Assessment of palliative approach in the pain management in endodontic emergencies during Covid-19 outbreak: Retrospective cohort study

Aim: During the coronavirus disease, a palliative approach was recommended for the management of endodontic emergencies. This retrospective cohort study was conducted to investigate the effectiveness of dexamethasone or ibuprofen-acetaminophen combination for pain management in endodontic emergencies. Material(s) and Method(s): One hundred and eight records of patients who presented to the emergency department with dental pain were evaluated retrospectively. Since interventional procedures were not performed during the pandemic period, Specific analgesics/antibiotics for the management of pain were preferred. A follow-up protocol with a questionnaire was developed to observe the effectiveness of palliative treatment and make changes if necessary. All participants received a questionnaire to rate the pain levels 6, 12, 18, 24, 48, and 72 hours after taking the drug. All data were collected from the patient file and assessed. After inclusion and exclusion criteria, 32 patients were included (n = 19, ibuprofen + acetaminophen;n = 13, dexamethasone). Data were analyzed using the chi-square test (P = 0.05). Result(s): In both groups, a significant decrease in pain was experienced immediately after medication and at 6, 12, and 18 hours, with no significant difference (P >.05). However, dexamethasone (Group II) resulted in lower pain levels than ibuprofen\acetaminophen (Group I) at 24 and 48 hours (P <.05) Discussion: Both dexamethasone and ibuprofen-acetaminophen can be good palliative choices in endodontic emergencies in pandemic conditions. However, at 24 and 48 hours, dexamethasone resulted in lower pain levels.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Comorbidity of periodontitis and herpes in the postcovid period

Improving the diagnosis and provision of dental care for patients with chronic periodontitis in combination with herpetic diseases is an urgent goal of many studies. At the same time, the COVID-19 pandemic, including the course of its post-covid period, has somewhat changed the view of specialists on the diagnosis and treatment of these comorbid diseases. The aim of the study was a metagenomic analysis of the microbiota of patients with periodontitis in combination with herpetic lesions in the postcovid period. Materials and methods. 28 people aged 18—19 years were examined: 8 patients with chronic periodontitis and herpes of the lips in the postcovid period (group I), 9 patients with chronic periodontitis and herpetiform stomatitis in the postcovid period (group II), 11 conditionally healthy young people (group III, comparisons). The biomaterial was selected after professional oral hygiene from periodontal spaces;metagenomic analysis was carried out using a Nanodrop ND-2000 spectrophotometer, "Quant-iT dsDNA HS” analysis kits and "MiSeq” sequencer (Illumina). Results. The structures of microbial communities of 28 samples of the microbiome of periodontal spaces were analyzed, the average length of the resulting sequences was 460 base pairs, an average of 13 974 sequences accounted for the sample, 183 phylotypes belonging to 17 types were identified, of which 46 of the most numerous phylotypes were identified. Relative to the comparison group, the experimental groups showed a tendency to decrease the normal microbiota (Streptococcus, Rothia), an increase in the biodiversity of Shannon and individual representatives of the conditionally pathogenic spectrum (group I — Prevotella, Fusobacterium, Campylobacter, Haemophilus, Selenomonas, Treponema, Tannerella and Filifactor;group II — unclassified TM7-3, Actinomyces, Veillonella, unclassified Gemellaceae, Porphyromonas). Conclusion. The features of the microbiome of the periodontal pocket in comorbid patients with periodontitis and herpes in the postcovid period were revealed, individual representatives of the microbiome were identified, their features were described, which gives grounds for the use of various treatment methods, including using minimally invasive therapy against the background of antiviral agents. © 2023 Clinical Dentistry LLC. All rights reserved.

