Association between salivary flow and dental caries in institutionalized adolescents: Cross-sectional study.

Background: Brazil has a larger number of adolescent offenders, but studies evaluating their oral health are still limited. Objective: Assess the association between salivary flow and caries experience in youngsters deprived of liberty. Methodology: Sixty-eight male adolescents in conflict with the law, aged between 15 and 19 years, from a Socio-Educational Assistance Center in Brazil participated in the present study. They answered a structured questionnaire, and oral examination was performed by the Decayed, Missing, and Filled Teeth (DMFT) index. The salivary flow rate was obtained using the mechanically stimulated total saliva method. Adjusted Poisson regression was used for the association with total DMFT and its decayed component, using the salivary flow (continuous fashion) or the hyposalivation (≤1 ml/min) as independent variables. Results: Participants were divided into two groups, those who did not have any decayed teeth at the moment of the examination (n = 39) and those who had at least one decayed tooth (n = 29). Moreover, two groups were formed based on the DMFT: those who had DMFT = 0 (n = 20) and those who had DMFT≥1 (n = 48). In the multivariate analysis, hyposalivation was associated with DMFT≥1 (p = 0.048), but when the salivary flow was included, no significant association with DMFT index was identified (p = 0.178). Conversely, the presence of at least one decayed tooth was significantly associated with the salivary flow (p = 0.004), but not with hyposalivation (p = 0.091). Conclusions: Institutionalized adolescents who present hyposalivation or low salivary flow are associated with DMFT≥1 index or presence of at least one decayed tooth, respectively.

Periodontal disease and sports performance: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to assess the association between athletic performance and periodontal disease (PD). Observational studies published up to April 2022 were searched in online databases (PubMed, Scopus, Web of Science, The Cochrane Library, LILACS, OpenGrey, and Google Scholar). PECO statement focused on studies with professional athletes (Participants) with PD (Exposition) compared to those with healthy periodontium (Comparison) and its effects on sports performance (outcome). Searches were conducted according to the PRISMA guidelines (registration protocol: 10.17605/OSF.IO/7ADH6) and risk of bias evaluation according to the Joanna Briggs Institute checklist. A total of 793 references were retrieved, of which eight were considered eligible. Two studies did not show an association between clinical PD parameters and performance. A meta-analysis with 396 participants suggested a relationship between PD and self-reported reduction in sports performance (odds ratio [OR] = 1.55; 95% confidence interval [CI] 1.04-2.31; p = 0.03; I2 = 0%) with moderate quality of evidence accordingly GRADE analysis. Despite the differences in performance evaluations between studies, PD was associated with reduced self-reported sports performance. Additional studies assessing confounding factors and objective assessment of PD and performance are needed to clarify the real effect of both conditions.

Is there an association between dental caries and genetics? Systematic review and meta-analysis of studies with twins.

OBJECTIVE: This review aimed to assess the agreement of dental caries experience between monozygotic (MZ) and dizygotic (DZ) twins. DATA RESOURCES: This systematic review was performed by reviewers in the databases Embase, MEDLINE-PubMed, Scopus, Web of Science and manual searches and gray literature Google Scholar® and Opengray. Observational studies that evaluated dental caries in twins were included. The risk of bias was analyzed using the Joanna Briggs checklist. Meta-analyses were performed to assess the pooled Odds Ratio to estimate the agreement values of dental caries experience and DMF index between pairs of twins (p < 0.05). To assess the certainty of evidence, the GRADE scale was used. STUDY SELECTION: 2533 studies were identified, of which 19 were included in the qualitative analysis, six in the quantitative synthesis, with two meta-analyses being carried out. Association between genetics and the development of the disease was observed in most studies. In the risk of bias analysis, 47.4% had moderate risk. Higher agreement of dental caries experience was observed in MZ twins than DZ in both dentitions (OR: 5.94; 95% CI: 2.00-17.57). However, there was no difference between the MZ and DZ twin groups in the analysis comparing DMF index agreement (OR: 2.86; 95%CI: 0.25-32.79). The certainty of evidence was considered low and very low for all studies included in meta-analyses. CONCLUSION: With very low certainty of the evidence, the genetic factor seems to influence the agreement of the caries experience. CLINICAL RELEVANCE: Understanding the genetic influence on the disease has the potential to contribute to the development of studies that may use biotechnologies for prevention and treatment as well as guide future research involving gene therapies aiming to prevent the occurrence of dental caries.

