Manifestações orais e Covid-19: Revisão Sistemática da literatura / Oral Manifestations and Covid-19: Systematic literature review

A doença COVID-19, que se tornou uma pandemia em pouco espaço de tempo, apresenta uma ameaça grave para a saúde global. As condições bucais de pacientes com COVID-19 foram analisadas em vários estudos. Diante disso, observou-se que diversas manifestações bucais foram encontradas nesses pacientes. O objetivo deste trabalho foi realizar uma revisão de literatura sistemática sobre as manifestações bucais que podem estar associadas à doença COVID-19. A pesquisa foi realizada por meio de uma revisão sistemática nas bases de dados Bireme, PubMed e SciELO, no período de 30 de abril de 2021 a 11 de maio de 2023. A busca utilizou os descritores "COVID-19", "coronavirus" e "oral manifestations". Foram utilizados como critério de inclusão a presença do artigo completo disponível na íntegra e publicado nos anos de 2020 a 2023 e excluídos aqueles que não relatavam alguma manifestação da COVID-19 ou que não abordavam formas de tratamento. Foram incluídos 19 artigos. As informações foram compiladas de forma a compreender a importância de se investigar as manifestações orais em decorrência dessa doença, devido a sua importância internacional dadas às suas circunstâncias devastadoras. Concluiu-se que é notável a importância da anamnese e o exame intraoral para diagnosticar as manifestações orais nos pacientes sob suspeita ou confirmados com a COVID-19, e o diagnóstico precoce das alterações é fundamental para assegurar um suporte adequado ao paciente acometido. Mais estudos são necessários para comprovar a associação direta entre a COVID-19 e as manifestações orais relatadas.

COVID-19, which has become a pandemic in a short time, poses a serious threat to global health. The oral conditions of patients with COVID-19 have been analyzed in several studies. Therefore, it was observed that several manifestations were found in these patients. The objective of the work is to carry out a systematic literature review on the oral manifestations that may be associated with the disease COVID-19. The research was carried out through a systematic review in the databases Bireme, PubMed and SciELO, from April 30, 2021 o May 11, 2023. The search using the descriptors "COVID-19", "coronavirus" and "Oral manifestations". Inclusion criteria were the presence of the full article available in full and published in 2020 and 2023. Articles that did not report any manifestation of COVID-19 or those that did not address forms of treatment were excluded. 19 articles were included. The information was compiled in order to understand the importance of investigating oral manifestations as a result of this disease, due to its international importance given to its devastating entities. It was concluded that the importance of anamnesis and intraoral examination for the diagnosis of oral manifestations in patients suspected or confirmed with COVID-19 is remarkable, and the early diagnosis of alterations is essential to ensure adequate support for the affected patient. Further studies are needed to prove the direct association between COVID-19 and the reported oral manifestations.

Concordância entre agravos bucais autorreferidos durante e após a COVID-19 e condições clínicas de pacientes de um município do Sul do Brasil / Agreement between self-reported oral disorders during and after COVID-19 and clinical conditions of patients in municiplity in Southerm Brazil

O objetivo do presente estudo foi identificar a concordância entre agravos bucais autorreferidos durante e após a COVID-19 e condições clínicas de pacientes do município de Palhoça-SC. Materiais e Método: Estudo exploratório, transversal de base quantitativa descritiva com 30 participantes que possuíram testagem positiva para COVID-19 no município de Palhoça-SC. Cada paciente participou de uma avaliação clínica, identificando os agravos bucais, nessa mesma oportunidade, foram registrados dados sociodemográficos e condições bucais autorreferidas. Todas as análises foram conduzidas pelo Software Stata® versão 13. Análises descritivas, inferenciais pelo teste de Qui-quadrado de Pearson (α=5%). Concordância entre presença dos agravos bucais autorreferidos e presença do agravo avaliado clinicamente, pelo coeficiente Kappa e classificadas como: fraca 0 a 0,20; razoável 0,41 a 0,60; boa 0,61 a 0,80; muito boa 0,81 a 0,92; e excelente 0,93 a 1,00. Resultados: A maioria da amostra foram de mulheres (70%), com idade entre 36-59 anos (56,6%) e de baixa renda (70%). Houve concordância boa entre presença de cárie e relato de dor (Kappa=0,70), e para o diagnóstico clínico de sangramento gengival e autopercepção ruim/péssima a classificação também foi boa (Kappa=0,72). Todavia, a concordância entre o relato de sintomas de boca seca e baixo fluxo salivar foi considerada razoável (Kappa=0,57), assim como, para a presença de bolsa periodontal e o relato de autopercepção ruim/péssima (Kappa=0,41). Conclusão: A autopercepção das condições de saúde bucal durante a pandemia foi concordante com determinadas condições clínicas que necessitam de atendimento odontológico, corrobando com as preocupações sobre o agravamento das condições bucais durante a pandemia.(AU)

Aim: To identify the concordance between self-reported oral health problems during and after COVID-19 and clinical conditions of patients in the city of Palhoça-SC. Materials and Method: Exploratory, cross-sectional study with a descriptive quantitative base, formatted by 30 patients who tested positive for COVID-19 in the municipality of Palhoça-SC. Each patient participated in a clinical evaluation, identifying oral health problems. At the same time, sociodemographic data and self-reported oral conditions were recorded. All analyzes were performed using the Stata® Software, version 13. Descriptive and inferential analyzes were performed using Pearson's chi-square test (α=5%). Agreement between the presence of self-reported oral health problems and the presence of the clinically evaluated disease, by the Kappa coefficient and classified as: weak 0 to 0.20; take 0.21 to 0.40; reasonable 0.41 to 0.60; good 0.61 to 0.80; very good 0.81 to 0.92; and excellent 0.93 to 1.00. Results: Most of the sample were women (70%), aged between 36-59 years (56.6%) and low-income (70%). There was good agreement between the presence of caries and reported pain (Kappa=0.70), and for the clinical diagnosis of gingival bleeding and bad/very poor self-perception, the classification was also good (Kappa=0.72). However, the agreement between the report of symptoms of dry mouth and low salivary flow was considered reasonable (Kappa=0.57), as well as the presence of periodontal pockets and the report of poor/terrible self-perception (Kappa=0.41). Conclusion: The self-perception of oral health conditions during the pandemic was consistent with certain clinical conditions that require dental care, corroborating concerns about the worsening of oral conditions during the pandemic.(AU)