2C5-surface modified nanocarriers targeting neutrophil extracellular traps

Background: Neutrophil extracellular traps (NETs) are composed of processed chromatin bound to granular and selected cytoplasmic proteins and released by neutrophils. NETs consist of smooth filaments composed of stacked nucleosomes. Fully hydrated NETs have a cloud-like appearance and occupy a space 10-15-fold larger than the volume of the cells they originate from. DNases are the enzymes that cleave extracellular DNA including NETs. Together with their protective role in microbial infections, NETs are involved in multiple pathological processes and represent key events in a variety of pathologies including cancer, autoimmunity, and cardiovascular disease. Sites of NETs concentration are dangerous for the host if the process of NETs formation becomes chronic or the mechanism of NETs removal does not work. NETosis has been linked to the development of periodontitis, cystic fibrosis, type 2 diabetes, COVID-19 or rheumatoid arthritis as well as cancer progression. Purpose(s): Thus, the destruction of NETs is of primary significance in many pathologies. In our approach, we are focusing on mimicking one of the natural mechanisms of destroying excessive NETs by delivering deoxyribonuclease I to the specific site of pathological NETs accumulation by modifying the nanoparticles using an anti-nucleosome monoclonal antibody (2C5). The antibody is specific to nucleosomes and can recognize histones in NETs. DNase I is U.S. Food and Drug Administration (FDA)-approved active component and is commonly used in therapeutic methods of modern medicine for cystic fibrosis to clear extracellular DNA fibers in the lungs and systemic lupus erythematosus. Recent findings have also shown the effectiveness of DNase I in the digestion of NETs. However, the low serum stability and fast deactivation by environmental stimuli have been considered as the limiting factors for clinical applications of DNase I, which can be overcome by its targeted specific delivery in pharmaceutical nanocarriers. Method(s): In this study, we generate NETs in vitro using human neutrophils and HL-60 cells differentiated into granulocyte-like cells. We used interleukin-8, lipopolysaccharide from E.Coli (LPS), phorbol myristate acetate (PMA), and calcium ionophore A23187 (CI) to generate the NETs. We confirmed the specificity of 2C5 toward NETs by ELISA, which showed that it binds to NETs with the specificity like that for purified nucleohistone substrate. We further utilized that feature to create two delivery systems (liposomes and micelles) for DNAse I enzyme to destroy NETs, which was confirmed by staining NETs with SYTOX Green dye and followed by flow cytometric measurements and microscopic images. Conclusion(s): Our results suggest that 2C5 could be used to identify and visualize NETs and serve as a ligand for NET-targeted diagnostics and therapies. Also, we proved that our carrier can successfully deliver DNase to NETs to provide their degradation.

Awareness and Knowledge of Carpal Tunnel Syndrome among Adult Saudi Population

Introductions: The median nerve's occasional or persistent compression or entrapment in the carpal tunnel from the wrist to the hand causes carpal tunnel syndrome (CTS). The main symptoms are pain, tingling, swelling, and loss of grip strength and function in the thumb, index finger, middle finger, and thumb of thumb. This study examined Saudi adults' awareness and understanding of Carpal Tunnel Syndrome and its link with demographics and chronic conditions. Material(s) and Method(s): This cross-sectional study examined adults' knowledge, attitudes, and practices regarding carpal tunnel syndrome from 2021 to 2022 in different Saudi Arabian regions. This study used a researcher-created questionnaire. In the awareness category, general public questions included CTS clinical aspects, etiology, and effects on daily life. Practice questions covered CTS preventive and chronic diseases. Volunteers were selected following informed consent. Result(s): 420 participants aged 34.8 +/- 13.49 years. 280 (66.6%) were male, 140 (33.3%) females. 38 (9.04%) were non-Saudi workers, while 384 were Saudis. 235 (55.9%) individuals knew about wrist CTS and 161 (38.3%) about pain. 157 (37.3%) individuals experienced thumb tingling or numbness, while 117 and 142 agreed that CTS may produce thumb weakness (27.8%) and hand grip (35.2%). The older age group reported more thumb numbness or tingling than the other groups, although there was no statistical difference (p= 0.09). CTS was not associated with chronic disease;however, diabetes was the main comorbidity in all age groups (44;45.3%), especially in the middle age group (21;60%). 5.4% had CTS. CTS was rare during pregnancy (0.7%), however all age groups agreed that it could influence their employment and social life (p= 0.014 and < 0.00001). The average knowledge score was 43.3 +/- 40.5, whereas the awareness score was 50.1 +/- 44.2. These findings indicate that Saudis were aware of CTS clinical symptoms. Conclusion(s): The study examined Saudi adults' awareness and understanding of CTS and estimated the association between CTS and demographics and chronic conditions. The study found that adult CTS awareness and knowledge were sufficient and associated with age and quality of life. CTS awareness campaigns may lower risk and raise knowledge of prevention and treatment. People who work with discomfort or use computers for long periods of time without breaks are more prone to develop CTS. Larger research is needed to understand how physical exercise causes CTS.Copyright © 2023, Ibn Sina Trust. All rights reserved.

