Dr Mitthra Suresh
@dental.srmist.edu.in
SRM KATTANKULATHUR DENTAL COLLEGE & HOSPITAL
RESEARCH, TEACHING, or OTHER INTERESTS
Dentistry, General Dentistry
Scopus Publications
Scopus Publications
Paul V Abbott, Arunajatesan Subbiya, Nagarajan Geethapriya, Suresh Mitthra, and Venkatachalam Prakash
Jaypee Brothers Medical Publishing
AIM
The aim of this study was to assess and compare the pain during infiltration by a modified two-stage local anesthetic infiltration technique under topical anesthesia (TA).
MATERIALS AND METHODS
In this cross-over double-blind study, 30 volunteers participated, where two groups were given single-stage infiltration and the other two had two-stage infiltrations. Depending upon the infiltration technique (one- or two-stage) and the use of TA, the patients were randomly divided into four groups. Local anesthesia (LA) was administered by infiltration into the mucobuccal fold of the maxillary central incisor, and the pain perceived during the infiltration in each group was recorded. The volunteers were recalled after 24 hours to assess the tenderness at the injection site. The volunteers were recalled 2 weeks after infiltration for the subsequent groups to assess the pain for this cross-over study.
RESULTS
A statistically significant difference was observed in the pain perceived when TA was used and when the infiltration was done in two stages. Regarding the pain at the site of injection after 24 hours, no significant difference was observed among the volunteers.
CONCLUSION
Topical anesthesia was effective in reducing the pain of injection when compared to placebo. The pain of injection is further reduced with a two-stage infiltration technique after TA application.
CLINICAL SIGNIFICANCE
Topical anesthesia can be used routinely before infiltration, and LA infiltration injections are less painful if administered in two stages.
Arunajatesan Subbiya, Suresh Mitthra, Kesavaram Padmavathy, Krishnan Mahalakshmi, Alagarsamy Venkatesh, and Kotishwaran Gayathri
Jaypee Brothers Medical Publishing
AIM
To evaluate the antibacterial efficacy of calcium hydroxide (CH) with antibiotic combinations: daptomycin and gentamicin against Enterococcus faecalis (E. faecalis) dentinal biofilm.
MATERIALS AND METHODS
Sixty freshly extracted single-rooted mandibular premolars were inoculated with E. faecalis(ATCC 29212) (n = 30) (group A) and clinical isolates (n = 30) (group B) for 3 weeks to form a biofilm. The tooth samples of groups A and B were randomly divided into three subgroups of 10 each, groups 1A and 1B (CH), groups 2A and 2B (CH+G), groups 3A and 3B (CH+D), depending on the medicaments to be placed for one week. The difference between initial and final CFU was calculated and statistically analyzed.
RESULTS
Among the clinical isolates, CH-antibiotic combinations were more effective than CH alone, which was statistically significant (p = 0.006).
CONCLUSION
The dentinal biofilm of clinical isolates of E. faecalis strains exhibited more reduction in bacterial colonies with CH in combination with antibiotics (D and G).
CLINICAL SIGNIFICANCE
Daptomycin and gentamicin when used as an intra-canal medicament in combination with CH are effective in eliminating E. faecalis. Keywords: Calcium hydroxide, Daptomycin, Dentinal biofilm, E. faecalis, Gentamicin.
