Oral Changes in Hospitalized COVID-19 Patients: A Cross-Sectional Multicentric Study.

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread over the globe, and several oral symptoms have been documented. However, it is unclear whether these lesions are the result of coronavirus infection or are secondary symptoms of the patient's systemic illness. The aim of this study was to collect data from various hospitals on COVID-19 patients with oral involvement in order to highlight different oral changes that may be manifested in those patients. Methods: This observational cross-sectional multicenter study used an online questionnaire covering oral signs and symptoms that were believed to be related to COVID-19 patients who were hospitalized in different hospitals in Egypt. Results: 94.3% of the 210 patients who participated in the current study developed oral symptoms. Altered taste sensation (56.2%), burning sensation (43.3%), and oral candidiasis (40%) were the most prevalent oral symptoms (34.4%) that were found in the studied sample. Conclusions: COVID-19 has a major influence on the oral cavity, with numerous oral symptoms that may impair quality of life. Thus, considering the need for support, pain control, and management for a better prognosis, the clinical dental evaluation of hospitalized patients with infectious diseases like COVID-19 should be addressed.

Clinical Comparison of the Volumetric Changes in Single Pontic Site Development through Connective Tissue Grafting Using Modified Pouch Technique versus Pouch Technique in the Maxillary Esthetic Zone: A Randomized Controlled Clinical Trial.

Aim: The aim is to compare the volumetric changes between pouch technique versus the modified pouch technique in pontic site development using connective tissue graft in patients that have Seibert class I ridge defects in the maxillary esthetic zone. Methodology. This randomized, controlled, double-blinded, parallel-grouped clinical trial included sixteen patients with a single pontic site in the maxillary esthetic area presenting Seibert Class I ridge defects. Patients were randomly assigned into two equal groups: test group (n: 8) received soft tissue augmentation with connective tissue graft using the modified pouch technique and control group (n: 8) received soft tissue augmentation with connective tissue graft using pouch technique. The volumetric evaluation was carried out by taking impressions at baseline, 3 and 6 months after the surgery. Keratinized tissue thickness was also measured at baseline, 3 and 6 months after the surgery. Visual analogue scale (VAS) was recorded by the patients at day 3, day 7, and day 14 after the surgery. Results: The test group had more increase in soft tissue volume than the control group at baseline, 3 months, and 6 months. The keratinized tissue width at baseline in the test group had a higher value than that of the control group. At 3 months, both groups had the same mean value, while at 6 months, the test group had a higher value than the control group. Regarding postoperative pain, the visual analogue scale shown at day 3 in the test group had a higher value than that of the control group, while at day 7, the control group had a higher value than the test group. At day 14, both groups had the same mean value. Conclusions: Soft tissue augmentation using both the traditional pouch technique and the modified pouch technique led to successful soft tissue volume augmentation in pontic site development in Seibert Class I ridge defects with no statistically significant difference between the two techniques.

The frequency of periodontitis in end-stage renal disease on hemodialysis in a sample of Egyptian population: multi-center clinical cross-sectional study.

BACKGROUND: There is a general assumption that periodontal disease is highly prevalent among patients with chronic renal failure undergoing hemodialysis. The aim of the study to estimate the frequency of periodontitis in patients on hemodialysis among a sample of the Egyptian population, as well as the correlation between different clinical parameters of periodontal status with serum creatinine and blood urea. This may rule out the bidirectional relationship between periodontitis and renal failure in patients on hemodialysis. METHODS: The study was conducted on 263 hemodialysis patients (165 males and 98 females) at three dialysis centers in Benha Governorate, Egypt (Benha Hospital, Tukh hospital, Qalyub hospital). Periodontal parameters including plaque index (PI), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) had been recorded in these patients. Serum urea and creatinine levels had been measured, the data had been collected and undergone statistical analysis. RESULTS: Frequency of periodontitis was 85.6% with stage III is the most prevalent stage. There was a significant positive strong correlation between age and periodontitis stage (rs = 0.707, p < 0.001). There was a positive correlation between clinical parameters and serum creatinine level. CONCLUSION: In the present study, a high frequency of periodontitis had been found among ESRD patients on hemodialysis in the severe form (stage III) periodontitis. There was a significant direct correlation between the severity of periodontitis and CAL with a duration of hemodialysis. There was a weak insignificant association between periodontal indices (PD, BOP, and plaque score) and duration of hemodialysis.

