Personalized Oral and Dental Care.

Recent advances in genomics, data analytics technologies, and biotechnology have been unprecedented, ushering in a new era of healthcare in which interventions are increasingly tailored to individual patients [...].

Fighting the Consequences of the COVID-19 Pandemic: Mindfulness, Exercise, and Nutrition Practices to Reduce Eating Disorders and Promote Sustainability

Over the past two years, the world's population has been tested by the COVID-19 health emergency. This has changed population habits worldwide by encouraging a sedentary lifestyle and overnutrition. Isolation and reduction of social life, for most of the population, was mandatory but it quickly became a new lifestyle. Nowadays, we are encountering the consequences with an increase in nutritional associated disorders and conditions that cause illnesses in the general population. These disorders include diet excesses that lead to obesity and diet deficiencies and malnutrition which could rapidly lead to death. These eating disorders are very complex to manage because they become mental disorders which can negatively impact physical or mental health. This work will disucss the benefits associated with the mindfulness-exercise-nutrition (MEN) technique. From a nutritional point of view it will focus on the nutritional effect of a plant-based diet, such as the Mediterranean diet (MD) which has a high tryptophan content which can increase serotonin (the 'feel good';hormone) levels. The MEN technique takes a multidisciplinary approach and aims to integrate healthy behaviors into clinical practice using healthy eating, active living, and mindfulness. This method includes controlled physical movements, stretching techniques such as yoga, and aerobic exercise to achieve optimal mental and physical health. This literature review, carried out using the PubMed, ScienceDirect, Scopus, and Google Scholar databases, aims to investigate the latest research on this topic. This study may be useful for healthcare professionals and clinicians and may help patients to be more self-aware, encouraging them to lead a healthier lifestyle, make thoughtful choices, and ameliorate their mental health. The final aim of this study is to promote physiological homeostasis and well-being.

COVID-19 Related Information on Pediatric Dental Care including the Use of Teledentistry: A Narrative Review.

In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people's health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on oral health also favored by the changing eating and oral hygiene habits during the multiple lockdowns. Furthermore, dental settings and practices were generally perceived as at high risk for SARS-CoV-2 transmission, thus unsafe, and by general and pediatric dentists themselves. Last, the consequences of stress related to deprivation of social life and playful activities should not be underestimated in children, exposing them to the deleterious effects of bad oral habits, with repercussions on the balanced growth and development of the stomatognathic system. The present work intends to analyze the medium-term and long-term impact of COVID-19 on pediatric oral and dental care provision, reviewing pediatric dentistry practice and oral and dental needs of pedodontics patients during the first peak and the various waves of the COVID-19 pandemic, and lessons learned.

Dare to jump: The effect of the new high impact activity SuperJump on bone remodeling. A new tool to maintain fitness during COVID-19 home confinement.

SuperJump is a high impact activity performed on an elastic trampoline that mixes aerobic and anaerobic exercises already proposed as home-based activity for preventing a sedentary lifestyle. We determined in a randomized controlled trial whether 20 weeks of SuperJump activity would promote bone formation and reduce resorption in eumenorrheic women. Twenty-four women were randomized to a non-exercise group (control group) or an exercise group that performed SuperJump activity three times a week for 20 weeks. Blood samples were collected in both groups at baseline and at the end of the 20 weeks and compared within and between the groups for C-terminal telopeptide (CTX), a marker of bone resorption, osteocalcin, a marker of bone formation, and the markers of bone metabolism parathyroid hormone (PTH), calcitonin, albumin-adjusted calcium (Aa calcium), vitamin D, phosphate and potassium. After 20 weeks of SuperJump activity, levels of CTX were significantly reduced while levels of osteocalcin were increased. PTH, calcium and potassium were involved in the mechanism of action because PTH was reduced while calcium and potassium were increased. Calcitonin, vitamin D and phosphate levels did not change. These data suggest that SuperJump activity is able to reduce bone resorption and improve bone formation by acting on essential regulators of bone metabolism. They also suggest that SuperJump training may be used as a valuable intervention to prevent the occurrence of osteoporosis in aging because it improves bone homeostasis in favor of bone formation and could counteract a sedentary lifestyle, such as during COVID-19 home confinement, which could itself contribute to the variation of bone metabolism. Trial registration: Clinicaltrials.gov NCT04942691 -retrospectively registered.

