THE METHOD OF ASSESSING THE DEGREE OF GLOSSOPTOSIS ACCORDING TO CLINICAL AND X-RAY ANTHROPOMETRICAL PREDICTORS: CLINICAL GUIDELINES.

The article provides a description of the clinical application of the authors' method of quantitative assessment of the degree of severity of glossoptosis based on clinical and X-ray anthropometric indicators (predictors). In the presentation of the scale for assessing clinical predictors (head position, shape of the palate, frenulum of the tongue, posture of the tongue by dr. John Mew, size of the palate), functional predictors (functional test with a bucket of water, index of degree of difficulty of tracheal intubation by dr. Seshagiri Rao Mallampati, degree of tongue elevation impairment for dr. S. Zaghi), X-ray - anthropometric indicators, (assessment of the position of the hyoid cyst along the C3-RGn line, type of slit growth). Each predictor was assessed by the number of scores. The sum of points according to all criteria indicated the level of importance of glossoptosis: mild severity - 0-20 points; moderate severity - 21-48 points; severe - 49 - 76 points. The algorithm for assessing the stage of glossoptosis is illustrated with a clinical case. The aim of the study - to improve the diagnosis of glossoptosis by determining clinical and X-ray anthropometric predictors of quantitative assessment of its severity. Results and discussion. As a result of the analysis of literature data and our own clinical studies, we have developed a methodology for the quantitative assessment of glossoptosis based on clinical and X-ray anthropometric predictors, namely: clinical predictors (head position, palate shape, tongue frenulum, tongue posture according to John Mew, the size of the palatine tonsils), functional predictors (functional test with a sip of water, the difficulty index of tracheal intubation according to Mallampati, the degree of tongue elevation according to S. Zaghi), X-ray - anthropometric predictors (estimation of the position of the hyoid bone relative to the C3-RGn line, type jaw growth) Conclusions. As a result of the analysis of special literature over the last 10 years and the conducted own clinical and additional examinations of 168 patients, a method of quantitative assessment of the severity of glossoptosis based on clinical and X-ray anthropometric indicators (predictors) was developed. It allows not only to detect the presence of glossoptosis, but also to quantitatively assess its severity: light - 0-20 points; average - 21-48 points; difficult - 49 - 76 points. What will allow us to plan orthodontic treatment, individualize myofunctional correction programs and motivate parents for successful cooperation with the doctor during the active period and during the retention period.

Effect of Tongue Position on Facial Morphology of Pakistani Adults and Different Growth Patterns.

OBJECTIVE:  To determine the effect of tongue position on facial morphology of Pakistani adults and different growth patterns. STUDY DESIGN:  Cross-sectional study. Place and Duration of the Study: Department of Orthodontics, Karachi Medical and Dental College, Karachi, Pakistan, from January to April 2021. METHODOLOGY:  The study included individuals aged 17 to 30 years with no history of prior orthodontic treatment, absence of wound, burn, or scar tissue in the neck region, comfortable breathing through the nose, absence of deglutition disorder, and a skeletal Class I or II relationship. The exclusion criteria were a cleft lip or palate, or a history of chronic mouth breathing, snoring, or tonsillectomy. According to their skeletal relationships, the subjects were split into three groups; Group I (low-angle), Group II (normal growth), and Group III (high-angle). Vertical growth pattern was assessed on radiograph by interpreting the values of NS / ML (nasion-sella / mandibular plane) angle, and angle formed between FH / ML (Frankfort horizontal plane / mandibular plane). A predesigned proforma was used to record all the measurements made on pre-treatment lateral cephalograms by the sole investigator. Data were analysed using SPSS 24.0. RESULTS:  Data from the lateral cephalogram of 79 patients, consisting of 18 (22.8%) males and 61 (77.2%) females who met the inclusion criteria, were analysed. The sample included 15 low-angle, 45 normal vertical growth, and 19 high-angle cases. Fifty participants had Class I skeletal relationships, while 29 had Class II relationships. According to the ANOVA test, FH / ML and NS / ML measurements showed no statistically significant variations in tongue position and growth trends. CONCLUSION: There was no statistically significant difference between tongue position and facial morphology of Class I or II subjects with different vertical growth patterns. However, there was a statistically sufficient evidence showing the tongue height was greater in Class I skeletal relationship patients as compared to Class II skeletal cases (p = 0.008). KEY WORDS: Tongue position, Tongue space, Tongue length, Growth pattern.

