DT India & South Asia No. 6, 2021

Understanding ventilation to curb COVID-19 risk / Mucormycosis dedicated center at ACPM, Dhule / Breakthrough COVID-19 infections among the vaccinated may not be a severe threat / Sumita Mitra nominated for European Inventor Award 2021 / Now a T-cell-based clinical test for COVID-19 / Are new SARS-CoV-2 variants escaping PCR detection?

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DENTALTRIBUNE
The World’s Dental Newspaper · South Asia Edition

Published in India

www.dental-tribune.in

Severe threat

Award 2021

Breakthrough
COVID-19
infections among
the vaccinated
may not be a
severe threat

Sumita Mitra
nominated for
European Inventor
Award 2021

Clinical Test

PCR detection

Now a T-cell-based
clinical test for
COVID-19

” Page 04

” Page 03

06/21
Are new SARS-CoV-2
variants escaping PCR
detection?

” Page 05

” Page 06

Understanding ventilation to curb
COVID-19 risk
by Amisha Parekh,
Dental Tribune South Asia
Information
on
the
transmission of SARS-CoV-2
has constantly been evolving
right from droplet spread
to the virus being declared
airborne. The acknowledgment
of
airborne
transmission
prioritizes ventilation along
with masks, hand hygiene, and
social distancing. This article
focuses on ventilation, the
most critical measure to curb
the spread by intentionally
introducing outdoor air into
closed spaces.
SARS-CoV-2 infected individuals
generate many small respiratory
particles laden with the virus.
When they exhale, some of these
particles will be inhaled almost
immediately by those within a
short distance (<1 m). In contrast,
many particles disperse over
longer distances and can be
inhaled by others that are further
away (>2 m). Traditionally we
refer to the larger-size shortrange particles as droplets and
the smaller-sized long-range
particles as droplet nuclei.
However, we need to understand
that they are all aerosols because
they can be inhaled directly from
the air.
Ventilation flow rate and
viral transmission1,2
Increased viral transmission
in crowded and indoor places
is not a novel concept and has
been previously documented
during influenza and the H1N1
pandemic. A study shows that
a low ventilation flow rate is
associated with relatively high
aerosol transmission. In contrast,
a sufficiently high ventilation
flow rate reduces the chances of
airborne transmission to very
low levels.
Superspreaders of COVID-191,3
Superspreading is loosely
defined as a situation wherein a
single person infects many others
in a short time. Poorly ventilated

and sensors, etc., are ways to
minimize COVID-19 spread in
less ventilated places.
Conclusion
We need to focus on reducing
SARS-CoV-2 transmission
in
indoor settings as the risk for
outdoor transmission seems
to be minimum6. Improving
ventilation will help us achieve
virus-free air indoors, and
further help us prevent major
superspreaders.

Ventilation is the key measure to curb COVID-19 spread because it is an airborne infection. CO2
concentrations have been suggested to be a valuable proxy for clean air. (Image: Girts Ragelis/
Shutterstock)

spaces like slaughterhouses,
megachurches, fitness centers,
and nightclubs have given rise
to many such superspreading
events during this pandemic.
There have been many instances of COVID-19 superspreading
events reported in indoor spaces and have surprisingly affected not only people in close contact with the infected person but
also those at a distance, thereby
ruling out any chances of droplet
or surface transmission.
Examples of some superspreading events:
1. The Guangzhou (China)
restaurant outbreak,
2. Bus in Ningbo carrying
68 passengers, out of which 23
got infected during the one-anda-half-hour journey,
3. Choir practice in Skagit
Valley infected 53 out of the
61 people who attended a twoand-a-half-hour meeting.
A detailed epidemiological
and environmental study of
the restaurant outbreak in
Guangzhou showed how families
that did not have close contact
during lunch got infected. Many
members were sitting back to
back, which ruled out droplet
and surface transmission.
This study suggested that
“strong
airflow
from
the

air conditioner“ could have
propagated droplets from one
table to another and predicted
that there was recirculation of a
contaminated bubble in the area
where these families were sitting.
The most crucial finding from
this study was the evidence of
low ventilation rates due to a
lack of outdoor air supply. The
exhaust fans in the walls were
turned off, exacerbating the
ventilation deficit where these
families were sitting.
Carbon-dioxide (CO2) and
COVID-19 transmission3,4
CO2 concentrations have been
suggested to be a valuable proxy
for clean air. According to air
quality experts,
1. CO2 concentration below
500 ppm in a room means the
ventilation is good;
2. at 800 ppm, 1% of the
air someone is breathing has
already been exhaled recently by
someone else; and
3. at 4,400 ppm, it rises to
10% and would be considered
dangerous. Such dangerous
levels are seen only in crowded
spaces with poor airflow.
An experiment showed that
outdoor air contains around
400 ppm of the CO2, and people‘s
exhaled breath contains about