Changes in COVID-19 Perception and in TMD Prevalence after 1 Year of Pandemic in Italy.

OBJECTIVES: The study aims to report the perception of dental practices and assess the individual's psychological stress level and related temporomandibular disorders (TMD) symptoms by evaluating the changes that occurred during the year following the first lockdown (May 2020). MATERIALS AND METHODS: An online questionnaire was submitted to the Italian population between 20 March and 20 April 2021. It was sent via online platforms and included 14 questions. STATISTICAL ANALYSIS: The data were analyzed using a chi-squared test and a comparison of the current data with the May 2020 survey data was performed using independent samples t-tests. The level of significance was set at p < 0.05. RESULTS: Forty-three percent of subjects (872) considered the dental practice to be a place with a high risk of infection. Temporomandibular pain and joint sounds were reported by 35.7% (724) of the population; of these more frequently were women (71.8%, 520/724, p < 0.001). About 31% of the participants had moderate/severe psychological distress and, among them, it was found that 46.4% (294/634) reported TMD pain (p < 0.001) and 34.9% (221/634) complained of temporomandibular joint sounds (p < 0.001). CONCLUSIONS: Most participants did not consider dental practices as a place with a higher risk of coronavirus disease 2019 transmission and, in contrast to the data from a previous study, people were less afraid to go to dental practices. After the first year of the pandemic, the level of stress and depression increased and the prevalence of TMD pain and joint sounds increased, in association with gender, age, and level of distress.

Oral-Systemic Health and Disorders: Latest Advances on Oral–Gut–Lung Microbiome Axis

In particular, the bi-directional communication network, also known as the gut lung axis connecting the intestinal and pulmonary microbiota, is considered responsible for the massively increased bacterial load in the cecum after acute lung injury, causing alterations in airway microbiota and its transitory translocation into the bloodstream toward the bowel [7,8]. [...]subjects with chronic obstructive pulmonary disease often show intestinal hyper-permeability and a high prevalence of IBD [9]. Both mechanisms would underlie the association between periodontitis and inflammatory and degenerative diseases, such as atherosclerosis, Alzheimer’s disease, age-related macular degeneration [22], chronic inflammatory bowel disease [23], and solid neoplasms, such as colorectal carcinoma [24]. [...]intestinal microbes could, due to mucosal barrier impairment, translocate to the liver through the biliary tract and the portal vein, and oral dysbiosis could exacerbate chronic liver diseases, likely modulating the gut ecosystem through the oral–gut axis, on the one side, and may reflect the intestinal dysbiotic ecosystem, affected in turn by hepatic diseases, on the other side [12,25]. Furthermore, mainly the upper but also the lower airways of healthy individuals frequently harbor oral anaerobes, including Prevotella and Veillonella species, probably secondary to continuing microaspiration by contiguity. [...]detecting oral bacterial DNA in the lower airways in healthy subjects could represent the traces of aspirated oral bacteria either not eliminated through physiological clearance or living in dynamic equilibrium with host defensive responses by promoting mucosal immunity of the Th17/neutrophilic phenotype and suppressing innate immunity. Whether bacteria from the oral microbiome regulate responses to pulmonary pathogens and whether they interfere in inflammatory lung disease pathogenesis [26] is still under study. [...]a growing body of evidence highlights that gut and oral dysbioses, interconnected with the local microbial and inflammatory environment of the lung, liver, and other organs, are crucially implied in a multitude of diseases also involving distant organs.

Oral Lesions in Pediatric Subjects: SARS-CoV-2 Infection and COVID-19 Vaccination

A plethora of systemic manifestations of COVID-19 and adverse reactions to COVID-19 vaccines have been described in pediatric subjects. Therefore, the present systematic review primarily aimed to assess the prevalence and macro-microscopic features of oral lesions following SARS-CoV-2 infection, grading primary oral lesions based on COVID-19 forms, in pediatric subjects. The secondary aim was to evaluate the epidemiology, clinical appearance, and histopathology of oral lesions following the WHO Emergency Use Listing approved and EMA authorized vaccines, in relation to cases and vaccine characteristics. The study protocol was compliant with the PRISMA statement and registered on PROSPERO (CRD42022351821). Case reports, case series, and observational studies were electronically searched till 27 July 2022, on MEDLINE/PubMed, Scopus, and Cochrane library databases, and the PROSPERO register. Data from nine studies describing oral lesions following viral infection and two records reporting oral lesions following vaccine administration, evaluated through the ROBINS-I tool for quality, were independently extracted and qualitatively synthesized, resulting in scarce, jeopardized, and incomplete findings. Since most of the rare lesions recorded were a part of broad-spectrum systemic disorders and syndromes and, thus. undetailed or nonspecific, further studies should assess oral lesions following SARS-CoV-2 infection and vaccination in pediatric subjects, considering novel viral variants and newly developing vaccines.