Clinical manifestations of syphilis in the oral cavity: a review / Manifestações clínicas da sífilis na cavidade oral: uma revisão bibliográfica

Introduction: Syphilis is a sexually transmitted infection caused by Treponema pallidum bacterium, which impact on a significant increase in contagions reported worldwide, bringing up the need of urgent actions to ensure the control, treatment, and diagnosis of the disease. Objective: Given this context, this work presents a bibliographical review on syphilis, aiming to describe the most common oral manifestations that occur on the four stages of this infection. Methods: For the literature review, the searches were carried out in the PubMed, Science Direct, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences Literature and databases of Virtual Health Library. Results: Regarding the primary syphilis, the main clinical manifestations in the oral cavity include chancres in the palate, buccal mucosa, tongue, and lips. In the secondary stage, the presence of diffuse and nonspecific oral lesions was identified. In tertiary syphilis, stomatitis and glossitis are present, being the hard palate and the tongue the main affected regions. In congenital syphilis, the patients are affected with dental and jaw malformations. Conclusion: The clinical manifestations of syphilis in the oral cavity can appear at any stage of the infection, being the oral cavity the second most affected region by this sexually transmitted infection. Therefore, the knowledge regarding this subject is extremely important for health professionals, as well as for the population, being essential to carry out the correct diagnosis and adequate treatment for the rapid cure of this infection (AU)

Introdução: A sífilis é uma infecção sexualmente transmissível oriunda da bactéria Treponema Pallidum, com transmissão através de relações sexuais sem o uso de preservativos ou por contato com lesões contaminadas. Nos últimos anos, diversos novos casos estão sendo reportados de forma alarmante, mostrando uma realidade dura sobre as dificuldades do diagnóstico da doença. Objetivo: Diante desse contexto, este trabalho apresenta uma revisão bibliográfica sobre a sífilis, com o objetivo de descrever as manifestações orais mais comuns nos quatros estágios possíveis da doença. Métodos: Para a revisão de literatura, realizou-se a busca dos artigos nas bases de pesquisas PubMed, Science Direct, Scientific Electronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Biblioteca Virtual em Saúde. Resultados: Observou-se que, na sífilis primária, as principais manifestações clínicas na cavidade oral ocorrem com a presença de cancros no palato, na mucosa jugal, na língua e nos lábios. No estágio secundário, identificou-se a presença de lesões orais difusas e inespecíficas. Na sífilis terciária, podem ocorrer estomatites e glossites, sendo o palato duro e a língua as principais regiões acometidas. Na sífilis congênita, os possíveis sinais clínicos na cavidade oral são malformações dentárias e nos maxilares. Conclusões: As manifestações clínicas da sífilis na cavidade oral podem surgir em qualquer estágio da infecção, sendo a cavidade oral a segunda região com maior acometimento da infecção. Portanto, é de extrema importância o conhecimento das manifestações orais da sífilis pelos profissionais da área da saúde, bem como pela população, sendo fundamental o correto diagnóstico e tratamento rápido para a cura precoce da doença. (AU)

Triclosan antimicrobial activity against dental-caries-related bacteria

Triclosan (TCS) is a chlorinated diphenyl ether and a possible active agent against microorganisms. Due to its probability of reducing dental plaque accumulation, TCS can be added as a substance for oral hygiene. Aim: To evaluate the efficacy and antimicrobial capacity of TCS against Pseudomonas aeruginosa and Streptococcus mutans. Methods: This work evaluates the percentage of bacteria inhibition of P. aeruginosa (ATCC 27853) and S. mutans (ATCC 25175). TCS concentrations between 2 and 128 µg.mL-1 were tested. Results: An inhibitory potential of TCS was found against S. mutans. No percentage of inhibition was detected against P. aeruginosa (technical and biological triplicate). Conclusion: TCS, an antimicrobial agent used in dentifrices, can reduce S. mutans levels therefore these dentifrices should be indicated for patients with a high risk of caries. However, further study is needed, including antimicrobial analyses against other microbial conditions

Disbiosis bacteriana y su efecto en enfermedades bucales: una revisión bibliográfica / Bacterial dysbiosis and its effect on oral diseases: a review bibliographic

Objetivo: actualizar la información sobre la disbiosis bacteriana oral y su efecto en enfermedades bucales. Material y métodos: se realizó una revisión bibliográfica detallada, donde la búsqueda de artículos comenzó desde el 2014 con trabajos de investigación relacionados con el tema. Se aplicaron palabras clave para facilitar y delimitar el tema. En los resultados obtenidos se observa información específica de disbiosis bacteriana y los problemas y enfermedades que causan en la cavidad bucal. Conclusión: la cavidad oral es un ecosistema muy complejo e interactivo donde se desarrollan variedades de hábitats que establecen relaciones entre los microorganismos en los distintos medios bucales. Por lo general, el cuerpo humano vive en simbiosis con dichas bacterias, esta relación hospedador-huésped es producto de años de evolución y convivencia para poder tolerar a dichas especies y por medio de años de investigación, determinar a los agentes patógenos y a los simbióticos, lo que permitirá en un futuro tener enfoques terapéuticos y científicos, para así solucionar, mejorar y evitar problemas relacionados con la salud (AU)