Correlation between Periodontal Diseases and COVID-19: Systematic Review and Meta-Analysis

Objective: To finding the correlation of COVID-19 with periodontal status. Methods: This systematic review and meta-analysis were aimed to overview studies of the relationship between periodontal disease and the severity of COVID-19 (hospitalization). There were nine studies, analyzed in this systematic review (nine reviews and three meta-analyses). The quality assessment of studies was using Newcastle-Ottawa Scale (NOS) and the pooling effect of meta-analysis were using random-effects model. Results: The NOS scores were Satisfied (5-6 stars) for seven studies, meanwhile good (7 stars) for two studies. The estimated OR was 2.68 (P= 0.006). The heterogeneity (I2 ) was 61%, showed moderate (P=0.006). The heterogeneity (I2 ) was 61%, showed moderate het-erogeneity. COVID-19 and severity depended on the host and viral factors that influence the immune response. The surge of cytokines (especially IL-6) was found as an imperative role in the COVID-19 and periodontal diseases. Finally, periodontal diseases were found positively contributed to the severity of COVID-19. Conclusion: Periodontal diseases were found associated with the severity and mortality of COVID-19. However, further studies are a necessity to generalize in other populations of COVID-19 patients. © 2022 JDMFS.

Absence of Supportive Periodontal Treatment during the Covid-19 Pandemic - Recurrence of Periodontal Inflammation

Case presentation: Supportive periodontal care (SPC) is defined as step IV by the 2020 and 2022 EFP Guidelines for the treatment of periodontitis stages I-IV. SPC aims to maintain periodontal stability after active periodontal treatment is finished and the endpoints of periodontal therapy are achieved. SPC presumes preventive and therapeutic procedures performed at individualised, patient-based intervals. This case report describes a patient, 43 y/o female, with diagnoses of generalised periodontitis stage IV, grade C and periodontal health on reduced periodontium who was enrolled in longterm SPC provided at 3 - 4-monthly intervals. During the COVID-19 pandemic, the patient did not report for regular SPC due to personal fears of the contagion. After 20 months of absence, the patient was admitted for SPC. The comprehensive periodontal exam showed excellent oral hygiene (FMPS=7%), the presence of five 4 and 5 mm pockets and relapse of periodontal inflammation (FMBS=42%). The affected areas were mostly in the lower jaw. As periodontitis is a chronic disease, patients need to be continuously monitored. SPC reduces the probability of disease progression and tooth loss, as timely re-treatment can be provided in cases of disease recurrence. Various factors can contribute to disease relapse. In terms of the described patient, despite good oral hygiene, factors such as psychological stress and unhealthy living habits experienced during the COVID-19 pandemic might have negatively impacted the innate host response and led to disease relapse.

Oral and Dental Needs and Teledentistry Applications in the Elderly: Real-Time Surveillance Using Google Trends

Featured ApplicationThe present cross-sectional analysis aimed to evaluate the level of interest in oral and dental needs and teledentistry applications among the elderly, as well as whether COVID-19 pandemic outbreaks were influenced by real-time surveillance, using Google Trends. As the number of elderly dental patients continues to increase, there is a growing need for specific interventions that address the biological and psychological issues of this population. Teledentistry represents a healthcare delivery system that can overcome these problems, although the oral and dental care provision methods involved are still unknown to most people. Indeed, there is a need to raise awareness of the indications for teledentistry, the available interventions, and the potential benefits for the oral and dental care of elderly patients.Considering the increasing need for oral and dental care in the elderly, teledentistry has been proposed to improve the education of elderly patients in oral health maintenance and risk factor control, identify patients' concerns in advance, facilitate monitoring, and save time and money. The present cross-sectional analysis of Google search data through real-time surveillance with Google Trends aimed to determine Google users' interest in oral and dental needs and teledentistry applications in the elderly, and to compare search volumes before and after the COVID-19 outbreak. Extracted CVS data were qualitatively analyzed. Pearson and Spearman correlation analyses were performed between searches for "elderly” and "teledentistry”, and all the oral and dental needs and teledentistry applications. The Mann–Whitney U test compared search volumes in the 36 months before and after the beginning of the COVID-19 pandemic. Google users' interest in the elderly and related oral and dental needs was diffusely medium–high, while teledentistry and its applications were of lower interest. Interest in teledentistry and its applications was strongly related to interest in the older population, which is consistent with the assumption that older adults represent the population segment that could benefit most from these tools. A positive correlation was also found between searches for "Elderly” and searches for almost all oral and dental needs typical of the geriatric population. Search volumes increased significantly after the outbreak of the COVID-19 pandemic. More information about teledentistry should be disseminated to increase knowledge and awareness, especially among older patients, about its indications, applications, and advantages.

