Background/Aims: A link between oral cavity infections and chemotherapy-induced oral mucositis (CIOM) in patients with hematological malignancies (HMs) undergoing intensive chemotherapy (IC) or hematopoietic stem cell transplantation (HSCT) has been suggested. However, conclusive data are lacking, and there are no current guidelines for the prophylactic use of antimicrobials to prevent CIOM in these populations. Methods: The relationships between herpes simplex virus (HSV) reactivation and Candida colonization in the oral cavity and CIOM in patients with HMs undergoing IC or HSCT were evaluated. Patients aged ≥ 19 years with HMs undergoing IC or HSCT were enrolled. Each patient was evaluated for HSV and Candida in the oral cavity along with CIOM at baseline and during the 2nd, 3rd, and 4th weeks. Results: Seventy presentations among 56 patients were analyzed. CIOM was observed in 23 presentations (32.9%), with a higher incidence associated with HSCT (17 of 35 presentations, 48.6%) than with IC (six of 35 presentations, 8.6%). The reactivation of HSV-1 was significantly associated with an increased incidence of CIOM after adjusting for age, sex, type of disease, and treatment stage. A higher HSV-1 viral load was associated with an increased incidence of CIOM. The presence of Candida was not associated with CIOM. Conclusions: HSV-1 reactivation in the oral cavity was highly associated with CIOM in patients with HMs undergoing high-dose chemotherapy.
Ginseng is a traditional medicine that has been used for millennia. Asian ginseng (Panax ginseng Meyer) has multiple pharmacological properties. To determine the efficacy of ginseng-derived exosome-like nanoparticles (GDEs), GDEs should be isolated and characterized. GDEs from P. ginseng were isolated via sequential centrifugation using 68 and 27% of sucrose cushioning followed by ultracentrifugation. The size distribution, zeta potential, and morphology of GDEs were evaluated using DLS, NTA, and TEM. GDEs were quantified by measuring the total RNA and protein concentration. The stability of the freeze-dried GDEs was evaluated for 90 days. Uniform and reproducible GDEs were successfully isolated with high yield and purity. GDEs were found to be spherical with an average diameter of 105.8 nm and a negative surface charge of − 20.7 mV. Substantial amounts of nanoparticles of GDEs were counted using NTA, with a concentration of 2.05 × 1013 particles/mL. According to the evaluation of their protein and total RNA concentration, the freeze-dried GDEs were stable for up to 60 days at room temperature. The results suggest the utility of a brief isolation protocol using sucrose double fractionation, which can be used for the mass production of plant-derived exosome-like nanoparticles. In addition, the stability of GDEs was maintained even after freeze-drying and storage for 60 days. This method has potential for application in the research for plant-derived exosome-like nanoparticles, where cost-effective exosome isolation with high yield and purity is an important step.
Mask-wearing is still recommended owing to the continuing impact of the COVID-19 pandemic. Within the closed chamber created by the mask, people are increasingly self-aware of their oral malodor. In this prospective and cross-sectional study, we aimed to measure volatile sulfide compound (VSC) levels in patients with halitosis and investigate the oral microbiome profile on the inner surface of their KF94 masks. We also investigated which oral microbiota increases VSC levels and whether the oral microbiomes of oral saliva and mask are correlated. A total of 50 subjects (41 women, average age 38.12 ± 12.58 years old) were included in the study, 25 healthy subjects and 25 patients with halitosis who wore masks for more than 3 h. The dominant bacterial species, bacterial profile, and Shannon diversity index of whole unstimulated saliva and the inner surface of the mask were investigated. The bacterial 16S ribosomal RNA genes of the major oral bacterial species were analyzed using real-time PCR. Gas chromatography was used to measure hydrogen sulfide (H2S) and methyl mercaptan (CH3SH), which are representative VSCs. The total bacterial DNA copy number was significantly higher in the saliva sample than in the mask sample (p < 0.001), and the average value was 276 times greater. Shannon diversity index was also significantly higher in saliva than in the inner surface of the mask (2.62 ± 0.81 vs. 1.15 ± 1.52, p < 0.001). The most common Gram-negative and Gram-positive species in the masks were Porphyromonas gingivalis (Pg) and Lactobacillus casei (Lc), respectively. The bacterial species with significant positive correlations between saliva and mask samples were Prevotella intermedia (Pi) (r = 0.324, p = 0.022), Eikenella corrodens (r = 0.309, p = 0.029), Lc (r = 0.293, p = 0.039), and Parvimonas micra (Pm) (r = 0.366, p = 0.009). The mean value of CH3SH was significantly higher in the halitosis group than in the non-halitosis group (17.84 ± 29.00 vs. 3.84 ± 10.57 ppb, p = 0.031). In the halitosis group, the DNA copy numbers and VSC levels showed highly positive correlation coefficients in the order Pg, Treponema denticola (Td), Tannerella forsythia (Tf), Pi, and Prevotella nigrescens (Pn) (all p < 0.05). Regarding bacterial profiles of the mask, Td was strongly correlated with CH3SH (r = 0.414, p = 0.040) and total VSCs (r = 0.374, p = 0.033) only in halitosis group. Mask-wearing time was strongly correlated with total VSCs, H2S, and CH3SH (all r > 0.8, p < 0.001). Oral bacteria, whose association with halitosis has been identified, increased VSC levels in mask-wearing subjects during the COVID-19 pandemic, particularly the number of Gram-negative anaerobes such as Pg and Td. Mask-wearing time was a major factor in increasing VSC levels. The study results suggest that people with halitosis could control these Gram-negative bacteria by improving oral hygiene and regularly changing masks.
