COVID-19 and Oral Mucosal Lesions: a Systematic Review.

Introduction: COVID-19 disease is caused by a mutated strain of the coronavirus family "SARS-CoV-2". It affects especially the respiratory system, but many clinical manifestations outside this system have been reported. Oral manifestations are uncommon, however, with the absence of common signs, they may represent the onset of COVID-19 disease. The aim of this systematic review is to observe if there is a correlation between SARS-CoV-2 infection and oral manifestations. Methods: The research was conducted on PubMed, Scopus, Google Scholars and Cochrane Library from March 2020 to May 2023. Each study was subjected to data extraction; including authors, year and month of publication, study type, patients' average age, type and localization of oral lesions, the positivity of the SARS-CoV-2 virus test, and comorbidities. Results: A total of 43 studies met the inclusion criteria and a total of 507 COVID-19 patients with 496 oral lesions were included. The most frequent was ulceration and the most common localization was the tongue. Conclusions: The results of our systematic review show a possible correlation between COVID-19 infection and oral manifestations. Further studies are required to determine if the lesions are directly connected to the virus.

Effects of laser photobiomodulation in the management of oral lichen planus: a literature review.

Objectives: This review aims to understand whether Photobio-modulation (PBM) therapy is a valid aid in the management of Oral Lichen Planus (OLP) and its symptoms. Moreover, an analysis to determine whether it is a valid replacement for conventional therapies and whether standardized protocols can be used in PBM sessions or whether these should be changed depending on the type of injury has been made. Finally, an evaluation to determine whether PBM may induce transformation of dysplastic oral keratinocytes into squamous cell carcinoma has been made. Materials and Methods: Searches were conducted on two search databases for relevant publications released between 1992 and 2019. The databases used were: Pubmed "Medline", and Google Scholar. Forty-four articles complied with the inclusion criteria and were included for quality assessment and data extraction. Results: All the studies reported positive effects of PBM; how-ever, there was wide heterogeneity in the laser parameters used in the management of the OLP. The effective dose ranges from 2 to 3 J/cm2, in order to see the desired biological effects. Conclusions: PBM is useful in controlling algal sensation and can be used in cases of OLP lesions that are not responsive to conventional therapies or when corticosteroid doses are too high for the patient, resulting in possible side effects. Standardized biostimulation protocols with further scientific insights are therefore required.

CO2 laser ablation of oral leukoplakia: with or without extension of margins?

PURPOSE: The purpose is to determine the sufficient extension of margins during laser ablation of oral leukoplakia and observe its short-term recurrence rate. MATERIALS AND METHODS: The study was designed as a randomized controlled clinical trial was conducted on 33 oral leukoplakia lesions diagnosed in 30 patients (16 Females and 14 Males) with an age range between 39 and 79 years. The lesions were divided into three groups; Group A: 11 lesions in 11 patients, in which the laser ablation was done for the entire lesion without extension of margins; Group B: 11 lesions in 8 patients, in which the laser ablation was done for the lesion adding at least 3mm extension of margins; and finally the Group Control: consists of 11 untreated lesions in 11 patients, in which only "wait and see" approach was done. RESULTS: Complete healing of 13 lesions occurred in both groups A and B. Complete regression of 3 lesions occurred in Group Control. After 6 months of follow-up, 6 of 9 lesions in both groups A and B that showed the recurrence, had shown an initial recurrence after 3 weeks of the laser ablation. Patients with no history of smoking habits showed complete healing of 87.5%, while in ex-smokers complete healing was 42.8%. The statistical analysis was performed, and the averages of all groups are significantly different (p <0.00001). DISCUSSION: The primary treatment focuses on the elimination of associated risk factors (smoking, alcohol, and local irritating factors). In the literature, the recurrence rate varies between 13.6% and 40.7%, while in our study, it was 45.5% in Group A and 36.4% in Group B. CONCLUSION: The recommended extension of margins should be at least 3mm in width. Further research can be performed to evaluate the immediate re-ablation of the lesions which showed an initial recurrence after 3 weeks of laser ablation.

