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1.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-21252488

RESUMO

SARS-CoV2 is transmitted primarily through oral mouth secretions and respiratory droplets. Commercial mouthwashes, povidone iodine (PI), hydrogen peroxide (HP) and chlorhexidine (CHX) have been tested in cell culture and RT-PCR studies for their efficacy to reduce SARS-CoV2 burden. Here, we evaluated SARS-CoV2 burden in whole mouth fluid (WMF) and respiratory droplets (RD) samples before and after the use of PI, HP or CHX mouthwashes in hospitalized COVID-19 patients using RT-PCR and rapid antigen test (RAT). Thirty-six SARS-CoV2 RT-PCR-positive in-patients were randomly assigned to one of the four groups: 20 and 60 minutes after 1% w/v PI or 1.5% HP; 90 and 180 minutes after 1.5% HP or 0.2% w/v CHX. WMF and RD samples were collected concurrently at baseline and after the two different time points. RD (92%) showed a higher reduction in SARS-CoV2 burden than WMF samples (50%; p=0.008). SARS-CoV2 burden was statistically lower at both 20 minutes (p=0.02) and 60 minutes (p=0.03) with PI; at 20 minutes with HP (p=0.0001); and 90 minutes with CHX (p=0.04). The overall and individual mean logarithmic reductions in the WMF and RD samples were greater than 1.0 at 20, 60 and 90 minutes after PI, HP or CHX. RAT-positive patients at 90 minutes post-treatment (n=3) demonstrated a one log increase in virus copies. Among the three RAT-negative post-treatment patients, SARS-CoV2 burden declined by one log in two while the third patient had a slight increase in RNA copies. In conclusion, we have shown for the first time that the mouthwashes, PI, HP and CHX can reduce the SARS-CoV2 burden in the concurrently collected RD and WMF samples. RAT is more appropriate than RT-PCR to evaluate the efficacy of the mouthwashes.

2.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-21249157

RESUMO

ImportanceThe nasopharyngeal swab (NPS) is considered the ideal diagnostic specimen for Covid-19, while WMF is recently promoted due to collection simplicity and importance in disease transmission. There is limited knowledge on the relative viral load in these samples - NPS, whole mouth fluid (WMF) and respiratory droplets (RD; another important source in transmission), on how the loads vary with disease severity and on how much virus is shed. ObjectiveTo quantify and compare SARS-CoV2 copies in the NPS, WMF and RD samples, and correlate with disease severity. DesignCross sectional study. SettingTertiary care multi-speciality hospital with limited resources in a low-to-middle income country. ParticipantsEighty suspected COVID-19 patients were recruited from the COVID-19 out-patient clinic and hospital isolation wards. InterventionConcurrent NPS, WMF and RD samples were collected from all the recruited patients and tested for SARS-CoV2 copies by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Main outcomes and measuresThe main outcome was COVID-19 measured by SARS-CoV2 quantitative RT-PCR in NPS samples. COVID-19 disease severity was determined according to NIH criteria. Virus shedding was defined as the presence of SARS-CoV2 copies in the WMF and RD samples. ResultsSARS-CoV2 was detected in 55/80 (69%) of the NPS samples. Of these 55, WMF and RD samples were positive in 44 (80%) and 17 (31%), respectively. The concordance of WMF with NPS was 84% (p=0.02). SARS-CoV2 copy numbers were comparable in the NPS (median: 8.74x10^5) and WMF (median: 3.07x10^4), but lower in RD samples (median: 3.60x10^2). Patients with mild disease had higher copies in the NPS (median: 3.46x10^6), while patients with severe disease had higher copies in the WMF (median: 1.34x10^6) and RD samples (median: 4.29x10^4). The 25-75% interquartile range of NPS SARS-CoV2 copies was significantly higher in the WMF (p=0.0001) and RD (p=0.01) positive patients. Conclusion and relevanceSARS-CoV2 copies are highest in NPS samples. WMF is a reliable surrogate sample for diagnosis. High copy numbers in the NPS imply initial virological phase and higher risk of virus shedding via WMF and RD. Key pointsO_ST_ABSQuestionC_ST_ABSHow the numbers of SARS-CoV2 copies in nasopharyngeal swab (NPS) samples might reflectvirus shedding from the whole upper aerodigestive tract and indicatedisease severity? FindingsIn this cross-sectional study involving 80 suspected COVID-19 patients, the data indicate higher SARS-CoV2 copies in NPS samples of patients with mild disease,and in the whole mouth fluid (WMF) and respiratory droplet (RD) samples of patients with severe disease. Patients with higher SARS-CoV2 copies in the NPS shed the virus in the WMF and RD samples at statistically higher levels. MeaningHigh SARS-CoV2 copies in NPS samples imply initial virological phase withhigh levels of shedding through both WMF and RD.