Features of inflammatory periodontal diseases course in combination with a new coronavirus disease. A systematic review.

Risk factors for severe COVID-19 are also associated with periodontitis. They are smoking, older age, obesity, diabetes mellitus, hypertension and cardiovascular diseases. The aim of the study was to select and analyze publications that consider a possible relationship between inflammatory periodontal diseases and the severity of COVID-19. Material and methods. The search for publications by the key words was conducted using the electronic databases: Cochrane Library;MEDLINE, eLIBRARY for systematic review. We selected 94 publications, the systematic review included 10 scientific articles presenting the results of randomized trials. Results. The results of the analysis showed the connection between COVID-19 severity and inflammatory periodontal diseases presence. In the patients with severe COVID-19 on the background of periodontitis it was established a high risk for artificial lung ventilation prescription. The course of COVID-19 is possibly depending on high expression of ACE2 receptors in oral mucosal cells and aspiration of pathogenic bacteria from periodontal tissues with saliva on the background of SARS-CoV-2 viral infection. The bacterial etiology of periodontitis plays important role of an immunological trigger that causes hyperreaction of humoral and cellular immunity, NETosis activation and NLRP3 inflammation. Conclusion. The presence of periodontitis in patients with overweight and obesity, DM or hypertension may be associated with severe COVID-19 course, possible development of complications and pneumonia.Copyright © Eco-Vector, 2023. All rights reserved.

Oral and systemic health: is there a "new" link with COVID-19?

OBJECTIVES: The objective of the present narrative review was to evaluate the evidence of a possible association between periodontitis and COVID-19, and its biological plausibility, using as models the potential associations with cardiovascular diseases, diabetes, and some respiratory diseases. METHODS: A recent systematic review was used as main reference to explore the associations of periodontitis with different respiratory diseases, including COVID-19, following two focussed questions: a PECOS question, aimed to explore epidemiological evidence, and a PICOS question, designed to explore the evidence derived from intervention studies. In addition to that evidence, other relevant scientific documents, including consensus papers, were carefully selected and appraised. FINDINGS: Convincing evidence was found to support the association of periodontitis and cardiovascular diseases, diabetes, and some respiratory diseases. The biological plausibility behind those associations is based on four factors: (1) bacteraemia of oral bacteria and periodontal pathogens, (2) increased systemic inflammation, (3) common genetic factors, and (4) common environmental risk factors. Limited initial evidence is available to support an association between periodontitis and COVID-19 complications. Among the proposed factors to explain the suggested association, a combination of the previously mentioned factors, plus additional factors related with SARS-CoV-2 characteristics and pathogenicity, has been suggested. CONCLUSIONS: Initial evidence suggests that periodontitis may be associated with a more severe COVID-19 and with a higher risk of death due to COVID-19. CLINICAL RELEVANCE: Due to the possible association between periodontitis and an increased severity for COVID-19, additional efforts should be made to improve oral and periodontal health, including the promotion of oral healthy habits, such as oral hygiene.

Evaluation of Salivary Galectin-3 Level and its Potential Role in Increasing the Severity of COVID-19 Infection in Patients with Periodontitis

Aim: To evaluate and compare the salivary galectin-3 (Gal-3) level in chronic periodontitis patients, coronavirus disease 2019 (COVID-19) patients, and patients with COVID-19 + periodontitis and thus determining the risk of periodontitis in increasing the severity of COVID-19 infection. Materials and methods: For the present study, a total of 77 participants were recruited to the study with 20 healthy controls (group I), 20 patients with chronic generalized periodontitis (group II), 19 COVID-19 patients (group III), and 18 with COVID-19 and periodontitis (group IV). Demographic characteristics and periodontal clinical parameters like plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded for all patients. Saliva samples were collected and Gal-3 levels were assessed using enzyme-linked immunosorbent assay (ELISA) kit. One-way analysis of variance (ANOVA) analysis and Tukey's honest significant difference post hoc tests were carried out for data analysis. Results: Group IV patients had a higher concentration of salivary Gal-3 (15.50 ng/mL) than that of group III (10.247 ng/mL) and group II (12.340 ng/mL), and the mean difference in Gal-3 level was statistically significant with the p-value 0.000. The mean PPD, CAL, and PI were significantly high in groups II and IV compared to groups I and II with a p-value of 0.000. Conclusion: The result of the present study showed that patients with periodontitis and periodontitis + COVID-19 presented significant higher salivary Gal-3 levels in comparison with COVID-19 patients and healthy subjects. Thus periodontitis can be a risk factor in increasing the severity of COVID-19 infection. Clinical significance: This study was carried out to evaluate whether periodontitis is a risk factor for increasing the severity of COVID-19 infection. This study also highlights the importance of maintaining good oral hygiene and periodontal health in preventing COVID-19 severity. © The Author(s). 2023.