Association between genetic factors and molar-incisor hypomineralisation or hypomineralised second primary molar: A systematic review.

OBJECTIVE: To determine the association between genetic factors and molar-incisor hypomineralisation (MIH) and/or hypomineralised second primary molars by means of a systematic review. DESIGN: A search was performed in Medline-PubMed, Scopus, Embase and Web of Science databases; manual search and search in gray literature were also performed. Selection of articles was performed independently by two researchers. A third examiner was involved in cases of disagreement. Data extraction was performed using an Excel® spreadsheet and independent analysis was performed for each outcome. RESULTS: Sixteen studies were included. There was an association between MIH and genetic variants related to amelogenesis, immune response, xenobiotic detoxification and other genes. Moreover, interactions between amelogenesis and immune response genes, and SNPs in the aquaporin gene and vitamin D receptors were associated with MIH. Greater agreement of MIH was found in pairs of monozygotic twins than dizygotic twins. The heritability of MIH was 20 %. Hypomineralised second primary molars was associated with SNPs in the hypoxia-related HIF-1 gene and methylation in genes related to amelogenesis. CONCLUSION: With very low or low certainty of evidence, an association was observed between MIH and SNPs in genes associated with amelogenesis, immune response, xenobiotic detox and ion transport. Interactions between genes related to amelogenesis and immune response as well as aquaporin genes were associated to MIH. With very low certainty of evidence, hypomineralised second primary molars was associated to a hypoxia-related gene and to methylation in genes related to amelogenesis. Moreover, higher agreement of MIH in pairs of monozygotic twins than dizygotic twins was observed.

Prevalence and associated factors of self-reported halitosis among institutionalized adolescents: Cross-sectional study.

OBJECTIVE: To assess the prevalence and associated factors of self-reported halitosis in institutionalized adolescents in a city in southern Brazil. METHODS: This cross-sectional study involved male institutionalized adolescents, aged 15-19 years old, at the Socio-Educational Assistance Center in the city of Passo Fundo, Brazil. Data collection was performed by a research team composed of two interviewers, two clinical examiners of oral health and two examiners of salivary flow. A structured questionnaire was applied, which included demographical, socioeconomical, general health behaviour, presence of health problems and oral health self-perception variables. Decayed, Missing, Filled Index was used for the clinical examination. The salivary flow collection was performed using the mechanically stimulated total saliva method, in which only the liquid component was measured. RESULTS: The prevalence of self-reported halitosis in this sample was 51.5% (n = 35). In the final multivariate analysis, halitosis was significantly associated with the non-white racial group (prevalence ratio [RP]:1.703; 95% confidence interval [95%CI]:1.101-2.634), use of crack (RP:1.857; 95%CI:1.270-2.714) and number of decayed teeth (PR: 1.123; 95%CI:1.008-1.252). The use of alcohol and access to dental care in the last 12 months were not significantly associated with self-reported halitosis. CONCLUSION: It was concluded that non-white and crack-user youngsters had a high occurrence of self-reported halitosis. Higher rates of dental caries are also associated with halitosis.

Influence of the timing of periodontal intervention on periapical/periodontal repair in endodontic-periodontal lesions: a systematic review.

