Platelet-rich plasma and platelet-rich fibrin in oral surgery: a narrative review

Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are biological products derived from the plasma fraction of autologous blood that have a platelet concentration above that of the original blood. Cytokines and growth factors are present in platelet-based preparations, and their application has gained great attention in dentistry. The aim of this review was to comprehensively examine the latest scientific evidence on the use of PRF and PRP in oral surgery, and to describe current operational protocols. Platelet-rich fibrin is used after third molar extractions, in the treatment of alveolar osteitis and trismus, and in implant surgery. Platelet-rich plasma is utilized in sinus lift procedures, after tooth extractions, and in patients undergoing the treatment of bisphosphonate-related osteonecrosis of the jaw. Based on this review, plenty of data indicates that the PRF-PRP usage in oral surgery shows promising results. However, no consistent protocols have been presented in the analyzed articles. Further research is needed to provide clinicians with evidence-based clinical recommendations and to develop protocols on the use of these preparations in dental surgery

The presence of Helicobacter pylori in oral cavities of patients with leukoplakia and oral lichen planus

Objective Helicobacter pylori infection is one of the most common bacterial infections in men. This gastrointestinal pathogen is closely related to gastritis, peptic ulcers, and the increased risk of gastric cancer. Numerous studies have indicated oral cavities as possible Helicobacter pylori reservoirs. Helicobacter pylori has been detected both in supragingival and subgingival plaques, and also in saliva. In addition, the relationship between lesions of oral mucosa and the presence of H. pylori has been evaluated and described in some studies. The aim of this study was to assess the presence of Helicobacter pylori DNA in the oral cavity of patients with oral leukoplakia and oral lichen planus. Material and Methods The study included 54 patients with oral leukoplakia, 72 with oral lichen planus lesions, and 40 healthy controls. The presence of Helicobacter pylori in oral cavity samples was analyzed using a single-step Polymerase Chain Reaction (PCR) method. All patients underwent a periodontal examination and the following clinical parameters were collected: pocket depth, bleeding, and plaque indexes. The periodontal status was assessed using the Offenbacher classification. Results In most patients, pathological lesions were in typical sites on the buccal mucosa (leukoplakia in 88%, and oral lichen planus in 93% of patients). The DNA of the Helicobacter pylori was present in 20% of patients with leukoplakia and 23% of patients with lichen planus. We did not find the DNA of H. pylori in healthy controls. The periodontal status described by periodontal indices was worse in the investigated group than in the control group. Conclusion These findings suggest that the H. pylori presence in oral cavities may be related with leukoplakia and lichen planus oral lesions

Evaluation of Oral Health Status and Oral Care of Patients with Rheumatoid Arthritis

Objective. Rheumatoid arthritis (RA) and periodontal disease (PD) are common chronic, immunoinflammatory, destructive, and progressive diseases; however, the correlations between those two are not yet widely discussed. The purpose of this study was to evaluate the relationship between the selected demographic and clinical parameters of RA patients and oral health status parameters, on the basis of self-assessment. Materials and Methods. Three hundred patients under treatment were included in the study. Questionnaires were completed by 164 out of 300 patients. Results. A total of 100 females and 64 males took part in the study, with a mean age of 65 ± 11.1 years. In younger patients, the disease activity score (DAS28) was higher, and it was associated with pain or discomfort in the oral cavity and with difficulties in toothbrushing. Discomfort or pain in the oral cavity was to a significant extent associated with the poor gingival state, gingival bleeding, and difficulties in biting or chewing. Conclusions. In RA patients, difficulties in biting or chewing, discomfort or pain in oral cavity, feeling of the presence of movable teeth, and gingival bleeding are indications of periodontal infection. Maintaining awareness of oral health and RA is a key issue in the simultaneous management of proper oral care and RA due to the mutual influence of those two factors

Facial and oral manifestations following COVID-19 vaccination: a survey-based study and a first perspective

