Role of telemedicine in COVID-19 pandemic – An overview

COVID-19 pandemic has caused worldwide havoc. The present healthcare system is ruined, distancing both patients and doctors. To avoid transmission of infection, travel restrictions were made, making the patient’s visit to the doctor difficult. However, routine checkups for patients not infected with COVID-19 should be given without the threat of getting exposed to other patients in the hospital. In this respect, telemedicine becomes a reliable source that provides health services as well as reduces the infection spread. The first known evidence of real-time (live) video consultation occurred in 1959 at the University of Nebraska where doctors used telemedicine to transmit neurological examinations to students. During the first 3 months of 2020, there was a 50% increase in telehealth visits. Most patients from January to March 2020 approached for a condition other than COVID-19. Many telemedicine applications have been launched for teleconsultation such as Practo, Mfine, TATA Health, and Doctor 24 × 7 provide teleconsultation. Telemedicine has shown a huge impact on the present healthcare system during this pandemic and has placed itself in the spotlight during recent times. Through this paper, the role of telemedicine in the current scenario of pandemics and its development through recent times is discussed.

Comparative evaluation of 5% sodium hypochlorite and Nd:YAG laser in reducing endotoxins level from infected root canals – An in vivo microbiological study

Objectives: Endodontic infection is one of the most challenging aspects of dental treatment which is primarily caused by Gram-negative anaerobic bacterial species. The primary objective in the management of endodontic treatment is eradication of bacteria, as well as elimination of endotoxin. The aim of this study was to compare the effectiveness of 5% sodium hypochlorite, a mixture of calcium hydroxide+2% chlorhexidine (CHX) gel and Nd:YAG lasers for decreasing the level of endotoxin in infected root canals. Material and Methods: Forty four patients in the age group of 18–50 years were carefully chosen for the study and divided into control (Group 1, n = 11) and experimental group (Group 2, n = 33). Experimental group was further split into three subgroups according to the medicaments used. Samples were collected after the access opening (pre-operative specimens), after the biomechanical preparation (intermediate samples), and after the application of intracanal medicament for 15 days. The concentration of endotoxin in each sample was measured using quantitative chromogenic limulus amebocyte lysate assay. The data collected were statistically analyzed using SPSS for Windows (Statistical Package for the Social Sciences, Inc., Chicago, IL,) Version 15.0 Statistical Analysis Software. The level of significance was set at 0.05 for all tests. Results: Pretreatment endotoxins level observed was 6.783EU/ml in Control group and 7.261EU/ml, 6.963EU/ml, 7.247EU/ml in experimental subgroups. After biomechanical preparation and use of medicaments endotoxins level reduced to 3.919EU/ml in Control group and 0.5222EU/ml (sodium hypochlorite) 1.164EU/ml (calcium hydroxide+chlorhexidine), 0.841EU/ml (laser). Conclusion: This study concluded after analyzing the data that use of 5% sodium hypochlorite and Nd:YAG laser was effective in decreasing the level of endotoxins and use of intracanal medicament (2% CHX+ calcium hydroxide) for 15 days further helps to reduce the endotoxin level.

Digital oral rehabilitation with cast partial denture: A clinical report

Digitization has slowly become the new conventional technique today offering multiple advantages, its application in the field of implantology and fixed prosthodontics has been time tested, and its gradually being utilized in removable prosthodontics also. Digitization allows digital surveying, designing the framework with components, and obtaining a 3D printed resin framework, which can be tried intraorally and cast using conventional techniques. This technology is time-saving, highly accurate, also allows digital archiving of casts. This case report presents rehabilitation of a partially edentulous mandibular arch opposing completely edentulous maxillary arch using digital technology and casting using conventional technique.