Ravindranath Megha and Venkatachalam Prakash
Jaypee Brothers Medical Publishing
Ab s t r Ac t Aim and objective: To present the endodontic treatment of maxillary right first molar with three roots and seven root canals diagnosed with cone-beam computed tomographic imaging and its successful management. Background: The anatomic complexities and variations of maxillary first molar reported vastly in the literature are constant challenges for successful endodontic therapy. Detection of all the root canals and their disinfection is important for proper healing and long-term survival of the tooth. CBCT imaging is being used extensively over the past two decades for the diagnosis of teeth with multiple root canals. The use of CBCT and various diagnostic tools for the successful management of a maxillary first molar with multiple root canals is discussed herein. Case description: This case report represents an unusual morphology of three roots and seven root canals in the maxillary first molar. A rare configuration of two mesiobuccal, two distobuccal, and three palatal root canals is reported. The diagnosis was done using multiple angulated radiographs and CBCT imaging. Nonsurgical endodontic treatment was performed followed by a full-coverage porcelain crown. Conclusion: Clinicians should always be mindful of various possible aberrations in the canal morphology of maxillary molars. This necessitates the use of various diagnostic tools like CBCT and dental operating microscope (DOM). The use of these aids led to successful diagnosis and treatment in the present case, thereby avoiding possible endodontic failure. Clinical significance: This case report along with the literature discusses and highlights the fact that maxillary first molars have the highest incidence of additional root canals. It also signifies the importance of CBCT and DOM as essential diagnostic tools in detecting the additional canals.
Narasimhan Manasa Suresh Mitthra Balasubramaniam Anuradha
Institute of Medico-legal Publications Private Limited
Pregnancy is a physiological state with significant changes in a woman’s body. Pregnant women are moreprone to gingival diseases due high levels of fluctuating pregnancy hormones.The aim of this article is tobring to light the changes in oral cavity during pregnancy, the consequences of not treating them and thecurrent recommendations for dental management of pregnant patients in different trimesters.
S. Mitthra, Manasa Narasimhan, R. Shakila and B. Anuradha
Institute of Medico-legal Publications Private Limited
Various tissues in the body like bone, enamel dentin and cementum are composed of inorganic material and they are exposed to multiple cycles of Demineralisation and remineralisation. Understanding these biological mechanisms are necessary for developing treatments for these mineralisation related diseases and specifically dental caries as far as dentistry is concerned. This article focuses on the mechanism and rate of demineralisation and discusses in detail the causes of demineralisation.
Sahithi Reddy, V. Prakash, R. Tamilselvi and A. Karthick
Institute of Medico-legal Publications Private Limited
The mandibular premolars are more prone to aberrations of canals. They include bifurcation and trifurcationof canals which makes it difficult to diagnose and manage. The failure to treat them leads to re-infectionand persistence of infection in the tooth. Hence, it is of utmost importance for the clinician to know themorphologic variations. The present case report is aimed to give a clinical insight of such aberrations.The first case presents with mandibular first premolar with 2 roots and 2 root canals and second case is amandibular second premolar with 1 root and 3 canals which was diagnosed with CBCT. Both the cases weretreated endodontically and successfully managed.
Sahithi Reddy, V. Prakash, A. Subbiya and S. Mitthra
Institute of Medico-legal Publications Private Limited
Ever since the introduction of calcium hydroxide in 1920, it has been widely used in dentistry. This is dueto the therapeutic properties of calcium hydroxide imparted by its high pH and dissociation to form ionsCa+2 and OH?. This makes it a remineralizing agent, a bactericidal or bacteriostatic agent based on the pHconcentration and also an anti-inflammatory agent. It is being applied for various purposes in dentistry likeintracanal medicament, pulp capping agent, root canal sealer, cavity liner, apexification, pulpotomy, canalswith exudate, perforation management and root resorption. This review article aims to describe in detail thevarious properties of calcium hydroxide and applications marking 100 years of its use in dentistry.