3.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-20248437

RESUMO

IntroductionSARS-CoV2, the aetiological agent of the current COVID-19 pandemic, has been detected in saliva and recently implicated in several oral diseases. Collection of nasopharyngeal swabs (NPS) and detection by reverse transcriptase-polymerase chain reaction (RT-PCR) requires medical / technical expertise. A reliable and easy to handle point-of-care (POC) test is highly desirable, especially to curb transmission. Therefore, in this study, we evaluated a commercially available POC rapid antigen test (RAT) for the detection of SARS-CoV2 antigens in the saliva of RT-PCR confirmed positive and negative patients. MethodsThirty saliva samples of 10 saliva RT-PCR negative and 20 saliva RT-PCR positive patients were tested by RAT. ResultsRAT was negative in 10/10 (100%) RT-PCR-negative samples; positive in 9/20 (45%) RT-PCR-positive samples; concordance was 63% (p=0.001). Patients with positive RAT had higher virus copies in their NPS samples compared to the RAT-negative patients. This difference was also statistically significant (p=0.01). ConclusionThus, the POC RAT may be used to detect SARS-CoV2 as a reliable tool for self-testing, large-scale population screening and emergency medical/dental screening. Patients negative by RAT should be confirmed by RT-PCR.

4.
Indian J Radiol Imaging ; 23(4): 342-6, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24604939

RESUMO

Cone-beam computed tomography (CBCT) is an emerging technology finding application in all branches of dentistry. The current series highlights the application of CBCT in the preoperative assessment of dentigerous cyst of the jaws.

5.
Indian J Dent Res ; 23(3): 435-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23059598

RESUMO

The achievement of passive fit is an important prerequisite for the prevention of complications in full-arch screw-retained implant prosthesis. With cemented prosthesis, the cementation compensates for the discrepancies in the cast framework, but the lack of retrievability seems undesirable. The aim of this paper is to propose a modified screw-retained prosthesis design for complete arch implant fixed rehabilitation. A technique for the fabrication of a full-arch metal-resin implant-supported screw-retained prosthesis is described. Cementation of the framework to the abutments intraorally improves the passivity of fit of the prosthesis on the implants. Maintenance of screw-access channels in the final prosthesis ensures retrievability. The metal-resin design allows for easy repair and maintenance. The prosthesis is cost-effective compared to conventional options and can be employed as a viable treatment alternative when considering metal-acrylic resin complete arch fixed prosthesis.


Assuntos
Resinas Acrílicas , Ligas Dentárias , Implantes Dentários , Adaptação Marginal Dentária , Materiais Dentários , Prótese Dentária Fixada por Implante , Planejamento de Dentadura , Resinas Acrílicas/química , Adulto , Cimentação/métodos , Análise Custo-Benefício , Ligas Dentárias/química , Projeto do Implante Dentário-Pivô , Implantação Dentária Endo-Óssea/métodos , Materiais Dentários/química , Prótese Dentária Fixada por Implante/economia , Bases de Dentadura , Planejamento de Dentadura/economia , Reparação em Dentadura , Retenção de Dentadura/instrumentação , Prótese Total Imediata , Prótese Total Superior/economia , Humanos , Carga Imediata em Implante Dentário , Masculino , Dente Artificial
6.
J Oral Implantol ; 38(2): 149-53, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20932151

RESUMO

Passive fit of a long-span screw-retained implant prosthesis is an important criteria for the success of the restoration. This article describes a technique for fabricating a ceramometal implant fixed dental prosthesis (FDP) for a long-span partially edentulous situation by altering the conventional screw-retained design. The possibility of a passive fit is maximized by intraoral luting of the cast frame to milled abutments, and the potential framework distortion during fabrication is compensated to a major extent. Retrievability is ensured by screw retention of the prosthesis to the implants. Compared with conventional porcelain fused to metal screw-retained FDP, this prosthesis is relatively inexpensive to fabricate.