Background. The coronavirus disease 2019 (COVID-19) pandemic has impeded access to timely dental care, and there is an urgent need for adjuvant therapies that can reduce orofacial pain in emergencies. Aims. To provide information on the benefits and limitations of eight representative home remedies as palliative care for orofacial pain during the coronavirus disease 2019 (COVID-19) pandemic. Methods. PubMed and Medline were electronically searched for eight home remedies for orofacial pain that can be used in COVID-19. Papers published in English in the past 30 years were considered. Among the published studies suitable for the research purpose, those in which the abstract and body text were confirmed were targeted, and duplicate studies were excluded. Finally, 86 studies were included. Results. There is extensive and high-level scientific evidence for the application of tooth brushing and flossing, mouth rinsing with chlorhexidine, use of over-the-counter pain medication, and application of cryotherapy in emergencies. Gargling with salt water, brushing with bamboo salt, gargling with garlic juice, and oil pulling are traditional methods used for centuries. The use of natural products for orofacial pain has a significant empirical effect but has weak scientific evidence. Conclusions. Knowing the correct application method, effects, and side effects is desirable to use these methods appropriately in emergencies. However, scientific evidence is unclear and generally lacking for home remedies to be the main treatment strategy, and there are clear limitations to their use as a single main treatment.
Sleep bruxism (SB) is a condition characterized by repetitive clenching or grinding teeth and/or by bracing or thrusting of the mandible during sleep. Although SB is not considered a disorder in children, SB can be a potential physical and psychological hazard or consequence, and this study examines whether SB is a risk factor for TMD as it is in adults. A narrative review on the topic of inferring the relationship between sleep bruxism and TMD in children was performed based on a search in the PubMed and Google Scholar databases for articles published between 1999 and 2022. A total of 76 articles were included in this review. SB is very common in children, may be related to psychological distress or sleep breathing disorder, with a prevalence of up to 49%, and mainly occurs in the non-rapid eye movement stage in the sleep structure. SB may be one cause of TMD. The prevalence of TMD in children is 16–33%. Compared to the female-dominant TMD prevalence in adults, the sex-differences in TMD prevalence in children are less pronounced. However, TMD-related pain is more prevalent in girls than in boys. Given the complex etiology of each of SB and TMD in children, it can be inferred that the explanation of the relationship between the two conditions is very challenging. Ultimately, their relationship should be understood in the individual biopsychosocial model in the process of special physical growth and mental development of children. Moreover, appropriate clinical guidelines for a definitive diagnosis of SB and TMD in children and more research with a high scientific evidence level, which is comprehensive, considering physical, psychological, genetic, and social cultural factors, are required.
The purpose of this study was to investigate whether various saliva collection methods affect the observed salivary microbiome and whether microbiomes of stimulated and unstimulated saliva and plaque differ in richness and diversity.Methods: Methods: Seven sampling methods for unstimulated saliva, stimulated saliva, and plaque samples were applied to six orally and systemically healthy participants. Bacterial 16S ribosomal RNA genes of 10 major oral bacterial species, namely, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia, Prevotella nigrescens, Streptococcus mitis, Streptococcus sobrinus, and Lactobacillus casei, were analyzed by real-time polymerase chain reaction. We comprehensively examined the dependence of the amount of bacterial ribosomal DNA (rDNA), bacterial-community composition, and relative abundance of each species on sample collection methods.Results: Results: There were significant differences in the bacterial rDNA copy number depending on the collection method in three species: F. nucleatum, P. nigrescens, and S. mitis. The species with the highest richness was S. mitis, with the range from 89.31% to 100.00%, followed by F. nucleatum, P. nigrescens, T. denticola, T. forsythia, and P. intermedia, and the sum of the proportions of the remaining five species was less than 1%. The species with the lowest observed richness was P. gingivalis (<0.1%). The Shannon diversity index was the highest in unstimulated saliva collected with a funnel (4.449). The Shannon diversity index was higher in plaque samples (3.623) than in unstimulated (3.171) and stimulated (3.129) saliva and in mouthwash saliva samples (2.061). Conclusions: Conclusions:The oral microbial profile of saliva samples can be affected by sample collection methods, and saliva differs from plaque in the microbiome. An easy and rapid technique for saliva collection is desirable; however, observed microbial-community composition may more accurately reflect the actual microbiome when unstimulated saliva is assayed.
We present the case of a 60-year-old male with post-macrotrauma disc displacement and retrodiscitis, in which temporomandibular joint (TMJ) injection and manual therapy were used to alleviate his symptoms. He visited our clinic with complaints of pain and swelling in his right facial area and malocclusion of his right side teeth after being hit on the right side of his face five days earlier. During clinical and radiological examinations, the inflammatory state of the joint and disc displacement on the right side, which led to malocclusion, were noted. At the initial visit, we performed TMJ intracapsular injection and prescribed medications to control pain and inflammation. Simultaneously, manual manipulation was performed to relocate the disc. The same treatments were employed two days later. However, 10 days after the first visit, his symptoms did not mitigate substantially. We also performed magnetic resonance imaging (MRI), prescribed nortriptyline, and created a stabilization splint. MRI images depicted inflammatory disc displacement and joint effusion in the right TMJ. Based on the accurate diagnosis, we kept administering a stabilization splint, intra-articular injection, and medication. His signs and symptoms were alleviated 20 days after the initial visit and did not reoccur for the next 40 days.
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