Jagadeesh Shuruthi, Dhakshinamoorthy Malarvizhi, Suresh Mitthra, and Arunajetasan Subbiya
Institute of Medico-legal Publications Private Limited
The irrigants used commonly do not always eradicate the entire microbial flora in infected root canals. Thus in quest other strategies, such as photodynamic therapy (PDT) have been developed. The word photodynamic means the applications of the dynamics of photons of light on the biological molecules. German physician Friedreich Mayer performed the first study, which was first called as photo-radiation therapy with porphyrins (1913) in humans. Photoactivated disinfection is based primarly on the interaction of a photosensitive antibacterial agent and a light source which uses a nontoxic dye named photosensitizer (PS) and lowintensity visible light. In the presence of oxygen, these combine to produce some cytotoxic species. The PS molecules attach to the bacteria membrane. Irradiation with a specific wavelength of the light may result in the production of singlet oxygen, resulting in rupture of the microbial cell wall. There are several applications for PDT in dentistry.. Photodynamic therapy has also been used to disinfect caries dentin before the restoration, disinfecting oral tissues before or during surgical procedures, treating denture stomatitis, and treating oral candidiasis in immunocompromised patients. Photodynamic therapy can also be used in combination with mechanical instrumentation and chemical antimicrobial agents, such as sodium hypochlorite.
Alagarsamy Venkatesh, Balasubramanian Anuradha, Suresh Mitthra, and T. Sanjana
Institute of Medico-legal Publications Private Limited
Suresh Mitthra, Balasubramaniam Anuradha, Joseph Changankary Pia, and Arunajatesan Subbiya
Institute of Medico-legal Publications Private Limited
Comprehensive oral care that combines both art and science to optimally improve dental health, aesthetics and function is termed as cosmetic dentistry. The objective of Cosmetic Dentistry is to provide maximum improvements in aesthetics with the minimum trauma to the dentition. Veneer is a layer of tooth colored material that is applied to a tooth to restore localized or generalized defects and intrinsic discoloration. Veneer are made up of chairside composite, processed composite, porcelain and compressed ceramic materials. This evolution of material sciences, ceramics, and adhesive system permits improvements of the aesthetic smile design of patients. The current manuscript is a review that highlights the diagnostic considerations; repair and maintenance; and recent advances in veneers.
Parthasarathy Rajasekar, Suresh Mitthra, Dhakshinamoorthy Malarvizhi, and Arunajetasan Subbiya
Institute of Medico-legal Publications Private Limited
Hemisection refers to the surgical separation of a multi-rooted tooth with the extraction of one root along with the overhanging crown. It is performed to retain the original tooth structure and attain the fixed prosthodontic prosthesis. Loss of the posterior teeth leads to teeth drifting, loss of masticatory function and loss of arch length, which requires prevention and maintenance measures. Management of periodontally involved molars with extensive decay is challenging and is limited to dental extraction and replacement with implants.
Balasubramaniam Anuradha, Deepika Katyal, Suresh Mitthra, and Dhakshinamoorthy Malarvizhi
Institute of Medico-legal Publications Private Limited
Metagenomics using next generation sequencing technologies has produced bacterial profiles and genomic profiles to study the relationships between microbial diversity, genetic variation, and oral diseases. Several oral metagenomic studies have examined the oral microbiome of periodontal disease and caries. Gene annotations in these studies support the association of specific genes or metabolic pathways with oral health and with specific diseases. The roles of pathogenic species and functions of specific genes in oral disease development have been recognized by metagenomic analysis. This review gives an overview on the interaction between oral microbiomes that determine a state of health or disease.
Parthasarathy Rajasekar, Suresh Mitthra, Venkatachalam Prakash, and Arunajetasan Subbiya
Institute of Medico-legal Publications Private Limited
This case report describes and analyses a tooth fragment reattachment technique used to resolve crown fractures of the anterior teeth. This treatment allows a conservative approach to traumatic coronal lesions offering a better possibility of maintaining aesthetics and function. The adhesive reattachment is a simple system to achieve good aesthetic and functional results. When tooth and fragment margins are intact, the reattachment technique without any tooth preparation is a simple and predictable procedure.
Joseph Changankary Pia, Suresh Mitthra, Balasubramanian Anuradha, and Arunajetasan Subbiya
Institute of Medico-legal Publications Private Limited
Local anesthetics (LA) are one among the safest drugs used in dentistry. The disadvantages include burning sensation upon injection, slow onset of action etc., Buffering of local anesthetics is introduced to counteract these undesirable qualities. The advantages of buffering of local anesthetics include quicker onset, more reliable and comfortable for the patient. This article provides an overview on buffering of local anesthetics.
