RESUMEN
Most public health measures to contain the COVID-19 pandemic are based on preventing the pathogen spread, and the use of oral antiseptics has been proposed as a strategy to reduce transmission risk. The aim of this manuscript is to test the efficacy of mouthwashes to reduce salivary viral load in vivo. This is a multi-centre, blinded, parallel-group, placebo-controlled randomised clinical trial that tests the effect of four mouthwashes (cetylpyridinium chloride, chlorhexidine, povidone-iodine and hydrogen peroxide) in SARS-CoV-2 salivary load measured by qPCR at baseline and 30, 60 and 120 min after the mouthrinse. A fifth group of patients used distilled water mouthrinse as a control. Eighty-four participants were recruited and divided into 12-15 per group. There were no statistically significant changes in salivary viral load after the use of the different mouthwashes. Although oral antiseptics have shown virucidal effects in vitro, our data show that salivary viral load in COVID-19 patients was not affected by the tested treatments. This could reflect that those mouthwashes are not effective in vivo, or that viral particles are not infective but viral RNA is still detected by PCR. Viral infectivity studies after the use of mouthwashes are therefore required. ( https://clinicaltrials.gov/ct2/show/NCT04707742 ; Identifier: NCT04707742).
Asunto(s)
Antiinfecciosos Locales/farmacología , Antisépticos Bucales/farmacología , SARS-CoV-2/efectos de los fármacos , Saliva/virología , Adolescente , Adulto , Anciano , Antiinfecciosos Locales/química , COVID-19/prevención & control , COVID-19/virología , Niño , Preescolar , Método Doble Ciego , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Antisépticos Bucales/química , Efecto Placebo , SARS-CoV-2/aislamiento & purificación , Carga Viral/efectos de los fármacos , Adulto JovenRESUMEN
OBJECTIVES: 1. - To measure the alveolar resorption processes that occur in patients wearing mandibular overdentures on 2 implants and fully-removable maxillary dentures, and to evaluate the same process on patients wearing fully-removable dentures on both arches. 2.- To verify whether Kelly's Combination Syndrome occurs in the group of patients wearing overdentures. METHOD AND MATERIAL: Forty patients were evaluated, of which a "cases" group was formed by 25 patients wearing mandibular overdentures on 2 lower jaw implants and fully-removable dentures on the opposite arch. The other 15 patients formed a control group that wore fully-removable dentures on both arches. Each one of the patients underwent orthopantograms from the moment the dentures were inserted until an average of 6 years later, which were assessed based on the Xie et al. method to estimate vertical bone loss. Once the data was collected, it was subjected to statistical analysis. RESULTS: In terms of the maxillary midline, we observed a greater loss in patients wearing overdentures, which was statistically significant, as it registered 0.32 mm/year. Mandibular bone loss was 2.5 times less in patients in the cases group. The rest of the clinical criteria for Kelly's Combination Syndrome were not observed. CONCLUSIONS: Kelly's Combination Syndrome did not occur in the patients in the cases group. In spite of the greater bone loss on a premaxillary level in this group, the placing of the overdenture on the implants significantly reduced mandibular bone resorption.