Using Advanced Convolutional Neural Network Approaches to Reveal Patient Age, Gender, and Weight Based on Tongue Images.

The human tongue has been long believed to be a window to provide important insights into a patient's health in medicine. The present study introduced a novel approach to predict patient age, gender, and weight inferences based on tongue images using pretrained deep convolutional neural networks (CNNs). Our results demonstrated that the deep CNN models (e.g., ResNeXt) trained on dorsal tongue images produced excellent results for age prediction with a Pearson correlation coefficient of 0.71 and a mean absolute error (MAE) of 8.5 years. We also obtained an excellent classification of gender, with a mean accuracy of 80% and an AUC (area under the receiver operating characteristic curve) of 88%. ResNeXt model also obtained a moderate level of accuracy for weight prediction, with a Pearson correlation coefficient of 0.39 and a MAE of 9.06 kg. These findings support our hypothesis that the human tongue contains crucial information about a patient. This study demonstrated the feasibility of using the pretrained deep CNNs along with a large tongue image dataset to develop computational models to predict patient medical conditions for noninvasive, convenient, and inexpensive patient health monitoring and diagnosis.

An atypical gunshot suicide: a case report and a literature overview.

Background: Gunshot suicides are more common in those people who live in countries with greater cultural accessibility of firearms and whose weapon's availability and use are easier. In the case of suicide by firearm, the most typical site of the entrance hole is represented by the temple, the forehead or the submental region, while only in a smaller percentage of cases is intra-oral. Case report: We present a particular case of suicide of an 85-year-old man, using a single-charge, short-barrelled firearm. The shot was fired on contact, with the entrance hole located at the tongue. The bullet remained held inside the body and there was no exit hole on the skin. A rigorous and multidisciplinary methodological approach was adopted, including an accurate judicial inspection of the environment, an anamnestic collection, an autoptic procedure completed by macroscopic and microscopic examination of the entrance hole and internal organs, and a radiological examination. Conclusions: In cases of gunshot suicide involving the intra-oral region, the tongue is rarely affected. Normally, the victim points the weapon upwards and the bullet follows this direction. When the entrance hole is on an atypical site, and different from the skin, and the trajectory are inusual, the interpretation of the dynamic of the event is more complex. So, it is essential to conduct a complete investigation, including the information of the forensic examination, with the data emerged in autopsy, radiological and histological examination.

Manejo cirúrgico de ferimento auto-infligido por arma de fogo em região maxilofacial / Surgical management of self-inflicted injury by gun in the maxillofacial region

INTRODUÇÃO: O manejo dos pacientes vítimas de PAF possui vertentes divergentes a respeito do tratamento cirúrgico, que pode ser realizado de forma imedata ou tardia. Em lesões auto-infligidas, a distância entre a arma e a região acometida é menor, causando consequências estéticas e funcionais mais devastadoras. Aliado ao fato desse tipo de trauma criar uma ferida suja devido à comunicação com a cavidade oral e seios paranasais, o manejo das lesões representam um desafio mesmo à cirurgiões experientes. OBJETIVO: Estre trabalho relata o manejo cirúrgico de uma ferida auto-infligida por arma de fogo que resultou em avulsão dos tecidos moles na região maxilofacial. DESCRIÇÃO DO CASO: Paciente do sexo masculino, 35 anos, vítima de projétil de arma de fogo auto-infligido em região maxilofacial, cursando com extenso ferimento em região de língua e mento. Clinicamente, o paciente não apresentava sinais de fratura em ossos da face. Ambos os ferimentos apresentavam secreção purulenta e o paciente manifestava disfonia devido a grande destruição tecidual. CONSIDERAÇÕES FINAIS: O tratamento de ferimentos por arma de fogo não só é um grande desafio para o cirurgião, como para toda a equipe multidisciplinar requerida para tais casos, visto que não há protocolos bem definidos para o tratamento dessas lesões(AU)