Oral Lesions Following Anti-SARS-CoV-2 Vaccination: A Systematic Review.

Increasing evidence relate anti-SARS-CoV-2 vaccinations to orofacial adverse reactions, therefore, the present systematic review aimed to evaluate primary oral lesions diagnosed in adult subjects, following the WHO Emergency Use Listing approved and EMA authorized vaccines, also in relation to cases' age, gender, comorbidities, and history of COVID-19, and in relation to vaccine type and doses. The study protocol, registered on PROSPERO (CRD42022339032) and compliant with the PRISMA statement, included an electronic search across Scopus, MEDLINE/PubMed, BioMed Central databases, and PROSPERO, ended on 18 June 2022 and succeeded by a manual search, an independent data extraction, and arisk of bias evaluation through ROBINS-I tool. Qualitatively synthesized data from the 13studies included showed an overall low prevalence (16 cases), though higher in females (68.8%), of oral lesions, mainly erosions and ulcers (34.5%). Nine cases were diagnosed following Pfizer-BioNTech, two Moderna, and one AstraZeneca, Serum Institute of India, Sinopharm, and Johnson&Johnson vaccines, respectively; specifically, eight after the first dose and seven after the second. In one case, vaccine type and dose were not specified. Considering newly developing vaccines, presented findings may be updated and further studies needed to highlight factors affecting oral lesion occurrence and specific macro-microscopic phenotypes in relation to cases' and vaccines' characteristics.

Education during the COVID-19 pandemic: the perception of Italian dental and medical students.

BACKGROUND: During COVID-19 pandemic many dental and medical students continued their education from home. From several studies it emerges that students prefer face-to-face teaching, due to the better interaction with teachers, the least number of distractions and due to the negative effect of social isolation on the psychological aspect. The aim of this study was to evaluate the perception of Italian dentistry and medicine students about teaching and training in this scenario. METHODS: Two online questionnaires were sent to medical and dental students of all Italian universities to investigate the limits and advantages of distance learning and the experience regarding the internship. A chi-square test was used to assess the association between gender, year of the course and region of residence (P<0.05). RESULTS: One thousand one hundred thirty-eight students answered the first survey, and 292 the second one. Most students preferred face-to-face teaching due to the difficult to maintain attention during online lessons. Many students reported that the online internship was not adequate for their education. CONCLUSIONS: Distance learning disadvantages are the greater number of sources of distraction, low level of interaction, and absence of the relationship with the patient during the practical training. Furthermore, isolation has strongly affected psychosocial balance of the students. The advantages are the greater comfort, the reduction of transport costs, the decrease in pollution, and the possibility of reviewing the lessons. Most Italian students considered appropriate to provide distance learning during the pandemic but believed that the best teaching method was teaching in presence.

Prevalence, Features and Degree of Association of Oral Lesions in COVID-19: A Systematic Review of Systematic Reviews.

Regardless of rapidly emerging findings on oral lesions described in adult SARS-CoV-2-positive subjects, the evidence level remains quite low and rather contrasting; therefore, the present systematic review of systematic reviews primarily aims to point out the overall prevalence of diagnosed cases. Secondary aims are to estimate the degree of association between oral lesions and SARS-CoV-2 infection and to grade, based on the reported frequency, the primary oral lesions, with related clinical presentations and microscopic features, in relation to COVID-19 forms. A study protocol compliant with the PRISMA statement was developed. Twelve studies were included, reporting highly heterogeneous and incomplete findings, thus precluding a meta-analysis. Further studies should be conducted to assess the overall prevalence of cases diagnosed with oral lesions among adult SARS-CoV-2-positive subjects, especially considering novel viral variants, and to determine their degree of association with SARS-CoV-2 infection and COVID-19 forms. Moreover, the reported findings noticed the need to evaluate the putative role both of SARS-CoV-2 in oral lesions genesis and of periodontitis and periodontal microbiome in COVID-19 worsening and re-activations. Deeper insights into oral lesions in adult SARS-CoV-2-positive subjects could enhance the comprehension of illness pathogenesis, natural history and clinical presentation, thus improving the preparedness of health professionals in the inter-disciplinary management of COVID-19.

