Gustatory dysfunction in COVID-19 patients: a rapid systematic review on 27,687 cases.

Objective: This is a rapid systematic review concerning taste alterations in 27,687 individuals infected with SARS-CoV-2, published in the worldwide literature.Material and methods: Of the 485 articles recovered, 67 eligible studies (27,687 confirmed COVID-19 cases) were included in this analysis. We analysed the prevalence of the taste alterations in patients considering the country of origin of the studies.Results: The results show strong important differences in the overall reported prevalence of taste alterations among the different countries (from 11% of Korea to 88.8% of Belgium).Conclusions: These data highlight that there is a different geographical distribution of taste alterations in COVID-19 patients. Gustatory dysfunction seems to be an understudied symptom of COVID-19 and this may explain the inconsistencies of diagnostic criteria for COVID-19 case definition. Furthermore, this diagnostic underestimation can lead to an increased risk of contagion for the whole population and for the working classes most at risk, including the dental one

Taxonomic Analysis of Oral Microbiome during Orthodontic Treatment

Background: Orthodontic appliances induce significant changes in the oral microbiome, but this shift in microbial composition has not been well established by the available evidence yet. Objectives: To perform a systematic review of existing literature in order to assess the taxonomic microbial changes in orthodontic patients during Fixed Appliance Treatment (FAT) and Clear Aligner Treatment (CAT), using next-generation sequencing (NGS) technique of the bacterial 16S rRNA gene. Search Methods and Selection Criteria. The search for articles was carried out in PubMed, including articles published in English until May 2021. They included every human study report potentially relevant to the review. Data Collection and Analysis. After duplicate study selection and data extraction procedures according to the PICOS scheme, the methodological quality of the included papers was assessed by the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies (SBU) method. Results: The initial search identified 393 articles, 74 of which were selected by title and abstract. After full-text reading, six articles were selected according to inclusion criteria. The evidence quality for all the studies was moderate. Conclusions: Orthodontic treatment seems to transiently affect the composition of subgingival microbiome, although not salivary, maintaining a stable microbial diversity. Different results were found in the shift of microbiome between plaque and saliva, depending on the type of orthodontic treatment. This review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies

COVID-19 and periodontitis: reflecting on a possible association

Recent studies have demonstrated a relationship between the severe clinical course of COVID-19 and other chronic diseases such as: cardiovascular disease, hypertension, diabetes mellitus, obesity and chronic renal disease. It may be possible to extend this association to a common and chronic oral disease in adults: periodontitis. Alternatively, the latter could be simply related to the systemic chronic diseases cited above, as already observed in the non-COVID-19 literature. In order to provide an overview and their opinion, the authors in this perspective article will report and discuss the most recent references of interest relating to COVID-19 and periodontitis pathophysiology. Within such a narrative review, the authors will hypothesize that the association between chronic periodontitis and COVID-19 could exist via two pathways: a direct link, through the ACEII and CD147 receptors used by the virus to infect the cells, which would occur in greater numbers in cases of periodontitis (thereby favoring a SARS-CoV-2 infection); and/or an indirect pathway involving the overexpression of inflammatory molecules, especially IL-6 and IL-17. An expression of the latter has been found to play a role in periodontitis, in addition to severe cases of COVID-19, although it is still unclear if it plays a direct role in the worsening of the clinical course

The Management of Dental Practices in the Post-COVID 19 Era: An Economic and Operational Perspective

Background: In order to protect dental teams and their patients during the COVID-19 pandemic, dentists have had to adopt several measures (operating and post-operating procedures) which may increase the total treatment time and costs relating to individual protective measures. This paper will propose a thorough analysis of operating dentistry procedures, comparing the economic performance of the activity in a dental surgery before and after the adoption of these protective measures, which are required to contain the risk of SARS-COV-2 infections. Methods: The economic analysis is articulated in three approaches. Firstly, it assesses a reduction in markup by maintaining current charges (A); alternatively, it suggests revised charges to adopt in order to maintain unvaried levels of markup (B). And the third Approach (C) examines available dental treatments, highlighting how to profitably combine treatment volumes to reduce markup loss or a restricted increase in dental charges. Results: Maintaining dental charges could cause a loss in markup, even rising to 200% (A); attempting to maintain unvaried levels of markup will result in an increase in dental charges, even at 100% (B); and varying the volumes of the single dental treatments on offer (increasing those which current research indicates as the most profitable) could mitigate the economic impact of the measures to prevent the transmission of SARS-COV-2 (C). Conclusions: The authors of this paper provide managerial insights which can assist the dentist-entrepreneur to become aware of the boundaries of the economic consequences of governmental measures in containing the virus infection

Oral lichen planus in children: An Italian case series

Oral lichen planus usually occurs in adults; there are no clear data regarding the incidence and the clinical features of oral lichen planus in children. This paper reports clinical findings, treatments, and outcomes of 13 Italian patients with oral lichen planus in childhood diagnosed between 2001 and 2021. The most common finding was keratotic lesions with reticular or papular/plaque-like patterns, confined to the tongue in seven patients. Although oral lichen planus in childhood is rare and the malignant transformation index is unknown, specialists must be aware of its characteristics and oral mucosal lesions must be correctly diagnosed and managed