Objective: this review aimed to update the information on oral bacterial dysbiosis and its effect on oral diseases. Material and methods: a detailed literature review was performed, where the search for articles began in 2014 with research papers related to the topic. Keywords were applied to facilitate and delimit the topic. The results obtained show specific information on bacterial dysbiosis and the problems and diseases they cause in the oral cavity. Conclusion: the oral cavity is a very complex and interactive ecosystem where a variety of habitats develop and establish relationships between microorganisms in different oral environments. Generally, the human body lives in symbiosis with these bacteria, this host-guest relationship is the product of years of evolution and coexistence to be able to tolerate these species and through years of research to determine the pathogens and symbiotics, which will allow in the future to have therapeutic and scientific approaches, to solve, improve and avoid health-related problems (AU)

Diagnóstico bucodental en niños de parvularia residentes de una zona urbano marginal / Oral diagnosis in preschool children living in a marginal urban area

La caries dental es un problema de salud pública que para el año 2016 afectaba a 3500 millones de personas. En los menores de seis años, la progresión de la lesión es más rápida, exponiéndolos a la caries de la temprana infancia y pérdidas dentales prematuras. Determinar el estado de salud/enfermedad del componente bucal de niños de parvularia de un centro escolar con vulnerabilidad social y económica del municipio de San Salvador, en el año 2018, según el índice y la prevalencia de la enfermedad de caries dental. El estudio es descriptivo, cuantitativo, de corte transversal, prospectivo. Las unidades de análisis son niños de cuatro y cinco años de edad, respetando todos los aspectos éticos y la confidencialidad. Se tomó el total del universo, conformado por 96 niños. Resultados. La frecuencia de caries dental en la población en estudio es del 95 %, el índice de dientes cariados, extraídos y obturados es de 6,38, que según la Organización Mundial de Salud es muy alto. La superficie dental más afectada es la oclusal, en los cuadrantes superiores, con un aproximado del 40 %, y en los inferiores, un aproximado del 20 %. La mayoría de la población en estudio padece de caries dental, siendo una minoría la que mantiene la cavidad bucal en estado óptimo

Dental caries is a public health problem, in 2016 it affected 3500 million people. In children under six years of age, the progression of the lesion is faster, exposing them to early childhood caries and premature dental loss. To determine the health/disease status of the oral component of nursery school children from a school with social and economic vulnerability in the municipality of San Salvador, in 2018, according to the index and prevalence of dental caries disease. The study is descriptive, quantitative, cross-sectional, prospective. The units of analysis are children between four and five years of age, respecting all ethical aspects and confidentiality. The total of the universe made up of 96 children was taken. Results. The frequency of dental caries in the study population is 95 %, the decayed, missing and filled caries index is 6,38, which according to the World Health Organization is very high. The most affected tooth surface is occlusal, in the upper quadrants with approximately 40 % and in the lower quadrants with approximately 20 %. The majority of the population under study suffers from dental caries, being a minority that maintains the oral cavity in an optimal state.

Efecto de la hipoxia sobre los tejidos de la cavidad oral: revisión de la literatura / Effect of hypoxia on oral tissues: a review of the literature

La exposición a hipoxia es considerada un estímulo estresante, por lo que el organismo desarrolla meca-nismos de aclimatación para asegurar la homeosta-sis. Si bien el efecto de la hipoxia sobre los distintos sistemas de tejidos y órganos ha sido bien documen-tado, el rol de los bajos niveles de O2 en la cavidad oral no ha recibido el mismo análisis. En este trabajo se revisaron los datos bibliográficos disponibles sobre el efecto de la hipoxia sobre el tejido periodontal, las glándulas salivales, la pulpa dental y el hueso mandi-bular y alveolar. De lo analizado en la bibliografía, re-sulta evidente que los bajos niveles de O2 aumentan el número de mediadores inflamatorios que inducen la progresión de la enfermedad periodontal y, a su vez, la inflamación establecida durante dicha enfermedad agrava aún más las condiciones de hipoxia tisular. Las glándulas salivales también se encuentran afectadas durante la exposición a hipoxia, disminuyendo la can-tidad de saliva secretada, observándose alteraciones ultraestructurales en el parénquima glandular. Por otra parte, se ha establecido que la hipoxia puede te-ner efectos deseados para el cultivo de células madre de la pulpa dental, lo cual resulta útil en el campo de la odontología reparativa y también para el movimien-to dental durante los tratamientos ortodónticos. En conclusión, para determinar los efectos de la hipoxia en la cavidad oral se debe analizar no sólo el tipo de tejido involucrado sino también las condiciones de hi-poxia a las cuales éste es sometido, así también como la duración de la exposición y la modalidad de hipoxia (AU)

Exposure to hypoxia is considered a stressful stimulus, therefore the organism develops acclimation mechanisms to try to ensure homeostasis. Although the effect of hypoxia on different tissues and organs has been very well documented, the role of low levels of O2 in the oral cavity has not received the same analysis. In this review, we analyzed the available bibliographic data concerning the effects of hypoxia on periodontal tissue, salivary glands, and dental pulp. The published evidence demonstrates that low O2 levels increase the number of inflammatory mediators that induce the progression of periodontal disease, and, in turn, the inflammation established during the progression of periodontitis aggravates tissue hypoxia conditions. Salivary glands are also affected during hypoxic exposure, decreasing salivary secretion, and leading to ultrastructural alterations in the glandular parenchyma. On the other hand, hypoxia could also be beneficial in some scenarios. It has been established that dental pulp cells grow better in culture under hypoxic conditions than they do in normoxia. Furthermore, mild hypoxia seems to stimulate periodontal ligament cells proliferation and matrix degradation, key events during for orthodontic treatments. In conclusion, to determine the effects of hypoxia in the oral cavity, it is necessary to analyze not only the type of tissue involved but also the hypoxic conditions to which it is subjected, as well as its duration and modality (AU)

Factores asociados al covid-19 desencadenantes de infecciones bucodentales en la población infantil / Factors associated with covid-19 that trigger oral infections in the child population