40,000 ppm. So, exhaling in a
room can gradually raise its
CO2 concentration unless the
ventilation is good enough to
remove all the excess. Thus,
to keep the risk of SARS-CoV-2
transmission low, CO2 levels
should be below 700 ppm.
Measures to improve ventilation3,4,5
A work published by Martin
Bazant and John Bush from
the Massachusetts Institute of
Technology calculated how long
it could be considered safe to stay
within a room that contains an
infected person.
Dr. Hong, using computer
models, studied how aerosols
would spread in a classroom.
He demonstrated how placing
an air cleaner or extractor fan
at the front of the room sets up
an airflow that prevents aerosol
movement. One can achieve an
even better aerosol-cleansing
effect by elevating the position of
fans and filters above the people
in the room, for which one can
use small, cheap box fans.
Air filters, disinfection of air
by placing germicidal ultraviolet
lamps within air-conditioners
or near the ceiling in a room,
issuing ventilation certificates
for buildings, CO2 level monitors

References
1. Li, Yuguo & Qian, Hua &
Hang, Jian & Chen, Xuguang
& Cheng, Pan & Ling, Hong &
Wang, Shengqi & Liang, Peng &
Li, Jiansen & Xiao, Shenglan &
Wei, Jianjian & Liu, Li & Cowling,
Benjamin & Kang, Min. (2021).
Probable airborne transmission
of SARS-CoV-2 in a poorly
ventilated restaurant. Building
and Environment. 196. 107788.
10.1016/j.buildenv.2021.107788
2. X. Gao, J. Wei, P. Xu, et al.,
Building ventilation as an effective
disease intervention strategy on
a large and dense social contact
network, PLos One 11 (9) (2016)
e0162481, https://doi.org/10.1371/
journal.pone.0162481.
3. Improving ventilation will
help curb SARS-CoV-2. https://
www.economist.com/sciencea nd-te ch nolog y/2021/05/26/
improving-ventilation-will-helpcurb-sars-cov-2
4. Environ. Sci. Technol. Lett.
2021, 8, 5, 392–397. Publication
Date:April 5, 2021 https://doi.
org/10.1021/acs.estlett.1c00183
5. Bazant MZ, Bush JWM.
A guideline to limit indoor
airborne
transmission
of
COVID-19. Proc Natl Acad Sci
U S A. 2021;118(17):e2018995118.
doi:10.1073/pnas.2018995118
6. A
Misleading
C.D.C.
Number. https://www.nytimes.
c o m/2 0 2 1/0 5/11/b r i e f i n g /
outdoor-covid-t ransm issioncdc-number.html

[2] =>

2

News

06/21

Mucormycosis dedicated center at
ACPM, Dhule

ACPM Dhule has set up a new center dedicated to post-COVID mucormycosis cases.
(Image: Dr. B.M. Rudagi)

by Rajeev Chitguppi,
Dental Tribune South Asia
Jawahar Medical Foundation
ACPM Medical College and the
OMFS department of ACPM
Dental College, Dhule, have
set up a center dedicated to
treat and manage post-COVID
mucormycosis cases.

We are witnessing a sudden
rise in mucormycosis cases in
people who recovered from
COVID-19 in India, especially in a
few states, like Maharashtra and
Gujarat.
The current crisis has made it
essential to create mucormycosisdedicated centers and post-

Dental
newspapers

operative ICUs to treat and
manage the cases effectively.
Jawahar Medical Foundation
ACPM Medical College and the
OMFS department of ACPM
dental college, Dhule, have set
up a dedicated center to manage
the rising number of post-COVID
mucormycosis cases.

The OMFS dept headed by
Prof. Bhimappa Mallappa Rudagi
has already treated more than
70 post-COVID mucormycosis
patients so far.
This is going to be a first-of-itskind center in Maharashtra with
two ventilators, a six-bed ICU, and
a hundred-bed general ward.

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The center will be managed by
a team of experts, including the
oral and maxillofacial surgeons
and specialists from general
medicine, ENT, ophthalmology,
and the nursing staff.
This initiative has come to
fruition under the leadership and
guidance of Kunal Patil .

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[3] =>

News

06/21

Breakthrough COVID-19 infections among
the vaccinated may not be a severe threat
by Amisha Parekh,
Dental Tribune South Asia
As the COVID-19 vaccination drive continues to expand
throughout the world, SARSCoV-2 variant mutations and
breakthrough infections have
posed a new public health concern.
Breakthrough COVID-19 infections: A breakthrough infection is a case of illness in which
a vaccinated individual becomes
sick from the same illness that the
vaccine is meant to prevent. Previously, breakthrough infections
have been identified in individuals immunized against a variety
of different diseases including
mumps, varicella (chickenpox),
and influenza and mostly these
infections in the vaccinated individuals only result in mild symptoms and are normally of shorter
duration 1.
CDC defines breakthrough
COVID-19 infection as ‘A
person who has SARS-CoV-2
RNA or antigen detected on a
respiratory specimen collected
≥14 days after completing the
primary series of a U.S. Food
and Drug Administration (FDA)authorized COVID-19 vaccine’ 2.
Are these breakthrough
infections a major concern?
Several studies have been
conducted on breakthrough
COVID-19 infections in various
parts of the world and the
following can be summarized
from them 3-15:
•
Breakthrough COVID19 infections largely remain
asymptomatic or mild and very
rarely lead to hospitalization or
death. Many vaccines have been
found to be effective against
the new variants inclusive of
the lethal ones. Indian Council
of Medical Research (ICMR)
recently stated that in India,
2-4 per 10,000 got infected with
COVID-19 after vaccinations.
•
It has been suggested
that natural COVID-19 infections
or vaccinations help in generating
cell-mediated immunity which
is minimally affected by the
variant mutations and this plays
a major role in the prevention of
severe disease. Variant mutations
have been found to have a
negligible effect on the global
CD4+ and CD8+ T cell responses
and these T cell responses may
contribute to limiting COVID19 severity that could be caused
by variants that have partially or
largely escaped the neutralizing