INTRODUCTION: This study is aimed at answering the following question: "Does the timing of periodontal intervention influence the periapical/periodontal repair in endodontic-periodontal lesions?". MATERIAL AND METHODS: Six electronic databases were systematically searched for studies published up to April 2022, without restriction of language or year of publication, following the PIOS strategy: (P) adult patients with a diagnosis of endodontic-periodontal lesions, (I) endodontic and periodontal treatment, (O) periapical and periodontal healing, and (S) clinical studies. Risk of bias assessment was performed with the revised Cochrane risk of bias tools for randomized trials (RoB 2) and non-randomized interventions (ROBINS-I). The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS: Three studies (one prospective, one retrospective, and one randomized clinical trial) were included in the present review. Non-randomized studies had a critical and serious risk of bias. The randomized clinical trial had some concerns risk of bias. Non-randomized studies reported that the endodontic intervention should be performed previous to the periodontal intervention. Randomized clinical trial reported improvements when endodontic and periodontal interventions were performed simultaneously. GRADE analysis showed a very low quality of evidence for both randomized and nonrandomized studies. CONCLUSIONS: Based on the evidence from the included studies, although it is suggested that the endodontic treatment should be performed prior to periodontal treatment, it is not possible to assure the best treatment sequence for endodontic-periodontal lesions. CLINICAL RELEVANCE: Evidences suggests that although the endodontic intervention should be the first therapy of choice, it was not possible to specify the best time to perform the periodontal intervention.

Awareness regarding antimicrobial resistance and confidence to prescribe antibiotics in dentistry: a cross-continental student survey.

BACKGROUND: The antimicrobial resistance (AMR) crisis is a major global threat and one of its biggest drivers is the overuse of antibiotics in humans. Dentists are responsible for 5-10% antibiotic prescriptions worldwide and recent data suggest that knowledge and prescribing practices need improvement. METHODS: A cross-sectional web-survey was sent to dental students from six universities in Norway, Canada, and Brazil. Topics addressed covered awareness, confidence to prescribe antibiotics, and education needs. Data were presented descriptively and statistical testing was employed to compare group means when applicable. RESULTS: In total, 562 responses were collected across the three countries with a response rate of 28.6%. 'Antibiotic resistance' was among the highest priorities (scale 1-10) with an average of 8.86 (SEM ± 0.05), together with 'Gender inequality' (8.68 ± 0.07) and 'Climate change' (8.68 ± 0.07). Only 28.8% thought that Dentistry was engaged in national/international campaigns promoting awareness on the topic and 8.9% stated to have heard about the 'One Health' concept. Final year dental students showed an average confidence to prescribe antibiotics of 7.59 (± 0.14). Most students demonstrated interest in receiving additional education on all topics listed, with the three most pressing being 'antibiotic prescription for treatment of infections' (82.9%), 'drug interactions' (80.9%), and 'spread of antibiotic resistance' (79.6%). A trend was observed between higher awareness regarding the topic and higher confidence to prescribe. CONCLUSIONS: There is a need to revisit dental education on antibiotic resistance with a global perspective and to create more stewardship initiatives that promote awareness on the topic.

Açaí (Euterpe oleracea Mart.) Attenuates Oxidative Stress and Alveolar Bone Damage in Experimental Periodontitis in Rats.

Açaí (Euterpe oleracea Mart.) juice is rich in phenolic compounds with high antioxidant capacity. It has been observed that the use of antioxidants may be an additional strategy to nonsurgical periodontal therapy as well as to prevent alveolar bone loss. Thus, the objective of this study was to investigate the effects of açaí supplementation on experimental periodontitis in rats. Twenty male Rattus norvegicus (Wistar) rats were assigned into control, açaí, experimental periodontitis, and experimental periodontitis with açaí supplementation groups. Periodontitis was induced by placing ligatures around the lower first molars. Animals in the açaí groups received 0.01 mL/g of clarified açaí juice for 14 days by intragastric gavage. At the end of the experimental period, blood was collected to assess the reduced glutathione (GSH), Trolox equivalent antioxidant capacity (TEAC), and lipid peroxidation (TBARS) levels. Moreover, hemimandibles were analyzed by micro-computed tomography (micro-CT) for alveolar bone loss and bone quality. Açaí supplementation increased blood total antioxidant capacity and decreased lipid peroxidation. It also reduced alveolar bone loss when compared to the experimental periodontitis group. Moreover, clarified açaí per se modulated the oxidative biochemistry and bone microstructure. Thus, açaí may be considered a viable alternative for managing periodontal oxidative stress and preventing alveolar bone loss.

Biological Activity of Copaiba in Damage to the Alveolar Bone in a Model of Periodontitis Induced in Rats.