La presencia de un nuevo coronavirus se propagó de manera inesperada alrededor de todo el mundo, desencadenando una crisis mundial sin precedentes. Ya para el año 2020, habían más de 7,9 millones de casos, y 434.796 muertes, en más de 200 países. En ese momento, se implementaron medidas de aislamiento y distanciamiento social en todo el mundo para contener el acelerado propagación de covid-19; entre las consecuencias, las clínicas dentales, se cerraron temporalmente y se suspendió la atención dental electiva, lo que conllevó a un aumento en el desarrollo de enfermedades bucodentales. Con relación a los niños y jóvenes, hubo un aumento en este tipo de enfermedades. Los niños se vieron obligados a pasar la mayor parte de su tiempo en el hogar con la adquisición de hábitos alimentarios incorrectos, ingesta de refrescos y bebidas energéticas que, además de contener altas cantidades de azúcares, su contenido ácido produce erosión dental y hace que el esmalte tejido menos resistente al ataque de bacterias cariogénicas. En este trabajo se analizó una población de 96 niños en edad escolar durante un periodo de dos años de 2020 al 2022. Los resultados mostraron que 100% de los escolares presentaron caries dentales al momento de su evaluación en enero 2022, mientras que 47% del total presentaron dientes obturados y el 64% del total de casos, perdieron algunas de sus piezas dentales. Estos resultados son, posiblemente, debido al desconocimiento de los escolares sobre la higiene para la prevención de las caries dental y sus consecuencias, siendo la más perjudicial la pérdida prematura de dientes temporales, lo que hace necesario implementar programas sobre la promoción y prevención en la salud bucodental en escolares, docentes, y padres y representantes(AU)

The presence of a new coronavirus spread unexpectedly around the world, triggering an unprecedented global crisis. By 2020, there were more than 7.9 million cases, and 434,796 deaths, in more than 200 countries. At that time, isolation and social distancing measures were implemented around the world to contain the accelerated spread of covid-19; Among the consequences, dental clinics were temporarily closed, and elective dental care was suspended, which led to an increase in the development of oral diseases. In relation to children and young people, there was an increase in this type of illness. The children were forced to spend most of their time at home with the acquisition of incorrect eating habits, intake of soft drinks and energy drinks that, in addition to containing high amounts of sugar, their acid content produces dental erosion and makes the enamel tissue less resistant to attack by cariogenic bacteria. In this work, a population of 96 school-age children was analyzed during a two-year period from 2020 to 2022. The results showed that 100% of the schoolchildren had dental caries at the time of their evaluation in January 2022, while 47% of the total had filled teeth and 64% of the total cases lost some of their teeth. These results are possibly due to the lack of knowledge of schoolchildren about hygiene for the prevention of dental caries and its consequences, the most damaging being the premature loss of temporary teeth, which makes it necessary to implement programs on promotion and prevention in the oral health in schoolchildren, teachers, and parents and representatives(AU)

Cannabis. Usos y aplicaciones en la práctica odontológica diaria: revisión de la literatura / Cannabis. Uses and applications in daily dental practice: a review of the literature

La evidencia científica presente en la literatura indica que el cannabis puede ser utilizado con fines terapéuticos para tratar distintas afecciones odontológicas. Dado el acceso sencillo a la cavidad bucal, las distintas formulaciones de cannabis pueden aplicarse de forma tópica. La aplicación local de dosis bajas de cannabis ha demostrado alta efectividad para tratar distintas afecciones bucales, constituyendo un tratamiento seguro con baja probabilidad de generar repercusiones sistémicas indeseadas. En la actualidad, está siendo incorporado a materiales convencionales de uso e higiene odontológica con la finalidad de aprovechar sus efectos terapéuticos. El cannabis tiene múltiples usos en odontología: como componen-te de enjuagues bucales y soluciones para la desinfección de conductos radiculares, en tratamientos de trastornos de ansiedad bucal, como complemento en terapias oncológicas, como analgésico para atenuar el dolor inflamatorio y el neuropático, como miorrelajante y condroprotector para tratar trastornos de articulación témporomandibular (ATM) y bruxismo, como osteomodulador para el tratamiento de patologías que comprometen la integridad ósea, como la enfermedad periodontal y la osteoporosis, y para la cicatrización ósea asociada a fracturas, extracciones dentarias e implantes, y como inmunomodulador con potencial terapéutico para tratar patologías autoinmunes como las enfermedades reumáticas. El trata-miento local con cannabis es efectivo, bien tolerado por el paciente y con pocos efectos adversos. Por lo tanto, se puede concluir que el cannabis aporta un enorme abanico de posibilidades terapéuticas para tratar distintas afecciones odontológicas, aunque aún se requiere mayor cantidad de estudios científicos que avalen su utilización en cada situación fisiopatológica particular (AU)

The scientific evidence present in the literature indicates that cannabis can be used for therapeutic purposes to treat different dental conditions. Given the easy access to the oral cavity, the different cannabis formulations can be applied topically. The local application of low doses of cannabis has shown high effectiveness in treating different oral conditions, constituting a safe treatment with a low probability of generating unwanted systemic repercussions. It is currently being incorporated into conventional materials for dental use and hygiene in order to take advantage of its therapeutic effects. Cannabis has multiple uses in dentistry: as a component of mouthwashes and solutions for disinfecting root canals, in the treatment of oral anxiety disorders, as a complement in oncological therapies, as an analgesic to reduce inflammatory and neuropathic pain, as a muscle relaxant and chondroprotective to treat temporomandibular joint disorders and bruxism, as an osteomodulator for the treatment of pathologies that compromise bone integrity, such as periodontal disease and osteoporosis, and or bone healing associated with fractures, dental extractions and implants, and as immunomodulator with therapeutic potential to treat autoimmune pathologies such as rheumatic diseases. Local treatment with cannabis is effective, well tolerated by the patient and with few adverse effects. Local treatment with cannabis is effective, well tolerated by the patient and with few adverse effects. Therefore, it can be concluded that cannabis provides an enormous range of therapeutic possibilities to treat different dental conditions, although more scientific studies are still required to support its use in each particular pathophysiological situation (AU)

Fisiopatología de la enfermedad COVID-19 / Pathophysiology of COVID-19 / Fisiopatologia da doença COVID-19