antibodies. Thus, the circulating
memory T cells in vaccinated
individuals and in those that
have been previously infected
would at least reduce COVID-19
severity if not prevent infection.
•
High concentrations of
SARS-CoV-2 IgG antibodies were
detected in the oral and nasal
mucosa specimens of vaccinated
individuals as well as in the nonvaccinated individuals with
previous SARS-CoV-2 infection
and it was found that these
antibodies persisted for a long
period of time. The presence and
persistence of such high antibody
concentrations at sites of primary
infection have been suggested to
play a very significant role in the
protection as well as prevention
of viral transmission.
•
It was found that an
increase in vaccine coverage
preceded the decline in mortality
amongst the elderly population.
This
rapid
increase
in
immunization coverage amongst
the elderly was associated with
a reduction in the proportionate
mortality rate ratios for the
elderly.
•
Previously, viral load
has been shown to be associated
with COVID-19 symptomatic
disease, and in vaccinated
individuals, this viral load has
been found to be decreased
up to 2.8–4.5-fold. Thus, it has
been suggested that COVID-19
vaccines might reduce the viral
load in breakthrough infections
and thereby further suppress
onward transmission.
•
Various
vaccine
manufacturers are working
on booster vaccine doses that
would target the new variants of
concern in order to overcome the
partial resistance to neutralizing
antibodies generated by natural
infections or vaccinations.
Conclusion:
Owing
to
the
above
observations we can safely
conclude
that
COVID-19
breakthrough infections, though
inevitable, may not pose a
severe threat in the future. As is
stated by Dr. Anthony Fauci “It
is inevitable that some people
who have been fully vaccinated
against the coronavirus will still
get a breakthrough infection
because no vaccine is 100%
effective. However, even if a
vaccine fails to protect against
infection, it often protects
against serious disease.” 16.

Breakthrough infections are to be expected but are not happening at an alarming rate.
(Image: Canva.com)

References:
1.
Wikipedia contributors.
(2021, April 21). Breakthrough
infection. In Wikipedia, The
Free Encyclopedia. Retrieved
15:04, May 6, 2021, from https://
e n .w i k ip e d i a .o r g/w/i n de x .
p h p?t i t l e =B r e a k t h r o u g h _
infection&oldid=1019166390.
2.
COVID-19
Breakthrough Case Investigations and
Reporting. https://www.cdc.gov/
vaccines/covid-19/health-departments/breakthrough-cases.html.
3.
TYAGI K, GHOSH
A, NAIR D, DUTTA K, Singh
BHANDARI P, Ahmed ANSARI
I, MISRA A, Breakthrough
COVID19
Infections
after
Vaccinations in Healthcare and
Other Workers in a Chronic
Care Medical Facility in New
Delhi,
India,
Diabetes
&
Metabolic Syndrome: Clinical
Research & Reviews, https://doi.
org/10.1016/j.dsx.2021.05.001.
4.
ICMR:
Covaxin
found to be effective against
Brazilian variant of virus
too. Read more at:http://
timesofindia.indiatimes.com/
articleshow/82361064.cms?
5.
Abu-Raddad
LJ,
Chemaitelly H, Butt AA; National
Study Group for COVID-19
Vaccination. Effectiveness of
the BNT162b2 Covid-19 Vaccine
against the B.1.1.7 and B.1.351
Variants
[published
online
ahead of print, 2021 May 5].
N Engl J Med. 2021;10.1056/
NEJMc2104974.
doi:10.1056/
NEJMc2104974.
6.
Shinde V, Bhikha S,
Hoosain Z, et al. Efficacy of
NVX-CoV2373 Covid-19 Vaccine
against the B.1.351 Variant
[published online ahead of
print, 2021 May 5]. N Engl J Med.

2021;10.1056/NEJMoa2103055.
doi:10.1056/NEJMoa2103055.
7.
Teran RA, Walblay KA,
Shane EL, et al. Postvaccination
SARS-CoV-2 Infections Among
Skilled
Nursing
Facility
Residents and Staff Members
— Chicago, Illinois, December
2020–March 2021. MMWR Morb
Mortal Wkly Rep 2021;70:632-638.
DOI: http://dx.doi.org/10.15585/
mmwr.mm7017e1.
8.
Keehner
J,
Horton
LE, Pfeffer MA, et al. SARSCoV-2
Infection
after
Vaccination in Health Care
Workers in California. N Engl
J Med. 2021;384(18):1774-1775.
doi:10.1056/NEJMc2101927.
9.
Tarke A, Sidney J,
Methot N, et al. Negligible
impact of SARS-CoV-2 variants
on CD4 + and CD8 + T cell
reactivity in COVID-19 exposed
donors and vaccinees. Preprint.
bioRxiv. 2021;2021.02.27.433180.
Published
2021
Mar
1.
doi:10.1101/2021.02.27.433180.
10. Redd
AD,
Nardin
A, Kared H, et al. CD8+ T
cell responses in COVID19 convalescent individuals
target
conserved
epitopes
from
multiple
prominent
SARS-CoV-2
circulating
variants. Preprint. medRxiv.
2 0 21;2 0 21.0 2 .11. 212 515 8 5.
Published 2021 Feb 12. doi:10.110
1/2021.02.11.21251585.
11. Detection of persistent
SARS-CoV-2 IgG antibodies in
oral mucosal fluid and upper
respiratory tract specimens
following COVID-19 mRNA
vaccination. Aubree Mades,
Prithivi Chellamuthu, Lauren
Lopez, Noah Kojima, Melanie
A MacMullan, Nicholas Denny,
Aaron N Angel, Joseph Casian,
Matthew Brobeck, Nina Nirema,

