Sarang Sharma

Zika Virus Diseases – The New Face of an Ancient Enemy as Global Public Health Emergency (2016): Brief Review and Recent Updates

Zika virus (ZIKV) disease is caused by a virus transmitted by Aedes mosquito. It presents as flu-like symptoms lasting for 5–7 days and shows potential association with neurological and autoimmune complications such as congenital microcephaly and adult paralysis disorder, Guillain–Barré syndrome. Treatment measures are conservative as the disease is self-limiting. ZIKV earlier affected several tropical regions of Africa and Asia from 1951 to 2006. Subsequently, it moved out from these regions to land as outbreaks in Yap Island, French Polynesia, South America, and most recently in Brazil. The WHO declared it as an international public health emergency in 2016 and an extraordinary event with recommendations for improving communications, tightening vigil on ZIKV infections, and improving mosquito control measures. The authors in this article aim to briefly discuss ZIKV infection, its epidemiology, clinical manifestations, management, and prevention.

Botulinum toxin the poison that heals: A brief review

Botulinum neurotoxins, causative agents of botulism in humans, are produced by Clostridium botulinum, an anaerobic spore-former Gram-positive bacillus. Botulinum neurotoxin poses a major bioweapon threat because of its extreme potency and lethality; its ease of production, transport, and misuse; and the need for prolonged intensive care among affected persons. This paper aims at discussing botulinum neurotoxin, its structure, mechanism of action, pharmacology, its serotypes and the reasons for wide use of type A, the various indications and contraindications of the use of botulinum neurotoxin and finally the precautions taken when botulinum neurotoxin is used as a treatment approach. We have searched relevant articles on this subject in various medical databases including Google Scholar, PubMed Central, ScienceDirect, Wiley Online Library, Scopus, and Copernicus. The search resulted in more than 2669 articles, out of which a total of 187 were reviewed. However, the review has been further constricted into only 54 articles as has been presented in this manuscript keeping in mind the page limitation and the limitation to the number of references. A single gram of crystalline toxin, evenly dispersed and inhaled, can kill more than one million people. The basis of the phenomenal potency of botulinum toxin (BT) is enzymatic; the toxin is a zinc proteinase that cleaves neuronal vesicle-associated proteins responsible for acetylcholine release into the neuromuscular junction. A fascinating aspect of BT research in recent years has been the development of the most potent toxin into a molecule of significant therapeutic utility. It is the first biological toxin which is licensed for the treatment of human diseases. The present review focuses on both warfare potential as well as medical uses of botulinum neurotoxin.

Endodontic management of nonvital permanent teeth having immature roots with one step apexification, using mineral trioxide aggregate apical plug and autogenous platelet-rich fibrin membrane as an internal matrix: Case series.

A tooth with blunderbuss canal and open apex can be an endodontic challenge because of difficulty in obtaining an apical seal, and existing thin radicular walls which are susceptible to fracture. To overcome the limitations of traditional long-term calcium hydroxide apexification procedures, nonsurgical one step apexification using an array of materials such as mineral trioxide aggregate (MTA) has been suggested. However, adequate compaction of MTA in teeth with wide open apices can be an arduous task, and an internal matrix is required for controlled placement of MTA against which obturating material can be condensed. Platelet-rich fibrin (PRF), a second generation platelet concentrate containing several growth factors that promotes hard and soft-tissue healing, has been used as an internal matrix to create an apical plug of MTA and hence prevent extrusion of filling materials. This case series presents the endodontic management of immature permanent teeth with open apices using internal matrix of autologous PRF membrane and one step apical barrier placement of MTA.