Prevalence, Features and Degree of Association of Oral Lesions in COVID-19: A Systematic Review of Systematic Reviews

Regardless of rapidly emerging findings on oral lesions described in adult SARS-CoV-2-positive subjects, the evidence level remains quite low and rather contrasting;therefore, the present systematic review of systematic reviews primarily aims to point out the overall prevalence of diagnosed cases. Secondary aims are to estimate the degree of association between oral lesions and SARS-CoV-2 infection and to grade, based on the reported frequency, the primary oral lesions, with related clinical presentations and microscopic features, in relation to COVID-19 forms. A study protocol compliant with the PRISMA statement was developed. Twelve studies were included, reporting highly heterogeneous and incomplete findings, thus precluding a meta-analysis. Further studies should be conducted to assess the overall prevalence of cases diagnosed with oral lesions among adult SARS-CoV-2-positive subjects, especially considering novel viral variants, and to determine their degree of association with SARS-CoV-2 infection and COVID-19 forms. Moreover, the reported findings noticed the need to evaluate the putative role both of SARS-CoV-2 in oral lesions genesis and of periodontitis and periodontal microbiome in COVID-19 worsening and re-activations. Deeper insights into oral lesions in adult SARS-CoV-2-positive subjects could enhance the comprehension of illness pathogenesis, natural history and clinical presentation, thus improving the preparedness of health professionals in the inter-disciplinary management of COVID-19.

COVID-19: The Patients' Perceived Impact on Dental Care.

OBJECTIVES: The present study aims to investigate the effect of the COVID-19 pandemic on people's mental and physical balance, oral hygiene habits, type of diet, perceived safety of returning to the dentist, and aesthetics with the use of masks. MATERIALS AND METHODS: An online questionnaire was submitted to the Italian population between December 2020 and January 2021. It was sent via online platforms and included 21 questions. STATISTICAL ANALYSIS: Differences in rates were calculated by using the Chi-square test. The level of significance was set at p <0.05. RESULTS: A total of 1,008 individuals completed the questionnaire. About 72% of participants were not concerned about returning to the dentist. Approximately 45% of the individuals intensified their oral hygiene and preventive rules. About 38% of participants increased their carbohydrate intake, while 28% increased their fat consumption. Furthermore, 75% of the participants felt that the mask did not diminish the beauty of their smile. CONCLUSIONS: Most participants felt comfortable returning to the dentist but only for more urgent treatment. However, most people reported that they had not stepped up their home oral hygiene measures. The biggest changes in the population's eating habits involved increased carbohydrate and fat consumption. Finally, most participants responded that mask use did not compromise their aesthetics.

Taopatch® combined with home-based training protocol to prevent sedentary lifestyle and biochemical changes in MS patients during COVID-19 pandemic.

In Multiple sclerosis (MS) it is important to preserve the residual physiological functions of subjects. The aim of the present study was to investigate the influence of nanotechnological device treatment combined with home-based training program (TP) on lactate level, hand grip strength and cervical mobility on MS patients. Seventeen MS patients were enrolled in the study and randomly assigned to an experimental group (EG) in which the Taopatch® nanotechnological device was applied or to a control group (CG). All the participants carried out a cervical range of motion (1) assessment and the hand grip test at baseline (T0) and after TP (T1), also investigating the lactate levels to figure out if there could be a correlation with the possible changes in the investigated parameters. The results showed no significant differences in both groups for ROM. As regards the hand grip test, EG showed a statistically significant improvement on strength for both hands, dominant (p = 0.01) and non-dominant (p = 0.04), while the CG showed an improvement only for the non-dominant hand (p = 0.001). No correlation was found between baseline lactate level and cervical ROM change. We can definitely conclude that exercise and Taopatch® can help to improve and maintain hand strength in MS subjects and also can prevent sedentary lifestyle during the COVID-19 pandemic time. These are preliminary results that need further investigations, possibly increasing sample size and lengthening time of intervention.

The perception of COVID-19 among Italian dental patients: an orthodontic point of view.

