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1.
Journal of Clinical Periodontology ; 49:348-349, 2022.
Article in English | EMBASE | ID: covidwho-1956766

ABSTRACT

Background: Necrotizing periodontal diseases (NPD) are fuso-spirochetal infections causing ulceration and destruction of periodontal tissues and associate with impaired host response. Elevated bacterial levels of Prevotella intermedia, Veillonella and Streptococci present in NPD lesions were detected in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Description of the procedure: A 40-year-old female, non-smoker patient was referred to the clinic with complaints of fever, halitosis, bad taste, severe gingival pain and bleeding. The patient reported a history of COVID-19 a month prior to any symptoms. Extra and intraoral examinations revealed submandibular lymphadenopathy, plaque accumulation, necrotic areas covered with pseudo-membranes, spontaneous gingival bleeding and suppuration. Alveolar bone loss was detected in the radiographic examination. Since periodontal pocket formation was present, the clinical diagnosis of the case was necrotizing gingivitis as a result of previously occurred periodontitis. During the first visit, necrotic areas were gently swabbed with 3% H2O2 moistened cotton pellets and oral hygiene instructions were given. Systemic antibiotic (metronidazole 500 mg 2 × 1) was prescribed for 5 days and rinsing with 0.12% chlorhexidine and 3% H2O2 was recommended. Three days later, since the acute complaints were reduced, clinical periodontal parameters were recorded and nonsurgical periodontal treatment (NSPT) was performed in 4 sessions in 2 weeks. One month after NSPT, all clinical periodontal parameters were recorded again. Outcomes: Following NSPT with the combination of systemic antibiotic regimen, all symptoms were resolved leading to the dissolution of necrotic areas. All clinical parameters were improved after NSPT. Conclusions: This case may be an evidence that COVID-19 could be a contributing factor for the appearance of NPD. Since COVID-19 leads to an altered immune response of the patient, a suitable environment becomes present orally for bacteria causing infections that result in NPD. The importance of routine intra-oral examination for COVID-19 patients is highlighted.

2.
Journal of Clinical Periodontology ; 49:158, 2022.
Article in English | EMBASE | ID: covidwho-1956760

ABSTRACT

Background and Aim: To determine the influence of the SARS-CoV 2 virus pandemic on periodontal status and to establish which factors are involved in these changes. Methods: Analysis of 50 questionnaires randomly distributed through the google forms program, with easy-to-follow graphics and processing of personal data while respecting confidentiality. The questionnaire included 30 questions with one or multiple answers and text boxes for individual completion. The questions were about oral hygiene and the gingival changes observed by participants in the first months after the pandemic broke out, including the lockdown period. Results: The average age of participants was between 20 and 30 years, most with higher education, from urban areas, 8.2% of them with pre-existing periodontal diseases but only 6.3% followed a periodontal treatment. 32.7% of participants tested positive for Sarcov2. The impairments of the marginal periodontium were observed by the increase with 9.6% (from 19.4% to 29%) of the gingival color changes, with 16.2% (from 16.1% to 32.3%) of the gingival volume, with 23% (from 51.6% to 74.2%) of gingival bleeding at tooth brushing and with 6.5% (from 0% to 6.5%) of dental mobility. Interest in oral health was modified by changing the frequency and the time of tooth brushing (less than 3 min increased with 8.2%), by reducing dental checks and halving specialized prophylaxis. 75% of the participants noticed an increase in stress during the pandemic, and 38.8% noticed a direct influence of the pandemic situation on their oral hygiene. Conclusions: The negative action of the SARS-CoV 2 virus is not limited to the direct one, the effects of the pandemic being felt in the field of oral health, having repercussions on the condition of periodontal tissues by influencing the measures of prophylaxis of these diseases.

3.
Journal of Clinical Periodontology ; 49:117, 2022.
Article in English | EMBASE | ID: covidwho-1956756

ABSTRACT

Background & Aim: There is ongoing international debate about the optimal frequency of dental check-ups and the effects of different recall intervals on periodontal health. Recommendations vary between countries but six-month dental check-ups have traditionally been advocated by clinicians in many high-income countries.The aim of this systematic review was to determine the optimal recall interval for maintaining periodontal health in a primary care setting. Methods: Cochrane Oral Health methods were followed. Randomized controlled trials assessing the effects of different dental recall intervals in a primary care setting were included. Two authors screened search results, extracted data and assessed risk of bias. The certainty of the evidence was assessed using GRADE. Results: Two studies were included with data from a total of 1736 participants. The main outcomes considered were: percentage of sites with gingival bleeding, mean periodontal probing depths and oralhealth- related quality of life (OHRQoL) measured using Oral Health Impact Profile-14 (OHIP-14). This review found high-certainty evidence of little to no difference between risk-based and 6-month recall intervals after four years for the outcomes: gingival bleeding (MD 0.78%, 95% CI -1.17% to 2.73%);periodontal disease (MD 0.03 mm, 95% CI -0.01 to 0.07) and OHRQoL (MD -0.35, 95% CI -1.02 to 0.32). There is high-certainty evidence of little to no difference between risk-based and 24-month recall intervals after four years for gingival bleeding (MD -0.07%, 95% CI -4.10% to 3.96%);periodontal disease (MD 0.10 mm, 95% CI 0.01 to 0.19) and OHRQoL (MD -0.37, 95% CI -1.69 to 0.95). Conclusions: The results of this systematic review affirm that dentists can accurately assess patients' risk of periodontal disease and allocate appropriate risk-based recall intervals. This research is valuable when considering the impact of the COVID-19 pandemic on dental services and provides reassurance those intervals between check-ups can be extended beyond six months without detriment to periodontal health.

