In published studies, it has been suggested that dental wear is associated with gastroesophageal reflux disease (GERD). This systematic review was carried out to evaluate the association of GERD, dental erosion, and halitosis and to compare the indices adopted in epidemiological surveys. The Medline database (until October, 2011) was searched systematically to identify studies evaluating the prevalence of oral alterations, such as dental erosion and halitosis, in patients with GERD symptoms. Two reviewers analyzed all reports and the selected studies were evaluated according to the quality of evidence, using the validated Newcastle-Ottawa Quality Assessment Scale. Full-text copies of a total of 32 publications were obtained in duplicate. Sixteen publications were identified among the citations in the Bibliographic lists of studies that fulfilled the exclusion/inclusion criteria and quality of evidence. The relationship between dental erosion and GERD patients was significant in only seven studies. According to three studies, halitosis could be one of several extraesophageal symptoms or manifestations in GERD patients. In one study, it was found that the mucosa of GERD patients was significantly more acidic in comparison with that of the control group. This systematic review showed that there is a relationship between GERD and oral diseases (dental erosion and halitosis). The epidemiological surveys used different indices to analyze GERD and dental erosion. Further research could investigate the best method for assessing the two diseases.

Objectives To investigate the relationship between coronavirus disease 2019 (COVID-19) and obesity in critically ill patients admitted to the intensive care unit (ICU). Methods We systematically searched PubMed, SCOPUS, Embase, LILACS, and Web of Science for studies published up to April 27, 2020. The outcome of interest was composite poor outcome, comprising mortality and severe COVID-19. We used a standardized data extraction form to collect information from published reports of eligible studies. Heterogeneity and publication bias were assessed using I 2 statistic and funnel plots, respectively. Results Nine studies including 6577 patients were selected for evaluation. The COVID-19 patients were 59.80% male and had comorbidities such as hypertension (51.51%), diabetes (30.3%), cardiovascular disease (16.66%), lung disease (15.99%), renal disease (7.49%), cancer (5.07%), and immunosuppression (1.8%). For patients with severe complications, the overall pooled event rates were 56.2% (random; 95% CI: 35.3–75.1; p = 0.015; I 2 = 71.461) for obesity, 23.6% (random; 95% CI: 17.9–30.5; p = 0.000; I 2 = 87.705) for type 2 diabetes, 45.9% (random; 95% CI: 38.0–53.9; p = 0.000; I 2 = 90.152) for hypertension, 20.0% (random; 95% CI: 7.9–42.0; p = 0.000; I 2 = 94.577) for smoking, 21.6% (random; 95% CI: 14.1–31.4%; p = 0.000, I 2 = 92.983) for lung diseases, and 20.6% (random; 95% CI: 15.2–27.5; p = 0.000, I 2 = 85.735) for cardiovascular diseases. Discussion This systematic review indicated the relationship between obesity, ICU admission, severe COVID-19, and disease progression in patients with COVID-19. Obese patients with hypertension, type 2 diabetes, smoking habit, lung disease, and/or cardiovascular disease should be cared for with increased attention.

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Background: Systemic bone loss may lead to more severe periodontal destruction, decreasing local bone mineral density. Aim: A cross-sectional designed was performed to study associations among alveolar bone pattern, salivary leptin concentrations, and clinical periodontal status in premenopausal obese and eutrophic women. Methods:Thirty morbid obese (G1) and 30 normal-weight (G2) women were included. Anthropometric and periodontal measurements (probing depth - PD, clinical attachment levels - CAL, presence of calculus, bleeding on probing -BOP, and plaque accumulation) were assessed. OHIP-14 was used for assessment of oral health impact on quality of life. Panoramic radiography was used to obtain the panoramic mandibular index (PMI), mandibular cortical index (MCI), and mental index (MI). Intraoral periapical (PA) radiography was taken to measure the total trabecular bone volume. Leptin was measured in saliva of fasted overnight women. Results:Groups 1 and 2 differed in all anthropometric aspects, but height. Pocket depth, calculus, BOP, and plaque index were worse in G1. No differences between groups were found considering OHIP. Normal-weight subjects showed higher proportion of dense bone trabeculae than obese subjects for pre-molars, but not for molars. Mental and panoramic mandibular indexes did not differ and were in normal level. Leptin concentration was dependent only on BMI. Conclusion:Obesity affected the periodontal conditions, the alveolar bone pattern, and the salivary leptin concentration.