Patients’ perceptions and experiences about the root canal treatment: An exploratory study among Saudi population

Objectives: Root canal treatment (RCT) is one of the most popular treatments at dental setting and pain and anxiety is a great source of concern for dental patients and dentist. However, in Saudi Arabia the current literature containing data on endodontic pain with clear comparisons of pre-treatment and post-treatment is extremely rare. The aim of this study was to investigate the perception of Saudi population about RCT and its relation with pain and anxiety. Material and Methods: A sample of 76 patients were selected for this questionnaire based survey. Participants were asked to provide their response toward the endodontic treatment before and after the treatment. Pre-validated questionnaires consisted of demographic data, questions on anxiety, pain, and concerned about RCT. Descriptive statistics, independent, and paired t-tests were used to compare between pre-test and post-test score. The level of statistical significance was set at 5%. Results: In the present study, patient’s anxiety score was assessed which was found to be significantly decreased from pre-treatment 31.47 ± 28.90 to post-treatment 23.28 ± 25.95. Likewise, mean anticipated and experience of pain score were also significantly reduced pre-treatment 41.07 ± 29.35 to post-treatment 21.90 ± 24.50. Conclusion: Current study reported a significant difference in reduction of mean anxiety for RCT post-treatment. Moreover, there was significant difference found between anticipated pain and experienced pain for the treatment. Before the treatment significant number of patients was not concerned for RCT and majority of the patients were concerned for pain associated to RCT.

Recombinant human PDGF-BB in combination with mineralized freeze-dried bone allograft in the treatment of Grade II furcation involvement: A case report

Recombinant human platelet-derived growth factor-BB (rhPDGF-BB) is commercially available biomaterial that can be used to regenerate the lost periodontal structure due to progression of periodontitis. The present case describes the surgical treatment of localized periodontitis with furcation Grade II involvement using platelet-derived growth factor BB (growth-factor enhanced matrix 21S) in combination with particulate allograft bone (mineralize freeze-dried bone allograft [FDBA]).This case report showed complete furcation closure after using rhPDGF-BB in combination with FDBA to treat localized periodontitis case with Grade II furcation involvement.

A suggested design for a tissue level dental implant

Objectives: The aim of the study was to test the stress distribution around a newly suggested design for tissue-level dental implant. Material and Methods: Newly designed modified reverse buttress thread dental implant is tested for the stress over the surrounding bone. Nine implant dimensions of this design were examined on two types of materials; commercially pure Titanium (TiG4) and Titanium alloy (TIG5). These nine implant dimensions, which can be used in the full dental arch are: (diameter/length; 3.5/11, 4/11, 4/9, 4.5/11, 4.5/9, 5/11, 5/9, 5/7, and 5.5/7 mm). The suggested implant was designed using Autodesk Inventor 202. ANSYS Workbench 2020 R2 was used for meshing and 3D finite element analysis. Results: Maximum Von Mises stress over the cortical bone is higher in the TiG5 model in all implant dimensions. The highest stress value was reported in the implant 4/9 mm dimension in both models. TiG5 model has the highest stress values over the cancellous bone. The higher level of stress over the surrounding cortical bone lies at the surface of the cortical bone, whereas the maximum stress over the surrounding trabecular bone was noticed near the tip of the first and second dental implant thread. Conclusion: Reasonable levels of stress were reported in the suggested design in both models. However, it would be justifiable to choose the TiG4 model for the suggested tissue level implant with the exclusion of a 4/9 mm dimension to ensure minimal stress over the surrounding cortical bone.

Antimicrobial efficacy of triple antibiotic paste in teeth with primary endodontic infection: A systematic review