INTRODUCTION: The management of patients who are victims of FAP has divergent aspects regarding surgical treatment, which can be performed immediately or late. In self-inflicted injuries, the distance between the weapon and the affected region is smaller, causing more devastating aesthetic and functional consequences. Allied to the fact that this type of trauma creates a dirty wound due to the communication with the oral cavity and paranasal sinuses, the management of injuries represents a challenge even for experienced surgeons. OBJECTIVE: This paper reports the surgical management of a self-inflicted gunshot wound that resulted in soft tissue avulsion in the maxillofacial region. CASE DESCRIPTION: Male patient, 35 years old, victim of a self-inflicted firearm projectile in the maxillofacial region, coursing with extensive injury in the region of the tongue and chin. Clinically, the patient did not show signs of facial bone fractures. Both wounds had purulent secretion and the patient had dysphonia due to extensive tissue destruction. FINAL CONSIDERATIONS: The treatment of gunshot wounds is not only a great challenge for the surgeon, but also for the entire multidisciplinary team required for such cases, since there are no well-defined protocols for the treatment of these injuries(AU)

An analysis on efficacy of applying ß-elemene intervention on chemically -induced tongue lesions using SAM algorithm.

An artificial intelligence (AI) model was designed to assist pathologists in diagnosing and quantifying structural changes in tongue lesions induced by chemical carcinogens. Using a tongue cancer model induced by 4-nitroquinoline-N-oxide and treated with ß-elemene, a total of 183 digital pathology slides were processed. The Segment Anything Model (SAM) was employed for initial segmentation, followed by conventional algorithms for more detailed segmentation. The epithelial contour area was computed using OpenCV's findcontour method, and the skeletonize method was used to calculate the distance map and skeletonized representation. The AI model demonstrated high accuracy in measuring tongue epithelial thickness and the number of papilla-like protrusions. Results indicated that the model group had significantly higher epithelial thickness and fewer papillae compared with the blank group. Furthermore, the treatment group exhibited reduced epithelial thickness and fewer papilla-like protrusions compared with the model group, though these differences were less pronounced. Overall, the SAM framework algorithm proved effective in quantifying tongue epithelial thickness and the number of papilla-like protrusions, thereby assisting healthcare professionals in understanding pathological changes and assessing treatment outcomes.

A Novel Tongue Coating Segmentation Method Based on Improved TransUNet.

BACKGROUND: As an important part of the tongue, the tongue coating is closely associated with different disorders and has major diagnostic benefits. This study aims to construct a neural network model that can perform complex tongue coating segmentation. This addresses the issue of tongue coating segmentation in intelligent tongue diagnosis automation. METHOD: This work proposes an improved TransUNet to segment the tongue coating. We introduced a transformer as a self-attention mechanism to capture the semantic information in the high-level features of the encoder. At the same time, the subtraction feature pyramid (SFP) and visual regional enhancer (VRE) were constructed to minimize the redundant information transmitted by skip connections and improve the spatial detail information in the low-level features of the encoder. RESULTS: Comparative and ablation experimental findings indicate that our model has an accuracy of 96.36%, a precision of 96.26%, a dice of 96.76%, a recall of 97.43%, and an IoU of 93.81%. Unlike the reference model, our model achieves the best segmentation effect. CONCLUSION: The improved TransUNet proposed here can achieve precise segmentation of complex tongue images. This provides an effective technique for the automatic extraction in images of the tongue coating, contributing to the automation and accuracy of tongue diagnosis.