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Background: Bariatric surgery may have a negative impact on oral bone structure. Aim: To verify the alveolar bone pattern through radiomorphometric indices of panoramic radiography and linear measurements performed in periapical radiographs in eutrophic and morbidly obese patients before and after bariatric surgery. Methods: The sample consisted of 31 women aged 20-35 years old, divided into two groups: obese group (GO-obese grade III) and control group (GC-eutrophic). Twenty eutrophic and 11 obese morbidities were evaluated in the pre and postoperative bariatric surgery (six months). Radiomorphometric and plaque indices were evaluated at T0 (baseline) and T1 (six months) times, in both groups. In the radiographic analysis the trabecular pattern through the Lindh visual ladder and the bone loss were evaluated by calculating the distance from the cement-enamel junction to the bone crest in periapical radiographs. Panoramic radiographs were used to measure the mandibular cortical index (ICM), mentonian index (IM) and panoramic mandibular index (MPI), in addition to the Turesky plate index. Results: There was a significant loss of bone in T1 in patients submitted to bariatric surgery, when compared to eutrophic patients (p<0.05). The trabecular pattern became sparser after surgery with a visual difference. The plate index showed a slight improvement after surgery and the eutrophic maintained similar values over time. Conclusion: The standard alveolar bone presents greater bone loss in obese patients and worsens this standard after bariatric surgery when compared to eutrophic patients. The same happens with the trabecular pattern that becomes sparser after bariatric surgery.

Objectives To evaluate tooth movement, orofacial pain, and leptin, interleukin (IL)–1β, and tumor necrosis factor (TNF)–α cytokine levels in the gingival crevicular fluid (GCF) during orthodontic treatment in obese adolescents. Materials and Methods Participants included adolescent patients aged 12–18 years: group 1, obese (n = 30), and group 2, nonobese controls (n = 30). They were evaluated before (T0) and after 1 hour (T1), 24 hours (T2), and 1 week (T3) of fixed appliance bonding. Periodontal examination (T0), collection of GCF (T1, T2, T3), and evaluation of Little's irregularity index (T0, T3) were performed, and a visual analog scale was used to measure pain (T1, T2, T3). Evaluation of IL-1β, TNF-α, and leptin cytokines was performed using a Luminex assay. Mann-Whitney and t-tests were used for intergroup comparisons, and a generalized estimating equation and cluster analyses were used for comparisons among observation times (P &lt; .05). Results The obese group had a higher prevalence of probing depth of ≥4 mm and bleeding on probing. Orthodontic tooth movement was similar in both groups. Peak of pain was at T2 in both groups and was higher in the obese patients. TNF-α showed a slight increase at T1, followed by a gradual decrease at T2 and T3 in both groups. The obese group had a higher concentration of IL-1β before and during orthodontic treatment. There was no difference in tooth movement between obese and control patients during the first week of orthodontic treatment. Conclusions Obese adolescents had a greater subjective report of orofacial pain after 24 hours of orthodontic treatment and higher concentrations of IL-1β proinflammatory cytokine before and during tooth movement as compared with nonobese control adolescents.

Evaluation of IL-1β, TNF-α and leptin during orthodontic movement in obese adolescents Orthodontic tooth movement and obesity influence the production of inflammatory cytokines. The present prospective Cohort study aimed to evaluate Interleukin-1 beta (IL-1β), Tumor Necrosis Factor-alpha (TNF-α) and leptin in gingival crevicular fluid (GCF), tooth movement and subjective assessment of orofacial pain during orthodontic. The sample consisted of 60 adolescents aged 12 to 18 years, divided into 2 groups: G1-Obese (n = 30) and G2-Eutrophic (n = 30). It was evaluated in 4 time: before bonding the fixed appliance (T0), 1 hour (T1), 24 hours (T2) and 1 week (T3) after the bonding of the fixed appliance. In T0, periodontal examination (depth of probing, index of gingival bleeding and presence of calculus), collection of GCF and evaluation of Little's irregularity index were performed. In T1 and T2, the GCF was collected and the Visual Analogue Scale (VAS) was applied for pain. And in T3, Little's irregularity index, GCF collection and VAS application for pain were evaluated. The evaluation of IL-1β, TNF-α and leptin was performed using the Luminex® assay. The Mann-Whitney test and Student's t-test were used to compare the two groups, and for the comparison between the phases (T0, T1, T2, T3), GEE and cluster (p <0.05). Obese had a higher prevalence of bleeding (p <0.05), calculus and depth probing of 4-5 mm before to the installation of the fixed appliance. Levels of IL-1β, TNF-α and leptin were higher in obese subjects at T0. The IL-1β reached its peak in 24h in the obese (20.1pg / ml) and in the eutrophic after one week (12.2pg / mL) of the fixed appliance installation, with significant difference between groups (p <0.05). TNF-α showed a slight increase after 1h, followed by a gradual decrease in T2 and T3 (p <0.05) in both groups. During tooth movement, leptin levels decreased in both groups in T1 and T2, returning to baseline levels in T3. The peak of pain was in T2 in both groups, being higher in the obese (p <0.05). Orthodontic tooth movement was similar in both groups after one week of treatment (p> 0.05). It was concluded that obese individuals had a higher concentration of IL-1β, TNF-α and leptin before and during orthodontic treatment, but there was no influence on tooth movement. Regarding orofacial pain, obese patients reported greater discomfort at all times.