4.
Journal of Clinical Periodontology ; 49:84, 2022.
Article in English | EMBASE | ID: covidwho-1956753

ABSTRACT

The aim is to determine oral manifestations in patients with COVID-19 disease and in the postcovid period. Methods: A special survey (questionnaire) was made in 424 people who had COVID-19 confirmed by RT-PCR, ELISA for specific IgM and IgG antibodies and Chest CT scan (168 people). 123 people had complaints and clinical symptoms in the oral cavity 2-6 months after the illness and they came to the University dental clinic. Laboratory tests have been performed (clinical blood test, blood immunogram, virus and fungal identification). Results: Survey results showed that 16,0% participants had asymptomatic COVID-19, 23,6% - mild and 48,1% moderate disease. 12,3% with severe COVID-19 were treated in a hospital with oxygen support. In the first 2 weeks 44,3% indicated xerostomia, dysgeusia (21,7%), muscle pain during chewing (11,3%), pain during swallowing (30,2%), burning and painful tongue (1,9%), tongue swelling (30,2%), catharal stomatitis (16,0%), gingival bleeding (22,6%), painful ulcers (aphthae) (8,5%) and signs of candidiasis - white plaque in the tongue (12,3%). After illness (3-6 months), patients indicated dry mouth (12,3%), progressing of gingivitis (20,7%) and periodontitis (11,3%). In patients who applied to the clinic we identified such diagnoses: desquamative glossitis - 16 cases, glossodynia (11), herpes labialis and recurrent herpetic gingivostomatitis (27), hairy leukoplakia (1), recurrent aphthous stomatitis (22), aphthosis Sutton (4), necrotising ulcerative gingivitis (13), oral candidiasis (14), erythema multiforme (8), Stevens-Johnson syndrome (2), oral squamous cell papillomas on the gingiva (4) and the lower lip (1). According to laboratory studies, virus reactivation (HSV, VZV, EBV, CMV, Papilloma viruces) was noted in 52 patients (42,3%), immunodeficiency in 96 people (78,0%), immunoregulation disorders (allergic and autoimmune reactions) in 24 people (19,5%). Conclusions: Lack of oral hygiene, hyposalivation, vascular compromise, stress, immunodeficiency and reactivation of persistent viral and fungal infections in patients with COVID-19 disease are risk factors for progression of periodontal and oral mucosal diseases.

5.
Akademik Acil Tip Olgu Sunumlari Dergisi ; 12(3):85-87, 2021.
Article in English | EMBASE | ID: covidwho-1822751

ABSTRACT

Introduction: Epistaxis and gingival bleeding are among the most common presentation to the emergency department for patients with thrombocytopenia. Here, we present a case who was admitted to the emergency department with thrombocytopenia and was diagnosed with metastatic cancer of unknown primary origin. Case Report: A 26-year-old male patient was admitted to the emergency department with gingival bleeding and epistaxis. The body temperature was 38.3 °C. Petechial rash, ecchymosis or organomegaly was not detected on physical examination. Laboratory results revealed thrombocytopenia as 31 × 103 (159-388 × 103/μL). Although hemoglobin and leukocyte counts were normal, no band or precursor cell was observed in the patient's peripheral blood smear. There was no history of weight loss, night sweats, arthritis, malar rash, photosensitivity, contact with ticks, animals, or a COVID-19 patient. Serological tests performed for infections such as HIV, EBV, HCV, Crimean-Congo hemorrhagic fever were negative. Bone marrow biopsy was performed due to the unexplained cytopenia, reported as "signet ring cell metastatic adenocarcinoma". Gastrointestinal system endoscopy was performed to detect primary cancer. A biopsy was taken from the antrum and corpus revealed gastritis. An FDG PET-CT was revealed heterogeneously pathologically increased FDG attitude in all axial and appendicular bones. Despite all the modalities of diagnosis, the origin was not found and the patient was transferred to the oncology department for treatment with a diagnosis of cancer of unknown origin with bone marrow infiltration. Conclusion: Bone marrow metastases should be kept in mind in patients presenting with thrombocytopenia.

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