Tongue-on-a-Chip: Parallel Recording of Sweet and Bitter Receptor Responses to Sequential Injections of Pure and Mixed Sweeteners.

A microfluidic tongue-on-a-chip platform has been evaluated relative to the known sensory properties of various sweeteners. Analogous metrics of typical sensory features reported by human panels such as sweet taste thresholds, onset, and lingering, as well as bitter off-flavor and blocking interactions were deduced from the taste receptor activation curves and then compared. To this end, a flow cell containing a receptor cell array bearing the sweet and six bitter taste receptors was transiently exposed to pure and mixed sweetener samples. The sample concentration gradient across time was separately characterized by the injection of fluorescein dye. Subsequently, cellular calcium responses to different doses of advantame, aspartame, saccharine, and sucrose were overlaid with the concentration gradient. Parameters describing the response kinetics compared to the gradient were quantified. Advantame at 15 µM recorded a significantly faster sweetness onset of 5 ± 2 s and a longer lingering time of 39 s relative to sucrose at 100 mM with an onset of 13 ± 2 s and a lingering time of 6 s. Saccharine was shown to activate the bitter receptors TAS2R8, TAS2R31, and TAS2R43, confirming its known off-flavor, whereas addition of cyclamate reduced or blocked this saccharine bitter response. The potential of using this tongue-on-a-chip to bridge the gap with in vitro assays and taste panels is discussed.

S5Utis: Structured State-Space Sequence SegNeXt UNet-like Tongue Image Segmentation in Traditional Chinese Medicine.

Intelligent Traditional Chinese Medicine can provide people with a convenient way to participate in daily health care. The ease of acceptance of Traditional Chinese Medicine is also a major advantage in promoting health management. In Traditional Chinese Medicine, tongue imaging is an important step in the examination process. The segmentation and processing of the tongue image directly affects the results of intelligent Traditional Chinese Medicine diagnosis. As intelligent Traditional Chinese Medicine continues to develop, remote diagnosis and patient participation will play important roles. Smartphone sensor cameras can provide irreplaceable data collection capabilities in enhancing interaction in smart Traditional Chinese Medicine. However, these factors lead to differences in the size and quality of the captured images due to factors such as differences in shooting equipment, professionalism of the photographer, and the subject's cooperation. Most current tongue image segmentation algorithms are based on data collected by professional tongue diagnosis instruments in standard environments, and are not able to demonstrate the tongue image segmentation effect in complex environments. Therefore, we propose a segmentation algorithm for tongue images collected in complex multi-device and multi-user environments. We use convolutional attention and extend state space models to the 2D environment in the encoder. Then, cross-layer connection fusion is used in the decoder part to fuse shallow texture and deep semantic features. Through segmentation experiments on tongue image datasets collected by patients and doctors in real-world settings, our algorithm significantly improves segmentation performance and accuracy.

Comparison between head rotation and standard techniques for i-gel™ insertion: a randomized controlled trial.

BACKGROUND: This study evaluated the effect of head rotation on the first-attempt success rate of i-gel insertion, aiming to alleviate the effect of gravity on the tongue and reduce resistance between the device and the tongue. METHODS: Adult surgical patients were randomized to standard and head rotation technique groups. In the head rotation technique group, patients' heads were maximally rotated to the left before i-gel insertion. The primary endpoint was the first-attempt success rate. Secondary endpoints included the success rate within two attempts (using the allocated technique), time required for successful i-gel placement within two attempts, and success rate at the third attempt (using the opposite technique). RESULTS: Among 158 patients, the head rotation technique group showed a significantly higher first-attempt success rate (60/80, 75.0%) compared to the standard technique group (45/78, 57.7%; P = 0.021). The success rate within two attempts was similar between the groups (95.0% vs. 91.0%, P = 0.326). The time required for successful i-gel placement was significantly shorter in the head rotation technique (mean [SD], 13.4 [3.7] s vs. 16.3 [7.8] s; P = 0.030). When the head rotation technique failed, the standard technique also failed in all cases (n = 4), whereas the head rotation technique succeeded in five out of the seven patients where the standard technique failed. CONCLUSIONS: The head rotation technique significantly improved the first-attempt success rate and reduced the time required for successful i-gel insertion. It was effective when the standard technique failed. The head rotation technique may be an effective primary or alternative method for i-gel insertion. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT05201339).

