PREVENTING CARIES AFTER RADIOTHERAPY TO THE HEAD AND NECK REGION - A SYSTEMATIC REVIEW.

OBJECTIVES: Radiotherapy to the head and neck region (HN) bears the risk of a rampant development of caries, making intensified prevention necessary. Aim of this systematic review was to summarize the evidence on the efficacy of caries preventive measures in these patients. METHODS: Clinical studies investigating caries in patients with radiotherapy in the HN with at least 1 caries preventive intervention compared to any control were included. Reports in languages other than English or German were excluded. Records were identified on PubMed, Web of Science, Google Scholar, and Cochrane Library mid-January 2024. Risk of bias was assessed with RoB2. Results were summarized. Planned meta-analyses could not be performed, because of heterogenous data. RESULTS: Five studies were included, with a total of 355 participants. They were irradiated with up to 70 Gy and received different caries preventive interventions, including sodium fluoride or stannous fluoride gels, remineralizing solutions, an "Intraoral Fluoride Release System" and sucrose restricted diet. Caries score increased between 0.48 DMF-S and 9.2 DF-S per year. Largest differences in caries increments were measured between groups with insufficient and with rigorous fluoride application. CONCLUSIONS: The main limitations were compromised randomization, heterogeneity of patients and small sample sizes. Clinical studies on caries prevention after radiotherapy to the HN are lacking and the existing ones bear extensive limitations. However, the large effect size and broad consensus suggest the use of fluoride to be indispensable in preventing caries in these patients. The study was funded by the Medical Center - University of Freiburg and was not registered.

Limits of Life and the Habitability of Mars: The ESA Space Experiment BIOMEX on the ISS.

BIOMEX (BIOlogy and Mars EXperiment) is an ESA/Roscosmos space exposure experiment housed within the exposure facility EXPOSE-R2 outside the Zvezda module on the International Space Station (ISS). The design of the multiuser facility supports-among others-the BIOMEX investigations into the stability and level of degradation of space-exposed biosignatures such as pigments, secondary metabolites, and cell surfaces in contact with a terrestrial and Mars analog mineral environment. In parallel, analysis on the viability of the investigated organisms has provided relevant data for evaluation of the habitability of Mars, for the limits of life, and for the likelihood of an interplanetary transfer of life (theory of lithopanspermia). In this project, lichens, archaea, bacteria, cyanobacteria, snow/permafrost algae, meristematic black fungi, and bryophytes from alpine and polar habitats were embedded, grown, and cultured on a mixture of martian and lunar regolith analogs or other terrestrial minerals. The organisms and regolith analogs and terrestrial mineral mixtures were then exposed to space and to simulated Mars-like conditions by way of the EXPOSE-R2 facility. In this special issue, we present the first set of data obtained in reference to our investigation into the habitability of Mars and limits of life. This project was initiated and implemented by the BIOMEX group, an international and interdisciplinary consortium of 30 institutes in 12 countries on 3 continents. Preflight tests for sample selection, results from ground-based simulation experiments, and the space experiments themselves are presented and include a complete overview of the scientific processes required for this space experiment and postflight analysis. The presented BIOMEX concept could be scaled up to future exposure experiments on the Moon and will serve as a pretest in low Earth orbit.

Mosses in Low Earth Orbit: Implications for the Limits of Life and the Habitability of Mars.

As a part of the European Space Agency mission "EXPOSE-R2" on the International Space Station (ISS), the BIOMEX (Biology and Mars Experiment) experiment investigates the habitability of Mars and the limits of life. In preparation for the mission, experimental verification tests and scientific verification tests simulating different combinations of abiotic space- and Mars-like conditions were performed to analyze the resistance of a range of model organisms. The simulated abiotic space- and Mars-stressors were extreme temperatures, vacuum, and Mars-like surface ultraviolet (UV) irradiation in different atmospheres. We present for the first time simulated space exposure data of mosses using plantlets of the bryophyte genus Grimmia, which is adapted to high altitudinal extreme abiotic conditions at the Swiss Alps. Our preflight tests showed that severe UVR200-400nm irradiation with the maximal dose of 5 and 6.8 × 105 kJ·m-2, respectively, was the only stressor with a negative impact on the vitality with a 37% (terrestrial atmosphere) or 36% reduction (space- and Mars-like atmospheres) in photosynthetic activity. With every exposure to UVR200-400nm 105 kJ·m-2, the vitality of the bryophytes dropped by 6%. No effect was found, however, by any other stressor. As the mosses were still vital after doses of ultraviolet radiation (UVR) expected during the EXPOSE-R2 mission on ISS, we show that this earliest extant lineage of land plants is highly resistant to extreme abiotic conditions.