Microencapsulation as a tool to counteract the typical low bioavailability of polyphenols in the management of diabetes.

Polyphenols are secondary metabolites widely distributed in many plant foods, such a tea, coffee, chocolate and fruits. The consumption of these compounds is related to the improvement or amelioration of many diseases, including diabetes. Nevertheless, the great barrier to the therapeutic use of polyphenols is the low bioavailability of these compounds once ingested. For that reason, the encapsulation of polyphenols in different matrices may protect them from digestion and improve their release and subsequent absorption to obtain target-specific health effects. Some studies have reported the beneficial effect of encapsulation to increase both bioavailability and bioaccessibility. However, these works have mostly been carried out in vitro and few studies are specifically addressed at improving diabetes. In the current work, an overview of the knowledge related to nanoparticles and their use in the diabetic condition has been reviewed.

Implant placement in oral squamous cells carcinoma patients treated with chemoradiotherapy: "Sapienza Head and Neck Unit" clinical recommendations.

OBJECTIVE: To date, the treatment of patients affected by head and neck squamous cell carcinoma (HNSCC) is highly challenging for clinicians. Possible therapies are surgical resection of the tumor mass, radiotherapy, chemotherapy or, more often, a combined treatment that inevitably affects both normal and tumor cells. Consequently, patients' anatomy and functions become reduced or altered. Nowadays the functional restoration is significantly improved thanks to the innovation in prosthetic rehabilitation and in radiotherapy. The current IMRT (Intensity Modulated Radiation Therapy) allows planning adequate treatments evaluating different tissues' involvement and radiation dosage. It is possible to define the most suitable sites for implant insertion, using data provided by dose-volume histogram (DVH). This study aims to illustrate the idea of obtaining a unique CT image by blending radiation-planning CT and Cone Beam CT. PATIENTS AND METHODS: Five patients among 54 candidates were selected for this study. Selection criteria were: good general health (PS0-1), age between 18 and 72 years, absence of metastatic disease or local recurrence, disease-free interval of at least 18 months. Radiation planning CT scan and maxillo-facial CT Cone Beam of every patient were overlapped and merged. Only one CT for every evaluated patient was obtained in order to plan the most suitable areas for implant placement. RESULTS: The placement of 10 implants in 5 patients was programmed using the explained method. Patients (all male) were aged between 48 and 72 years old, with a median age of 64.4 years. In every case of this study, a modification of the initial program of implant placement was necessary. The new imaging method we are proposing was able to provide information about radiation isodoses received in the planned osseointegrated implants' positions. CONCLUSIONS: This new method allows operators to correct their own therapy plans and choices, customizing the treatment plan on the actual condition of the patient. Moreover, it makes all the rehabilitation process safer and can reduce the risk of failure, side effects and inconveniences for the patients.

The role of heavy metals and polychlorinated biphenyls (PCBs) in the oncogenesis of head and neck tumors and thyroid diseases: a pilot study.

Previous literature has highlighted the mechanisms of molecular toxicity induced by substances such as arsenic, cadmium, chromium, nickel, lead, barium and PCBs. The research was carried out on 20 volunteers, all the patients gave their consent to the research: the aim of the study was to evaluate the presence of metals and PCBs in these different matrices (blood and hair), correlating the biochemical data to pathological conditions present, and also to the area in which patients resided. Various quantitative determinations were carried out on samples of blood and hair for 14 heavy metals and on blood samples for 12 PCBs. For the 11 patients the results indicated that blood levels for half of the 14 displayed heavy metals measured considerably higher compared to the reference values, whilst the levels measured in hair evidenced some positive values significantly higher than the maximum reference. Of the 12 PCBs assayed in blood some showed higher positive values compared to the maximum tabular reference (although there is no clear reference quantified in the WHO-2005 report). In the 9 healthy patients heavy metals in the blood were within the expected target range, with those showing positive results (≤ 3 out of 14 heavy metals for each patient) having values only slightly higher than the reference maximum. The levels of 14 heavy metals measured in hair were below thresholds, and levels for the 12 PCBs measured in blood showed negativity or positivity with values close to the minimum benchmarks. The analyses carried out on biological matrices have uncovered important and significant differences between healthy and unhealthy subjects, both qualitative and quantitative differences with respect to heavy metals and PCBs. All patients with head and neck cancer enlisted for the study had heavy metal and PCB blood levels at least twice the maximum reference level. The levels of heavy metals in hair were at least double the maximum reference. In contrast, all healthy volunteers enrolled showed no significant levels for either metals or PCBs.