Jeffrey D Klausner, Frederick
E Turner, Vladimir I Slepnev,
Albina
Ibrayeva
medRxiv
2021.05.06.21256403; doi: https://
doi.org/10.1101/2021.05.06.21256
403.
12. Estimating the early
impact of immunization against
COVID-19 on deaths among
elderly people in Brazil: analyses
of secondary data on vaccine
coverage and mortality. Cesar
Victora, Marcia C Castro, Susie
Gurzenda, Aluisio J D Barros
medRxiv
2021.04.27.21256187;
doi: https://doi.org/10.1101/2021
.04.27.21256187.
13. Levine-Tiefenbrun, M.,
Yelin, I., Katz, R. et al. Initial
report of decreased SARS-CoV-2
viral load after inoculation with
the BNT162b2 vaccine. Nat Med
(2021). https://doi.org/10.1038/
s41591-021-01316-7.
14. Hacisuleyman
E,
Hale C, Saito Y, et al. Vaccine
Breakthrough Infections with
SARS-CoV-2 Variants [published
online ahead of print, 2021 Apr
21]. N Engl J Med. 2021;10.1056/
NEJMoa2105000.
doi:10.1056/
NEJMoa2105000.
15. A DC, F C, N P, et al.
SARS-CoV-2 escape mutants
and
protective
immunity
from natural infections or
immunizations
[published
online ahead of print, 2021
Mar 29]. Clin Microbiol Infect.
2021; S119 8 -74 3X(21)0 0146 - 4.
doi:10.1016/j.cmi.2021.03.011.
16. Fauci:
Breakthrough
infections after vaccinations
‘inevitable‘. https://news.yahoo.
c o m /f a u c i - b r e a k t h r o u g h i n fe ct ion s-vacci n at ion sinevitable-173725342.html.

[4] =>

News

06/21

Sumita Mitra nominated for
European Inventor Award 2021

Sumita Mitra is known for her
innovative work in
nanocomposite dental
materials. (Photo: invent.org)

by Amisha Parekh,
Dental Tribune South Asia
Sumita Mitra, an IndianAmerican chemist, has been
nominated as a finalist for the
European Inventor Award 2021
for applying nanotechnology
to produce a new composite
restorative material, which
has many advantages over
conventional materials.
Ever since its advent in the
1960s, composite restorations
have revolutionized dentistry. All

thanks to Sumita Mitra, who in the
late 1990s brought in innovation
in the traditional composites
with the help of nanotechnology
ultimately making it more
esthetic and strong.
Sumita Mitra has been
nominated in the category
of non-EPO countries for her
innovation in ‘Restoring smiles
with nanomaterials’, the winners
of which shall be announced at a
ceremony on 17 June 2021.
Composites prior to the innovation 1: Until the 1990s composites used were either composite
microfills that were too weak to
bear biting forces or hybrid composites which were esthetically
inferior.
Sumita Mitra’s Innovation 1,2:
Sumita Mitra was the first person
to develop a dental filler using
nanotechnology that improved
the properties of restorations
in terms of strength, wear
resistance, and esthetics. This
new composite filling material
launched in 2002 was called Filtek
Supreme Universal Restorative
and was recognized as a versatile
material that could be used for
restoring teeth in any area of the
mouth after which 3M Oral Care
launched newer generations of
Filtek in 2005, 2012, and 2019.

Products made using Sumita
Mitra’s innovation 1,2: Mitra holds
about 100 US patents and their international equivalents which
have helped her and her team to
protect as well as commercialize
her innovation. Ranging from
nanocomposites, resin-modified
glass ionomers to dental adhesives, her innovation has formed
the base for multiple dental products which have been used in
over one billion restorations worldwide. Apart from Filtek some
other products that have made
use of her innovation include Viteremer and Vitrebond Resin-modified Glass Ionomers, RelyX Luting Cements, Scotchbond Multipurpose Adhesive, and APC Orthodontic Bracket Adhesive.
What inspired Mitra’s innovation 1: Sumita Mitra explains
that the key to her innovation
was a bunch of grapes and mentions that “If we look at a bunch
of grapes, they are all of the different sizes. Some are small and
some are big so that the small
ones can fit in between the large
ones to create a cluster. Also, the
size of the clusters can vary greatly. Some of the bunches could
have five grapes and some could
have 20 grapes or 100 grapes.”

