ABSTRACT
Background: Symptomatic patients with COVID-19 typically have a high SARS-CoV-2 viral load in their saliva. Procedures to reduce the viral load in their oral cavity are important for mitigating the viral transmission. Methods: This randomized clinical trial investigated the impact of two mouthwashes (0.075% cetylpyridinium chloride plus 0.28% zinc lactate (CPC+Zn) (n = 32), and 0.075% cetylpyridinium chloride (CPC) (n = 31)) on the viral load of SARS-CoV-2 in saliva when compared to the distilled water negative control (n = 32). Saliva was collected before (T0) and after (5 min, T1; 30 min, T2; and 60 min, T3) the intervention. Viral load in saliva was measured by qRT-PCR assays. The data in both groups was normalized for T0 and Negative Control, resulting in fold change values. Results: CPC+Zn oral solution reduced the viral load in saliva by 6.34-fold at T1, 3.6-fold at T2 and 1.9-fold at T3. Rinsing with the CPC mouthwash reduced the viral load in saliva by 2.5-fold at T1, 1.9-fold at T2 and 2.0-fold at T3. Conclusion: CPC+Zn mouthwash or with the CPC mouthwash reduced the viral load in saliva of COVID-19 patients immediately after rinsing. These reductions extended up to 60 min.
Subject(s)
Anti-Infective Agents, Local , COVID-19 , Humans , Cetylpyridinium , Mouthwashes , Saliva , SARS-CoV-2 , Viral LoadABSTRACT
Os cuidados gerais relativos ao paciente submetido ao transplante de medula óssea (TMO) incluem avaliações odontológicas rotineiras, as quais devem estar inseridas em um contexto multiprofissional. A cavidade oral constitui um sítio propício a infecções com grande potencial de desenvolvimento de bacteremia, sendo que lesões infecciosas devem ser previamente tratadas e controladas pelo cirurgião-dentista. O objetivo desta revisão é discutir questões em destaque na literatura nacional e internacional referentes aos quadros inflamatórios e infecciosos orais de importância para o paciente transplantado de medula óssea, tanto os predisponentes a complicações durante o transplante, quanto os que ocorrem durante e após a terapia mielossupressora. Destaca-se na literatura a doença periodontal avançada, a qual constitui um quadro infeccioso crônico que deve ser evitado ou controlado durante o TMO, principalmente devido à presença de S. viridans. Os fatores de risco para mucosite oral (OM), doença do enxerto contra o hospedeiro (DECH) e xerostomia ainda não estão definidos, principalmente para OM e DECH. São citadas na literatura alternativas promissoras de tratamento para OM, tais como crioterapia, administração de fatores de crescimento e laserterapia. O risco aumentado de cárie é controverso e, dentre as lesões fúngicas e virais, destacam-se as infecções orais e de orofaringe por Candida e pela família de herpesvírus, de importância clínica considerável. Em pacientes pediátricos são relevantes as alterações craniofaciais e dentárias, decorrentes principalmente da radioterapia.
General care in bone marrow transplant (BMT) patients includes routine dental evaluations, which must be included in a multi-professional context. The oral cavity is a site that favors infections with high potential for consequent bacteremia and so infectious lesions must be treated or controlled by the dentist. The aim of this review is to discuss key questions in national and international literature with reference to oral inflammatory conditions of BMT patients, both those with predisposition to complications during the transplant and those that emerge during and after myelosuppression therapy. The literature emphasizes advanced periodontal disease, which is a chronic infectious condition that must be avoided or controlled during BMT, particularly because of the presence of S. viridans. The risk factors for oral mucositis, graft-versus-host disease (GVHD) and xerostomia have not yet been defined, particularly for oral mucositis and GVHD. Promising alternatives in the treatment of oral mucositis, including cryotherapy, administration of growth factors and laser therapy, are emphatically mentioned. In children, craniofacial and dental alterations, particularly resulting from radiotherapy are relevant. The increased risk of caries is controversial, and among fungal and viral lesions, oral and oropharyngeal infections by Candida and the herpes virus are identified as being of considerable clinical importance.
Subject(s)
Bone Marrow Transplantation , Oropharynx , Periodontal Diseases , Stomatitis , Family , Oral Health , Risk Factors , Bone Marrow Transplantation , Bacteremia , Cryotherapy , Intercellular Signaling Peptides and Proteins , Laser Therapy , Graft vs Host Disease , Infections , MouthABSTRACT
OBJECTIVE: This in vitro study evaluated the influence of both Er:YAG and Nd:YAG laser irradiation on deciduous enamel demineralization. BACKGROUND DATA: Although there are still few studies on the use of the high-intensity laser for caries prevention in deciduous teeth, it is believed that its use on the dental structure can lead to a more acid-resistant surface. METHODS: Forty enamel samples obtained from 22 deciduous first molar teeth were ground and randomly divided into four groups (n = 10): group 1 (G1), no treatment (negative control); G2, fluoride (positive control); G3, Er:YAG laser (2 Hz, 60 mJ, 40.3 J/cm(2)); G4, Nd:YAG laser (80 mJ, 10 Hz, 0.8 W). After the surface treatment, the samples were submitted to an acid challenge that consisted of a 5-day immersion in demineralizing (3 h) and remineralizing solution (21 h). Next, a microhardness test was preformed. RESULTS: Analysis of variance (ANOVA) and Student Newman Keuls tests were performed (alpha = 5%). The percentage of lesion inhibition for each group was as follows: G2, 59.4%; G3, 35.7%; and G4, 40.4%. As regards the percentage loss of mineral volume, there was no statistical difference between groups G2 (444.37 +/- 146.42) and G3 (441.81 +/- 207.08) when compared with group G1 (281.03 +/- 134.57). All experimental groups presented a lower mineral loss compared with the non-irradiated samples (G4). CONCLUSION: The findings of the present study revealed that both Nd:YAG and Er:YAG lasers can be an alternative tool for enhancing deciduous enamel acid resistance.