Medication-related osteonecrosis of the jaws (MRONJ) and quality of life evaluation: a pilot study.

BACKGROUND: MRONJ (medication related osteonecrosis of the jaws) is a well-known side effect of certain drugs, which are used to influence bone metabolism for the cure of osteo-metabolic or cancer diseases. The aim of this study is to assess the quality of life (QOL) under a physical and mental point of view in patients affected by MRONJ compared with the general population. METHODS: The study has been accomplished through the administration of the SF-12 questionnaire: 30 patients of the MRONJ group were evaluated. RESULTS: Significant differences based on the level of education and age of the subjects, on the location and finally on the stage of necrosis of the jaw have been identified. In this pilot study the test sample shows how MRONJ can aggravate the conditions of patients, above all under a physical point of view. CONCLUSIONS: Prevention of MRONJ and its symptoms as dysphagia, oral pain, immunological compromission and the need of frequent antibiotic therapies is a crucial part of modern oral pathology and dentistry, above all for oncologic patients who already have a general decrease of physical and mental activities, leading to a poor quality of life.

Cleidocranial dysplasia: maxillary alterations on the transverse plane. Presence of crown-radicular anomalies and multidisciplinary approach of a clinical case.

INTRODUCTION: Cleidocranial Dysplasia (CCD) is a rare inherited autosomal dominant congenital syndrome that occurs in approximately one out of every one million individuals worldwide; it primarily affects bones that undergo intra-membranous ossification, generally the skull and clavicles. Other bones may be affected such as the long bones, spine, pelvis, bones of hands and feet showing hypoplasia of distal phalanges. Indispensable is the role of the gene Runx2, necessary for the differentiation of odontoblasts and osteoblasts; it regulates the expression of many genes related to the development of dental hard tissues. The aim of this study was to appraise the connection between the Cleidocranial Dysplasia and the appearance of skeletal and dental anomalies not much deepen to this day. With particular emphasis, it wants to describe the multidisciplinary therapeutic approach. CASE REPORT: The patient showed multiple skeletal features of CCD. A distinctive feature was the failed or delayed exfoliation of deciduous dentition and a delayed eruption of permanent teeth. The goal of the treatment is the improvement of both aesthetic and functional aspects. This objective can be achieved through an appropriate multidisciplinary treatment plan that arranges the orthodontic and surgical measures. RESULTS AND DISCUSSIONS: Because of the involvement of facial bones, the altered mode of tooth eruption and the presence of numerous included supernumerary teeth, CCD is a pathology that all dentists should be familiar with. The patients have small faces compared to the skull and the hypoplasia of maxillary, tear, nasal and zygomatic bones. The orthodontic approach in literature seems to be reduced to the guided eruption of bad-positioned and impacted teeth. Knowledge of the clinical features of CCD allows for the early planning of the procedures necessary to resolve the dental pathologies observed in CCD patients.

Histological ex vivo evaluation of peri-incisional thermal effect created by a new-generation CO2 superpulsed laser.

