Correlation between use of different type protective facemasks and the oral ecosystem.

BACKGROUND: Spread worldwide through droplets, the Virus Sars-Cov-19 has caused a global health emergency alarm. In order to limit its spread, the use of masks has become part of the daily life of the entire population, however, little is known about its constant use and the changes generated in the oral cavity. This work aims to investigate correlations between the continuous use of masks covering the nose and mouth for 3 h and changes in the ecological factors of the oral cavity. METHODS: 34 volunteers were divided into 2 groups: wear only the filtering facepiece code 2 (FFP2) mask (Group A) and wear the FFP2 mask covered by a surgical mask (Group B). Measurement of Volatile Organic Compounds (VOCs), saliva rehydration and consistency test, collection of basal saliva and saliva stimulated with paraffin gum and mucosal swab were collected and analyzed at two times: before using the mask(s) (T0) and 3 h after continuous use of the mask(s) (T1). RESULTS: The results indicated a significant difference between the groups, in which the basal saliva volume and pH and the peaks of VOCs increased for group B between T0 and T1. The rehydration time decreased and the volume and pH of the stimulated saliva increased, but with no significant difference between the groups. Furthermore, group B showed a significant decrease in Candida albicans Colony Forming Units (CFUs) and Total Bacterial Count (TBC) between T0 and T1. CONCLUSION: It is concluded that the prolonged use of the FFP2 mask covered by a surgical mask can generate oral alterations in the user.

Perioperative Management of Antithrombotic Therapy in Patients Who Undergo Dental Procedures: A Systematic Review of the Literature and Network Meta-Analysis.

BACKGROUND: The surgical dental treatment of subjects admitted for anticoagulants therapy represents a consistent risk for peri-operative bleeding. The aim of the present study was to investigate the clinical findings of dental surgery operative management of the patients under anticoagulants drugs protocol. METHODS: The literature screening was performed using Pubmed/Medline, EMBASE and Cochrane library, considering only randomized clinical trials (RCTs) papers. No limitations about the publication's period, follow-up time or clinical parameters were considered. RESULTS: A total of eight RCTs were included for the qualitative synthesis. No thromboembolic complications were reported in any studies. Several bleeding episodes associated with anticoagulant drugs in dental surgery were mild and generally happened on the first day after the treatment. CONCLUSIONS: The use of local haemostatic measures is generally effective for bleeding control with no further pharmacological drug management or suspension.

Implant Survival in Patients with Chronic Kidney Disease: A Case Report and Systematic Review of the Literature.

BACKGROUND: The aim of this systematic review and case reports was to evaluate osseointegration and implant survival rate in patients with chronic kidney disease. METHODS: The paper screening process was conducted on electronic databases in order to identify clinical studies concerning the study topic. The literature data were evaluated for eligibility and studies were included for the qualitative synthesis. The case report concerned a male subject affected by renal disorders, a candidate for full arch immediate loading procedure. RESULTS: The article screening process reported a total of 54 manuscripts and one paper identified through the manual search. At the end of the review process, a total of 45 articles were excluded while nine manuscripts were included for the descriptive synthesis. No significant complications or events were present during the intraoperative/post-operative phases. The clinical course reported no significant inflammation or symptoms. At follow-up, the rehabilitation was found to be functionally and aesthetically integrated with no complications, probing, or bone resorption. CONCLUSIONS: The available evidence supports the clinical efficacy of the early implant placement protocol. Present findings indicate that the early implant placement protocol results in implant outcomes similar to immediate and delayed placement protocols and a superior stability of peri-implant hard tissue compared with immediate implant placement.

Implant surface roughness influences osteoclast proliferation and differentiation.

The osteoclast is a hematopoietic cell derived from CFU-GM and branches from the monocyte-macrophage lineage during the differentiation process. Biological environment appears to be crucial for osteoclast formation and activity. It has been reported that bone remodeling following implant placement requires a coordinated activity by osteoclasts and osteoblasts. The response of such cells at the bone-implant interface has been suggested to be affected by the structural and morphological features of the biomaterial surface. To shed more light on this topic we performed a multiparametric analysis of murine monocytes response to different titanium surfaces. These cells, RAW 264.7 type TIB-71, represent a very useful system because they differentiate into osteoclasts following treatment of definite doses of the osteoclast-differentiation factor RANKL and macrophage colony-stimulating factor (M-CSF). Cells, cultured on glass (control), on grade 3 machined and on titanium pull-spray superficial-TPSS surfaces disclosed profound different responses in terms of morphological rearrangements, adhesion, and differentiation abilities. Indeed, after 14 days, cells cultured on glass and machined surfaces were uniformly distributed, while, on the TPSS surface cells strictly aggregated into small isolated clusters were observed. In addition, cells cultured on the machined surface displayed a higher adhesion ability, while cells cultured on the rougher surface disclosed a more evident capability to differentiate. These results could explain the higher bone-implant contact percentage found around implants with rougher surfaces and suggest that osteoclasts may play an important role in the initial period after implant placement to prime or prepare the implant surface for the osteoblast activity.

Spreading of epithelial cells on machined and sandblasted titanium surfaces: an in vitro study.

BACKGROUND: The purpose of this investigation was to determine the influence of the surface structure of dental implants on epithelial cell spreading and growth in vitro. Cell morphology on machined and sandblasted titanium surfaces was investigated. METHODS: A total of 10 machined and 10 sandblasted discs and 10 glass coverslips were used for the present study. Samples were analyzed using scanning electron microscopy (SEM) and the cell spreading area was determined using a video image analysis system. RESULTS: After 24 hours incubation, keratinocytes grown on sandblasted titanium samples displayed numerous, long, and branched or dendritic filopodia closely adapted to the surface roughness. Filopodia varied from 3 to 12 microm in length and 0.1 to 0.3 microm in width. Cells cultured on a machined surface did not present such cytoplasmic extensions and displayed a round morphology. Keratinocytes seeded on glass coverslips were flat and edged by filopodia (maximum length 7 to 8 microm) on the spreading site of the cluster. Though cell morphology is comparable with that observed on sandblasted specimens, cytoplasmic extensions suggestive of strong adhesion and spreading attitude were less pronounced. CONCLUSION: These results indicate that sandblasted surfaces are the optimal substrata for epithelial cell adhesion and spreading.