Oral and Dental Infections: Virus

The oral cavity is a prime entering point for all types of microbiota, including viruses. The majority of viruses that enter cause no symptoms. Some are potentially pathogenic, but focus on other organs. Only a few use the cells associated with the oral cavity for replication, but their activity may affect oral health. Papillomaviruses are probably involved in oral cancer, and several viruses can take part in ulceration. Viruses of the herpes family may have an additional role in the development of periodontitis. This chapter offers a brief introduction to virology before discussing the role of the more relevant viruses in oral diseases and their treatment. Local anti-herpes medications are used for sores on the lips, while treatment of similar herpes blister or ulcers inside the mouth would require systemic administration. This is rarely done, but related medicine has been used successfully in connection with periodontitis. Vaccination against papillomaviruses appears to decrease the prevalence of oral cancer. © 2022 Elsevier Inc. All rights reserved.

Correlation of Redondovirus and Entamoeba gingivalis Detections in the Human Oral Cavity Suggests That This Amoeba Is Possibly the Redondovirus Host.

The virome of the human oral cavity and the relationships between viruses and diseases such as periodontitis are scarcely deciphered. Redondoviruses were reported in the human oral cavity in 2019, including in periodontitis patients. Here, we aimed at detecting redondoviruses and at searching for a potential viral host in human saliva. Non-stimulated saliva was collected between December 2020 and June 2021. These samples were tested using real-time PCR regarding the presence of redondovirus and Entamoeba gingivalis DNA. Similarity searches were performed using BLAST against eukaryotic and prokaryotic sequences from GenBank. The redondovirus DNA was detected in 46% of the 28 human saliva samples. In addition, short fragments of redondovirus genomes were detected in silico within Entamoeba sequences. Finally, Entamoeba gingivalis DNA was detected in 46% of the 28 saliva samples, with a strong correlation between redondovirus DNA and E. gingivalis DNA detections, in 93% of the cases. Regarded together, these findings and previous ones strongly support the presence of redondoviruses in the human oral cavity and their association to E. gingivalis as their likely host.

Beneficial Effects of Melatonin on Periodontitis Management: Far More Than Oral Cavity.

Periodontitis as a highly prevalent chronic infection/inflammatory disease can eventually lead to tooth loss and masticatory dysfunction. It also has a negative impact on general health and largely impairs quality of life. The tissue destruction during periodontitis is mainly caused by the excessive immune-inflammatory response; hence, how to modulate the host's reaction is of profound importance for effective periodontal treatment and tissue protection. Melatonin, as an endogenous hormone exhibiting multiple biological functions such as circadian rhythm regulation, antioxidant, and anti-inflammation, has been widely used in general healthcare. Notably, the past few years have witnessed increasing evidence for the application of melatonin as an adjunctive approach in the treatment of periodontitis and periodontitis-related systemic comorbidities. The detailed underlying mechanisms and more verification from clinical practice are still lacking, however, and further investigations are highly required. Importantly, it is essential to establish standard guidelines in the near future for the clinical administration of melatonin for periodontal health and general wellbeing.

Clinical, immunological, and microbiological analysis of the association between periodontitis and COVID-19: a case-control study.