Severe acute respiratory syndrome coronavirus 2 pathology and cell tropism in tongue tissues of COVID-19 autopsies.

Since 2019, Coronavirus Disease 2019(COVID-19) has affected millions of people worldwide. Except for acute respiratory distress syndrome, dysgeusis is also a common symptom of COVID-19 that burdens patients for weeks or permanently. However, the mechanisms underlying taste dysfunctions remain unclear. Here, we performed complete autopsies of five patients who died of COVID-19. Integrated tongue samples, including numerous taste buds, salivary glands, vessels, and nerves were collected to map the pathology, distribution, cell tropism, and receptor distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the tongue. Our results revealed that all patients had moderate lymphocyte infiltration around the salivary glands and in the lamina propria adjacent to the mucosa, and pyknosis in the epithelia of taste buds and salivary glands. This may be because the serous acini, salivary gland ducts, and taste buds are the primary sites of SARS-CoV-2 infection. Multicolor immunofluorescence showed that SARS-CoV-2 readily infects Keratin (KRT)7+ taste receptor cells in taste buds, secretory cells in serous acini, and inner epithelial cells in the ducts. The major receptors, angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2), were both abundantly expressed in these cells. Viral antigens and receptor were both rarely detected in vessels and nerves. This indicates that SARS-CoV-2 infection triggers pathological injury in the tongue, and that dysgeusis may be directly related to viral infection and cellular damage.

Interexaminer agreement among pediatric dental specialists in assessment of tonsil size, Friedman tongue position, and Friedman staging of obstructive sleep apnea in children: An observational study.

BACKGROUND: The evaluation of tonsil size, Friedman Tongue Position (FTP), and Friedman staging in pediatric obstructive sleep apnea (OSA) holds significant clinical importance, offering manifold advantages in diagnosis and surgical management. AIMS AND OBJECTIVES: This study aimed to assess the reliability of pediatric OSA evaluation by determining inter-examiner agreement among pediatric dental specialists. MATERIALS AND METHODS: Conducted at the Department of Pediatric Dentistry, PMS College of Dental Science and Research Hospital (2023-2024), this observational study utilized conventional consulting rooms, headlights, and examination chairs. Thirteen medical practitioners reviewed video recordings of the oropharyngeal regions of twelve pediatric patients exhibiting mouth breathing. Friedman staging was determined based on tonsil size and tongue position gradings.Inter-examiner agreement was evaluated using Fleiss kappa analysis. RESULTS: Observers, including residents and practitioners in pediatric dentistry, demonstrated poor agreement regarding FTP and tonsil grading. CONCLUSION: Understanding the nuances of tonsil size and FTP in pediatric OSA evaluation, along with identifying avenues for refinement, can enhance medical decision-making among healthcare providers, including pediatric dentists.

Design and Test of an Intraoral Electrode Grid for Tongue High-Density Electromyography.

