Genetic and epigenetic control of ACE2 expression and its possible role in COVID-19.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a pandemic that is claiming hundreds of thousands of lives around the world. Angiotensin-converting enzyme-2 (ACE2) is a key player in COVID-19 due to its pivotal role in the SARS-CoV-2 infection. This enzyme is expressed throughout the body and the studies conducted so far have shown that its expression varies according to several factors, including cell type, sex, age, disease states and probably SARS-CoV-2 infection. Single-nucleotide polymorphisms (SNPs) and epigenetic mechanisms, including DNA methylation, histone post-translational modifications and microRNAs, impact ACE2 expression and may explain structural variation. The understanding of how genetic variants and epigenetic markers act to control ACE2 expression in health and disease states may contribute to comprehend several aspects of COVID-19 that are puzzling researchers and clinicians. This review collects and appraises the literature regarding some aspects in the ACE2 biology, the expression patterns of this molecule, SNPs of the ACE2 gene and epigenetic mechanisms that may impact ACE2 expression in the context of COVID-19.

Polymorphisms of Nav1.6 sodium channel, Brain-derived Neurotrophic Factor, Catechol-O-methyltransferase and Guanosine Triphosphate Cyclohydrolase 1 genes in trigeminal neuralgia.

SUBJECTS: Trigeminal neuralgia is a neuropathic pain characterized by episodes of severe shock-like pain within the distribution of one or more divisions of the trigeminal nerve. Pain can be influenced by ethnicity, environment, gender, psychological traits, and genetics. Molecules Nav1.6 sodium channel, Brain-derived Neurotrophic Factor, Catechol-O-methyltransferase and Guanosine Triphosphate Cyclohydrolase 1 have been involved in mechanisms that underlie pain and neurological conditions. OBJECTIVE: The aim of this case-control study was to investigate the occurrence of genetic polymorphisms in Nav1.6 sodium channel (SCN8A/rs303810), Brain-derived Neurotrophic Factor (BDNF/rs6265/Val66Met), Catechol-O-methyltransferase (COMT/rs4680/Val158Met), and Guanosine Triphosphate Cyclohydrolase 1 (GCH1/rs8007267) genes in trigeminal neuralgia patients. METHODS: Ninety-six subjects were divided into two groups: 48 with trigeminal neuralgia diagnosis and 48 controls. Pain was evaluated by visual analog scale and genomic DNA was obtained from oral swabs and analyzed by real-time polymerase chain reaction. RESULTS: No association was observed among SCN8A, BDNF, COMT or GCH1 polymorphisms and the presence of trigeminal neuralgia. Genotype distribution and allele frequencies did not correlate to pain severity. CONCLUSIONS: Although no association of evaluated polymorphisms and trigeminal neuralgia or pain was observed, our data contributes to the knowledge of genetic susceptibility to trigeminal neuralgia, which is very scarce. Further studies may focus on other polymorphisms and mutations, as well as on epigenetics and transcriptional regulation of these genes, in order to clarify or definitively exclude the role of Nav1.6, BDNF, COMT or GCH1 in trigeminal neuralgia susceptibility and pathophysiology.

Ultrasonography for long-term evaluation of hyaluronic acid filler in the face: A technical report of 180 days of follow-up.

PURPOSE: In this study, we used ultrasonography to monitor the use of hyaluronic acid (HA) as a filler in the face for esthetic reasons. We monitored changes in the filler shape, distribution, and relationship with adjacent anatomical structures over a 180-day period. MATERIALS AND METHODS: Two patients each received an ultrasound-guided injection of HA, with different products and application sites for each patient. In 1 patient, the injection was administered in the angle of the mandible, while in the other, it was administered in the zygomatic region. The injection sites were monitored via ultrasonography at 24 hours, 30 days, and 180 days, at which times the imaging characteristics of the filler were observed. All injections were performed by the same professional, as were the ultrasound exams, which were conducted using the same equipment. RESULTS: In both cases, the HA fillers were visualized using ultrasound at all time points. Some differences were observed between the cases in the images and the distribution of the pockets of filler. In 1 case, the filler appeared as a dark hypoechoic region with well-defined contours, and the material was observed to have moved posteriorly by the 180-day mark. In the other case, the material appeared hyperechoic relative to the previous case and presented no noticeable changes in its anteroposterior distribution over time. CONCLUSION: Based on these 2 cases, ultrasonography can be a complementary tool used to monitor facial fillers over the long term, allowing for the dynamic observation of different fillers.