The purpose of this study is the evaluation of the histological effects of a new-generation superpulsed CO2 laser through an "ex vivo" study. A CO2 ( λ = 10,600 nm) ultra-speed laser (SmartUS20D, DEKA, Florence, Italy) has been used at different parameters from 2 to 4 watt in Continuous Wave (CW) and Pulsed Wave (PW, 50 Hz) to obtain 30 samples from pig cadaver tongues. All the specimens have been subdivided into 6 groups (from A to F) and each group consisted of 5 samples. A final specimen has been taken by scalpel and used as control group. Histological analysis has been performed using an optical microscope (Leica DM 2000) at a magnification of × 40. Results showed that histological readability was optimal in all the samples. The thermal damage has been negligible in all the groups. Furthermore, the average of thermal damage was 0,095 mm in the epithelial, while it was 0.245 mm in the connective tissue. Statistical analysis using Graphpad Prism 5 software showed no significant differences among the groups. CO2 laser demonstrated a good surgical effectiveness provoking little peripheral damage onto the cut edges and allowing a safe histological diagnosis.

[Health surveillance activity and characterization of exposure to low levels of chromium: results of a 10-year follow-up]. / Attività di sorveglianza sanitaria e caratterizzazione dell'esposizione a basse dosi di cromo: risultati di un follow-up a dieci anni.

The 626/94 Decree amendment (see Decree 25/2002) regard a series of mandatory measures towards the exposure estimation both for future prevention activities as well as for the efficacy evaluation of measures that have already been carried out. This publication provides an updating on a study of the ten-year follow-up regarding occupational exposure to Cr (VI) in workers exposed to low levels of cromium.

[Determination of blood alcohol among aviation personnel: proposed operative protocol]. / Determinazione dell'alcolemia nel personale aeronavigante: proposta di protocollo operativo.

The problems of the use/abuse of alcohol need a special attention by the Public Authorities, based on the scientific evidences related to the subject. We would like to define in the present paper the procedures for alcohol testing (and drug testing) in the sailors, following the international aviation authorities (ICAO, JAR-OPS-1, FAA) recommendations. A Working Group was established to study both the scientific and the legal aspects of the problems related to alcohol testing in Italy. Experts from the Università "La Sapienza" and from Alitalia studied the alcohol testing issues abroad to set out criteria, guidelines and procedures for random testing in Italy.

New oleanane saponins in Chenopodium quinoa.

Six triterpenoid saponins were isolated from the seeds of Chenopodium quinoa (Chenopodiaceae). Their structures were as follows: phytolaccagenic acid 3-O-[alpha-L-arabinopyranosyl-(1' '-->3')-beta-D-glucuronopyranosyl]-28-O-beta-D-glucopyranoside (1); spergulagenic acid 3-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranosyl-(1-->3)-alpha-L-arabinopyranosyl-28-O-beta-D-glucopyranoside (2); hederagenin 3-O-[beta-D-glucopyranosyl-(1-->3)-alpha-L-arabinopyranosyl]-28-O-beta-D-glucopyranoside (3); phytolaccagenic acid 3-O-[beta-D-glucopyranosyl-(1-->4)-beta-D-glucopyranosyl-(1-->4)-beta-D-glucopyranosyl]-28-O-beta-D-glucopyranoside (4); hederagenin 3-O-[beta-D-glucopyranosyl-(1-->4)-beta-D-glucopyranosyl-(1-->4)-beta-D-glucopyranosyl]-28-O-beta-D-glucopyranoside (5); and spergulagenic acid 3-O-[alpha-L-arabinopyranosyl-(1' '-->3')-beta-D-glucuronopyranosyl]-28-O-beta-D-glucopyranoside (6). Saponins 5 and 6 are new. The structures were characterized on the basis of hydrolysis and spectral evidence, including IR, UV, optical rotations, 1D- and 2D-NMR (HMQC and HMBC), ESIMS, and FABMS analyses.

Influence of neonatal treatment with the pyrethroid insecticide cypermethrin on the development of dopamine receptors in the rat kidney.