Tongue motor function is crucial in a wide range of basic activities and its impairment affects quality of life. The electrophysiological assessment of the tongue relies primarily on needle electromyography, which is limited by its invasiveness and inability to capture the concurrent activity of the different tongue muscles. This work aimed at developing an intraoral grid for high-density surface electromyography (HDsEMG) to non-invasively map the electrical excitation of tongue muscles. We developed a grid of 4×8 electrodes deposited over an adhesive 8- µ m thick polyurethane membrane. The testing protocol was conducted on 7 healthy participants and included functional tasks (vowels articulation and tongue movements) aimed at activating different regions of the tongue. The electrical stability of contact was assessed by measuring electrode-tongue impedances before and after the tasks. The spatial amplitude distribution of global EMG and single motor unit action potentials (MUAPs) was characterized. Electrode-tongue impedance magnitude showed no significant changes in the pre-post comparison ( 58±46 k Ω vs. 67±58 k Ω at 50Hz). Contact stability was confirmed by the quality of the signals that allowed to quantify spatiotemporal characteristics of muscle activation during the different tasks. The analysis of the spatial distribution of individual MUAPs amplitude showed that they were confined to relatively small areas on the tongue surface (range: 0.5cm2 -3.9cm [Formula: see text]. A variety of different spatiotemporal MUAP patterns, likely due to the presence of different muscle compartments with different fiber orientations, were observed. Our results demonstrate that the developed electrode grid enables HDsEMG acquisition from the tongue during functional tasks, thus opening new possibilities in tongue muscle assessment both at global and single motor unit level.

Tongue orthotopic xenografts to study fusion-negative rhabdomyosarcoma invasion and metastasis in live animals.

PAX3/7 fusion-negative rhabdomyosarcoma (FN-RMS) is a childhood mesodermal lineage malignancy with a poor prognosis for metastatic or relapsed cases. Limited understanding of advanced FN-RMS is partially attributed to the absence of sequential invasion and dissemination events and the challenge in studying cell behavior, using, for example, non-invasive intravital microscopy (IVM), in currently used xenograft models. Here, we developed an orthotopic tongue xenograft model of FN-RMS to study cell behavior and the molecular basis of invasion and metastasis using IVM. FN-RMS cells are retained in the tongue and invade locally into muscle mysial spaces and vascular lumen, with evidence of hematogenous dissemination to the lungs and lymphatic dissemination to lymph nodes. Using IVM of tongue xenografts reveals shifts in cellular phenotype, migration to blood and lymphatic vessels, and lymphatic intravasation. Insight from this model into tumor invasion and metastasis at the tissue, cellular, and subcellular level can guide new therapeutic avenues for advanced FN-RMS.

Association between swallowing dynamics, tongue pressure and pulmonary function in patients with idiopathic pulmonary fibrosis.

BACKGROUND: Swallowing is a complex process that requires the coordination of muscles in the mouth, pharynx, larynx, and esophagus. Dysphagia occurs when a person has difficulty swallowing. In the case of subjects with respiratory diseases, the presence of oropharyngeal dysphagia potentially increases lung disease exacerbations, which can lead to a rapid decline in lung function. This study aimed to analyze the swallowing of patients with idiopathic pulmonary fibrosis (IPF). METHODS: Patients with IPF were evaluated using the Eating Assessment Tool (EAT-10), tongue pressure, the Timed Water Swallow Test (TWST), and the Test of Mastication and Swallowing Solids (TOMASS). The findings were related to dyspnea severity assessed by the modified Medical Research Counsil (mMRC) score; the nutritional status screened with Mini Nutritional Assessment (MNA) tool; and pulmonary function tests, specifically spirometry and measurement of the diffusing capacity for carbon monoxide (DLCO), the maximal inspiratory pressure (PImax), and the maximal expiratory pressure (PEmax). RESULTS: The sample consisted of 34 individuals with IPF. Those who exhibited swallowing modifications scored lower on the MNA than those who did not (9.6 ± 0.76 vs. 11.64 ± 0.41 points; mean difference 1.98 ± 0.81 points; p = 0.02). They also showed poorer lung function when considering the predicted force vital capacity (FVC; 81.5% ± 4.61% vs. 61.87% ± 8.48%; mean difference 19.63% ± 9.02%; p = 0.03). The speed of liquid swallowing was altered in 31of 34 of the evaluated subjects (91.1%). The number of liquid swallows correlated significantly with the forced expiratory volume in 1 s (FEV1)/FVC ratio (r = 0.3; p = 0.02). Solid eating and swallowing assessed with the TOMASS score correlated with lung function. The number of chewing cycles correlated negatively with PImax% predicted (r = -0.4; p = 0.0008) and PEmax% predicted (r = -0.3; p = 0.02). FVC% predicted correlated with increased solid swallowing time (r = -0.3; p = 0.02; power = 0.6). Swallowing solids was also impacted by dyspnea. CONCLUSION: Patients with mild-to-moderate IPF can present feeding adaptations, which can be related to the nutritional status, lung function, and the severity of dyspnea.