Several studies have investigated the effects of natural products in the treatment of diseases. Traditional Amazonian populations commonly use copaiba due to its well-known anti-inflammatory, antibacterial, and healing properties. In this study, we aimed to investigate the effects of systemic administration of copaiba oleoresin (Copaifera reticulata Ducke) on ligature-induced periodontitis in rats. To do so, 21 adult rats were divided into three groups (n = 7 each): a control group, ligature-induced periodontitis group, and ligature-induced periodontitis group treated with copaiba oleoresin (200 mg/kg/day). The ligature remained from day 0 to 14, and the copaiba oleoresin was administered via oral gavage during the last seven days. On day 14, the animals were euthanized, and mandibles were collected for histopathological evaluation and microcomputed tomography analysis. Our data showed that the administration of copaiba considerably reduced the inflammatory profile. Moreover, copaiba oleoresin limited alveolar bone loss, increased trabecular thickness and bone-to-tissue volume ratio, and decreased the number of trabeculae compared with those of the untreated experimental periodontitis group. Our findings provide pioneering evidence that supports the potential of copaiba oleoresin in reducing periodontitis-induced alveolar bone damage in rats.

Powered Toothbrushes: An Opportunity for Biofilm and Gingival Inflammation Control.

The present review aimed at a broad investigation on the potential of powered as compared to manual toothbrushes in different aspects of clinical dentistry. Studies evaluating plaque and gingival inflammatory parameters were included, as well as those that investigated adverse effects. Emphasis was given separately to adults, youngsters, special-needs patients, and those under fixed orthodontic therapy. In general, comparisons favored powered toothbrushes. In summary, approximately 68% of the included studies, in terms of plaque/gingival inflammation in adults, presented better results for powered toothbrushes. In children and special-needs populations, approximately 40% of the included studies favored powered toothbrushes for plaque/gingival inflammation, and none favored manual ones. In orthodontic individuals, 50% of the studies also demonstrated a better effect of powered toothbrushes on plaque and gingival inflammation. All included studies that assessed adverse events did not demonstrate a difference in these effects when comparing manual vs. powered toothbrushes. It is concluded that the use of powered toothbrushes is an opportunity to enhance patterns of plaque control and associated gingival inflammation.

Self-reported halitosis and associated factors among older adults: A cross-sectional study.

Background: Population-based studies assessing the prevalence and associated factors of halitosis among older adults are scarce. Objectives: To evaluate the prevalence of self-reported halitosis and associated factors among older adults. Method: ology: Individuals aged ≥60 years were included. The main outcome was self-reported halitosis. Exposure variables were age, sex, skin color, level of education, marital status, presence of systemic health problems, use of medication, smoking exposure, alcohol exposure, access to dental care, toothbrush frequency, use of dental floss, number of present teeth, use of and need for dental prosthesis. Associations between the outcome and independent variables were performed with Poisson regression models with robust variance (p < 0.05). Results: A total of 569 older adults were included, of which 35.5% (n = 202) self-reported halitosis. In the final multivariate model, higher age (prevalence ratio [PR]:0.967; 95% confidence interval [95%CI]:0.946-0.988) and level of education (PR:0.673; 95%CI:0.469-0.967 and PR:0.635; 95%CI:0.414-0.973 for medium and high level of education, respectively, compared to low level) were associated with halitosis. Conversely, no access to dental care (PR:1.322; 95%CI:1.044-1.676) and a higher number of teeth present (PR:1.023; 95%CI:1.009-1.037) were associated with a higher occurrence of self-reported halitosis. Conclusion: A high prevalence of self-reported halitosis was detected among older adults and was associated with lower age, lower level of education, no access to the dentist and higher number of teeth present.

