A five-step risk management process for geriatric dental practice during SARS-CoV-2 pandemic.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus that causes coronavirus infection (COVID-19). COVID-19 is a highly contagious disease transmitted through respiratory droplets, saliva and other contact routes. Within 10 months of its outbreak, SARS-CoV-2 has infected more than 23 million people around the world. Evidence suggests that older adults are the most vulnerable to infection and have an increased risk of mortality. Reduced immunity and underlying medical conditions make them risk-prone and vulnerable to critical care. Older adults affected with the SARS-CoV-2 virus present with distinct clinical manifestations necessitating specific treatment needs and management protocols. While it is crucial to prevent the spread of novel coronavirus (2019-nCoV), the role of oral healthcare workers in addressing the specific needs of ageing adult patients by adopting specific guidelines and appropriate infection control protocols is timely. This paper aims to develop specific guidelines and protocols for the dental management of geriatric patients during the COVID-19 pandemic.

Chlorhexidine for the Treatment of Peri-Implantitis: Is it a Benison?

PURPOSE: Chlorhexidine is the most favored and widely used antimicrobial agent for the treatment of peri-implantitis. But, not many clinicians are aware of its side effects on dental implants and its cytotoxic effects on osteoblasts. The objectives of this review are to study the effect of chlorhexidine on osteoblasts as well as on the surface topography of dental implants. MATERIALS AND METHODS: MEDLINE-PubMed (The National Library of Medicine, Washington DC) was used as a search engine. Databases were searched from 2010 to 2020 were explored using the following terms: "dental implant surface," "chlorhexidine mouthwash," "osteoblast cells," "osseointegration." From the total hits obtained, each article along with its cross-reference was manually read and filtered based on the focused question. The inclusion criteria included articles published only in English language involving human studies, randomized control trials, in vitro studies, and review articles. Exclusion criteria included studies published in languages other than English, orthodontic mini-implants, and pilot studies. The final process involved scrutinizing for any duplicate content of the hand searched articles. Following this, data was extracted from the compiled hand searched articles to obtain relevant information for the review. RESULTS: Chlorhexidine alters the surface topography of dental implants and causes cell cytotoxicity. This, in turn, can hinder the re-osseointegration potential and hence cause dental implant failure. It is, therefore, recommended to discourage the use of chlorhexidine as a surface decontaminant for peri-implantitis cases and practice implementing other antimicrobial agents.

Prosthetic Lip with the Retentive Attachment for a Unilateral Cleft Lip Patient: A Clinical Report.

Patients afflicted with congenital cleft lip defect experience disfigured facial esthetics and lack of oral competency that could reduce the speech intelligibility. Rehabilitation of such cosmetic deformities condition often encountered with dental abnormalities becomes the challenge. When surgical treatment is not desired, prosthetic reconstruction turns out to be an economical option. This clinical treatment describes the fabrication of a maxillary lip prosthesis supported by a cast partial denture retained with magnetic attachment in a cleft lip patient. The use of intraoral magnets placed labially on the cast partial denture and on the counterpart of the prosthesis improved the retention. Moreover, the biomedical-grade silicone prosthesis used to blend closely with the patient's skin shade fulfilled the esthetic needs.

Recreating an esthetically and functionally acceptable dentition: a multidisciplinary approach.

Patients today demand a youthful, attractive smile with comfortable functional acceptance. The complete oral rehabilitation of patients with a functionally compromised dentition frequently involves a multidisciplinary approach and presents a considerable clinical challenge. To a great extent, proper patient selection and careful interdisciplinary treatment planning, including acknowledgment of the patient's perceived needs, reasons for seeking services, financial ability, and socioeconomic profile, can govern the predictability of successful restorations. This clinical report describes a successful interdisciplinary approach for the management of a severely worn dentition with reduced vertical dimension of occlusion. Treatment modalities included periodontal crown lengthening procedures, endodontic treatment followed by post and core restorations, and prosthetic rehabilitation for severe tooth surface loss and reduced vertical dimension of occlusion comprising metal-ceramic restorations in esthetic zones and full-metal restorations in posterior regions.