Alagarsamy Venkatesh, Arunajatesan Subbiya, Suresh Mitthra, and Venkatachalam Prakash
Institute of Medico-legal Publications Private Limited
Vertical root fracture in teeth can be a barrier in diagnosis. There are other clinical and radiographic findings which can be vigilant to the clinician to the existence of fracture. Knowledge of the diagnostic aspects and the correct correlation and interpretation of radiograph was enough to establish the diagnostic hypothesis of vertical root fracture.
Joseph Changankary Pia, Suresh Mitthra, Venkatachalam Prakash, and Arunajetasan Subbiya
Institute of Medico-legal Publications Private Limited
Endodontically treated teeth are often associated with vertical root fracture (VRF) and it becomes difficult to differentiate a tooth with this condition from an endodontically failed one or one with concomitant periodontal involvement. The cause of VRF is mainly trauma and iatrogenic reasons. Both complete and incomplete VRF constitute an ongoing problem in dentistry because they are difficult to be diagnosed in the early stages. In majority of the cases, tooth extraction is the only reasonable treatment when the VRF is finally diagnosed. Treatment options included extraction of single rooted teeth, but with the advent of adhesive dentistry. There is a paradigm shift towards preservation of these teeth.
Venkatachalam Prakash, Ravindranath Megha, Suresh Mitthra, and Alagarsamy Venkatesh
Diva Enterprises Private Limited
Rajendran Devakar, Dhakshinamoorthy Malarvizhi, Suresh Mitthra, and Venkatachalam Prakash
Diva Enterprises Private Limited
Tamizharasan Sangavi, Arunajetasan Subbiya, Nagarajan Geethapriya, and Suresh Mitthra
Diva Enterprises Private Limited
Tamizharasan Sangavi, Arunajetasan Subbiya, Nagarajan Geethapriya, and Suresh Mitthra
Diva Enterprises Private Limited
Suresh Mitthra, Sekar Sangeetha, Ragupathy Shakila, and tirpuravaram Vinay Kumar Reddy
Diva Enterprises Private Limited
Suresh Mitthra, Lukram Nivedita, Venkatachalam Prakash, NewbeginSelvakumar Gold Pearlin Mary, Alagarsamy Venkatesh, and Arunajatesan Subbiya
Medknow
Objectives: The objective is to evaluate the effect of collagen stabilizing agents-chitosan and proanthocyanidin (PA) on the shear bond strength to dentin and microleakage of resin composite at enamel and cemental walls. Materials and Methods: Thirty premolars were decoronated 2 mm above cemento-enamel junction and restored with composite resin. Teeth were then randomly divided into three groups: Group I - Control, Group II - Pre-treatment with chitosan, and Group III - Pre-treatment with PA. Samples were then subjected to thermocycling for 500 cycles at 5°C and 55°C with the dwell time of 30 s and transfer time of 5–10 s. Then, the samples were subjected to shear bond strength evaluation on Universal testing machine. Shear load was applied until failure occurred. The load to failure was recorded individually and statistical analysis was done. Microleakage was determined by methylene blue dye penetration method and subjected to stereomicroscopic evaluation. Statistical analysis was carried out using Mann–Whitney test and Chi-square test. Results: Group II specimens produced the highest median shear bond strength and group I showed the least. In addition, Group I, Group II, and Group III showed no statistically significant difference in microleakage. Conclusions: Application of Chitosan and PA improved the shear bond strength to dentin as compared to the control. However, no significant difference in shear bond strength and microleakage was found between them.
Suresh Mitthra, Nivedita Lukram, Venkatachalam Prakash, New Begin Selvakumar Gold Pearlin Mary, Jagadeesh Shuruthi, and Arunajatesan Subbiya
Diva Enterprises Private Limited