A randomized comparative prospective study of platelet-rich plasma, platelet-rich fibrin, and hydroxyapatite as a graft material for mandibular third molar extraction socket healing

Aim: The purpose of this study was to compare the efficacy of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and hydroxyapatite (HA) for reduction of pain and swelling, absence of dry socket, soft tissue healing, and bone regeneration after mandibular third molar extraction in human patients. Materials and Methods: Forty patients requiring extraction of mandibular third molars were randomly grouped as control, PRP, PRF, and HA-treated. The patients were assessed for postoperative pain, swelling, dry socket, and soft tissue healing on the 3rd, 7th, and 14th day of postoperative periods depending on the standard methods. Radiological assessment of the extraction site was done at 1, 2, and 6 months interval to compare the change in bone density in the sockets in control and treated patients. Results: Pain and swelling were less on PRP and PRF site when compared to HA and control site. PRP and PRF site showed better soft tissue healing when compared to HA and control site. Radiographic assessment showed comparatively lesser bone density values in PRP, PRF, and control site at 1, 2, and 6 months than HA site. Conclusion: Our study showed that PRP and PRF are better graft materials than HA regarding pain, swelling, dry socket, and soft tissue healing. Bone regeneration is induced promptly by HA as compared to other graft materials. However, a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of the graft materials.

The Role of Dentistry in Disaster Management and Victim Identification: An Overview of Challenges in Indo-Nepal Scenario

BackgroundRecently, natural disasters and terrorist activities have been leading to mass casualty situations unexpectedly around the globe. In addition to the traditional emergency medical services centering around medically trained and paramedic personnel, dental practitioners having vital skills and attributes may be important in responding to a mass casualty situation.ObjectiveThis paper aims at discussing the role of dentists in disaster management and the role of forensic odontology in the disaster victim identification (DVI), its status in India and some suggestions to develop the plans for same.Materials and methodsArticles were searched in various medical databases such as Google Scholar, Pubmed Central, Sciencedirect,Wiley online Library, Scopus, Copernicus to gather all relevant information on the subject. Various keywords were used as search tool such as ‘Mass disaster’, ‘Forensic odontology’, ‘Victim identification’.ResultsThe search resulted in total of 170 articles which we reviewed. Due to limitation to the list of references we have constricted our review to only 39 articles for more informative literature and supported the topic of the present manuscript ‘The Role of Dentistry in Disaster Management and Victim Identification: An Overview of Challenges in Indo-Nepal Scenario’ more specifically.ConclusionEvery disaster is unique and involves interplay of different factors and circumstances such as nature of disaster, number of victims and extent of body fragmentation that ultimately challenges the disaster response planning. Apart from the victim recovery and evacuation, the disaster response planning must include the established procedures for the identification of the victims of the disaster. The identification of victims essentially relies on forensic anthropology, radiology, DNA typing and fingerprints, as well as odontology.

Large Periapical or Cystic Lesions in Association with Roots Having Open Apices Managed Nonsurgically Using 1-step Apexification Based on Platelet-rich Fibrin Matrix and Biodentine Apical Barrier: A Case Series

&NA; Teeth having open apices in the absence of a natural apical constriction pose several challenges during conventional endodontic treatment, especially when establishing an apical seal. Treatment is further challenging when these teeth are associated with large periapical or cystic lesions having resulted in expansion and/or thinning of adjacent cortical plates. Although surgical intervention is commonly adopted in the management of such cases, a conservative treatment option offering equally good prognosis is always desirable. This case series describes 3 cases: a 39‐year‐old woman, a 45‐year‐old woman, and a 15‐year‐old boy having teeth with concomitant open apices and large periapical/cystic lesions managed conservatively by (1) following a strict intracanal disinfection protocol, (2) intracanal aspiration with digital decompression of associated swelling, and (3) 1‐step apexification for closure of the root apex by placing a preliminary barrier of platelet‐rich fibrin (PRF) and a secondary barrier of Biodentine (Septodont, Saint‐Maur‐des‐Fossés, France). In all 3 cases, the treatment outcomes, both clinical and radiographic, were highly satisfactory. PRF and Biodentine collectively rendered an apical plug that proved to be a suitable alternative to commonly used mineral trioxide aggregate in 1‐step apexification. Biodentine provides good interfacial adhesion and sealing with dentin attributed to its property of hydroxyapatite crystal deposition at the material‐dentin interface. Also, because of its bioactivity, it likely promotes the conversion of adjacent PRF into a calcific barrier, thus reinforcing the apical seal. Additionally, host‐modulating responses of PRF contribute in expediting the healing process. Reasonable osseous healing in the periapex could be appreciated as early as 3 months in all patients. The rapidity with which healing occurred may have been an incidental finding but definitely draws attention.