PURPOSE: Periodontitis and coronavirus disease (COVID-19) share risk factors and activate similar immunopathological pathways, intensifying systemic inflammation. This study investigated the clinical, immunological and microbiological parameters in individuals with COVID-19 and controls, exploring whether periodontitis-driven inflammation contributes to worsening COVID-19 endpoints. METHODS: Case (positive RT-PCR for SARS-CoV-2) and control (negative RT-PCR) individuals underwent clinical and periodontal assessments. Salivary levels of TNF-α, IL-6, IL-1ß, IL-10, OPG, RANKL, neutrophil extracellular traps, and subgingival biofilm were analyzed at two timepoints. Data on COVID-19-related outcomes and comorbidity information were evaluated from medical records. RESULTS: Ninety-nine cases of COVID-19 and 182 controls were included for analysis. Periodontitis was associated with more hospitalization (p = 0.009), more days in the intensive care unit (ICU) (p = 0.042), admission to the semi-ICU (p = 0.047), and greater need for oxygen therapy (p = 0.042). After adjustment for confounders, periodontitis resulted in a 1.13-fold increase in the chance of hospitalization. Salivary IL-6 levels (p = 0.010) were increased in individuals with COVID-19 and periodontitis. Periodontitis was associated with increased RANKL and IL-1ß after COVID-19. No significant changes were observed in the bacterial loads of the periodontopathogens Porphyromona gingivalis, Aggregatibacter actinomycetemcomitans, Tanerella forsythia, and Treponema denticola. CONCLUSIONS: Periodontitis was associated with worse COVID-19 outcomes, suggesting the relevance of periodontal care to reduce the burden of overall inflammation. Understanding the crosstalk between SARS-CoV-2 infection and chronic conditions such as periodontitis that can influence disease outcome is important to potentially prevent complications of COVID-19.

Peculiarities of Periodontal Pocket Microbiome in Patients with Generalized Periodontitis in the Post-Covid Period

The oral cavity, like the lungs, is often referred to as the <<ecological niche of commensal, symbiotic, and pathogenic or-ganisms,>> and the emigration and elimination of microbes between them are constant, ensuring a healthy distribution of saprophytic microorganisms that maintains organ, tissue, and immune homeostasis. The prolonged hospital stays due to COVID-19 complications, cross-infection, oxygenation therapy through the mask or incubation, and long-term intravenous infusions limit the patient's ability to care about the oral cavity, regularly clean teeth, floss interdental, etc., which creates extremely favorable conditions for colonization by aerobic and anaerobic pathogens of the oral cavity and periodontal pockets and leads to the rapid progression of chronic generalized periodontitis in this category of patients in the future. The goal of the study was to assess the state of the microbiome of the periodontal pockets of dental patients in the post-covid period. Methods. The object of the study was 140 patients with generalized periodontitis of the I and II stages of development in the chronic course (GP), among which 80 patients had coronavirus disease in the closest past. The patients were randomized by age, sex, and stage of GP development. The diagnosis of periodontal disease was established according to the classification by Danilevskyi. The bacteriological material for aerobic and facultative anaerobic microflora and yeast-like fungi was collected from periodontal pockets with a calibrated bacteriological loop and immediately seeded on blood agar. Results. Significant qualitative and quantitative changes in the nature of the oral microbiocenosis were observed in patients with GP after the recent coronavirus disease, compared with similar patients who did not suffer from COVID-19. We have noticed almost complete disappearance of bacteria that belong to the transient representatives of the oral microflora such as Neisseria, corynebacteria (diphtheria), micrococci, and lac-tobacilli. The main resident representatives of the oral microflora, i.e., alpha-hemolytic Streptococci of the mitis group, were found in all healthy individuals and patients of groups A and C, but in 30.0 +/- 4.58% of patients in group B, alpha-hemolytic streptococci in the contents of periodontal pockets are present in quantities not available for detection by the applied method (<2.7 lg CCU/mL). In terms of species, Streptococcus oralis and Streptococcus salivarius are more characteris-tic in gingival crevicular fluid in healthy individuals (93.8% of selected strains). In 68.4 +/- 3.32% of patients in group A, 64.0 +/- 3.43% of patients in group B, and 67.5 +/- 3.76% of patients in group C, the dominant species were Streptococcus gordonii and Streptococcus sanguinis (p<0.01), which increased pathogenic potential as they produce streptolysin-O, inhibit complement activation, bind to fibronectine, actively form biofilms on the surface of tooth enamel and gum epithelial surface, and can act as an initiator of adhesion of periodontal pathogens. The other representatives of the resident microflora of the oral cavity - Stomatococcus mucilaginosus and Veillonella parvula for the patients of group C are also found in periodontal pockets with a significantly lower index of persistence and minimal population level. In the post-covid period, both the population level and the frequency of colonization of periodontal pockets by Staphylo-cocci and beta-hemolytic Streptococci decreases rapidly. For these patient groups, unlike for those that did not suffer from COVID-19, we did not find any case of colonization with Staphylococcus aureus, as well as beta-hemolytic Streptococci and Epidermal staphylococcus were also absent. The most characteristic in the post-covid period is a decrease in the proportion of alpha-hemolytic Streptococci, an increase in the proportion of yeast-like fungi of Candida species, as well as the appearance of a significant number of gram-negative rod-shaped bacteria (Enterobacteria and Pseudomonads). In periodontal patien s, the microbial count is approximately 2 orders of magnitude lower than in those with GP who did not suffer from COVID-19 (p<0.05). Conclusions. The overpassed coronavirus disease due to intensive antibiotic therapy leads to a marked decrease in the number of viable saprophytic microorganisms in the periodontal pockets of patients with GP. In the post-covid period for the patients with GP, there is a decrease in the level of colonization of periodontal pockets by species of resident oral microflora - alpha-hemolytic Streptococci, reduction of resident micro-organism's species, and almost complete disappearance of transient microflora. On the other hand, the frequency of colonization of periodontal pockets by fungi species, enterobacteria, and pseudomonads significantly increases. There are more expressed disorders in the periodontal pocket's microbiome for the patients with a severe and complicated course of coronavirus disease, such as post-covid pulmonary fibrosis, which requires reconsideration of approaches to therapeutic and pharmacological treatment in this category of patients.Copyright © 2022, Zabolotny Institute of Microbiology and Virology, NAS of Ukraine. All rights reserved.