La enfermedad por coronavirus es una infección respiratoria causada por el virus SARS-CoV 2, el cual genera una cascada de eventos sistémicos, afectando diferentes órganos y tejidos. El entendimiento de la fisiopatología del COVID-19 es indispensable no solo al momento de brindar tratamiento a los pacientes, sino que también para comprender las causas de las complicaciones que presentan un número importante de pacientes recuperados. El objetivo de este trabajo es presentar una revisión actualizada de los efectos de la infección en diferentes órganos y sistemas principales que sea de utilidad como material de referencia para profesionales y estudiantes de la salud. Para ello se realizó una búsqueda bibliográfica en los portales PubMED, Scielo, Google Scholar, Cochrane y Springer Link, así como en las bases de repositorios científicos pre-publicación bioRxiv ("bioarchives") y medRxiv ("med-archives") y sobre un total de cerca de 200 mil artículos, se seleccionaron 100 artículos para esta revisión en base a su relevancia o sugerencias de parte de profesionales especializados.

Coronavirus disease is a respiratory infection caused by the SARS-CoV-2 virus, which causes a cascade of systemic events, affecting various organs and tissues. Understanding the pathophysiology of COVID-19 is essential to treat patients and understand the causes of the complications in a significant number of recovered patients. This article presents a review of the effects of infection on various organs and systems that will be useful as reference material for healthcare professionals and medical students. To this end, a literature search was conducted in PubMED, Scielo, Google Scholar, Cochrane, and Springer Link portals, as well as in the pre-publication scientific repositories bioRxiv ("bioarchives") and medRxiv ("med-archives") databases. From about 200,000 papers, 100 articles were selected for this review based on their relevance or suggestions from experts in the field.

A doença coronavírus é uma infecção respiratória causada pelo vírus SARS-CoV-2, que gera uma cascata de eventos sistêmicos, afetando diferentes órgãos e tecidos. Compreender a fisiopatologia da COVID-19 é essencial não apenas no tratamento de pacientes, mas também para compreender as causas das complicações que um número significativo de pacientes recuperados apresenta. O objetivo deste trabalho é apresentar uma revisão atualizada dos efeitos da infecção em diferentes órgãos e principais sistemas que seja útil como material de referência para profissionais de saúde e estudantes. Para isso, foi realizada uma pesquisa bibliográfica nos portais PubMED, Scielo, Google Scholar, Cochrane e Springer Link, bem como nos repositórios científicos de pré-publicação bioRxiv ("bioarquivos") e medRxiv ("arquivos med"). Num total de cerca de 200 mil artigos, 100 artigos foram selecionados para esta revisão por sua relevância ou sugestões de profissionais especializados.

Potencial del uso de la radiografía panorámica como ayuda diagnóstica en derechohabientes de una institución de seguridad social / Potential for the use of panoramic radiography as a diagnostic aid in beneficiaries of a social security institution

Introducción: A pesar de que actualmente la radiografía panorámica es un instrumento auxiliar de diagnóstico de uso común, desafortunadamente sus beneficios no se aprovechan en su totalidad y su empleo se limita al uso en determinadas áreas de la odontología y en ocasiones se omiten hallazgos que pueden tener un significado clínico importante. Material y métodos: Estudio transversal y descriptivo de una muestra aleatoria de 500 estudios de imagen (radiografías panorámicas) durante el periodo de enero a mayo de 2018 analizadas por expertos estandarizados y empleando estadística descriptiva básica mediante el paquete estadístico Excel. Resultados: Se incluyeron 500 estudios, 67% correspondió a mujeres en un rango de cinco a 91 años de edad con una mediana de 43 años, 48% presentó alteraciones siendo las más frecuentas pérdida del proceso alveolar 45%, alteraciones en articulación temporomandibular 34%, y calcificación del ligamento estilohioideo 31%. Conclusión: Se reportaron hallazgos clínico-radiográficos significativos, resaltando la necesidad de un análisis cuidadoso de los métodos auxiliares de diagnóstico que permitan visualizar de manera contextual el tratamiento odontológico de los pacientes y/o reportar al especialista correspondiente otro tipo de hallazgos (AU))

Introduction: Although panoramic radiography is currently a commonly used diagnostic auxiliary instrument, unfortunately its benefits are not fully exploited and its use is limited to use in certain areas of Dentistry and eventually findings that may have important clinical significance are omitted. Material and methods: Crosssectional and descriptive study of a random sample of 500 imaging studies (panoramic radiographs) during the period from January to May 2018, analyzed by standardized experts and using basic descriptive statistics using the Excel statistical package. Results: 500 studies were included corresponding to 67% women and an age range from five to 91 years of age with a median of 43 years, 48% presented alterations, the most frequent being loss of the alveolar process 45%, alterations in the temporomandibular joint 34%, and calcification of the hyoid ligament 31%. Conclusion: In this study significant clinical-radiographic findings are reported, highlighting the need for a careful analysis of auxiliary diagnostic methods that allow visualize the dental treatment of the patients and / or report other findings to the corresponding specialist (AU)

O uso emergente da teleodontologia durante a pandemia de Covid-19: experiência de um município do sul do Brasil / The emerging use of teleodontology during the Covid-19 pandemic: experience from a municipality in southern Brazil

Objetivo: descrever a experiência do serviço de teleodontologia no município de Palhoça, Santa Catarina, durante a pandemia da Covid-19. Métodos: trata-se de um estudo observacional, de caráter transversal. A pesquisa foi realizada com os dados de pacientes atendidos pelo serviço de teleodontologia do município Palhoça, Santa Catarina. Foram registrados dados referentes ao perfil sociodemográfico do usuário, agravos bucais e desfecho do caso. Resultados: houve 20.745 teleatendimentos e 7.666 agendamentos. A maioria dos usuários era do sexo feminino, sendo a faixa etária mais prevalente composta por jovens adultos. As principais queixas relatadas foram para monitoramento de caso e dor. Dos casos agendados, 91,23% dos usuários foram encaminhados para as unidades básicas de saúde. Conclusão: diante dos achados, a teleodontologia demonstrou ser uma excelente ferramenta, contribuindo para a diminuição no fluxo de pessoas em unidades de saúde e colaborando com os processos instituídos no atendimento, possibilitando a manutenção da assistência de casos.(AU)

