Mucormycosis during Coronavirus Disease Pandemic: A Diagnosis we Cannot Afford to Miss

Mucormycosis is a very aggressive, devastating opportunistic fungal infection commonly involving nasal, maxillary,orbital, and cerebral regions. In the second wave of the coronavirus disease 2019 (COVID-19) pandemic, a high frequency of mucormycosis infections has been seen because of the triad of COVID-19, systemic steroids, and preexisting diabetes mellitus. A patient might present with a simple mobile tooth/teeth with multiple gingival abscesses Necrotic bone could be seen in the palate. Blackish discoloration might be present in the oral mucosa. There might be extraoral swelling . If rhino-oculo cerebral mucormycosis is diagnosed, then there are two immediate treatment modalities to be followed. Both surgical and medical treatment are necessary. Surgical is thorough debridement of the necrotic tissue. To prevent the occurrence of mucormycosis, meticulous glycemic control and rational use of steroids and antibiotics for the shortest possible time with adequate attention toward the ventilators and tubing are necessary.

Root Form and Morphology of Human Permanent Maxillary First Premolars of an Indo-Dravidian Population Based in Southern India: An In Vitro Study

Aim:

The aim of this study was to analyze root form and morphology of human maxillary first permanent premolars of an Indo-Dravidian population from southern India.

Materials and Methods:

Eight hundred and twenty-two maxillary first permanent premolars were cleansed and stored appropriately. Morphology and root form analysed, segregated into Groups (Gps): Gp I, Gp II, and Gp III, and later divided into subgroups (SGs) based on specific criteria. Gp I was divided into two SGs: SG A (minimal or absence of grooving in the root) (n = 252) and SG B (clear and defined longitudinal groove in the root) (n = 104), and Gp II was divided into SG C (roots dividing in coronal one-third) (n = 154), SG D (roots dividing in the middle one-third) (n = 158), and SG E (roots dividing in the apical one third) (n = 138). Gp III consisted of only one SG F (teeth with three roots) (n = 16). The groups were analyzed separately, their external root form and morphology were recorded. Root form was analyzed, and results were tabulated. This study was compared with other studies and statistically analyzed.

Results:

Gp II was common with an incidence of 54.74%. Gp I was the next most common with an incidence of 43.3%. Gp III was the least common with an incidence of 1.94%. The number and distribution of roots was also computed. Six types of root form were identified (Type [Ty] A = 30.65%, Ty B = 12.65%, Ty C = 18.73%, Ty D = 19.22%, Ty E = 16.78%, and Ty F = 1.94%).

Conclusion:

Awareness and assessment of root form, number preoperatively with regard to specific populations before initiation will pave way for successful outcome of therapy.

An In Vitro Comparative Evaluation of Distribution of Three Different Sealers by Single-Cone Obturation Technique

Aim:

The aim of this study was to evaluate the distribution of sealer at different levels of the root canal using three different sealers in a single-cone obturation technique.

Materials and Methods:

Thirty freshly extracted mandibular premolar teeth were selected and access opening was performed. Working length was determined. Cleaning and shaping were done till 25 size K file followed by ProTaper till F2 size. Teeth were then obturated with matching gutta-percha points with the following sealers: Group I, 10 teeth with zinc oxide eugenol sealer; Group II, 10 teeth with AH plus sealer; and Group III, 10 teeth with NanoSeal-S sealer. Teeth were cross sectioned at 3 and 6 mm from the apex. Color photographs of sections were taken at a magnification of ×40 using a camera connected to a stereo-operating microscope and the images were transferred to a computer. Sealer distribution was observed and the canal perimeters coated or uncoated with the sealer can be calculated using a computer digital imaging system.

Results:

Of the three groups, zinc oxide eugenol showed least sealer distribution. AH Plus and Nanoseal-S showed no significant difference between the distribution at the 3- and 6-mm levels.

Conclusion:

Both AH Plus and Nanoseal-S showed excellent sealer distribution when compared to zinc oxide eugenol.

Malignant melanoma of the mandibular gingiva

Oral malignant melanoma is an infrequent neoplasia making up less than 1% of all melanomas, which exhibits much more aggressive behavior than those found on the skin. We present an aggressive case of oral malignant melanoma located on the mandibular gingiva in a 24-year-old male patient, who developed metastases to not only the regional lymph nodes but also the lungs and liver. The advanced stage of the disease contraindicated any surgical intervention and palliative chemotherapy was planned.