Use and need of dental prosthesis among community dwelling elderly: a cross-sectional population-based study / Uso e necessidade de próteses dentárias em idosos domiciliados: um estudo transversal de base populacional

Abstract Background By the use of complete or partial dental prosthesis, function, esthetics, and phonetics are reestablished. Few population-based studies are available in the literature using an older adult population. Objective Evaluate the use of and need for dental prostheses and their associated factors. Method This study included a random sample of 287 elderly, in the city of Cruz Alta, Brazil. Use of and need for dental prostheses were the main outcomes, and two analytical models were constructed. Subgroup analyses were performed for individuals using fixed partial denture (FPD) and removable (partial and/or complete) dental prosthesis (RDP). Results Use of and need for dental prosthesis were identified in 83.6% (n=240) and 42.5% (n=122) of the elderly, respectively. Women presented a significantly higher prevalence ratio (PR) for use of dental prostheses (PR=1.15; 95%IC:1.02-1.28) and lower need (PR=0.70; 95%IC:0.54-0.91). No statistically significant difference was demonstrated for the use of FPD regarding the sex. Higher education level was associated with lower use of prostheses (PR=0.73; 95%IC:0.58-0.91) when compared to lower level of education. Medium level of education showed a significantly lower need for dental prostheses (PR=0.61 - 95%IC:0.39-0.94). Those that did not consume alcohol presented with a significantly lower use of FPD and RDP (PR=0.46; 95%IC:0.23-0.93 and 0.90;0.81-0.99, respectively). Conclusion The use of and need for dental prostheses were associated with sex, level of education, and behavioral factors.

Resumo Introdução Pelo uso de próteses dentárias completas ou parciais, função, estética e fonética são reestabelecidas. Poucos estudos de base população estão disponíveis na literatura utilizando a população idosa. Objetivo Avaliar o uso e a necessidade de prótese dentária, bem como seus fatores associados. Método Esse estudo incluiu uma amostra randômica de 287 idosos da cidade de Cruz Alta, no Brasil. Uso e necessidade de prótese dentária foram os desfechos primários, e dois modelos analíticos foram construídos. No uso de prótese dentária, análises de subgrupos foram realizadas para Prótese Parcial Fixa (PPF) e Prótese Removível (parcial e/ou completa) (PR). Resultados Uso e necessidade de prótese dentária foram detectados em 83,6% (n=240) e 42,5% (n=122) dos idosos, respectivamente. Mulheres apresentaram significativa maior Razão de Prevalência (RP) para o uso de prótese dentária (RP:1,15; IC95%:1,02-1,28) e menor necessidade (RP:0,70; IC95%:0,54-0,91). Nenhuma associação significativa foi encontrada para o uso de PPF em relação aos gêneros. Alto nível educacional esteve associado ao menor uso de prótese (RP:0,73; IC95%:0,58-0,91), quando comparado com escolaridade baixa. Escolaridade média mostrou significativa menor necessidade de prótese dentária (RP:0,61 - IC95%:0,39-0,94). Aqueles que não utilizam álcool apresentaram um menor uso de PPF e PR (RP:0,46; IC95%:0,23-0,93 e 0,90;0,81-0,99, respectivamente). Conclusão Uso e necessidade de prótese dentária estão associados ao gênero, nível educacional e fatores comportamentais.

Effects of periodontitis and periodontal treatment on systemic inflammatory markers and metabolic profile in obese and non-obese rats.

BACKGROUND: Little is known about a synergistic effect of periodontitis and obesity on systemic biomarkers and a possible effect periodontal treatment may exert. This study aimed to evaluate the impact of periodontitis and periodontal treatment on systemic inflammation and metabolic profile in obese and non-obese rats. METHODS: Sixty male Wistar rats were randomly divided in six groups differentiated by diet and periodontal status: no periodontitis (G1 and G4), untreated ligature-induced periodontitis (G2 and G5), and treated ligature-induced periodontitis (G3 and G6). Groups G4, G5, and G6 were exposed to cafeteria diet to induce obesity. Periodontitis was induced by silk ligatures over 4 weeks (G2, G3, G5, and G6). Rats in G3 and G6 received scaling and root planing and were followed for additional 4 weeks. After sacrifice, serum levels of C-reactive protein (CRP), interleukin (IL)-1ß, IL-6, IL-10, IL-17a, tumor necrosis factor alfa (TNF-α), glucose, triglycerides, and total cholesterol (TC) were compared between groups. RESULTS: CRP was significantly higher in obese rats with than without periodontitis (G5 = 10.15 versus G4 = 4.47 µg/L, P = 0.01). No beneficial effects of periodontal treatment were observed for CRP levels, IL-6, IL-1ß, IL-17a, and TNF-α, glucose and triglycerides. Treated periodontitis (G6) exhibited significantly lower TC than the periodontitis group (G5) in obese rats. CONCLUSION: Periodontitis increased serum CRP in obese rats, indicating a synergistic role of periodontitis in the systemic inflammatory burden triggered by obesity. The treatment of induced periodontitis reduced TC levels in obese rats.