Objective: to describe the experience of a Dentistry- by-phone (Teleodontologia) service in the city of Palhoça, SC, Brazil, during the Covid-19 pandemic. Methods: this is an observational, cross-sectional study. The research was carried out with data from patients assisted by the service. Data regarding the user's sociodemographic profile, oral health problems and case results were recorded. Results: there were 20745 calls and 7666 appointments. Most users were female, with the most prevalent age group being young adults. Main reported complaints were for case monitoring and pain. From the scheduled cases, 91% of users were referred to the UBSs (Health Basic Units). Conclusion: the service was considered to be an excellent tool, assisting on reducing the flow of people in health units and collaborating with the processes established in the service, allowing for health care maintenance.(AU)

The unfolding consequences of postponing routine dental care / Explorando las consecuencias de posponer las atenciones odontológicas de rutina

The COVID-19 pandemic represents some of the most distressing challenges for health systems all over the world in the past decades, forcing clinicians to modify standards, prioritise treating conditions that require immediate care, and implement elements of remote attention in record time (Douglas et al., 2020). These challenges have also had an impact in the population's oral health.

Defectos bucodentales en personas con síndrome de Down: una prioridad en salud bucal / Oral-dental defects in people with Down's syndrome: a priority in oral health

RESUMEN El síndrome de Down con frecuencia se acompaña de defectos bucodentales que comprometen la función masticatoria y fonatoria del paciente. Las acciones de prevención y promoción de salud bucal, el diagnóstico precoz y seguimiento de estas enfermedades, contribuyen al logro del verdadero enfoque interdisciplinario que demandan estos pacientes, para lograr una plena inclusión social. Se realizó una búsqueda bibliográfica sobre el tema, con el objetivo de estructurar los referentes teóricos relacionados con los principales defectos bucodentales -congénitos y adquiridos- que afectan a la población con síndrome de Down, para lograr la prevención de estos defectos y el incremento de la calidad de vida de los pacientes. Los defectos bucodentales congénitos más frecuentes encontrados en la trisomía 21, fueron la microdoncia, la macroglosia y la erupción dental tardía. La enfermedad periodontal fue el defecto adquirido de mayor presentación, al que se asocian diversos factores de riesgo, muchos modificables. Las intervenciones tempranas en salud bucal pueden incrementar la calidad de vida de los niños y adultos que padecen este trastorno, ayudándolos a lograr un pleno desarrollo como seres humanos (AU).

ABSTRACT Down's syndrome is frequently accompanied by oral-dental defects compromising the masticatory and phonatory function of the patients. Oral health promotion and prevention actions, precocious diagnosis and follow-up of these diseases contribute to achieving the true interdisciplinary approach these patients demand to reach their full social inclusion. A bibliographic search on the theme was carried out, with the objective of structuring the theoretical referents related to the main oral-dental defects -congenital and acquired-, affecting the population with Down's syndrome to reach these defects prevention and increasing these patients' life quality. The congenital oral-dental defects more commonly found in trisomy 21 were microdontia, macroglossia, and delayed tooth eruption. Periodontal disease was more frequently found acquired defect, to which several risk factors are associated, many of them modifiable. Early interventions in oral health may improve the life quality of these children and adults, helping them to achieve a full development as human beings (AU).

Prevalência das lesões orais em idosos atendidos no serviço de estomatologia do Instituto de Saúde de Nova Friburgo ­ UFF/RJ / Prevalence of oral lesions in the elderly treated at the stomatology service of the Instituto de Saúde de Nova Friburgo ­ UFF/RJ

Objetivo: realizar um levantamento epidemiológico acerca das alterações na mucosa oral dos pacientes acima de 60 anos, atendidos no serviço de Estomatologia do Instituto de Saúde de Nova Friburgo - UFF/RJ, no período de 2013 a 2018, e estabelecer as principais causas e formas de tratamento. Materiais e Métodos: estudo retrospectivo e observacional, com análise descritiva, através da coleta de dados nos prontuários: idade, sexo, cor da pele, ocupação, lesão e sua localização. Resultados: foram analisados 640 prontuários, destes, 395 (61,7%) apresentaram lesão, sendo 132 (20,6%) deles com mais de uma lesão. Dos 395 com lesão, 57,0% (225) eram do sexo feminino. A cor de pele branca representou 56,7% (224), porém 107 prontuários não apresentaram essa informação. A amostra contou com pacientes de 60 a 91 anos, com média de 65 anos. No total foram encontradas 613 lesões. Queilite actínica foi a mais prevalente 15,5% (95), seguida da estomatite protética 14,0% (86) e hiperplasia fibrosa 13,4% (82). Conclusão: os indivíduos idosos do presente estudo apresentaram alta frequência de lesões orais, sendo a queilite actínica, estomatite protética e hiperplasia fibrosa as mais comuns.

Objective: to carry out an epidemiological survey of oral mucosa lesions of patients aged over 60 years, attended at the Stomatology Service of the Nova Friburgo Health Institute - UFF/RJ, from 2013 to 2018, and to establish the main etiologies and forms of treatment. Materials and Methods: retrospective and observational study through data collection from medical records as: age, gender, skin color, occupation, lesion and its location. Results: 640 medical records were analyzed, of which 395 (61.7%) had lesions, 132 (20.6%) had more than one lesion. Of the 395 with injuries, 57.0% (225) were female. White skin color represented 56.7% (224), but 107 medical records did not present this information. The sample included patients aged 60 to 91 years, with a mean of 65 years. In total, 613 injuries were found. Actinic cheilitis was the most prevalent 15.5% (95), followed by prosthetic stomatitis 14.0% (86) and fibrous hyperplasia 13.4% (82). Conclusion: the elderly individuals in the present study had a high frequency of oral lesions, with actinic cheilitis, denture stomatitis and fibrous hyperplasia being the most common.