Alveolar bone loss and tooth loss are associated with COVID-19 severity but are not independent risk factors. An explorative study

Purpose: This study explores the association between alveolar bone loss, tooth loss and severity of COVID-19. Material(s) and Method(s): In this retrospective cohort study, we included patients with confirmed COVID-19 who have had a dental panoramic radiograph within a maximum period of 5 years, providing information about alveolar bone loss and tooth loss. The severity of COVID-19 was determined based on the WHO clinical progression scale: (1) Mild/Ambulatory;(2) Moderate/Hospitalized;(3) Severe/Intensive care unit (ICU) or death. Result(s): 1730 patients were identified with COVID-19 from until October 31, 2020 in the Isala Hospital. Of these patients, 389 ever visited the OMFS department. 133 patients have had an orthopantomograph within a maximum period of 5 years and were included for analysis. The results showed a significant association between alveolar bone loss and COVID-19 severity (p = 0.028). Patients with alveolar bone loss had 5.6 times higher odds to be admitted to ICU or died, compared to ambulatory patients (OR: 5.60;95%CI: 1.21;25.99;P = 0.028). More tooth loss was significantly associated with COVID-19 severity (p = 0.047). Per tooth lost, patients had 4.2% higher odds for severe than mild COVID-19 (OR: 1.04;95%CI: 1.00;1.09;P = 0.047) and 6.0% higher odds for severe than moderate COVID-19 (OR: 1.06;95%CI: 1.01;1.11;P = 0.017). When adjusting for confounders in multivariate analyses, the significant associations of COVID-19 with alveolar bone loss and tooth loss were no longer present. Conclusion(s): In this retrospective explorative pilot study, alveolar bone loss and tooth loss are associated with the severity of COVID-19, however they are not independent risk factors. The current study could contribute to the design of further studies on the relationship between oral health and COVID-19.Copyright © 2021 The Authors

Teledental Consultations Using a Messaging Application during the COVID-19 Pandemic: Experience from a Singapore COVID-19 Community Care Facility

Introduction: During the 'Circuit Breaker' period of the COVID-19 pandemic in Singapore from April to June 2020, governmental policies restricted the practice of dentistry nationwide to the provision of emergency treatment only, regardless of the patient's COVID status. As such, teledentistry was used as an alternative means to continue providing some form of dental care to COVID-19-positive patients who were admitted to a COVID-19 Community Care Facility. Description: The patients were physically triaged by physicians who would send clinical photos to the author via a messaging application, who would in turn triage the patients and assess if they required referral for emergency dental treatment. For patients who did not meet the criteria for referral, the author would advise the physicians on the subsequent management plan which included, but was not limited to, the provision of symptomatic relief. Conclusion(s): This article shows the feasibility of undertaking teledental consultations using clinical photos transmitted via a messaging application. The practical implication is a reduced barrier for patients and healthcare professionals to access teledentistry, without having to resort to sophisticated equipment. Hopefully, this will translate into the continued provision of some form of dental care to patients during the ongoing pandemic as opposed to no care at all.Copyright © The Author(s) 2022.