Back in the 1990s Sumita Mitra
had realized the shortcomings of
the traditional composites while
working in the Oral Care division of 3M, an American multinational company, and was determined on finding an alternative.
On realizing that the root cause of
all the problems was the particle
size in the case of hybrid composites and loose packing of particles
in the case of micro-filled composites, Mitra and her team experimented by incorporating uniform
nanoparticles of approximately
20 nanometres in size into the resins and found that although the
mechanical and optical properties improved, this technique was
unsuitable in dentistry.
Then, inspired by the ‘bunch
of grapes model’ they developed
a technique for creating loosely
bound clusters of nanoparticles
of varied sizes and combined
these
nanoclusters
with
precisely engineered individual
nanoparticles
of
varying
diameters which resulted in a
robust, durable, and lustrous
material with excellent handling
properties. Further, by adding
tiny amounts of pigment and
altering the chemical composition
of nanoparticles, they could even
create a range of shades to match
individual patient’s teeth.

Sumita Mitra currently runs
her own consulting company and
also volunteers in her community
to inspire young minds to develop
an interest in science to ensure
that the legacy of innovation
continues in the future.
‘Just as a magic wand
enhances the magic of a magician,
innovations like that of Sumita
Mitra complement the smiles
delivered by dentists’.
References
1. Finalist for the European
Inventor Award 2021. https://
w w w.e p o.org/n e ws - eve nt s/
e ve n t s/e u r o p e a n - i nve n t o r/
finalists/2021/mitra.html
2. Sumita Mitra. https://www.
invent.org/inductees/sumitamitra
1. Sumita Mitra‘s innovation
made use of nanotechnology
to overcome the drawbacks of
traditional composites.
2. The new composite ‚Filtek
Supreme Universal Restorative‘
was a versatile material which
could be used for restoring teeth
in any area of the mouth.
3. Sumita Mitra holds
about 100 US patents and their
international equivalents.

LifeCare Devices Private Limited
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Customer Service
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News

06/21

Now a T-cell-based clinical test
for COVID-19

First clinical T-cell-based COVID-19 test to confirm recent or prior
infections. (Photo: https://www.t-detect.com/)

by Rajeev Chitguppi,
Dental Tribune South Asia
Our interest in the significance
of T-cell immunity in fighting
SARS-CoV-2 infection and in
providing resistance to re-infection
is only growing more. Now, we
have the first clinical T-cell-based
test for patients to confirm recent or
prior COVID-19 infection.
So far, we have heavily relied
upon SARS-CoV-2 antibodies to test
if a person has been exposed to the
virus.
Also, neutralizing antibody
(nAb) response has been the key
to establishing protection against
the virus, not because it is the best
mechanism, but simply because it is
easier to measure them. 1
Now, routine T-cell testing has
entered a new era after the US Food

and Drug Administration (FDA)
gave Emergency Use Authorization
(March 05, 2021) to “T-Detect“ COVID19 test (Adaptive Biotechnologies). 2
It is a laboratory-based nextgeneration sequencing test that
identifies T cells that recognize
SARS-CoV-2 antigens.
The test aims to identify
individuals with an adaptive T cell
immune response to SARS-CoV-2 by
analyzing DNA sequences from T
cells, where a positive test indicates
recent or previous SARS-CoV-2
infection. In contrast, a negative
test result means that a patient is
unlikely to have been infected with
the virus. 2
T-Detect COVID Test is a labbased procedure with a seven- to tenday turnaround time and meant for
samples taken at least 15 days after
symptom onset. A test can detect T

cell response in the blood several
days after initial infection.
The T-Detect COVID assay
showed 97.1% sensitivity (positive
percent agreement) and 100%
specificity
(negative
percent
agreement) compared to RT- PCR
testing from 15 days or more after
diagnosis. 3
Thus, it is not meant to diagnose
an active infection. Instead, it works
as a complement to antibody tests to
confirm recent or previous infections.
Additional points:
1.
A negative result does not
preclude an ongoing or acute SARSCoV-2 infection.
2.
The test should not be used
to diagnose current SARS-CoV-2
infection.
3.
It is a valuable tool to
determine if a person previously had
COVID-19.
4.
The test results are meant
to be used in combination with
clinical findings, patient medical
history, and other findings.
The test will be of great help for
individuals who may have exhibited
symptoms previously and suspect
an exposure previously but have not
tested positive for COVID-19 using
an RT PCR or rapid antigen test.
Patients can now order T-Detect
COVID online at www.t-detect.
com by answering a few eligibility
questions. 4