Evaluation of qualitative and quantitative taste alterations in COVID-19

Taste dysfunctions occur in a large proportion of COVID-19 patients. This observational study compared interleukin-6 (IL-6) levels in mild and moderate COVID-19 patients with the type (quantitative or qualitative) of taste disorders. The 208 COVID-19 patients (118 men and 90 women) showing only taste dysfunctions as prodromic symptoms were classified as mild and moderate patients. The evaluation of the taste disorder was carried out using a survey. The IL-6 levels were measured with a chemiluminescence assay. Statistical analysis was performed using the Wilcoxon rank, Welch's, and Mann-Whitney tests (p <0.05). The results showed that there were no statistically significant differences in the perception of sour and salty, nor in the presence of dysgeusia and phantogeusia in moderate versus mild patients (p>0.05). However, there were statistically significant differences in the perception of umami, bitter, sweet, and the presence of parageusia in moderate versus mild patients (p<0.05). There was an impairment of multiple tastes up to ageusia in patients with high IL-6 levels. The results showed that dysfunctions in the perception of sweet, bitter, umami, and the presence of parageusia can be considered as signs of more severe forms of COVID-19

Evaluation of qualitative and quantitative taste alterations in COVID-19

Taste dysfunctions occur in a large proportion of COVID-19 patients. This observational study compared interleukin-6 (IL-6) levels in mild and moderate COVID-19 patients with the type (quantitative or qualitative) of taste disorders. The 208 COVID-19 patients (118 men and 90 women) showing only taste dysfunctions as prodromic symptoms were classified as mild and moderate patients. The evaluation of the taste disorder was carried out using a survey. The IL-6 levels were measured with a chemiluminescence assay. Statistical analysis was performed using the Wilcoxon rank, Welch’s, and Mann-Whitney tests (p 0.05). However, there were statistically significant differences in the perception of umami, bitter, sweet, and the presence of parageusia in moderate versus mild patients (p<0.05). There was an impairment of multiple tastes up to ageusia in patients with high IL-6 levels. The results showed that dysfunctions in the perception of sweet, bitter, umami, and the presence of parageusia can be considered as signs of more severe forms of COVID-19

Tooth Loss in Periodontitis Patients—A Risk Factor for Mild Cognitive Impairment: A Systematic Review and Meta—Analysis

Background: Periodontal disease and tooth loss have been long suggested as risk factors of mild cognitive impairment. The underlying mechanisms could be systemic chronic inflammatory mediators, direct pathologic challenge to the nervous system, malnutrition and/or loss of neurosensory stimulation input causing brain atrophy. This review aimed to examine the existing literature studies linking the effect of periodontal disease and tooth loss on the development of mild cognitive impairment. Methods: A systematic review using PEO was conducted. Three electronic databases, namely Embase, Medline and DOSS (UCLan), were searched for relevant articles published up to April 2023. Google Scholar and a hand search were also conducted to ensure no relevant studies had been missed. The Newcastle–Ottawa scale was used to assess the quality of studies. Results: The findings showed that chronic periodontitis and tooth loss, both individually and in combination, led to an increased risk of mild cognitive decline in adults over 50 years. Within the limitations of this review, periodontitis and tooth loss both contribute to an increased risk of mild cognitive impairment and dementia, but the evidence so far is not strong. Conclusions: In future, more robustly designed studies investigating periodontal disease and tooth losslink with cognitive health decline are required with a longer follow-up duration

Evaluation of Vitamin D (25OHD), Bone Alkaline Phosphatase (BALP), Serum Calcium, Serum Phosphorus, Ionized Calcium in Patients with Mandibular Third Molar Impaction. An Observational Study

The aim of this study was to evaluate the levels of vitamin D (25OHD) and other bone biomarkers in patients with third molar impaction (TMI). Thirty males and 30 females with unilateral or bilateral impacted mandibular third molar, and 15 males and 15 females as a control group (CG) were recruited. Rx-OPT was used to evaluate dental position and Pederson index to measure the difficulty of the intervention. Bone biomarkers were measured through blood venous sample in TMI group and CG. Mann-Whitney test, Pearson’s correlation coefficient, linear regression model were used to compare the different parameters in the two groups. 25OHD showed lower values in TMI group than in CG (p &lt; 0.05) with values significantly lower in bilateral impaction (p &lt; 0.05). Pearson’s coefficient for 25OHD presented a negative correlation with the Pederson index ($ = 0.75). Bone alkaline phosphatase (BALP) showed significantly lower dosage in TMI group than CG (p = 0.02), Pearson’s coefficient for BALP presented a negative correlation with the Pederson index. Serum calcium, serum phosphorus, ionized calcium levels in TMI and CG groups were similar and Mann- Whitney test did not significantly differ between TMI and CG. TMI could be a sign of vitamin D deficiency and of low BALP levels that should be investigated