Oral Lesions Associated with COVID-19 and the Participation of the Buccal Cavity as a Key Player for Establishment of Immunity against SARS-CoV-2.

BACKGROUND: Some oral lesions have been described in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the possibility has been raised that the buccal lesions observed in patients with the coronavirus disease 2019 (COVID-19) are due to this virus and the patient's systemic condition. The aim of this review was to integrate the knowledge related to the oral lesions associated with COVID-19 and the participation of the buccal cavity in the establishment of immunity against SARS-CoV-2. METHODS: A literature search on the manifestations of buccal lesions from the beginning of the pandemic until October 2021 was carried out by using the PubMed database. A total of 157 scientific articles were selected from the library, which included case reports and reports of lesions appearing in patients with COVID-19. RESULTS: Oral lesions included erosions, ulcers, vesicles, pustules, plaques, depapillated tongue, and pigmentations, among others. The oral cavity is a conducive environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, immunodeficiencies, and autoimmunity primarily. CONCLUSIONS: The oral cavity is an accessible and privileged environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; the direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, in particular those related to immunodeficiencies and autoimmunity.

Evaluation of the Potential Risk of Mortality from SARS-CoV-2 Infection in Hospitalized Patients According to the Charlson Comorbidity Index.

Background: The pandemic of COVID-19 has represented a major threat to global public health in the last century and therefore to identify predictors of mortality among COVID-19 hospitalized patients is widely justified. The aim of this study was to evaluate the possible usefulness of Charlson Comorbidity Index (CCI) as mortality predictor in patients hospitalized because COVID-19. Methods: This study was carried out in Zacatecas, Mexico, and it included 705 hospitalized patients with suspected of SARS-CoV-2 infection. Clinical data were collected, and the CCI score was calculated online using the calculator from the Sociedad Andaluza de Medicina Intensiva y Unidades Coronarias; the result was evaluated as mortality predictor among the patients with COVID-19. Results: 377 patients were positive for SARS-COV-2. Obesity increased the risk of intubation among the study population (odds ratio (OR) = 2.59; 95 CI: 1.36-4.92; p = 0.003). The CCI values were higher in patients who died because of COVID-19 complications than those observed in patients who survived (p < 0.001). Considering a CCI cutoff > 31.69, the area under the ROC curve was 0.75, with a sensitivity and a specificity of 63.6% and 87.7%, respectively. Having a CCI value > 31.69 increased the odds of death by 12.5 times among the study population (95% CI: 7.3-21.4; p < 0.001). Conclusions: The CCI is a suitable tool for the prediction of mortality in patients hospitalized for COVID-19. The presence of comorbidities in hospitalized patients with COVID-19 reflected as CCI > 31.69 increased the risk of death among the study population, so it is important to take precautionary measures in patients due to their condition and their increased vulnerability to SARS-CoV-2 infection.

Análisis Elemental de las Propiedades Morfológicas, Físicas y Químicas de Dos Instrumentos Rotatorios Protaper Universal

RESUMEN: Los instrumentos rotatorios utilizados en el tratamiento de conductos dentales necesitan cumplir con ciertas características físicas que le confieran un uso correcto, adecuado y seguro para su uso clínico. En el mercado comercial existen una serie de instrumentos importados que dejan en duda la autenticidad de estos debido a sus bajos costos. En este estudio evaluamos física, química y morfológicamente dos kits de instrumentos rotatorios Protaper universal (Dentsply) mediante análisis de MEB, EDX, microdureza y EDS. Uno de los kits (grupo 1) se adquirió directamente de la casa comercial y otro kit importado que a simple vista no parecía cumplir con los estándares de calidad de un correcto empaquetado (grupo 2). En el análisis de MEB se observaron características morfológicas muy diferentes entre ambos kits, el grupo 2 presentó diversas irregularidades en la superficie de las limas, sin embargo, en el EDS no se encontró diferencia alguna. En cuanto al análisis de microdureza se observó una estadística estadísticamente significativa y en el EDS se observaron mayores picos de intensidad en cuanto a la aleación de Ni-Ti en el grupo 2. Estos resultados sugieren que existen instrumentos rotatorios importados que a pesar de su bajo costo pueden presentar ciertas características muy similares a los kits auténticos, sin embargo, física y químicamente pueden resultar en un riesgo para su uso clínico debido a la diferencia entre estos.

ABSTRACT: Rotatory files are instruments used in the treatment of dental canals roots. These instruments need to comply with certain physical characteristics for a correct, adequate and safe use for clinical use. In the commercial market there are a series of imported instruments that cast doubt on their authenticity due to their low costs. In this study we physically, chemically and morphologically evaluated two Protaper universal rotary instrument kits (Dentsply) using SEM, EDX, microhardness and EDS analysis. One of the kits (group 1) was purchased directly from the commercial house and another imported kit that a simple view did not seem to meet the quality standards of a correct packaging (group 2). In the SEM analysis, very different morphological characteristics were observed between both kits, group 2 presented various irregularities on the surface of the files, however, no difference was found in the EDS. Regarding the microhardness analysis, a statistically significant statistic was observed and in the EDS, higher intensity peaks were observed in terms of the Ni-Ti alloy in group 2. These results suggest that there are imported rotary instruments that despite their low cost can present characteristics very similar to authentic kits, however, physically and chemically they can result in a risk for their clinical use due to the difference between them.