The influence of neonatal treatment with the pyrethroid insecticide cypermethrin ((R,S)alpha-cyano-3-phenoxybenzyl (1R,S)-cis-trans-3-(2,2-dichloro-vinyl)-2,2-dimethylcyclopropane carboxylate) on postnatal development of renal dopamine receptors was investigated by radioligand binding assay techniques. Treatment with cypermethrin was made on rats from the 10th to the 16th day after birth. Dopamine D1- and D2-like receptors were assayed in frozen sections of kidney of 21-, 30-, 60- and 90-day-old rats using as ligands of dopamine D1- and D2-like receptors [3H]([R](+)-(chloro-2,3,4,5,-tetrahydro-5-phenyl-1,4,-benzazepinal hemimaleate) (SCH 23390) and [3H]spiperone, respectively. Treatment with cypermethrin was without effect on the affinity (Kd value) or the density (Bmax value) of dopamine D1- and D2-like receptors of rats of 21 days of age. In older groups, treatment with the compound reduced the affinity and increased the density of dopamine D1-like receptors, whereas it was without effect on the affinity of dopamine D2-like receptors and decreased their density. These findings indicate that neonatal treatment with the pyrethroid insecticide cypermethrin induces long-lasting impairment of renal dopamine D1- and D2-like receptors and that kidney is a target of the toxic action of the compound. Renal dopamine receptor changes caused by cypermethrin are consistent with possible alterations of renal tubular function and of sympathetic neuroeffector modulation. The above data suggest also that, different from the adult, neonatal exposure to pyrethroid insecticides may induce toxic effects.

Postnatal development of dopamine D1-like and D2-like receptors in the rat kidney: a radioligand binding study.

Dopamine exerts important natriuretic and renal haemodynamic changes mediated through the interaction with dopamine D1-like and D2-like receptors. Dopamine-mediated natriuresis and renal vascular effects are less in younger than in older animals. The pharmacological profile and the density of dopamine D1-like and D2-like receptors were assessed in the kidney of rats ranging from 2 to 90 days of age by using radioligand binding assay techniques. [3H]SCH 23390 was used as ligand of dopamine D1-like receptors. [3H]Spiperone was used as a ligand of dopamine D2-like receptors. The dissociation constant (Kd) value of [3H]SCH 23390 binding was slightly decreased from the 21st day of age in comparison with animals of 2 and 7 days of age. The maximum density (Bmax) of [3H]SCH 23390 binding sites increased progressively until the 21st day of age and then plateauned. A similar trend was found for [3H]Spiperone binding sites. In [3H]Spiperone binding experiments, the Kd value was remarkably decreased from the 21st to the 90th day of life. Bmax value of [3H]Spiperone binding sites were similar in rats of 2 and 7 days of age and subsequently increased to values similar to those found in adult rats from the 21st day of life. The pharmacological profile of [3H]SCH 23390 and [3H]Spiperone was similar in rats of the different ages investigated. These findings suggest that renal dopamine D1-like and D2-like receptors undergo maturational changes in the first 3 weeks after birth and then are stabilized at the adult levels. The possibility that the increased expression of renal dopamine receptors postnatally may be linked with the gradual appearance of dopamine-mediated renal responses after birth is discussed.

Effects of alpha-tocopherol administration on red blood cell membrane lipid peroxidation in hemodialysis patients.

The result of vitamin E treatment in 19 uremic patients in chronic hemodialysis is evaluated. In particular, the levels of erythrocyte malonyldialdehyde (MDA) and vitamin E were determined, and the fatty acid composition of red blood cell (RBC) membrane before and after treatment with parenterally administered vitamin E. A decrease of RBC MDA levels, an increase of RBC vitamin E concentrations, and a decreased saturated fatty acid to unsaturated fatty acid ratio were found after treatment with vitamin E. There was a statistically significant increase of the packed RBC volume.