A Case of Periradicular Surgery: Apicoectomy and Obturation of the Apex

Introduction: The purpose of the current case is to give a detail description on an incidence of a traumatized upper left central incisor with symptomatic periapical periodontitis which was root treated. Descriptions: The apical portion of the tooth had a large apical lesion with external root resorption that end up with an open apex due to the loss of tooth cementum, dentine and adjacent hard tissue. The tooth was endodontically retreated, and the apical region was treated surgically with apical curettage and retrograde Mineral Trioxide Aggregate filling (MTA). Result(s): The affected tooth was considered successful both functionally and aesthetically during a 12-month follow-up. Conclusion(s): Apicoectomy and retrograde filling with MTA is a viable option in case of treating traumatized tooth with large peri-apical lesion and open apex.Copyright © 2023 Japan University of Health Sciences & Japan International Cultural Exchange Foundation.

XXI ExpoPPGIm Annual Meeting of the Graduate Program in Immunology, Online, 1-3 September 2021

These proceedings contains 30 articles that covered various topics related to immunology and related fields. The conference papers presented focused on investigating the role of genetics, microbiome, and immunological pathways in disease pathogenesis and treatment. Studies presented at the conference explored the genetic factors associated with obesity in Brazilian children, the role of flavonoids in reprogramming microglia towards a neuroprotective inflammatory profile, the gut microbiome in asthmatic individuals, and the involvement of the MTOR gene and its variants in the severity of COVID-19. Other studies evaluated the immunodiagnostic potential of a protein exclusive to Corynebacterium pseudotuberculosis, genetic markers associated with alcohol dependence and asthma, and the effects of nicotine on glial cells in Parkinson's disease. The conference also presented research on the molecular mechanisms associated with the anti-glioma and immunomodulatory effects of flavonoids, the influence of Trypanosoma cruzi co-infection on the immune response and clinical outcome of patients with cutaneous leishmaniasis, and the association of metalloproteinase gene variants with periodontitis. Furthermore, the papers presented discussed the production of Zika virus singular peptide for the development of serological immunassays, and the role of genetic polymorphisms in the IL1B and IL6 genes in periodontitis. Lastly, the conference included research on the immunological response of broiler chickens fed with diet supplemented with zinc, and the modulatory effects of Agatis flavone on the glial response in an ex vivo model of brain trauma.

Cytokine status of the oral fluid in periodontitis in patients with a survey of coronavirus infection

On the development of the development of dentistry, periodontal diseases are an identified problem and occupy a leading position in the special dental diseases of countries in different countries. COVID-19 and periodontitis measure the proportion of the cytokine status of the oral fluid, therefore, the question of the calorie content of studying the level of salivary cytokines in people with periodontal diseases who have had a coronavirus infection is relevant, since in the case of studying the COVID-19 process, data were found that allow for accurate interpretation in relation to periodontitis. The aim of the study is to determine the immunological parameters of the oral fluid of patients with periodontitis who are not affected by coronavirus infection. Materials and methods. The study involved 100 people: 40 healthy participants, 30 patients with chronic periodontitis, 40 patients with periodontitis who had COVID-19. The fact of a coronavirus infection was established on the basis of anamnesis data and an enzyme immunoassay for IgG antibodies to the SARS-CoV-2 S protein. The level of cytokines (IL-2, IL-4, IL-6, IL-8) is determined by enzyme-linked immunosorbent assay. Results. Apparently healthy participants have lower levels of all cytokines. Patients with periodontitis who have recovered from COVID-19 require higher levels of IL-6 and IL-8 (by 2 pg/ml and 23 249 pg/ml, respectively) compared to patients with periodontitis who have not had a coronavirus infection. However, the difference in the concentration of IL-2 and IL-4 (by 0.3 pg/ml and 2.6 pg/ml, respectively) was not statistically significant. No difference was found at the level of IL-2 and IL-4. Conclusion. To assess the cytokine status of the oral fluid in patients with periodontitis, the determination of IL-2 and IL-4 is most often used due to the fact that their level is relatively high in the presence of a coronavirus infection. © 2022 Clinical Dentistry (Russia). All rights reserved.