Short term effect of antimicrobial photodynamic therapy and probiotic L. salivarius WB21 on halitosis: A controlled and randomized clinical trial.

OBJECTIVE: This study aimed to evaluate the effect of antimicrobial photodynamic therapy (aPDT) and the use of probiotics on the treatment of halitosis. METHODS: Fifty-two participants, aged from 18 to 25 years, exhaling sulfhydride (H2S) ≥ 112 ppb were selected. They were allocated into 4 groups (n = 13): Group 1: tongue scraper; Group 2: treated once with aPDT; Group 3: probiotic capsule containing Lactobacillus salivarius WB21 (6.7 x 108 CFU) and xylitol (280mg), 3 times a day after meals, for 14 days; Group 4: treated once with aPDT and with the probiotic capsule for 14 days. Halimetry with gas chromatography (clinical evaluation) and microbiological samples were collected from the dorsum of the tongue before and after aPDT, as well as after 7, 14, and 30 days. The clinical data failed to follow a normal distribution; therefore, comparisons were made using the Kruskal-Wallis test (independent measures) and Friedman ANOVA (dependent measures) followed by appropriate posthoc tests, when necessary. For the microbiological data, seeing as the data failed to follow a normal distribution, the Kruskal-Wallis rank sum test was performed with Dunn's post-test. The significance level was α = 0.05. RESULTS: Clinical results (halimetry) showed an immediate significant reduction in halitosis with aPDT (p = 0.0008) and/or tongue scraper (p = 0.0006). Probiotics showed no difference in relation to the initial levels (p = 0.7530). No significant differences were found in the control appointments. The amount of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were not altered throughout the analysis (p = 0.1616, p = 0.2829 and p = 0.2882, respectively). CONCLUSION: There was an immediate clinical reduction of halitosis with aPDT and tongue scraping, but there was no reduction in the number of bacteria throughout the study, or differences in the control times, both in the clinical and microbiological results. New clinical trials are necessary to better assess the tested therapies. TRIAL REGISTRATION: Clinical Trials NCT03996044.

Impaired metal perception and regulation of associated human foliate papillae tongue transcriptome in long-COVID-19.

Chemosensory impairment is an outstanding symptom of SARS-CoV-2 infections. We hypothesized that measured sensory impairments are accompanied by transcriptomic changes in the foliate papillae area of the tongue. Hospital personnel with known SARS-CoV-2 immunoglobulin G (IgG) status completed questionnaires on sensory perception (n = 158). A subcohort of n = 141 participated in forced choice taste tests, and n = 43 participants consented to donate tongue swabs of the foliate papillae area for whole transcriptome analysis. The study included four groups of participants differing in IgG levels (≥ 10 AU/mL = IgG+; < 10 AU/mL = IgG-) and self-reported sensory impairment (SSI±). IgG+ subjects not detecting metallic taste had higher IgG+ levels than IgG+ participants detecting iron gluconate (p = 0.03). Smell perception was the most impaired biological process in the transcriptome data from IgG+/SSI+ participants subjected to gene ontology enrichment. IgG+/SSI+ subjects demonstrated lower expression levels of 166 olfactory receptors (OR) and 9 taste associated receptors (TAS) of which OR1A2, OR2J2, OR1A1, OR5K1 and OR1G1, as well as TAS2R7 are linked to metallic perception. The question raised by this study is whether odorant receptors on the tongue (i) might play a role in metal sensation, and (ii) are potential targets for virus-initiated sensory impairments, which needs to be investigated in future functional studies.