Limitations of T cell response:
We still do not know how long
after infection the T cell immune
response remains and the level of
protection it provides.
References:
1.
Sheridan, C. COVID19 testing turns to T cells. Nat
Biotechnol 39, 533–534 (2021). https://
doi.org/10.1038/s41587-021-00920-9
2.
Coronavirus (COVID-19)
Update: FDA Authorizes Adaptive
Biotechnologies T-Detect COVID Test.
https://www.fda.gov/news-events/
press-announcements/coronaviruscovid-19-update-fda-authorizesadaptive-biotechnologies-t-detectcovid-test
3.
Sudeb C. Dalai, Jennifer
N. Dines, Thomas M. Snyder, et
al. Clinical Validation of a Novel
T-cell Receptor Sequencing Assay
for Identification of Recent or Prior
SARS-CoV-2 Infection. medRxiv
2021.01.06.21249345; doi: https://doi.
org/10.1101/2021.01.06.21249345
4.
Adaptive Biotechnologies
Launches
T-Detect™
COVID,
First Clinical T-Cell Based Test for
Patients to Confirm Recent or Prior
COVID-19 Infection. https://www.
g lob e n e ws w i r e.com/e n/n e ws release/2021/02/23/2180346/0/
e n/Ad ap t ive -Bio t e c h n olog ie s Launches-T-Detect-COVID-FirstC l i n ica l-T- Cel l-Ba s ed-Te st-forPat ients-to-Con fi rm-Recent-orPrior-COVID-19-Infection.html

Dr. Rajeev Chitguppi gets COVID
care educator award
by Amisha Parekh,
Dental Tribune South Asia
Dr.
Rajeev
Chitguppi,
executive editor at Dental Tribune
South Asia, has been awarded
the COVID care educator award
during the 8th Famdent Excellence
in Dentistry Awards (2021)’ for his
relentless research work related
to COVID-19, providing authentic
and reliable information.
The science of COVID-19
involves many virology and
immunology concepts that are not
the mainstay of dentistry. Dr. Rajeev
made these concepts easier for dental
practitioners and common people to
understand. Right from the early
days of the pandemic he has been
analyzing the emerging literature
and posting the summary in concise
formats on social media platforms.
His
contributions
include
evidence-based suggestions to make
dental practice protocols simpler
and safer. His proposals include
using chlorhexidine mouthwash,

pulse oximeter to measure SpO2,
rapid antigen tests (esp saliva-based
tests) to identify the asymptomatic
virus carriers entering the clinic all suggestions were made when
the available evidence was scant.
His recent work includes – survey
of oral and maxillofacial surgeons
for mucormycosis, and suggestion
of a novel grading system for
mucormycosis.
Dr. Chitguppi has extensively
used the platform provided by
Dental Tribune South Asia to
disseminate the knowledge by
making complex concepts simpler to
understand.
Apart
from
utilizing
various social media platforms,
Dr. Chitguppi has also used the
digital platform of ICPA Health
Products Ltd to reach out to a
maximum number of doctors from
different medical specialties. Apart
from writing, Dr. Chitguppi has
been continuously giving webinars
and interviews throughout the
pandemic phase.

In his speech, Dr. Chitguppi
mentioned that his prime objective
has been ‘to alleviate people’s
anxiety and provide hope during
these tough times.’
Dr. Chitguppi has recently
completed two years as the
Executive Editor at Dental Tribune
South Asia. Apart from being an
eminent dentist and researcher,
he also mentors numerous dental
students and guides them to excel in
this competitive scenario.
About Famdent: Founded by Dr.
Anil Arora in 1999 as a publication
on Clinical Dentistry based on
international standards, Famdent
now has multiple offerings with a
strong foothold in the Indian Dental
Industry. Its activities involve
trade shows, conferences, awards,
corporate
solutions,
hands-on
courses, workshops and more. The
Famdent Excellence in Dentistry
Awards (FEDA) recognize the
highest standards of excellence in
the dental profession, honoring
individuals in respective fields for

Dr Rajeev Chitguppi gets ‘COVID
Care Educator Award’

their outstanding achievement.
Famdent shows hold annual
events in Mumbai and other cities
throughout the year and are at par
with international dental events.
During this pandemic Famdent has
conducted numerous informative
webinars on various evolving key
concepts of dentistry by renowned
speakers. It’s most recent activity has
been the 8th Famdent Excellence in
Dentistry Awards (FEDA) 2021.

IMPRINT
PUBLISHER & CHIEF EXECUTIVE
OFFICER
Torsten R. OEMUS
CHIEF CONTENT OFFICER
Claudia DUSCHEK
DENTAL TRIBUNE SOUTH ASIA
EDITION
PUBLISHER
Ruumi J. DARUWALLA
CHIEF EDITOR
Dr. Meera VERMA
CLINICAL EDITOR
Dr. Dilip DESHPANDE
RESEARCH EDITOR
Dr. Shobha DESHPANDE
ASSOCIATE EDITOR
Dr. GN ANANDAKRISHNA
EXECUTIVE EDITOR
Dr. Rajeev CHITGUPPI
ASSISTANT EXECUTIVE EDITOR
Dr. Amisha PAREKH
DESGINER
Anil LAHANE
PRINTER
Mehernosh & Burzin MISTRY
Ampersand, Mumbai, India
Material from Dental Tribune
International GmbH that has been
reprinted or translated and reprinted
in this issue is copyrighted by Dental
Tribune International GmbH. Such
material must be published with
the permission of Dental Tribune
International GmbH. Dental Tribune
is a trademark of Dental Tribune
International GmbH.
DENTAL TRIBUNE
INTERNATIONAL GMBH
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Germany
Tel.: +49 341 48 474-302
Fax: +49 341 48 474-173
General requests:
info@dental-tribune.com
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www.dental-tribune.com
All rights reserved. © 2021 Dental
Tribune
International
GmbH.
Reproduction in any manner in
any language, in whole or in part,
without the prior written permission
of Dental Tribune International
GmbH is expressly prohibited.
Dental Tribune International GmbH
makes every effort to report clinical
information and manufacturers’
product news accurately but
cannot assume responsibility for
the validity of product claims or for
typographical errors. The publisher
also does not assume responsibility
for product names, claims or
statements made by advertisers.
Opinions expressed by authors are
their own and may not reflect those
of Dental Tribune International
GmbH.