Investigation of oral and general health status and IL-1ß gene polymorphism as risk factors for oral mucositis in hematopoietic stem cell transplantation patients.

The aim of the present study was to analyze the relationship of OM with possible risk factors such as oral health condition, immunological status and IL-1ß profile in patients submitted to hematopoietic stem cell transplantation (HSCT). Fifty-four individuals submitted to HSCT were included. All patients received previous dental treatment and photobiomodulation (PBM) as the institutional OM preventive protocol. OM scores, immune status, and IL-1ß levels were determined during the conditioning period and at D+3 and D+8 after HSC infusion. IL-1ß gene polymorphism was also analyzed during conditioning. Possible associations of OM with risk factors were analyzed using conditional Fisher's exact test. OM was observed in 34 patients (62.9%) classified as Grade 1 (13 patients/24.1%), Grade 2 (14 patients/25.9%), Grade 3 (3 patients/5.5%), and Grade 4 (4 patients/7.4%). Allogeneic HSCT individuals exhibited a higher OM grade than autologous subjects. Moreover, an association was observed between severe OM and severe gingivitis (p = 0.01), neutropenia (p = 0.03), and leukopenia (p = 0.04). A significant association between OM and lower IL-1ß levels was detected at three time points, i.e., conditioning (p = 0.048), D+3 (p = 0.01), and D+8 (p = 0.005). The results showed that IL-1ß gene polymorphism was not associated with OM. Our study provided important insights into the scope of OM risk factors in the setting of HSCT. Patients submitted to HSCT with severe gingivitis prior to chemotherapy and with severe neutropenia and leukopenia exhibited a higher OM grade. Further investigation will be necessary to better understand the exact role of IL-1ß in the context of OM pathobiology and to validate cytokine analysis in larger cohorts.

Self-Perception of Teeth Alignment and Colour in Adolescents: A Cross-sectional Study.

OBJECTIVE: This study aimed to evaluate the prevalence and factors associated with self-perception of teeth alignment and colour in adolescents. METHODS: This cross-sectional study was carried out in public and private schools in Passo Fundo, Brazil. A representative sample of students aged 15 to 19 years were included. The outcome of this study was self-perception of teeth alignment and colour according to selected items from a structured and validated questionnaire (the Child's and Parent's Questionnaire about Teeth Appearance). Bivariate and multivariable analysis, using Poisson regression with robust variance, were used. A P value <.05 was established for statistical significance. RESULTS: The study included 736 adolescents. The worst self-perception of teeth alignment and colour was observed in 46.5% (n = 342) of the adolescents. Nonsmokers presented a prevalence ratio (PR) 29% lower (95% CI, 0.57-0.89) for the worst self-perception of teeth alignment and colour when compared to smokers/former smokers. Adolescents with highly educated mothers presented a lower prevalence of negative self-perception than those with mothers with a low level of education (PR: 0.66; 95% CI, 0.51-0.86). Presence of orthodontic treatment with (PR: 0.76; 95% CI, 0.62-0.94) or without (PR: 0.61; 95% CI, 0.46-0.76) tooth whitening were associated with better self-perception of teeth alignment and colour. CONCLUSIONS: Exposure to smoking and lower maternal level of education were associated with worse self-perception of teeth alignment and colour in adolescents. A history of orthodontic treatment with or without tooth whitening was associated with a lower concern with aesthetics.

Virucidal efficacy of chlorhexidine: a systematic review.