Comparação entre as técnicas de raspagem e alisamento radicular e desbridamento ultrassônico no protocolo de desinfecção de boca toda: relato de caso / Comparison between scaling and root planing and ultrasonic debridement techniques in the full mouth disinfection protocol: case report

O tratamento periodontal consiste na remoção do biofilme patogênico, através da raspagem e alisamento radicular. O desbridamento ultrassônico de boca toda promove uma instrumentação mais conservadora, porém eficiente da superfície radicular, em sessão única. Evitando a translocação bacteriana de uma região tratada para outra que já foi. O objetivo do presente trabalho foi realizar uma comparação entre a eficácia da raspagem manual e a ultrassônica dentro do protocolo da FMD, através de um relato de caso clínico. Houve uma melhora nos parâmetros clínicos periodontais em todos os quadrantes, porém resultados superiores foram observados com o desbridamento com ultrassom e irrigação com clorexidina. A instrumentação com ultrassom associada a clorexidina no tratamento da periodontite estágio III grau C generalizada, reduz com eficácia o tempo de tratamento, otimizando o tempo do paciente e profissional(AU)

Periodontal treatment consists of removing the pathogenic biofilm, by scaling and root planing. Ultrasonic debridement of the entire mouth promotes more conservative, yet efficient instrumentation of the root surface, in a single session. Avoiding bacterial translocation from one treated region to another that has already been. The objective of the present study was to make a comparison between the effectiveness of manual and ultrasonic scraping within the FMD protocol, through a clinical case report. There was an improvement in periodontal clinical parameters in all quadrants, but superior results were observed with debridement with ultrasound and irrigation with chlorhexidine. Instrumentation with ultrasound associated with chlorhexidine in the treatment of generalized stage III grade C periodontitis, effectively reduces treatment time, optimizing patient and professional time(AU)

Manifestações orais do Covid-19: uma breve revisão da literatura / Oral manifestations of Covid-19: a brief review of the literature

A pandemia gerada pelo SARS-CoV-2 gerou uma série de estudos sobre essa nova doença. Este cenário proporcionou mudanças na odontologia, modificando a forma de atendimento e a rotina do consultório. O conhecimento sobre as implicações desse vírus no sistema estomatognático pode fornecer informações valiosas no conhecimento sobre o mecanismo dessa doença na cavidade oral. Dessa forma, foi realizada uma revisão de literatura, a fim de discutir os efeitos do COVID-19 na cavidade oral. No entanto, há poucas evidências na literatura sobre a correlação da COVID-19 e manifestações orais. Pode-se concluir que o vírus possui reflexo na cavidade oral, apresentando diferentes alterações, tais como: úlceras, periodontite, alterações do paladar, infecções oportunistas, dentre outras. Ainda se faz necessária a realização de mais estudos, para compreensão dos mecanismos fisiopatológicos da doença. Além disso, o trabalho ressalta a importância do cirurgião-dentista no ambiente hospitalar, para diagnóstico e conduta no tratamento dessas manifestações na cavidade oral(AU)

The SARS-CoV-2 pandemic has spawned several studies on this new disease. This scenario provided changes in Dentistry by modifying the form of care and the routine of the office. The knowledge about the implications of this virus in the stomatognathic system can provide valuable information in the knowledge about the mechanism of this disease in the oral cavity. Thus, a literature review was carried out to discuss the effects of COVID-19 on the oral cavity. However, there is little evidence in the literature about the correlation between COVID-19 and oral manifestations. It can be concluded that the virus is reflected in the oral cavity, such as ulcers, periodontitis, changes in taste, opportunistic infections, among others. Further studies are still needed to understand the pathophysiological mechanisms of the disease. Besides, the work highlights the importance of the Dental Surgeon in the hospital environment for diagnosis and management in the treatment of these manifestations in the oral cavity(AU)

Planejamento digital para cirurgia de aumento de coroa clínico estético: relato de caso / Digital planning for aesthetic clinical crown increase surgery: case report