[6] =>

News

06/21

Are new SARS-CoV-2 variants
escaping PCR detection?
other RNA viruses, which means
fewer mutations and less genetic
variability over time.
Targets used by RT PCR to
detect SARS-CoV-2:
The ORF1ab/ RdRp, E, N, and
S genes are the most frequently
used targets for SARS-CoV-2
detection by RT-PCR.
Different protein targets of
SARS-CoV-2:
1.
The nucleocapsid (N)
protein has 90% amino acid
similarity with SARS-CoV (the
2003 pandemic of Asia), which
means that this gene/ sequence
has been conserved over time.
This stability makes the N gene
one of the most promising targets
for
SARS-CoV-2
detection.
Therefore PCR tests designed

People in India are worried that PCR tests are not able to detect the
new SARS-CoV-2 variants. (Image: Canva.com)

by Rajeev Chitguppi,
Dental Tribune South Asia
Several media reports have
come up with scary headlines
that the new SARS-CoV-2
variants are fooling the RT-PCR
test, which is considered the
gold standard test for detecting
the SARS-CoV-2 infection.

Anecdotal reports say PCR tests
are not able to detect the virus
due to the new mutations. Is it
true? Let us explore science and
find out the truth.
Are mutations frequent in
coronaviruses?
NO. Coronaviruses make
far fewer replication errors than

and

Strictly physiologic!

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Position 2 : i-PRF : 700 rpm / 3 min
Position 3 : i-PRF M : 700 rpm / 4 min
Position 4 : i-PRF + : 700 rpm / 5 min
Position 5 : A-PRF Liquid : 1300 rpm / 5 min
Position 6 : Custom : 1300 rpm / 3 min
Position 7 : Manual : Free settings

+ tubes S« PRF Box » allow you to get the membranes always hydrated and of
constant thickness, but also to recover the exsudate rich in proteins:
Vitronectin and Fibronectin. You can also produce ‘‘plugs’’ of PRF.

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- PRF Clots
- PRF Membranes
- PRF Plugs

tubes

(Green) 10ml
For Liquid PRF, for:
- Sticky Bone
- Large Membranes
- Intra oral Injections
(Pre-Op. Flap Injection /
Papilla / TMG / Endo)

PRF box with a crusher in Teflon, with compartments of different
sizes to easily create large membranes and sticky bone.

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Blood Collectors
Blood collectors are used to draw blood.

INDICATIONS:
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► Soft tissue surgery

► Dermatology

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► Socket preservation

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► Regenerative medicine

► Aesthetics

Your distributor:

LifeCare Devices Private Limited
New Jubilee Building, Office no. 1, Laxmiben Chheda Road, Nalasopara West, Palghar 401 203.
Mumbai Metropolitan Region, Maharashtra, INDIA. | E: info@lifecare.in | Customer Service : +91 99304 50170
| Customer Service WhatsApp : +91 99304 50169 | Management WhatsApp : +91 99304 50163/+91 99997 86275

for the N gene will easily detect
SARS-CoV-2.
2.
Point mutations in the
RdRp gene have given the virus
the ability to interfere with
diagnostic assays and anti-viral
treatments (e.g., Remdesivir).
3.
S gene (for the Spike
glycoprotein):
has
multiple
mutations that confer a genetic
advantage to the virus (greater
transmissibility)
Can a PCR be designed to
detect a single viral target?
A PCR test can have a single
target, provided it is a „stable“
target, such as the N protein.
What does the World
Health Organization (WHO)
recommend?
WHO recommends at least
two targets for SARS-CoV-2
detection by RT PCR:
1.
one sarbecovirus specific E-gene
2.
one SARS-CoV-2- specific gene (N, RdRp or ORF1b, etc.)
Why use multiple targets?
The advantage of using
multiple targets in a PCR is that
the test remains accurate even if
a target sequence mutates. For
the same reason, manufacturers
often include secondary and
tertiary sites in their assays. If
one of the targets produces a
false negative due to mutations,
the other sites can generate PCR
signals to detect SARS-CoV-2
correctly.
RT PCR tests in India:
The new variants and their
mutations can not escape detection
and can not give negative results
as the RT-PCR tests used in India
target more than two genes. Both
sensitivity and specificity of the RTPCR tests remain the same as earlier.
Then why are people testing
negative?
1.
Testing too early after
exposure: The best time to test is
one week after exposure. It can be a
range of five to seven days. Earlier
than that, PCR may test negative.
2.
Testing too late after
infection: eight to nine days after
infection. At this point, only
BronchoAlveolar Lavage Fluid
(BALF) samples may test positive
and not the nasal/ throat swabs.
3.
No test is perfect. It is well
known that all PCR tests have some
false negatives.