In vitro antimicrobial activity of Caesalpinia coriaria (Jacq. ) Willd extracts on Streptococcus pyogenes and Candida albicans / Actividad antimicrobiana in vitro de extractos de Caesalpinia coriaria (Jacq. ) Willd sobre Streptococcus pyogenes y Candida albicans

Background: "Dividivi" Caesalpinia coriaria (Jacq.) Willd fruits are traditionally used by the Wayuú community in La Guajira (Colombia) to treat oral and skin cavity diseases caused by bacteria and fungi. Streptococcus pyogenes is a gram-positive cocci of group A (beta-hemolytic) that is the cause of pharyngeal disease, scarlet fever, cellulitis, erysipelas, or toxic shock-like syndrome. Alternatively, Candida albicans is a yeast-like fungus that is a normal flora of the digestive tract, vagina, or skin folds; it has been known to be the root cause of opportunistic diseases such as diaper rash, oral and esophagus thrush, or vulvovaginitis. Objective: This study evaluated the antimicrobial activity of methanolic and ethanolic extracts of C. coriaria (Jacq.) Willddry fruits on S. pyogenes ATCC 12384andC. albicans ATTC 14053. Method: C. coriaria extracts were obtained from the Soxhlet method using two solvents (methanol and ethanol 98%) prepared from pulverized fruits. A phytochemical test and an antimicrobial activity assay were performed using the obtained extracts and tested using S. pyogenes ATCC 12384 and C. albicans ATTC 14053 strains. Results: A phytochemical profile was performed, examining the presence of bioactive metabolites (tannins, alkaloids, glycosides, saponins, and anthraquinones) from each extract. Antimicrobial susceptibility tests showed that the ethanolic extract inhibited S. pyogenes ATCC 12384,causing inhibition halos of 14.1 ± 0.1 mm and a Minimum Inhibitory Concentration (MIC) of 172 mg/ml, and C. albicans test shows inhibition halos of 16.1 ± 0.2 mm and MIC of 212 mg/ml. Additionally, the methanolic extract inhibited S. pyogenes with inhibition halos of 15.2 ± 0.2 mm and MIC of 152 mg/ml; no inhibitory effect was observed on C. albicans.Conclusion: This study revealed that C. coriaria has an antimicrobial effect on the tested species opening the field of its possible use as a therapeutic agent

Introducción: Los frutos del "Dividivi" Caesalpinia coriaria (Jacq.) Willd son usados tradicionalmente por la comunidad indígena Wayuú en La Guajira (Colombia) para el tratamiento de enfermedades de la cavidad bucal y cutáneas ocasionadas por bacterias y hongos. Streptococcuspyogenes es un coco grampositivo del grupo A (beta-hemolítico) que es la causa de enfermedad faríngea, escarlatina, celulitis, erisipela o síndrome tipo shock tóxico. Candida albicans es un hongo levaduriforme que es flora normal del tracto digestivo, la vagina o los pliegues de la piel; se sabe que es la causa principal de enfermedades oportunistas como la dermatitis del pañal, aftas bucales y esofágicas, o vulvovaginitis. Objetivo: El objetivo de este estudio fue evaluar la actividad antimicrobiana de extractos metanólicos y etanólicos de frutos secos sobre microorganismos patógenos específicamente S. pyogenes ATCC 12384yC. albicansATTC 14053. Método: A partir de frutos polverizados de C. coriaria, usando el método Soxlet, se evaluaron dos solventes (metanol y etanol al 98%), los cuales, fueron usados para estudiar su actividad antimicrobiana evaluando su efecto en cepas de S. pyogenes ATCC 12384 y C. albicans ATTC 14053. Resultados: Mediante un perfil fitoquímico se determinó la presencia de grupos de metabolitos secundarios con compuestos bioactivos (taninos, alcaloides, glucósidos, saponinas, y antraquinonas). Las pruebas de sensibilidad antimicrobiana mostraron que el extracto etanólico tuvo un efecto inhibidor sobre S. pyogenesATCC 12384 con halos de inhibición de 14.1 ± 0.1 mm y una concentración mínima inhibitoria (CMI) de 172 mg/mL, y sobre C. albicans se presentaron halos de inhibición de 16.1 ± 0.2 mm y CMI de 212 mg/mL, mientras que el extracto metanólico tuvo un efecto inhibidor sobre S. pyogenes con halos de inhibición de 15.2 ± 0.2 mm y CMI de 152 mg/mL no se observó efecto inhibidor sobre C. albicans. Conclusión: Este estudio demostró que C. coriaria tiene efecto antimicrobiano en las especies evaluadas, abriendo un campo de investigación en la evaluación de su uso como agente terapéutico

Association between bariatric surgery and oral health: a literature review

Objective: to review the literature on the relationship between oral health and bariatric surgery in obese individuals. Methods: articles published until March 2021 were searched in the Medline/PubMed, LILACS, BBO, and Web of Science databases. The search used a combination of descriptors related to the words: obesity, bariatric surgery, and oral health. Results: one hundred thirty-five studies were identified in the database search. Of these, 47 were included in this review. The oral changes investigated in the literature for individuals who underwent bariatric surgery were dental caries, tooth wear/erosion, hypersensitivity, periodontal disease, hyposalivation, halitosis, and changes in mastication and oral soft tissue. The evaluated articles showed methodological controversy regarding the study design, follow-up period, sample size, and assessed clinical parameters, which complicated the comparison of studies. Final considerations: there is no consensus in the literature regarding the relationship between oral health and bariatric surgery in obese individuals. Further prospective cohort studies should be conducted to investigate this association better.(AU)

