using different impression trays and materials with open tray impression technique. Materials and Methods. A machined aluminum reference model with four parallel implant analogues was fabricated. Forty implant level impressions were made. Eight groups (n = 5) were tested using impression materials (polyether and vinylsiloxanether) and four types of impression trays, two being custom (self-cure acrylic and light cure acrylic) and two being stock (plastic and metal). The interimplant distances were measured on master casts using a coordinate measuring machine. The collected data was compared with a standard reference model and was statistically analyzed using two-way ANOVA. Results. Statistically significant difference (p < 0.05) was found between the two impression materials. However, the difference seen was small (36 µm) irrespective of the tray type used. No significant difference (p > 0.05) was observed between varied stock and custom trays. Conclusions. The polyether impression material proved to be more accurate than vinylsiloxanether impression material. The rigid nonperforated stock trays, both plastic and metal, could be an alternative for custom trays for multi-implant impressions when used with medium viscosity impression materials.

CAD/CAM-Assisted Auricular Prosthesis Fabrication for a Quick, Precise, and More Retentive Outcome: A Clinical Report.

Auricular defects comprise a large proportion of maxillofacial deformities. Most patients with acquired deformities have psychosocial ineptness and seek cosmetic rehabilitation. Although minor defects can be corrected surgically, extensive deformities are difficult to reconstruct with plastic surgery. Contrary to that, prosthetic restoration can provide excellent esthetic results. The conventional methods of maxillofacial prosthesis fabrication are time consuming and the outcome depends on the technician's skill. The advent of CAD/CAM technology in the field of dentistry has brought enormous improvement in the quality of health care provided. In the past decade, several methods have been described employing CAD/CAM techniques for the cosmetic rehabilitation of auricular defects. This clinical report details the integration of multiple digital technologies of CT scanning, computer aided design, and rapid prototyping to construct an ear prosthesis with limited number of appointments.

Cranioplasty with custom made alloplastic prosthetic implant: A case report.

Cranial defects often occur due to trauma. The treatment of such defects is a challenge to the skill and knowledge of the practitioner. This article presents one such case, where a 15-year-old boy had suffered extensive loss of the right cranium following a road traffic accident. The patient required rehabilitation of the right fronto-temporal cranial anatomy and was managed using a custom made heat polymerized acrylic alloplastic implant.

A comparative evaluation of linear dimensional accuracy of the dies obtained using three conceptually different die systems in the fabrication of implant prosthesis: an in vitro study.

STATEMENT OF PROBLEM: Given that meticulous implant prosthodontic procedures are recommended to obtain the best possible intraoral fit, the die systems used for multi implant casts warrant further investigation. Die stone expansion and errors introduced by removable die casts may exceed the accuracy required for the passive fit of implant prosthesis. PURPOSE: The purpose of the study was to evaluate the linear dimensional accuracy between the implant master die and three conceptually different die systems such as Pindex system, Accu-trac precision die system, and Conventional brass dowel pin system. MATERIALS AND METHODS: Thirty impressions of implant master die were made with polyether impression material. Ten experimental implant casts were fabricated for each of the three different die systems tested: Accu-trac precision die tray system, Pindex system, and conventional brass dowel pin system. The solid experimental casts were sectioned and then removed from the die system 30 times. Linear distances between all six possible distances were measured from one centre of the transfer coping to the other, using a co-ordinate measuring machine in millimeters up to accuracy of 0.5 microns. Data were tabulated and statistically analyzed by Binomial non parametric test using SPSS version 15. RESULTS: Significant differences were found for distance A-B (P = 0.002), A-C ( P = 0.002), A-D (P value = 0.002), and B-D ( P = 0.021) in Conventional Dowel pin system however for Accu-trac precision die tray system, it was significant only for distance A-D (P = 0.002) but for Pindex system it was non-significant for all the distances measured. CONCLUSION: Within the limitations of this study, use of Pindex system is recommended when sectioned dies are needed for a multi implant retained prosthesis.

Comprehensive Rehabilitation of Partially Amputated Index Finger with Silicone Prosthesis: A Case Report with 3 years of Follow Up.

The loss of all or part of a finger following traumatic amputation may have a negative impact on physical and psychological well-being. An esthetic prosthesis can offer psychological, functional, and rehabilitative advantages. One of the major problems associated with somato-prosthetic replacement of partially amputated finger is inadequate retention of the prosthesis. This may stem from the weight of the prosthesis, inadequate tissue support, and/or the particular area of the finger to be replaced. A number of means have been employed to enhance retention. Among the more common are adhesives, adhesive tape, magnets and implants. The purpose of this article is to describe a technique which eliminates the need for adhesive materials and utilizes copper wire to fabricate a finger ring as a primary means of retention. This technique can be utilized whenever the prosthesis encompasses more than 180° of the affected area. This clinical report presents a case of rehabilitation of a partially amputated index finger defect and describes a method of retention for the same with a copper ring.