Is saliva collected passively without forceful coughing sensitive to detect SARS-CoV-2 in ambulatory cases? A systematic review.

OBJECTIVE: This systematic review was conducted to assess the sensitivity rate of SARS-CoV-2 detection in the saliva of ambulatory asymptomatic and mildly symptomatic patients, with saliva being collected passively without any forceful coughing. STUDY DESIGN: A literature search was performed from January 2020 to July 2021. Prospective studies excluding letters to editors were included in our review only if saliva and nasopharyngeal samples were collected simultaneously and sensitivity was reported using reverse transcription polymerase chain reaction (RT-PCR) in asymptomatic or mildly symptomatic ambulatory cases. RESULTS: A total of 436 studies were assessed; 10 (4 cohorts and 6 cross-sectional) studies met our inclusion criteria. The sensitivity rate of saliva to detect SARS-CoV-2 varied from 85.7% to 98.6% in all except for 3 studies. Lower sensitivity levels were attributed to low viral load (51.9% and 63.8%) or lack of supervision while collecting saliva (66.7%). CONCLUSIONS: Passively collected saliva in the absence of coughing has a high sensitivity rate to detect SARS-CoV-2 in asymptomatic and mildly symptomatic patients compared with nasopharyngeal swabs. Limitations of previous studies, such as lack of attention to the method of saliva collection, stages, and severity of the disease at the time of sample collection, can be researched in future investigations.

Assessing the utility of serum C-telopeptide cross-link of type 1 collagen as a predictor of bisphosphonate-related osteonecrosis of the jaw: A systematic review and meta-analysis.

BACKGROUND: The authors of this systematic review and meta-analysis assessed the utility of serum C-telopeptide cross-link of type 1 collagen (sCTX), a biomarker of bone resorption, as a predictor of the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). TYPES OF STUDIES REVIEWED: The authors searched for studies involving adult participants, written in English, and published through January 20, 2016, using the following electronic databases: the Cochrane Library, MEDLINE via PubMed, and Web of Science. They also searched Google Scholar and the reference lists of all eligible trials and reviews. They identified 16 articles that met their inclusion criteria (9 controlled studies and 7 case series). They applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and meta-analyses. They independently extracted data in duplicate, including the characteristics of study participants, risk factors, control groups, and outcomes. They assessed risk of bias, and they resolved any disagreements between review authors through discussion. RESULTS: A meta-analysis with 9 controlled studies revealed no significant difference in mean sCTX values between patients with BRONJ and control participants (difference in means, -31.417; 95% confidence interval [CI], -91.560 to 28.726; P = .306). A second meta-analysis with 4 studies showed no significant difference in risk of having an sCTX value below 150 picograms per milliliter for patients with BRONJ compared with control participants (risk ratio, 1.892; 95% CI, 0.636-5.626; P = .251). CONCLUSIONS AND PRACTICAL IMPLICATIONS: A systematic review of the literature with meta-analysis does not support the use of sCTX levels as a predictor of the development of BRONJ. Further prospective large sample studies are needed to understand the role of sCTX as a predictor for BRONJ.

Gaucher disease with jawbone involvement: a case report.

INTRODUCTION: Gaucher disease is an autosomal recessive systemic condition, and the most common of the lysosomal storage disorders. It is characterized by lipid accumulation in certain cells and organs, particularly macrophages, which appear on light microscopy as 'Gaucher cells' or vacuolated lipid-laden reticuloendothelial cells. Long bone involvement is common in Gaucher disease, whereas craniofacial bone involvement is extremely rare. Reports confirming the diagnoses of Gaucher disease involving craniofacial bones by histopathologic evidence are even rarer. CASE PRESENTATION: A 46-year-old Caucasian Ashkenazi Jewish woman with Gaucher disease presented with jawbone pain and lytic radiographic lesions of her mandible. Surgical biopsy of a mandibular lesion revealed Gaucher cells infiltrating the mandible, which correlated with radiographic and clinical findings, supporting a diagnosis of Gaucher disease with jawbone involvement. CONCLUSIONS: Lysosomal storage diseases can have head and neck manifestations, and bone involvement in Gaucher disease is common. Therefore, careful consideration of signs and symptoms and medical history, with a thorough review of systems, is important when evaluating patients with lysosomal storage disorders to rule out head and neck involvement of disease. Biopsy may be warranted in some cases for more definitive diagnosis of painful jawbone lesions and to rule out other odontogenic and non-odontogenic conditions in the differential diagnosis.

Osseointegration of dental implants and osteonecrosis of the jaw in patients treated with bisphosphonate therapy: a systematic review.