(1) Background: Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) emerged in Wuhan, China, in late 2019. The development of effective and safe vaccines against SARS-CoV-2 has been extremely fast. The list of orofacial adverse effects of BNT162b2 and mRNA-1273 vaccines based on the clinical trials are reported to be rare. The aim of this study was to investigate the facial and oral manifestations of COVID-19 vaccination using a survey-based study. (2) Methods: The questionnaire was developed using Google Forms and sent anonymously to a total of 700 subjects (medical personnel) in Poland, Italy, and other EU countries. (3) Results: 223 people answered the questionnaire, mainly vaccinated with BNT162b2. Only 3.1% and 5.4% experienced oral and facial symptoms, respectively. General diseases presence and age have significant influence on the probabil- ity of oral symptoms occurrence after the second dose. Facial symptoms are correlated with general disease; autoimmune pathologies and age, at first and second dose, respectively. Gender, smoking and regular medication intake have significant influence on the probability of taking an absence day. Gender, age, and smoking have a significant influence on the duration of symptoms after second dose. (4) Conclusions: Based on the results of this preliminary survey, there is no observed significant correlation between vaccine administration for COVID-19 and facial and oral manifestations

The presence of Helicobacter pylori in oral cavities of patients with leukoplakia and oral lichen planus

ABSTRACT Objective Helicobacter pylori infection is one of the most common bacterial infections in men. This gastrointestinal pathogen is closely related to gastritis, peptic ulcers, and the increased risk of gastric cancer. Numerous studies have indicated oral cavities as possible Helicobacter pylori reservoirs. Helicobacter pylori has been detected both in supragingival and subgingival plaques, and also in saliva. In addition, the relationship between lesions of oral mucosa and the presence of H. pylori has been evaluated and described in some studies. The aim of this study was to assess the presence of Helicobacter pylori DNA in the oral cavity of patients with oral leukoplakia and oral lichen planus. Material and Methods The study included 54 patients with oral leukoplakia, 72 with oral lichen planus lesions, and 40 healthy controls. The presence of Helicobacter pylori in oral cavity samples was analyzed using a single-step Polymerase Chain Reaction (PCR) method. All patients underwent a periodontal examination and the following clinical parameters were collected: pocket depth, bleeding, and plaque indexes. The periodontal status was assessed using the Offenbacher classification. Results In most patients, pathological lesions were in typical sites on the buccal mucosa (leukoplakia in 88%, and oral lichen planus in 93% of patients). The DNA of the Helicobacter pylori was present in 20% of patients with leukoplakia and 23% of patients with lichen planus. We did not find the DNA of H. pylori in healthy controls. The periodontal status described by periodontal indices was worse in the investigated group than in the control group. Conclusion These findings suggest that the H. pylori presence in oral cavities may be related with leukoplakia and lichen planus oral lesions

Current Concepts and Challenges in the Treatment of Cleft Lip and Palate Patients—A Comprehensive Review

Cleft lip and cleft palate has one of the highest incidences in the malformations of the oral cavity, that varies between populations. The background underlying the issue of cleft lip and palate is multifactorial and greatly depends on the genetic factors and environmental factors. The aim of this nonsystematic narrative review is to present the cleft palate and or lip pediatric population as target for interdisciplinary treatment. The purpose of this narrative review is to sum up the modern knowledge on the treatment of patients with clefts, as well as to highlight the importance of the great need for cooperation between different dental specialists along with medical professionals such as oral surgeons, prosthodontists, orthodontists along with medical professions such as pediatricians, speech therapists and phoniatrics, and laryngologist