A exposição excessiva de gengiva durante o sorriso é denominada como sorriso gengival. O fator etiológico dessa alteração é variado e sua identificação é fundamental para confecção de um plano de tratamento eficaz. O planejamento clínico pode ser realizado utilizando uma abordagem dinâmica e digital do sorriso. Sendo assim, software, exames imaginológicos, modelo virtual 3D e guia cirúrgico aumentam a qualidade e a precisão do tratamento, trazendo inúmeros benefícios para o paciente. Objetivo: demonstrar a importância do fluxo digital no planejamento e na correção do sorriso gengival. Relato de caso: paciente apresentou queixas em relação ao tamanho dos dentes e ao excesso de exposição de gengiva durante o sorriso. Após exames clínico e radiográfico, foi possível realizar o diagnóstico do fator etiológico como erupção passiva alterada (EPA). O tratamento de escolha foi o recontorno gengival associado à realização de osteotomia e osteoplastia. Para uma maior precisão do tratamento, foi confeccionado um guia cirúrgico duplo. Após o procedimento, a paciente foi orientada e medicada. Considerações finais: a abordagem digital do sorriso favoreceu um tratamento cirúrgico preciso, eficaz e satisfatório para a paciente, reestabelecendo assim a harmonia dento-gengivo-facial.(AU)

Excessive gum exposure during a smile is called a gum smile. The etiologic factor of this alteration is varied, the identification is essential to create an effective treatment plan. Clinical planning can be performed using a dynamic and digital smile approach. Therefore, software, imaging tests, 3D virtual model and the surgical guide increase the quality and precision of the treatment thus bringing numerous benefits to the patient. Objective: this case report aims to demonstrate the importance of digital flow in smile planning and correction of a gum smile. Case report: the patient presented complaints regarding tooth size and excessive gum exposure during the smile. After the clinical and radiographic examination, the etiological factor was diagnosed as an altered passive eruption (APE). The treatment of choice was the gingival contour associated with osteotomy and osteoplasty. For the precision of the treatment, a double surgical guide was made. After the procedure the patient was guided and medicated. Conclusion: the digital smile approach favored an accurate, effective and satisfactory surgical treatment for the patient thus restoring the tooth-gingival-facial harmony.(AU)

Associação entre metilação do DNA e periodontite crônica: revisão de literatura / Association between DNA methylation and chronic periodontitis: literature review

A periodontite crônica (PC) é uma doença bucal caracterizada pela presença de bactérias que promovem a inflamação dos tecidos de suporte e inserção dos dentes, como resultado de complexas interações entre patógenos periodontais e a resposta imune do hospedeiro. A PC é multifatorial e os fatores envolvidos com a regulação gênica podem interferir na predisposição ao aparecimento dos sinais e sintomas da doença. Neste contexto estão os mecanismos epigenéticos caracterizados por modificação na expressão dos genes sem afetar a sequência do DNA. As principais evidências de alterações epigenéticas na PC se relacionam à análise do perfil de metilação em genes relacionados à resposta imunoinflamatória. A metilação do DNA é um mecanismo epigenético caracterizado pela adição de um grupo metil no carbono 5' do anel de citosina, inibindo efetivamente a transcrição gênica. O objetivo do estudo foi revisar a literatura sobre a metilação do DNA na PC e avaliar sua associação com a patogênese da doença. Foi realizada uma busca na base de dados (Pubmed), sem restrição de ano e/ou idioma, utilizando os seguintes descritores: (Methylation [MeSh] OR Methylation OR DNA methylation [MeSh] OR DNA methylation) and (Chronic periodontitis [Mesh] OR Chronic periodontitis). Apesar dos estudos epigenéticos em doença periodontal ainda serem escassos, com diversos pontos a serem elucidados, os achados sugerem o envolvimento da metilação do DNA em genes da resposta imunoinflamatória na patogênese da PC. (AU)

Chronic periodontitis (CP) is an oral disease characterized by the presence of bacteria that promote inflammation of the supporting tissues of the teeth, as a result of complex interactions between periodontal pathogens and the host immune response. The CP is multifactorial and the factors involved in gene regulation may interfere with the predisposition on the appearance of the signs and symptoms of the disease. In this context it has been observed the epigenetic mechanism characterized by change ingene expression without affecting the sequence of DNA. The main evidence of epigenetic changes in CP are related to the analysis of the methylation profile in genes involved with the immune response. DNA methylation is an epigenetic mechanism characterized by the addition of a methyl group on the 5' carbon of the cytosine ring, effectively inhibiting the gene transcription. The aim of this study was to review the literature on DNA methylation in CP and evaluate its association with the pathogenesis of the disease. The search was performed in the database (Pubmed) without year or language restriction restriction, using the following key words: (Methylation [MeSh] OR Methylation OR DNA methylation [MeSh] OR DNA methylation) and (Chronic periodontitis [Mesh] OR Chronic periodontitis). Despite the epigenetic studies on periodontal disease are still scarce, with several points to be elucidated, the findings suggest the involvement of DNA methylation in immune response genes in the pathogenesis of CP (AU)