This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic searches were performed in four databases (PubMed, Scopus, Embase, and Web of Science). Only studies that presented the following characteristics were included: (1) verified virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1), any Influenza, or any human coronavirus (HcoV); and (2) compared the virucidal efficacy of CHX with essential oils (Listerine®), quaternary ammonium compounds, povidone-iodine, hydrogen peroxide, negative control substance, and absence of therapy. Two researchers independently selected the studies, extracted data and evaluated the risk of bias. A narrative data synthesis was used. Twenty-five studies were included, of which 21 were in vitro and four were randomized clinical trials (RCT). Studies assessed the virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1) (10 studies), Influenza A (InfluA) (4 studies), human coronavirus (HCoV) (4 studies) and Severe Acute Respiratory Syndrome-Related Coronavirus (SARS-CoV-2) (11 studies). Most studies demonstrated that CHX has a positive virucidal efficacy against HSV-1 and InfluA strains. However, lower efficacy was shown to InfluA strain in comparison to povidone-iodine. Lower to none virucidal efficacy of CHX is expected for HCoV and SARS-CoV-2 strains for in vitro studies. Three RCT demonstrated that CHX was able to significantly reduce the viral load of SARS-CoV-2 for a short period. CHX may present an interesting virucidal efficacy against HSV-1 and InfluA viruses. CHX also presents transient efficacy against SARS-CoV-2 when used as a mouthwash.

Investigation of oral and general health status and IL-1β gene polymorphism as risk factors for oral mucositis in hematopoietic stem cell transplantation patients

Abstract: The aim of the present study was to analyze the relationship of OM with possible risk factors such as oral health condition, immunological status and IL-1β profile in patients submitted to hematopoietic stem cell transplantation (HSCT). Fifty-four individuals submitted to HSCT were included. All patients received previous dental treatment and photobiomodulation (PBM) as the institutional OM preventive protocol. OM scores, immune status, and IL-1β levels were determined during the conditioning period and at D+3 and D+8 after HSC infusion. IL-1β gene polymorphism was also analyzed during conditioning. Possible associations of OM with risk factors were analyzed using conditional Fisher's exact test. OM was observed in 34 patients (62.9%) classified as Grade 1 (13 patients/24.1%), Grade 2 (14 patients/25.9%), Grade 3 (3 patients/5.5%), and Grade 4 (4 patients/7.4%). Allogeneic HSCT individuals exhibited a higher OM grade than autologous subjects. Moreover, an association was observed between severe OM and severe gingivitis (p = 0.01), neutropenia (p = 0.03), and leukopenia (p = 0.04). A significant association between OM and lower IL-1β levels was detected at three time points, i.e., conditioning (p = 0.048), D+3 (p = 0.01), and D+8 (p = 0.005). The results showed that IL-1β gene polymorphism was not associated with OM. Our study provided important insights into the scope of OM risk factors in the setting of HSCT. Patients submitted to HSCT with severe gingivitis prior to chemotherapy and with severe neutropenia and leukopenia exhibited a higher OM grade. Further investigation will be necessary to better understand the exact role of IL-1β in the context of OM pathobiology and to validate cytokine analysis in larger cohorts.

Is There Any Association Between Chronic Periodontitis and Anxiety in Adults? A Systematic Review.

Periodontitis is a multifactorial disease triggered by dysbiotic biofilms, involving the host's immune response, systemic and behavioral factors, including psychosocial conditions. This systematic review aimed to investigate the possible association between periodontitis and anxiety in adults. Searches were performed in PubMed, Scopus, Web of Science, Lilacs, Cochrane, and OpenGrey databases, without language restrictions, considering studies in adults (P-Participants), with (E-Exposure) and without periodontitis (C- Comparison) in an outcome of association with anxiety (O-outcome). Methodological quality assessment was carried out using the Newcastle-Ottawa protocol for case-control and cross-sectional studies, followed by an analysis of the level of evidence using the GRADE tool. Metanalysis was not performed due to several differences in methods applied by authors in primary studies. Eleven observational studies were selected according to the inclusion criteria from the total of 6,380 studies retrieved from databases. Eight studies demonstrated higher anxiety levels in subjects with periodontitis, among which only one study presented a high risk of bias. The GRADE tool revealed a low level of evidence for the anxiety outcome measured by the State-Trait Anxiety Inventory (STAI), both for case-control and cross-sectional studies. However, since anxiety may affect the quality of life of many subjects, it reinforces the need for further studies that evaluate this association for more extended periods. Clinical Trial Registration:PROSPERO-CRD42020190445.