BACKGROUND: The present study aimed to investigate the patients' perception of the dental practice during the COVID-19 outbreak, and whether the pandemic will affect the attendance of orthodontic patients at the dental practice. An online questionnaire, including the Patient Health Questionnaire-4 (PHQ-4), was submitted to Italian dental patients with items about their perceived risks when going to the dentist, concerns about continuing orthodontic treatment, and the onset of temporomandibular disorders (TMD). Data were analyzed with a chi-square test and logistic regression analysis. The level of significance was set at P < 0.05. RESULTS: A total of 1566 subjects completed the survey, including 486 who were under orthodontic treatment or who had a child in orthodontic treatment. A total of 866 participants (55.3%) thought the risk of contracting the COVID-19 infection was higher in a dental practice; this perception was associated with gender (women more than man), age (over 60 years old) and high levels of distress (P<0.001). However, 894 patients (57.1%) felt comfortable going back to the dentist. Most of the orthodontic patients (84%) would continue their treatment. After the lockdown, there was a slight increase in the frequency of TMD pain (356 versus 334). CONCLUSIONS: Most of the participants believed that the dental practice is a place at greater risk of contracting COVID-19, even if they continue to go to the dentist. Gender, age, and the level of distress were associated with the increase in the fear of going to the dentist due to COVID-19. Because of the pandemic, 16% of patients undergoing orthodontic treatment would not return to the dental practice to continue their orthodontic treatment after the lockdown. The prevalence of TMD pain in the population increased due to the pandemic.

COVID-19: The Dentists' Perceived Impact on the Dental Practice.

OBJECTIVES: The present study aimed to investigate the dentists' knowledge of the risks from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and how it will impact their practice. MATERIALS AND METHODS: An ad hoc self-administered anonymous questionnaire was submitted to Italian dentists. STATISTICAL ANALYSIS: Differences in rates were calculated using the chi-square test. The level of significance was set at p < 0.05. RESULTS: A total of 849 dentists fully completed the survey. Eighty-eight per cent of Italian dentists are worried about the health of their families, with no difference in high-risk (red zone) and low-risk (orange zone) regions. About 86% of professionals report some income loss and 94% fear a drop in patients after the quarantine phase, with the dentists working the red zone claiming a greater economic loss and fearing a reduced practice after the end of the lockdown. DISCUSSION: A large majority of the Italian dentists appears to be aware of the need for changes in their dental practices by planning specific sterilization processes between appointments, testing patients for SARS-CoV-2 serology, asking patients not to be accompanied, and reducing the number of visits per day. CONCLUSION: The survey expresses the serious concern of the dentists for the pandemic's effects on their profession.

Infection Control in Dental Practice During the COVID-19 Pandemic.

COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19 syndrome, the particular transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency from China has spread rapidly all over the world. Human-to-human transmission seems to occur mainly through close contact with symptomatic people affected by COVID-19, and the main way of contagion is via the inhalation of respiratory droplets, for example when patients talk, sneeze or cough. The ability of the virus to survive outside living organisms, in aerosol or on fomites has also been recognized. The dental practitioners are particularly exposed to a high risk of SARS-CoV-2 infection because they cannot always respect the interpersonal distance of more than a meter and are exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The aim of this paper is to provide practical advice for dentists based on the recent literature, which may be useful in reducing the risk of spreading COVID-19 during clinical practice.

The Perception of COVID-19 among Italian Dentists: An Orthodontic Point of View.

COVID-19 has severely impacted dentists, who are at a great risk of infection. This study aimed to investigate if dentists are anxious about returning to their daily activities, and what the perception of the risk is for dentists and orthodontists regarding orthodontic procedures. An online questionnaire, including the Patient Health Questionnaire-4 (PHQ-4), was sent to Italian dentists during the final days of the lockdown with items about anxiety, fear, distress, perceived risk for operators, and concerns about orthodontic patients caused by working during the COVID-19 outbreak. Data were analyzed with a chi-square test and logistic regression analysis. The level of significance was set as p < 0.05. A total of 349 dentists completed the survey, including 183 orthodontists. Returning to their daily work activity was a source of anxiety for 192 participants and this was associated with the level of distress (odds ratio (OR) = 3.7; p < 0.001). Most of the orthodontists (67.6%) thought that they would increase the number of working hours during the week (OR = 1.8; p = 0.007). Italian dentists were mostly scared to return to their daily activities because they considered their jobs a high risk to them and their families. Dentists with an exclusive/prevailing orthodontic activity were forced to increase their working day during the week.