Green dentistry: organic toothpaste formulations. A literature review

Dentistry as a profession should take into account the goals of sustainable development in daily practice and encourage the transition to a green economy. Consumers are becoming more conscious about the impact of self-care products, including toothpastes, on the environment. Organic toothpastes are considered very safe. A broad literature review was conducted to: (i) identify the ingredients in available organic toothpastes; (ii) classify them into active and inactive; and (iii) evaluate each ingredient's purpose and the adverse events that may be associated with its use. A comprehensive list of available organic toothpastes and their ingredients was compiled based on the products from the largest Italian organic supermarket chain (NaturaSì®) that is representative of the European market. Then, PubMed, Scopus and Google Scholar databases were searched to identify, classify and evaluate each ingredient. The final sample consisted of 46 organic toothpastes that included 156 ingredients; 139 (89.1%) and 17 (10.9%) were classified as active and inactive, respectively. Overall, 32 (20.5%) ingredients were associated with known adverse events. The results of this study indicate that organic toothpastes are highly biocompatible with oral cavity tissues. Careful product selection may help consumers avoid potential adverse effects that can be caused by ingredients such as polymers (e.g., polyethylene glycol) and carbomers, detergent agents (e.g., sodium lauryl sulfate), and triclosan. The lack of clinical studies should encourage the development of sufficient evidence to provide consumers with recommendations for daily use, based on both efficacy and biocompatibility

Metronidazole-Loaded Porous Matrices for Local Periodontitis Treatment: In Vitro Evaluation and In Vivo Pilot Study

Periodontal therapy focuses on thorough removal of subgingival calculus and plaque products followed by the smoothing out of root surfaces. However, such conventional mechanotherapeutic approaches are inefficient with regard to microbial biofilm elimination from the space between the root and deep periodontal pockets. Therefore, local chemotherapeutic agents need to be applied. Local antimicrobial treatment is also considered a safer treatment, as it avoids systemic complications related to drug application. In this study, porous matrices consisting of gelatin (GE) and cellulose derivatives (carboxymethylcellulose (CMC) and hydroxyethyl cellulose (HEC)) were loaded with antimicrobial drug metronidazole (MTZ). The matrices’ structural morphology, physiochemical properties, swelling and degradation ratio, mechanical properties, and MTZ release from the matrices were analyzed. Additionally, cytotoxicity tests for fibroblast and osteoblast cell cultures (L929 and U2-OS, respectively) and antimicrobial activity assessments of MTZ-loaded matrices against anaerobic Bacteroides sp. Bacteria were performed. Finally, clinical application of HEC matrices into periodontal pockets was conducted. The applied matrices showed a high antibacterial efficacy and a moderate cytotoxicity in vitro. The clinical application of HEC dressings corresponded with the decrease of periodontal pockets’ depth and bleeding observed 1 month after a single application. The presented results show that intra-pocket application of metronidazole using manufactured matrices may serve not only as a support for a standard treatment in periodontal practice but also as an alternative to systemic drug administration in this setting. Clinical data were analyzed using a nonparametric Friedman’s ANOVA for dependent trials

SARS CoV-2 IgG seropositivity post-vaccination among dental professionals: a prospective study

Abstract Background The COVID-19 pandemic has spread very rapidly around the world. Various regional and national lockdowns were imposed to control the spread. Meanwhile, vaccine development and population vaccination were the next steps for pandemic control. Workers in the dental field, both dentists and dental assistants, however, were close to the sources of aerosol generated during dental procedures and thus were the group of workers the most exposed to COVID-19 infection. The aim of our study was to monitor the immune response before and after the vaccine in a high-risk population, composed by dental professionals. Methods A clinical prospective study was carried out among dental professionals at the Academic Dental Polyclinic, Wroclaw Medical University (Wrocław, Lower Silesia region, Poland). Blood samples were collected at an interval of one year – March/April 2020, before the vaccination against COVID-19, and April 2021, after the vaccination. The analysis was performed on serum with four different methods: qualitative, semi-quantitative, and quantitative IgG count for SARS-CoV-2, and SARS-CoV-2 neutralizing antibodies. Results A total of 42 healthy adult volunteers participated in the study. The results showed a statistically significant difference (p < 0.05) in antibody levels before and after vaccination (1st and 2nd measurement) for each test method. The tests that were used affected the results and the test that showed the strongest relationship with the result was the Qualitative test. Conclusions Dental professionals are the adult working population most at risk for COVID-19. Monitoring SARS-CoV-2-status-related seropositivity can provide useful information occupational risk factors for dental professionals