Mucormycosis, a rare fungal infection seen in diabetes, is now very frequent owing to the deadly triad of COVID-19 infection, diabetes, and rampant use of corticosteroids. Immediate management revolves around therapeutic drugs like antifungals, antibiotics, and aggressive surgical debridement. The cases described in the article explain prosthetic rehabilitation of maxillectomy defects. The findings focus on prosthetic rehabilitation of patients with acquired maxillectomy defects after mucormycotic necrosis post-COVID-19 infection and the techniques to overcome the complications like lack of supporting tissues and post-surgical microstomia. The maxillectomies were performed on patients who suffered a superinfection of mucormycosis after COVID-19 contraction and uncontrolled blood sugar levels. Case 1 elaborates a technique to overcome the complications like lack of supporting structures and microstomia by fabrication of sectional and hollow obturator prostheses using sectional impression technique and lost salt technique. Case 2 explains the management of an extensive defect with a mobile soft tissue flap and lone standing tooth by using a functional impression technique to gain retention and support from the remaining soft and hard tissues. Both the techniques overcome the clinical complications and give predictable outcomes. Prosthetic rehabilitation of such challenging cases needs modifications depending upon the clinical challenges encountered.

No abstract

Aims: The intraoral microbiota has a high potential to undergo dysbiosis, causing inflammatory changes with respect to the tissues surrounding either a natural tooth or an implant. Thus, the longevity of implant prosthesis depends on a thorough implant decontamination protocol. Among all the techniques available for doing so, laser is garnering increasing popularity, owing to minimal bleeding, high efficiency, and faster healing. However, limited literature exists regarding the superiority of lasers over chlorhexidine (CHX), the indisputable gold standard antibacterial chemical agent. The aim of this study was to compare the percentage of bacterial reduction of Aggregatibacter actinomycetemcomitans from implant healing abutments post red diode laser therapy versus 0.2% CHX treatment. Settings and Design: The current study had an ex vivo , observational, case–control design. Materials and Methods: Patients reporting for the second stage of the implant surgery were taken as the source of data and the healing abutments, the clinical samples. Eleven patients were chosen with one intraoral implant serving as the test site for laser treatment and another, the control site for CHX treatment. Microbiological analysis was performed via quantitative real time polymerase chain reaction to compare the bacterial reduction percentage after each treatment. Statistical Analysis Used: Repeated measures ANOVA and independent sample t test were used. Results: The mean bacterial viability of the test group (laser) was 1.2%–1.6%, and 0.6%–1.4% for the control group (CHX). The former caused a mean bacterial reduction of 96.1% while the latter, 96.3%. Both the treatments caused a highly statistically significant reduction of viable bacterial counts ( P = 0.001). However, when compared, there was no statistically significant difference in the bacterial reduction, when compared in between the two ( P = 0.902). Conclusion: Laser treatment is at par with chemical implant surface decontamination. It can help bypass the complications of CHX and revolutionize the protocols for implant surface decontamination.

Purpose of Study: Bacterial biofilm-induced peri-implantitis has been one of the leading causes of implant failure. There are a plethora of local and systemic factors that have been studied at a depth and thereafter have been proven to have a contributory role in the overall disease progression. Epidemiological factors such as site specificity and gender stand to be two confounding factors that have insufficiency in the literature regarding their involvement in the same. Thus, the present article aims to address this gap in the literature and present conclusive evidence about the gender-based comparative evaluation of the microbial load of Aggregatibacter actinomycetemcomitans, one of the potential periodontopathogens for the disease progression, present in anterior versus posterior implant sites. Materials and Methods: Twelve patients (six males and six females) undergoing the implant prosthetic rehabilitation at two intraoral sites, one anterior and one posterior region, were selected as suitable subjects and the healing abutments as the clinical test samples. Culture-independent microbiological analysis was carried out for all the samples for quantification of A. actinomycetemcomitans. Results: The mean viable bacterial DNA count was 503076.49 copies/μL for the male subjects and 474587.85 copies/μL for the female subjects. Hence, there was no significant function correlating gender specificity and the viable bacterial DNA counts. The mean total of viable bacterial DNA counts for the anterior region (site 1) was 407087.17 copies/μL and for the posterior region (site 2) was 570577.17 copies/μL, irrespective of the gender. Thus, a highly significant difference was observed in the mean viable bacterial DNA counts between site 1 and site 2 (F = 20.214; P = 0.001) irrespective of the gender. Conclusion: There seems to be no gender-based predilection for the quantification of viable bacterial DNA counts for A. actinomycetemcomitans. However, a propensity for the presence of higher bacterial load of A. actinomycetemcomitans, one of the causative microorganisms of per-implant diseases, does exist for the implants placed in the posterior region as compared to those placed in the anterior region.