Bisphosphonate (BP) drugs are a commonly prescribed group of medications used in the treatment of metabolic and oncologic bone disorders. The aim of this study was to conduct a systematic review in order to evaluate whether patients on BP therapy are appropriate candidates for dental implants as compared to patients not taking BP drugs with respect to successful implant osseointegration and the risk of developing bisphosphonate-related osteonecrosis of the jaw. Based on the current literature, a history of oral or intravenous BP use is not an absolute contraindication for dental implant placement, and dental implants can osseointegrate successfully in this patient population. Importantly, the studies currently available on this topic are of moderate to weak strength of evidence with inherent bias and limitations, and hence results must be interpreted in this context. Well-controlled studies with higher strength of evidence and larger population sizes are required to address this topic more accurately in the future.

Oral microflora in patients on hemodialysis and kidney transplant recipients.

INTRODUCTION: We aimed to determine oral microflora of patients on long-term hemodialysis and kidney transplant recipients, and to compare them with individuals without kidney disease. MATERIALS AND METHODS: We studied on 3 groups including patients on at least 6 months of hemodialysis, kidney transplant recipients for more than 2 years, and controls with a normal kidney function. Staining and culture were applied for samples from the dorsum of the tongue and the oral floor in order to detect aerobic and anaerobic bacteria and Candida. RESULTS: The participants were 49 patients on hemodialysis, 50 kidney transplant recipients, and 50 volunteers in the control group. The abundance of Candida was significantly higher in the hemodialysis and transplant groups compared with the control group. The mean of various microorganisms was found to be significantly higher in the hemodialysis group than the control group (P = .03); however, the frequency of these microorganisms in the transplant group was lower than that in the hemodialysis group. Adjusting for confounding factors, the odds of having Candida in the hemodialysis and transplant groups were 3.54 (95% CI, 1.21 to 10.41) and 3.49 (95% CI, 1.27 to 9.18) times higher compared to the control group, respectively. CONCLUSIONS: Hemodialysis and kidney transplantation could affect oral microflora. Candida was significantly more frequent in these patients compared to healthy adults. Streptococcus mutans, Lactobacilli, Porphyromonas, and Candida is seen slightly less frequently after kidney transplantation, which might be in favor of promising effects of kidney transplantation on oral microflora.

Comparison of superoxide dismutase activity in saliva of smokers and nonsmokers.

BACKGROUND: Considering the role of superoxide dismutase (SOD) as one of the most important salivary antioxidant enzymes, this study was performed to compare the level of this enzyme in smokers and nonsmokers. METHODS: Unstimulated saliva of 60 volunteers (30 smokers and 30 nonsmokers) was collected. The activity of salivary SOD was measured in each group and compared. RESULTS: The mean value of superoxide dismutase activity was significantly higher in the smoking group (P < 0.001), while no detectable activity level was found in nonsmokers. CONCLUSION: Cigarette smoke leads to an elevation in salivary superoxide dismutase activity.

Effect of Rowatinex on calculus clearance after extracorporeal shock wave lithotripsy.

INTRODUCTION: our aim was to evaluate the effect of Rowatinex, an essential oil preparation of terpenic type, on kidney calculi clearance after extracorporeal shock wave lithotripsy (SWL). MATERIALS AND METHODS: A randomized controlled trial was performed at Hormozgan Hospital in Bandar Abbas, Iran, on 100 patients with 10-mm to 20-mm kidney calculi. They underwent SWL, and then, they were randomly assigned into 2 groups to receive either Rowatinex, 100 mg, 3 times per day, or placebo after SWL. Patients were followed up with plain abdominal radiography, ultrasonography, and excretory urography (if required), 2 and 4 weeks postoperatively. RESULTS: Two weeks following SWL, 6 (12%) and 9 (18%) patients in the Rowatinex and control groups had fragmented calculi without clearance, 26 (52%) and 24 (48%) had less than 50% clearance, 9 (18%) and 15 (30%) had more than 50% but not total clearance, and 9 (18%) and 2 (4%) patients were stone free, respectively. Rowatinex had a significant effect on the stone-free rate (P = .02). Four weeks post-SWL, 3 (7.3%) and 7 (14.6%) other patients in the Rowatinex and control groups became stone free, respectively. Overall, Rowatinex had no significant effect on the stone-free rate (P = .46). No complications or differences between the two groups in symptoms and signs were reported. CONCLUSION: Rowatinex does not have a significant effect on clearance rate of kidney calculi after SWL. However, it can accelerate calculus passage after 2 weeks, and it does not have any significant adverse effects.