Clinical Comparison of MEBO and Hyaluronic Acid Gel in the Management of Pain after Free Gingival Graft Harvesting: A Randomized Clinical Trial.

AIM: This study aimed to compare the effect of MEBO versus 0.2% hyaluronic acid gel (Gengigel®) applied to the palatal donor site on postoperative pain reduction and wound healing after free gingival graft harvesting. Methodology. Thirty-nine patients with different mucogingival defects were included in this study for harvesting a free gingival graft (FGG) for soft tissue augmentation. Patients were randomly assigned into three equal groups: group I (MEBO), group II (0.2% HA Gengigel®), and group III (control). Postoperative pain was recorded by using the Visual Analogue Scale (VAS). Analgesic consumption was recorded for 7 days postoperatively. Wound size was measured at baseline and on days 3, 7, 14, and 21. Postoperative healing of the palatal wound was assessed by the VAS score for color match on days 3, 7, 14, 21, and 42. RESULTS: Results of this study showed significant postoperative pain reduction for the three groups; MEBO showed statistically significant less VAS score compared to the other two groups, while HA showed statistically significant less VAS score compared to the control group. Both MEBO and HA showed statistically significant less total analgesic consumption. No statistically significant difference was observed between groups for wound size. MEBO showed statistically significant higher VAS for color match. CONCLUSIONS: Both treatment modalities could reduce postoperative pain following harvesting of FGG and improve the palatal wound healing. However, MEBO showed better outcomes in terms of postoperative pain and color match.

Effect of Locally Delivered Melatonin as an Adjunct to Nonsurgical Therapy on GCF Antioxidant Capacity and MMP-9 in Stage II Periodontitis Patients: A Randomized Controlled Clinical Trial.

OBJECTIVES: Periodontitis is characterized by inflammatory destruction of periodontal tissue, loss of attachment, and bone resorption. The increase in reactive oxygen species (ROS) is responsible for the oxidative damage occurring in periodontal tissues. Melatonin has important immunomodulatory, anti-inflammatory, and powerful antioxidant functions. The current study was carried out to evaluate the effect of topical melatonin gel as an adjunct to nonsurgical periodontal therapy. METHODS: This split-mouth randomized controlled clinical trial was performed on 24 patients with grade II periodontitis. Two sites in each patient were randomly assigned; test sites were treated by nonsurgical therapy followed by intrapocket application of 5% melatonin gel. Control sites were treated by nonsurgical therapy followed by intrapocket application of placebo gel. Both the melatonin and placebo gel were applied weekly once for four weeks. Assessment of clinical parameters (PD and CAL) was done at baseline and 3 months after therapy. Total antioxidative capacity (TAC) and matrix metalloproteinase-9 (MMP-9) levels in GCF were also evaluated utilizing commercially available enzyme-linked immunosorbent assay kits (ELISA) at baseline and 3 months after therapy. RESULTS: Treatment with topical melatonin was associated with a reduction in periodontal inflammation reflected as an improvement in the clinical periodontal parameters. Melatonin-treated sites showed a more statistically significant percent reduction in PD and more statistically significant percent gain in CAL than the control site. Additionally, a significant increase in TAC and a significant decrease in MMP-9 levels in GCF were found in melatonin-treated sites in comparison to control sites. CONCLUSIONS: The adjunctive use of topical melatonin gel with nonsurgical periodontal therapy has potent anti-inflammatory and antioxidant activity in the treatment of grade II periodontitis patients.

The effect of smoking on clinical presentation and expression of TLR-2 and CD34 in Oral lichen Planus patients: clinical and immunohistochemical study.

