Aims. The aim of this study was to determine prevalence of oral manifestations related to COVID-19 infection among a sample of recovered patients in the Basrah province of Iraq. Methodology. This cross-sectional study included a total of 574 individuals from Basrah city, Iraq (196 males and 378 females), who had been previously infected with COVID-19. A questionnaire was developed and used to record the demographic data, medical history, severity of respiratory infection followed by hospitalization along with oral signs and symptoms that occurred during the COVID-19 infection and their persistence after recovery. Results. Oral manifestations were reported in 88.3% of the studied sample. The most common oral manifestation was ageusia (66.8%), followed by dry mouth (59%), gustatory changes (46%), dysphagia (40.5%), burning sensation (20.8%), oral ulceration (14.5%), and gingival bleeding (3.3%). The findings suggested that ageusia was the only symptom that persisted following recovery from the COVID-19 infection. The results showed a significant statistical correlation between the incidence of oral manifestations and the severity of COVID-19 infection followed by hospitalization. A significant correlation was also found between the age groups and COVID-19 oral manifestations, whereas no significant statistical relationship was observed between gender, smoking, and systemic diseases. Conclusions. COVID-19 infection has considerable impacts on the oral cavity and salivary glands and after recovery from the infection, some patients continue to complain of ageusia for several months. There is a positive correlation between the incidence of oral signs and symptoms associated with COVID-19 infection and the severity of the infection.

This study aimed to compare the antimicrobial effect of an aqueous extract Red Roselle calyx (RE), Chlorhexidine (CH), Amoxicillin-clavulanic acid (ACA), Tetracycline (Tet), and Metronidazole (Met)on Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus) and Enterococcus faecalis (E. faecalis) bacteria. The bacterial inhibition zones (BIZ)of the RE (25, 50, 75, 100) mg/ml and CH solutions (0.2%, 2%) were determined using the agar well diffusion method. Additionally, the susceptibility of the tested bacteria against (30 μg) of standard antibiotics of ACA, Tet, and Met was examined. The bacterial minimum inhibitory concentration (MIC) was measured using the Broth Micro dilution method (BMDM). All tests were carried out in triplicates, and water was considered the negative control. For S. mutans, the RE at 50 mg/ml or above concentrations displayed higher BIZ than 0.2% CH. 100 mg/ml of RE recorded a greater BIZ than the 2% CH. The greater BIZ against S. mutans was recorded by Tet. A comparable effect was found with 0.2% CH (75, 100) mg/ml of the RE against S. aureus. Greater BIZ for S. aureus and E. faecalis were reported for 100 mg/ml RE compared to the Tet and Met RE at 100 mg/ml inhibited the E. faecalis growth in a zone size comparable to the CH (0.2%, 2%).The RE with 50,100 mg/ml concentrations showed comparable antimicrobial effect to 0.2%, 2% concentrations of CH, respectively. As an herbal substitute for commercial disinfectants, the RE can be considered an effective final endodontic irrigant and dental mouthwash.

Background Cancer stem cells are responsible for tumour progression and chemoresistance. Fibroblasts surrounding a tumour also promote progression and fibroblast “activation” is an independent prognostic marker in oral cancer. Cancer stem cells may therefore promote tumourigenesis through communication with stromal fibroblasts. Methods Cancer stem cells were isolated from oral cancer cell lines by adherence to fibronectin or cisplatin resistance. Fibroblasts were exposed to conditioned medium from these cells, and the activation markers, alpha smooth muscle actin and interleukin‐6, were assessed using qPCR and immunofluorescence. Stem cell markers and smooth muscle actin were examined in oral cancer tissue using immunohistochemistry. Results Adherent and chemoresistant cells expressed increased levels of stem cell markers CD24, CD44 and CD29 compared with unsorted cells. Adherent cells exhibited lower growth rate, higher colony forming efficiency and increased cisplatin resistance than unsorted cells. Smooth muscle actin and Interleukin‐6 expression were increased in fibroblasts exposed to conditioned medium. In oral cancer tissue, there was a positive correlation between expression of αSMA and stem cell markers. Conclusions Adherence to fibronectin and chemoresistance isolates stem‐like cells that can activate fibroblasts, which together with a correlation between markers of both in vivo, provides a mechanism by which such cells drive tumourigenesis.

Background: Cancer stem cells (CSC) are a subpopulation of cells within a tumour that are primarily responsible for tumour progression and resistance to therapy. Fibroblasts in the stromal tissue surrounding a tumour are also involved with its progression and fibroblast ‘activation’ is an independent prognostic marker in oral cancer. We hypothesise that CSCs can be isolated from oral cancer cell lines using functional assays and that they may drive tumour progression through communication with stromal fibroblasts. Methods: CSCs were isolated from oral cancer cell lines (H357 and SCC4) by their rapid adherence to fibronectin or resistance to cisplatin. Conditioned medium from both CSC and unsorted H357 and SCC4 cell lines were applied to cultures of NOFs for 24 hours. The gene and protein expression of the activation markers alpha smooth muscle action (αSMA) and interleukin-6 was assessed using qPCR and immunofluorescence. Expression of CSC markers and αSMA were examined in OSCC tissue using immunohistochemistry. Results: Cells isolated using both methods expressed significantly increased levels of stem cell markers CD24, CD44 and CD29 compared to unsorted cells. Adherent cells exhibited lower growth rate, higher colony forming efficiency and increased cisplatin resistance compared to unsorted cells. Conversely, the cisplatin-resistant cells adhered to fibronectin in greater numbers than unsorted cells. Expression of αSMA and IL-6 was increased in NOFs following exposure to either H357 or SCC4 CSC conditioned medium. In OSCC tissue there was a positive correlation between expression of αSMA and both CD24 and CD44. Conclusions: Rapid adherence to fibronectin and chemo-resistance effectively isolates a sub-population of cells from cell lines which show stem cell-like characteristics. Our data also suggests that factors released by CSC can activate fibroblasts towards a CAF-like phenotype, which together with evidence of correlation between markers of both in vivo, provides evidence of a mechanism by which such cells can drive tumour progression.

The periodontal pathogen Porphyromonas gingivalis can invade host cells, a virulence trait which may contribute to the persistence of infection at subgingival sites. Whilst the antibiotic protection assay has been commonly employed to investigate and quantify P. gingivalis invasion, data obtained have varied widely and a thorough investigation of the factors influencing this is lacking. We investigated the role of a number of bacterial and host-cell factors and report that the growth phase of P. gingivalis, source (laboratory strain vs. clinical strain), host-cell identity (cell line vs. primary), host-cell lysis method, and host-cell passage number had no significant effect on bacterial invasion. However, incubation time, host-cell seeding density, method of quantification (viable count vs. DNA), and whether host cells were plated or in suspension, were shown to influence invasion. Also, cells isolated by rapid adhesion to fibronectin exhibited higher levels of P. gingivalis invasion, possibly as a result of increased levels of active α5β1 integrin. Interestingly, this may represent a population of cells with stem cell-like properties. This study provides important new information by identifying the most important factors that influence P. gingivalis invasion assays and may help to explain variations in the levels previously reported.