Conclusion:
False-negative PCR tests in the
second wave could be mainly due to
any of the three reasons mentioned
above, but not due to the new
variants and their mutations. Labs
may have been overwhelmed by the
work overload impacting the quality
of test results, but no one should
worry about the variants missing
the PCR tests purely because of the
mutations.
Our recommendations for
people who have a suspected
exposure to an infected person:
Isolate yourself immediately
and prevent the spread to other
family members. It is an airborne
infection that spreads rapidly
indoors. Hence, take maximum
precautions at home. Keep windows
open. Improve ventilation and air
circulation. Get tested after five to
seven days from the day of suspected
exposure. During isolation too, keep
monitoring SpO2 levels (with a pulse
oximeter) and body temperature.
The best time to get tested is the
first day of symptoms.
References:
1.
DNA Explainer: How the
new COVID-19 variant is fooling
RT-PCR tests - all you need to
know. https://www.dnaindia.com/
explainer/report-dna-explainerhow-the-new-covid-19-variant-isfooling-rt-pcr-tests-all-you-need-toknow-2886515
2.
Kalita D, Deka S (2020)
Effectiveness of Different GeneTarget Strategies for SARS-CoV-2
Screening by RT-PCR and Other
Modalities: A Scoping Review. J Med
Diagn Meth 9:298. doi: 10.35248/21689784.2020.9.298
3.
Kocemba-Pilarczyk KA,
Bentke-Imiolek A, Dudzik P. Does
the absence of SARS-CoV-2 specific
genes always exclude the infection?
How to interpret RT-PCR results?The scenario of interactive online
workshop. Biochem Mol Biol Educ.
2021 Mar 27. doi: 10.1002/bmb.21506.
Epub ahead of print. PMID:
33773033.
4.
SARS-C0V-2 Tests & Their
Targets. https://blog.microbiologics.
com/sars-c0v-2-tests-their-targets/
5.
Viral targets: What makes
a good Covid-19 RT- PCR test?
https://www.zymoresearch.com/
blogs/blog/what-makes-a-goodcovid-19-rt-pcr-test
6.
Variants not leading to
false negative test results, says Centre
https://www.hindustantimes.com/
india-news/variants-not-leadingto-false-negative-test-results-sayscentre-101618610884979.html

[7] =>

Sydney, Australia

26-29 September 2021

Broadcast from the International Convention Centre
4 day Streamed Scientific Programme
200+ sessions on-demand for an extended period of 60 days
High quality International and Local presenters
Europe, America, Africa, Middle East, Asia, Australia & New Zealand
Extensive virtual Exhibition with product demonstrations
Meet the exhibitor’s in a virtual showroom
Interact live with speakers, ask questions
Passport competition with great prizes

Australian CPD Requirements
Dental practitioners in Australia are required to complete a minimum
of 60 hours of CPD activities over a three-year CPD cycle (current cycle
ends Wednesday 30th November 2022).

ADA CERP
The FDI World Dental Association is an ADA CERP Recognised Provider. ADA
CERP is a service of the American Dental Association to assist dental
professionals in identifying quality providers of continuing dental education.
ADA CERP does not approve or endorse individual courses or instructors, nor
does it imply acceptance of credit hours by boards of dentistry.
This continuing education activity has been planned and implemented in
accordance with the standards of the American Dental Association Continuing
Education Recognition (ADA CERP) through joint efforts between FDI
World Dental Association and the Australian Dental Association.
Concerns or complaints about a CE provider may be directed to the provider
or to the Commission for Continuing Education Provider Recognition
at ADA.org/CERP.

Educating for Dental Excellence

www.world-dental-congress.org

[8] =>

7 News

Amelotech
Synahealth Singapore Pte. Ltd.
16 Raffles Quay
#41-01 Hong Leong Building
Singapore 048581

7/19

LifeCare Devices Private Limited
New Jubilee Building, Office no. 1, Laxmiben Chheda Road,
Nalasopara West, Palghar 401 203. Mumbai Metropolitan Region,
Maharashtra, INDIA. | E: info@lifecare.in | Website: www.lifecare.in
| Customer Service : +91 99304 50170
| Customer Service WhatsApp : +91 99304 50169
| Management WhatsApp : +91 99304 50163/+91 99997 86275

) [page_count] => 8 [pdf_ping_data] => Array ( [page_count] => 8 [format] => PDF [width] => 794 [height] => 1134 [colorspace] => COLORSPACE_UNDEFINED ) [linked_companies] => Array ( [ids] => Array ( ) ) [cover_url] => [cover_three] =>

[cover] => DT India & South Asia No. 6, 2021

[toc] => Array ( [0] => Array ( [title] => Understanding ventilation to curb COVID-19 risk [page] => 1 ) [1] => Array ( [title] => Mucormycosis dedicated center at ACPM, Dhule [page] => 2 ) [2] => Array ( [title] => Breakthrough COVID-19 infections among the vaccinated may not be a severe threat [page] => 3 ) [3] => Array ( [title] => Sumita Mitra nominated for European Inventor Award 2021 [page] => 4 ) [4] => Array ( [title] => Now a T-cell-based clinical test for COVID-19 [page] => 5 ) [5] => Array ( [title] => Are new SARS-CoV-2 variants escaping PCR detection? [page] => 6 ) ) [toc_html] =>

Table of contents

[toc_titles] =>

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