Using CBCT, occurrences of ≥2 mm maxillary facial alveolar bone were found on no more than 3% of root surfaces 1.0 to 5.0 mm apical to the bone crest in this sample of maxillary central incisors. The study evidenced prevalence of a thin facial alveolar bone (<2 mm) that may contribute to risk of facial bone fenestration, dehiscence, and soft tissue recession after immediate implant therapy.
Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in late 2019, the world has faced a major healthcare challenge. There remains limited understanding of the reasons for clinical variability of coronavirus disease 2019 (COVID-19), and a lack of biomarkers to identify individuals at risk of developing severe lung disease. This article aims to present a hypothesis on a vascular route of transfer of SARS-CoV-2 from the oral cavity to the lungs. Saliva is a reservoir of SARS-CoV-2, thus any breach in the immune defenses of the mouth may facilitate entrance of the virus to the vasculature through the gingival sulcus or periodontal pocket. From the oral vasculature, the virus would pass through veins of the neck and chest, and reach the heart, being pumped into pulmonary arteries, and to the small vessels in the lung periphery. The binding of the virus to the angiotensin-converting enzyme 2 receptor (ACE2), present on the endothelial surface of lung vessels, inactivates ACE2 and increases angiotensin-II levels, leading to pulmonary vasoconstriction and immunothrombosis (inflammatory-mediated clotting). This leads to vascular congestion, proximal vasodilatation, and subsequent lung parenchymal damage mediated by endothelial dysfunction. The biological rationale for the oral-vasculo-pulmonary route of infection is discussed in detail in this article, including pertinent radiological and oral cavity scientific findings. We propose that dental plaque accumulation and periodontal inflammation would further intensify this pathway. Therefore, it is suggested that daily oral hygiene and oral healthcare should be prioritized as such measures could be potentially lifesaving for COVID-19 patients. If this proposed pathological pathway is verified, it would be hugely significant in terms of understanding disease management. Simple low-cost measures, such as use of specific mouthwashes, could decrease the salivary viral load, and help prevent or mitigate the development of lung disease and severe COVID-19.
Curcumin, the main bioactive ingredient in turmeric, has been used to treat multiple diseases and conditions due to its numerous health benefits and therapeutic effects. The properties of natural and chemically modified curcumin (CMC) have been extensively investigated, with strong evidence on its anti-inflammatory, antimicrobial (antibacterial, antiviral, antifungal properties), antioxidant, anti-angiogenic, anti-carcinogenic, antispasmodic, hepato-protective, and wound healing properties. The aim of this review aims to present an overview of the use of curcumin in periodontal therapy and the biological mechanisms behind its properties. Findings from in vitro studies suggest that curcumin can promote osteogenesis, down regulate proteases, promote wound healing, and suppress periodontal bacteria. Results from animal studies suggest the potential of curcumin to reduce periodontal inflammation and alveolar bone loss. Topical application of curcumin has been evaluated in clinical studies as an adjunct to periodontal therapy in the form of gel, mouthwash, irrigation solution, adhesive strip, sponge, and chip. The benefits of the topical use of curcumin have been compared to those of chlorhexidine and have been widely confirmed in pre-clinical studies. The majority of clinical studies report superior clinical and microbiological results when curcumin is used in combination with mechanical therapy. Nonetheless, there is a lack of randomized clinical trials with long-term follow-up and adequate sample
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