Adenomatoid Odontogenic Tumor of Maxillary Sinus – A Diagnostic Dilemma: Case Report and Brief Literature Review

Adenomatoidodontogenic tumor (AOT), constituting approximately 3-7% of all odontogenic tumors is described as a rare benign epithelial tumor of odontogenic origin. It is composed of odontogenic epithelium arranged in a variety of histoarchitectural presentations and closely resembles an ameloblastoma. AOT is mostly asymptomatic and is usually associated with impacted teeth in maxillary anterior region. We present a case of intraosseus follicular AOT existing in the maxillary sinus of a 14-year-old female child involving lateral incisor and canine impacted towards the orbital floor.The cystic tumor filled maxillary sinus and was removed along with the retained tooth. At one year follow up, healing was uneventful and no local recurrence was seen

Newer proposed classification of periimplant defects: A critical update

The term peri-implantitis is used to describe a destructive inflammatory process affecting the soft and hard tissues around osseo integrated implants, leads to the formation of a peri-implant pocket and loss of supporting bone. Predisposing factors are Poor Plaque Control, inflammation, infection, Smoking, Diabetes and Occlusal Overload. It is diagnosed on the basis of clinical and radiographic interpretation and still no definite criteria have been proposed for the diagnosis and treatment of peri-implantitis. However treatment can be both conservative and surgical. The cumulative interceptive supportive therapy protocol serves as good guide for the treatment of the peri-implantitis. There is lack of a standard classification system to differentiate the various degrees of peri-implantitis, which produces dilemma in evaluating the stages clinical and radiological status, treatment and its outcome. Many classification has been proposed in medical literature with their pros and cons but still there is lack of standard classification system of implant defects and definite treatment protocol according to the same. The classification should be easy to use, clearly understandable and help in communication by clinicians of different speciality. This review aimed to introduce a classification system based on added clinical, and detailed radiological parameters with prognosis and staged treatment algorithms.

Non-Surgical Management of Teeth with Wide Open Apices and Large Periapical Lesions: A Conservative Reality

CASE-1 A 26-year-old male visited the Department of Conservative Dentistry and Endodontics after referral from Oral Surgery for opinion regarding maxillary right lateral incisor. Diagnosis established in Oral Surgery was of an infected cyst in relation to tooth #12 and the treatment suggested was enucleation and curettage. Patient’s dental history revealed anterior trauma at 10 years of age and his chief complaint was found to be recurrent swelling and pus discharge in relation to maxillary right anteriors for the past 1-2 years. Clinical examination revealed a discolored tooth #12 [Table/ Fig-1a] and sinus opening within an erythematous area measuring 0.5cm on the palate [Table/Fig-1b]. On palpation, the palatal region had a paper like soft consistency. Thermal and electrical pulp testing elicited no response in tooth #12 but positive responses in both tooth #11 and tooth #13. Pre-operative radiograph revealed a large radiolucency approximately 15mmX15mm, involving tooth #12, and extending up till teeth #11 and #13 [Table/Fig-1c]. Tooth #12 showed large canal space, open root apex, and ragged irregular margins at the apex suggesting inflammatory external resorption. We decided to treat tooth #12 conservatively and include surgical intervention, only if deemed necessary.

RETRACTED ARTICLE: Honey Extract as Medicament for Treatment of Dry Socket: An Ancient Remedy Rediscovered—Case Series and Literature Review

The article has been retracted as a result of an enquiry carried out on complaints of plagiarism and subsequent withdrawal of the article by the corresponding author, Deepak Passi. The Editor-in-Chief has after due dilligence determined that the article failed to meet with the highest ethical standards of Scientific publishing followed by our journal. The online version of this article contains the full text of the retracted article as electronic supplementary material.