Search

Objectives: Growing evidence exists about post‐COVID condition/syndrome as sequelae of Sars‐CoV‐2 infection in healed patients, possibly involving the lungs, brain, kidney, cardiovascular and neuromuscular system, as well the persistency of taste dysfunction. Such symptoms develop during or after infection and continue for more than 12 weeks with pathogenesis related to virus persistency but variable by organs or systems. Materials and Methods: We recently observed six patients recovered from COVID‐19 and with negative RT‐PCR testing, showing oral mucosa lesions (mainly ulcers) overlapping those occurring in the acute phase, persisting up to 20 days and thus needing a biopsy with histological investigation and spike protein evaluation by immunohistochemistry. Results: We found epithelial ulceration, inflammatory infiltrate, vessels with increased diameter and flattened endothelium but no thrombi formation; also, we found a weak epithelial SARS‐CoV‐2 positivity limited to the basal/spinosum layers, progressively decreasing toward the periphery, and the intraepithelial lymphomonocytes, endothelium, and perivascular pericytes too. Conclusions: Our findings provide evidence that SARS‐CoV‐2 can persist, as for other organs/systems, also in the oral epithelium/mucosa after the acute phase and can be responsible for lesions, although by a pathogenetic mechanism that should be better defined but certainly referable as the oral mucosa counterpart of post‐COVID syndrome. [ABSTRACT FROM AUTHOR]

Objective: Oral lesions received increased attention as likely new signs or secondary manifestations of COVID‐19. Therefore, we clinically examined oral cavity of patients with COVID‐19 and investigated oral lesions and patient comorbidities as possible risk factors of COVID‐19 disease outcome. Methods: From January to March 2022, a prospective study was conducted by recruiting all COVID‐19 patients admitted to the Intensive Care Unit and Respiratory Intensive Care Unit of Maxi‐Emergencies Hospital in Bari, Italy. Results: From the enrolled 103 COVID‐19 patients, 46.6% were females and 53.4% were males. Findings show that risk of presenting with severe COVID‐19 disease was higher in patients who developed oral lesions related to COVID‐19 than those with no oral lesions (RR = 7.998, p =.002). Next, patients with concomitant autoimmune diseases were at higher risk of a negative COVID‐19 disease outcome than those without comorbidities (OR = 8.838, p =.026). Conclusions: COVID‐19‐related lesions of oral mucosa should not be ignored as they can be early and easily detectable signs of severe COVID‐19 disease condition, thus, serving as a prevention measure for any potential unfortunate event. Findings of this study, without implying causation, offer a direction for future investigations that aim to confirm the presence of specific oral lesions in COVID‐19 patients as signs of severe disease progression. [ABSTRACT FROM AUTHOR]

Objectives: To describe the association between endodontic treatment failure and medication‐related osteonecrosis of the jaw (MRONJ) in a cohort of oncologic patients in therapy with antiresorptive and antiangiogenic drugs. Materials and Methods: Patients were selected as affected by MRONJ in absence of the common local risk factors (oral surgical procedures or ill‐fitting dentures) but showing failure of previous endodontic treatment performed at least 6 months before the starting of antiresorptive/antiangiogenic therapies. Jaw lesions were all surgically treated and patients underwent a strict clinical and radiological follow‐up. Results: Among 18 patients, who developed 18 MRONJ, the only detectable local risk factor was the presence of teeth with failed endodontic treatment (more precisely, root canal underfilling in eight cases, root canal overfilling in two cases, root perforation in three cases, root fracture in five cases). All patients completely healed after surgical procedure and no recurrence was observed. Conclusions: Endodontic treatment failure should be considered a local risk factor for MRONJ development in oncologic patients. For such reason, it is mandatory to carefully evaluate them prior than the beginning of antiresorptive and antiangiogenic drugs administration. [ABSTRACT FROM AUTHOR]

Objective: In the recent years, an increasing number of peri‐implant medication‐related osteonecrosis of the jaw (PI‐MRONJ) have been reported in literature, both in oncologic and osteoporotic patients. The aim of this study is to describe 19 cases of patients previously diagnosed as affected by peri‐implantitis, who were treated for PI‐MRONJ, with consideration on clinical and histopathological features. Materials and Methods: Patients included were affected by postmenopausal osteoporosis and were administered with different antiresorptive drugs. Due to the presence of clinical and radiological signs of peri‐implantitis not healed after non‐surgical periodontal treatment, they were referred to the Complex Operating Unit of Odontostomatology of the University of Bari. Then, after a drug holiday of at least 3 months and cycles of antibiotics, and after other cycles of periodontal treatment, patients underwent the surgical removal of implant fixtures and surrounding bone. Results: Although the previous diagnosis of peri‐implantitis, the histopathological analysis with both conventional and confocal laser scanner microscopy confirmed the diagnosis of peri‐implantitis‐like MRONJ. Conclusion: Peri‐implantitis not healed after conventional treatment in patients at risk on MRONJ occurrence should be considered as peri‐implantitis‐like PI‐MRONJ and treated as required in order to get complete healing of the pathological condition, thus avoiding delay in the diagnosis. [ABSTRACT FROM AUTHOR]