Assuntos
Implantes Dentários , Adaptação Marginal Dentária , Porcelana Dentária/química , Prótese Dentária Fixada por Implante , Retenção de Dentadura/instrumentação , Prótese Parcial Fixa , Ligas Metalo-Cerâmicas/química , Cimentação/métodos , Resinas Compostas/química , Projeto do Implante Dentário-Pivô , Implantação Dentária Endo-Óssea , Técnica de Moldagem Odontológica , Planejamento de Dentadura , Humanos , Registro da Relação Maxilomandibular , Arcada Parcialmente Edêntula/reabilitação , Arcada Parcialmente Edêntula/cirurgia , Maxila/cirurgia , Cimentos de Resina/química , Torque
7.
J Oral Implantol ; 38(6): 751-5, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21728840

RESUMO

Management of one or more failing distal implants in an implant supported fixed prosthesis in a completely edentulous maxilla creates a challenging situation. Restoring immediate function with additional implants in such a situation can be a challenge considering the loss of supporting bone, need for grafting, age, and the patient's desire for immediate fixed dental prosthesis. This clinical report describes a situation where a zygomatic implant has been placed unilaterally and splinted with osseointegrated conventional implants by an immediate fixed provisional restoration.


Assuntos
Implantação Dentária Endo-Óssea/métodos , Reparação em Prótese Dentária , Prótese Dentária Fixada por Implante , Carga Imediata em Implante Dentário , Zigoma/cirurgia , Idoso , Falha de Restauração Dentária , Humanos , Arcada Edêntula/reabilitação , Masculino , Maxila
8.
J Oral Maxillofac Surg ; 67(6): 1269-73, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19446215

RESUMO

PURPOSE: To study the intraoperative and perioperative complications associated with anterior maxillary osteotomy (AMO), and assess its safety and predictability in orthognathic surgery. PATIENTS AND METHODS: We performed a retrospective evaluation of 103 patients undergoing AMO as a single procedure, or in combination with other osteotomies over a period of 5 years, with a mean follow-up of 3 years. RESULTS: Twenty-seven (26.2%) patients in our series of 103 had complications of varying severity: 43.3% of these were soft tissue-related, and 36.6% were attributable to dental causes. All other complications accounted for the remaining 20%. CONCLUSION: Although its indications are limited, AMO is a safe and reliable procedure in routine orthognathic surgery.


Assuntos
Complicações Intraoperatórias , Maxila/cirurgia , Osteotomia/métodos , Complicações Pós-Operatórias , Perda Sanguínea Cirúrgica , Placas Ósseas , Transplante Ósseo , Sensibilidade da Dentina/etiologia , Seguimentos , Hematoma/etiologia , Humanos , Intubação Intratraqueal/instrumentação , Má Oclusão/cirurgia , Mandíbula/cirurgia , Maxila/anormalidades , Necrose , Mordida Aberta/cirurgia , Osteotomia/efeitos adversos , Palato/cirurgia , Palato Mole/lesões , Hemorragia Pós-Operatória/etiologia , Estudos Retrospectivos , Segurança , Extração Dentária
9.
Artigo em Inglês | MEDLINE | ID: mdl-17706436

RESUMO

Cemento-ossifying fibromas form a part of the spectrum of fibro-osseous lesions of the jaws and are considered benign but locally aggressive tumors. This report presents a 31-year-old female patient with a large cemento-ossifying fibroma of the maxilla, expanding into the orbit and causing proptosis. The report also discusses the surgical management of this lesion with successful preservation of optic nerve function and normal vision.


Assuntos
Exoftalmia/etiologia , Fibroma Ossificante/complicações , Neoplasias Maxilares/complicações , Tumores Odontogênicos/complicações , Adulto , Feminino , Fibroma Ossificante/cirurgia , Humanos , Neoplasias Maxilares/cirurgia , Tumores Odontogênicos/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Órbita/cirurgia
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