Objectives: This systematic review aims to assess the antimicrobial efficacy of triple antibiotic paste (TAP) as an intracanal medicament for root canal treatment of permanent or primary teeth with primary endodontic infection, as compared to other intracanal medicaments. Material and Methods: Three electronic databases, namely PubMed, CENTRAL, and Google Scholar, were searched for articles published in the English language till December 2019. Two hundred eighty-three studies were obtained for screening from an electronic database and one from the reference list of an article. After screening 234 records by title and abstract, 226 were excluded, and eight were selected for full-text eligibility assessment. Finally four studies were included in the systematic review. Results: Due to variations in the methods of outcome measurement and its evaluation at different time points, it was impossible to present the results as a meta-analysis. Thus, a narrative synthesis was performed for TAP compared to comparators used. The overall quality of included studies suggested a moderate risk of bias. Three comparators were reported in the included studies: Calcium hydroxide (CH) with 2% chlorhexidine (CHX), CH alone, and Ocimum sanctum. The antimicrobial efficacy of TAP was significantly better than plain CH and O. sanctum, whereas results did not differ significantly between TAP and CH plus 2% CHX. Conclusion: There is a lack of sufficiently high-quality clinical studies regarding the use of TAP. More clinical trials are recommended comparing the antimicrobial efficacy of TAP and other intracanal medicaments under standard protocols to establish a strong clinical evidence.

Ultra-low-frequency-transcutaneous electric nerve stimulation for recording cameo surface and detachable cheek plumpers for enhanced complete denture esthetics

Severely resorbed completely edentulous maxillary and mandibular arches from long-term complete edentulism may pose a treatment challenge for the treating prosthodontist. The loss of teeth, over a period of time, can lead to gross facial disfigurement and also has great psychological effect. The loss of teeth also has effect on the musculature and supporting tissues which may lead to muscle wasting and dystrophy. Ever since its introduction in 1971, Transcutaneous Electrical Nerve Stimulation (TENS) has been used in dentistry for various treatment modalities and it is especially indicated in management of tempo-mandibular dysfunctions (TMDs). TENS being a non-invasive, non-technique sensitive, and easy to use technique has evolved rapidly over the years as an adjunct in management of various dental therapies. Two case reports of completely edentulous patients are presented here, where ultra-low-frequency-TENS (ULF-TENS) was used as an aid in cameo surface recording and customizing the magnet retained cheek plumper within the physiological and functional limits of the orofacial musculature complex for rehabilitation with complete denture prosthesis.

Awareness among health care professionals regarding interrelationship between diabetes mellitus and periodontal diseases: A step towards interprofessional collaborative practice

Objectives: The objective of the study was to assess the level of awareness among health care professionals regarding interrelationships between diabetes mellitus (DM) and periodontal diseases. Material and Methods: A self-administered, structured questionnaire based on scientific literature, and practice was distributed among 100 non-oral health care professionals (NOHCP) and 100 oral-health care professionals (OHCP) for assessment of their awareness regarding DM and periodontitis interrelationship (DPI). One hundred fifty-four (154) participants who responded and returned the questionnaire were interviewed to avoid any obscurity pertinent to the questionnaire and to obtain their suggestions or recommendations. Twenty-seven participant’s questionnaires were excluded due to non-availability for interview to clarify the information given. Responses of 127 participants were finally statistically analyzed. Results: Almost 79% of OHCPs were aware of the DPI. About 9% of OHCPs did not agree with DPI and 11% of them were “unaware” about the DPI. Similarly, about 65% of NOHCPs were aware of the DPI. About 15% of OHCPs did not agree with DPI and 19% of OHCPs were “unaware” about the DPI. Conclusion: A limited awareness was observed among health care professionals participating in the present study for DPI, highlighting a gap of knowledge, attitude, and practice for DPI, which was higher among NOHCP than OHCPs.

Preventive role of mouthwashes in COVID-19 disease transmission: An overview

The current COVID-19 pandemic has changed the face of the health and medical care services. Due to the nature of dental treatment, which involves a very close proximity to patient’s oropharyngeal region and production of aerosols the dental healthcare providers, and dental patients are at a very high risk of getting or transmitting the virus. Efforts are being made to reduce the viral load in patient’s oral cavity, as well the dental clinic. For this, the role of mouthwashes has also been suggested. The aim of the present paper is to discuss the various mouthwashes, which exhibit virucidal actions, especially in relation to COVID-19.