Objetivo: revisar a literatura sobre a relação entre saúde bucal e cirurgia bariátrica em indivíduos obesos. Métodos: foi realizada uma busca de estudos publicados até março de 2021 nas bases de dados Medline/PubMed, LILACS, BBO e Web of Science. Foi utilizada uma combinação de descritores relacionada às palavras: obesidade, cirurgia bariátrica e saúde bucal. Resultados: foram identificados 135 estudos nas bases de dados pesquisadas. Desses, 47 estudos foram incluídos nesta revisão. As alterações bucais investigadas em indivíduos que realizaram cirurgia bariátrica apresentadas na literatura foram: cárie dentária, desgaste dentário/erosão dentária, hipersensibilidade, doença periodontal, hipossalivação, halitose, alterações da função mastigatória e alterações no tecido mole bucal. Os estudos avaliados mostraram controvérsia metodológica em relação a: tipo de desenho de estudo, tempo de seguimento, tamanho da amostra e parâmetros clínicos avaliados, fato que dificultou comparar os estudos. Considerações finais: não há consenso na literatura sobre a relação entre saúde bucal e cirurgia bariátrica em indivíduos obesos. Mais estudos de coorte prospectivos devem ser realizados para estudar melhor essa associação.(AU)

Condição bucal de mulheres com diabetes mellitus gestacional internadas em um hospital escola no sul do Brasil / Oral condition of women with gestational diabetes mellitus admitted in a school hospital in southern Brazil

Objetivo: avaliar a condição bucal de mulheres com diabetes mellitus gestacional (DMG) internadas no Hospital Escola (HE) da Universidade Federal de Pelotas (UFPel). Métodos: trata-se de um estudo transversal retrospectivo de base hospitalar, em que dois residentes treinados realizaram a coleta dos dados por meio da avaliação dos prontuários médicos e odontológicos, no período de setembro de 2019 a março de 2020. Os dados socioeconômicos e demográficos e o diagnóstico de DMG foram coletados dos prontuários médicos, enquanto hábitos e condição bucal, dos prontuários odontológicos. A análise dos dados foi realizada no programa Stata 11.0, usando os testes Exato de Fisher e Regressão de Poisson. Resultados: foram avaliados os prontuários de 83 gestantes, destas, 37 (44,6%) apresentavam DMG. A presença de DMG esteve asso-ciada com as gestantes de maior faixa etária (62,2%) e no terceiro trimestre de gestação. Em sua maioria, tinham renda de até dois salários mínimos, eram solteiras, tinham filhos e realizaram pré-natal. Em relação à avaliação bucal, apenas a presença de cálculo dental e inflamação gengival foi estatisticamente associada à presença de DMG (p= 0,030 e 0,014 respectivamente). A autopercepção do sorriso foi considerada ruim por 40,5%, e a maioria teve dentes perdidos por cárie (64,9%). Conclusões: a prevalência de DMG foi alta entre as gestantes internadas, sendo maior em mulheres de mais idade. Presença de cálculo dental e inflamação gengival foram fortemente associadas à presença de DMG, enquanto hábitos bucais e presença de cárie não apresentaram associação. Novas pesquisas, com exames periodontais completos, são necessárias para verifi-car as condições periodontais dessas mulheres.(AU)

Aim: to assess the oral condition of women with Gestacional Diabetes Mellitus (GDM) admitted in a School Hospital (HE)/UFPel. Methods: medical and dental records, from September 2019 to March 2020, were evaluated in this hospital-based retrospective cross-sectional study. Socioeconomic and demographic data were collected from medical records, while oral condition and habits were obtained from the dental records. Statistical analysis was performed with Stata 11.0 software using Fisher's exact test and Poisson regression. Results: the medical records of 83 pregnant women were evaluated, of which 37 (44.6%) had GDM. The presence of GDM was associated with pregnant women of older age (62.2%) and most in the third trimester of pregnancy. Most of them had an income of up to two minimum wages, were single, had children and underwent prenatal care. Regarding the oral evaluation, only the presence of dental calculus and gingival inflammation was statistically associated with the presence of GDM (p = 0.030 and 0.014 respectively). The self-perception of the smile was considered bad to 40.5% and many of them had lost teeth due to caries (64.9%). Conclusions: the prevalence of GDM was high in hospitalized pregnant women, being higher in older women. Presence of dental calculus and gingival inflammation were strongly associated with the presence of GDM, while oral habits and the presence of caries were not associated. Further research, with complete periodontal examinations is necessary to verify the periodontal conditions of these women.(AU)

El deber de actuar por la salud bucal y la felicidad / The commitment to act for oral health and happiness

La salud bucal y la felicidad requieren acción social. El buen estado de salud es uno de los principales determinantes de la felicidad, pues produce alegría y se expresa habitualmente a través de la sonrisa o risa que pudieran resultar inhibidas por afecciones bucales. La campaña "Unidos por la salud bucal", impulsada por la Federación Dental Internacional a nivel mundial, hace un llamado a decisores, profesionales y a la población para que asuman compromisos orientados a reducir la carga global de las enfermedades bucales. El establecimiento de compromisos y las acciones consecuentes pueden contribuir a mejoras en la salud bucal, aunque para ello es necesario establecer acciones sistemáticas. En el contexto cubano, es una fortaleza que la estrategia de la estomatología sea nacional y tenga un enfoque de salud pública, si bien se hace necesario reforzar el seguimiento y evaluación del impacto de las acciones, estimular la creatividad, la comunicación dialogada y revisar cuáles compromisos deben ser consolidados para contribuir a la salud bucal y, por consiguiente, a la felicidad(AU)

Oral health and happiness require social action. The good health is one of the main determinants of happiness, since it produces joy and is usually expressed through a smile or laughter that could be inhibited by oral conditions. The International Dental Federation's "United for Oral Health" Campaign in 2020 aims to make commitments for decision-makers, professionals and the population to reduce the global burden of oral diseases. Establishing commitments and consequent actions can contribute to improvements in oral health, making it necessary to establish systematic actions. In the Cuban context, it is a strength that the stomatology strategy is national and has a public health focus, although it is necessary to reinforce the monitoring and evaluation of the impact of the actions, stimulate creativity, dialogue communication, and review which commitments they must be consolidated to contribute to oral health and therefore to happiness."(AU)