BACKGROUND: Oral lichen planus is a chronic inflammatory disease which is considered as a potential precancerous condition. Numerous studies have confirmed that inflammation is a strong risk factor for cancer development. Smoking is associated with potentially malignant disorders of the oral and oropharyngeal mucosa. The adverse consequences of smoking in various pathologies are mediated by its effects on the immune-inflammatory system. Little is known about the influence of cigarette smoke content on the course of OLP and inflammatory response. METHODS: Twenty oral lichen planus smoker patients, 20 oral lichen planus non-smoker patients and 20 control patients were included in this work. Pain and clinical scores were calculated for each patient. Image analysis to calculate area percent for TLR-2 and CD34 immuno-expression was performed. Data was tabulated and statistically analyzed. RESULTS: The present study showed no statistically significant difference in clinical and pain scores between the smoker and non-smoker groups. However, there was a significant difference in area percent values for TLR-2 and CD34 immuno-expression between the smoker and the non-smoker groups. CONCLUSION: Smoking enhanced TLR-2 and CD34 expression in OLP which are considered as inflammatory mediators and are contributing factors in the pathogenesis of oral lichen planus.

Interferon gamma and interleukin 8 gene polymorphisms in patients with hepatitis C virus related oral lichen planus.

OBJECTIVES: This study aimed to determine the association of rs2430561 and rs4073 polymorphisms in the Interferon gamma (IFN-ɤ) and Interleukin 8 (IL-8) genes, respectively, with hepatitis C virus-related oral lichen planus and disease severity. DESIGN: This is a case-control study. 60 subjects were equally divided into patients with and without oral lichen planus. They were further subdivided into hepatitis C virus seropositive and seronegative patients. All patients were genotyped for IFN-γ rs2430561 thymine to adenine (T > A) and IL-8 rs4073 adenine to thymine (A > T) polymorphisms. All patients with oral lichen planus had their lesions measured and documented using the Escudier scoring system. RESULTS: Disease activity was significantly higher in the "oral lichen planus/hepatitis C virus-positive" patients than in the "oral lichen planus/hepatitis C virus-negative" patients (P = 0.003). IFN-γ rs2430561 T > A and IL-8 rs4073 A > T genotypes and allele frequencies were not associated with the oral lichen planus group or the normal group. Stratification of the two groups into HCV and non-HCV-infected patients or into erosive and non-erosive types revealed no significant associations. The "A-allele-containing" genotypes of IL-8 rs4073 A > T were significantly more prevalent in the patients with oral lichen planus than in those without. CONCLUSION: Hepatitis C virus infection is associated with the development of erosive oral lichen planus. The A-allele of IL-8 rs4073 A > T may have a role in the development and progression of oral lichen planus.

Prevalence of oral lichen planus among a sample of the Egyptian population.

OBJECTIVES: To report on the prevalence of oral lichen planus among a sample of the Egyptian population. STUDY DESIGN: 4470 Egyptian patients, aged 15-75 years, were seen at the outpatient clinic at the Faculty of Oral and Dental Medicine, Cairo University, Egypt. 31.25 % of these patients were males and 68.75% were females. Oral mucosal lesions consistent with oral lichen planus (OLP) were identified both clinically and confirmed histologically (in atypical cases) so that the prevalence of oral lichen planus in this study is 1.43%. RESULTS: 64 patients were diagnosed with OLP (20 males and 44 females). The average age of the affected group was 48.07 years. Associated skin lesions were detected in 15/64 patients (23.44%) and tobacco habits was observed in 20/64 patients (31.25%). The average period of follow-up of the affected cases was 1-2 years, during which two cases developed squamous cell carcinoma of the oral lesion. CONCLUSIONS: Within the limitations of this study it revealed the prevalence of OLP among middle-aged women. Atrophic lesions were most frequent, followed by the erosive forms. Anti-HCV circulating antibodies were more common in patients with OLP and, notably, OLP was associated with Diabetes mellitus in 15.63% of patients. Key words:Prevalence, oral lichen planus, Egypt.