Major considerations of dental care in COVID-19: an evidence-based on clinical studies and guidelines

Introduction: The COVID-19 pandemic has presented enormous challenges for dentists and patients. The risk of nosocomial transmission is a reality that requires the development of guidelines by the dental community to reduce the chances of infection by the new coronavirus. In this sense, it was necessary to implement alternative prophylactic techniques such as the adoption of oral rinses before dental care. Objective: To present the main considerations of clinical studies on dental care at COVID-19. Methods: The research was carried out from May 2021 to June 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the Systematic Review-PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: One study showed that 0.2% chlorhexidine and 1% povidone-iodine oral solutions are effective pre-procedural mouthwashes against salivary SARS-CoV-2 in dental treatments. It was observed in another study that the effect of reducing the salivary load with mouthwash with CPC and PI was maintained after 6 hours. PVP-I nasal and oral antiseptic solutions are effective in inactivating SARS-CoV-2 at a range of concentrations after exposure times of 60 seconds. There is sufficient in vitro evidence to support the use of antiseptics to potentially reduce the viral load of SARS-CoV-2. The effects against the new coronavirus in vivo still need more randomized clinical trials to prove its effectiveness. Conclusion: ACE2 receptors are highly expressed in the oral cavity, therefore, this could be a potential high-risk route for SARS-CoV-2 infection. The virus can be detected in saliva even before the appearance of symptoms of COVID-19. In this regard, randomized clinical studies have shown that some pre-procedure oral mouthwashes are effective against salivary SARS-CoV-2 in dental treatments. In addition, the American Academy of Implant Dentistry (AAID) reported on how COVID-19 impacts dental care through guidelines for general dentistry.

Disinfectants: Use of Different Types of Sanitization Techniques in 18th and 19th Centuries Britain and India

The article focuses on the use of different kinds of disinfectants used for sanitization and cleaning of public and private places for curbing the spread of diseases from one place to another. Multiple methods were employed for disinfection; some of which are easily accessible to the common people while others were particularly used in infirmaries and hospitals at the time of treatment. The article also shows that disinfectants were supplement to medicine and they target limiting of the contagion to a space whereas medicines were given for the treatment of patients. Historically, the eighteenth and nineteenth centuries witnessed unprecedented development in the field of chemistry which led to the discoveries of different types of antiseptic solutions and disinfectants apparently endorsed by the germ theory. Image Credit: Wellcome Library, London. Wellcome Images [email protected] http://wellcomeimages.org

Randomized Controlled Trial Evaluating the Efficacy and Cost Effectiveness of a Ready-to-Use Applicator Containing Iodine Povacrylex and Isopropyl Alcohol Compared with Conventional Skin Scrubbing and Painting in Patients Undergoing Colorectal Surgery

Objective: The aim of this study was to evaluate the efficacy and cost-effectiveness of a ready-to-use applicatorcontaining iodine povacrylex and isopropyl alcohol (IPIA) for the prevention of surgical site infection (SSI) followingintra-abdominal surgery.Materials and Methods: The IPIA was randomly used in patients who underwent colorectal surgical procedures.The control group for comparison was a group of patients who underwent colorectal surgical procedures usingconventional skin scrubbing and painting with antiseptic solutions without IPIA. In total, 100 patients were includedin the study, randomized into 2 groups: one was applied IPIA and another group a conventional skin preparation.The outcome measurements included ease-of-use as assessed by a questionnaire, preparation time comparison,estimated skin preparation expense, adverse reactions, and rate of SSI. All the patients were visited daily up to 7 dayspostoperation or until discharge, and then 14 and 30 days postoperatively for monitoring the occurrence of SSI.Results: Of the 100 patients undergoing elective intra-abdominal surgery enrolled in the study, 51 were males and49 females, with the mean age of 63.5 ± 11.3 years. The majority of the patients had undergone colorectal cancercolectomies or rectal resections. There was no mortality. Seven patients (7%) had postoperative SSI (4 patients inthe control group and 3 patients in the IPIA group, 4% vs. 3%, p = 0.45). The bacterial cultures revealed Gramnegative-bacilli in all of the patients with SSI. The preparation time for the skin preparation was 5.48 ± 2.49 min inthe control group and 2.65 ± 1.55 min in the IPIA group (p = 0.002), without statistical significance of expenses.Conclusion: IPIA was demonstrated to be as safe and effective as conventional antiseptic solutions as a skinpreparation to prevent SSI following colorectal surgery. With good ease of use, IPIA proved more convenient thana scrubbing preparation as well as offered better cost effectiveness by significantly reducing the time and cost ofthe skin preparation.

Randomized Controlled Trial Evaluating the Efficacy and Cost Effectiveness of a Ready-to-Use Applicator Containing Iodine Povacrylex and Isopropyl Alcohol Compared with Conventional Skin Scrubbing and Painting in Patients Undergoing Colorectal Surgery

Objective: The aim of this study was to evaluate the efficacy and cost-effectiveness of a ready-to-use applicatorcontaining iodine povacrylex and isopropyl alcohol (IPIA) for the prevention of surgical site infection (SSI) followingintra-abdominal surgery.Materials and Methods: The IPIA was randomly used in patients who underwent colorectal surgical procedures.The control group for comparison was a group of patients who underwent colorectal surgical procedures usingconventional skin scrubbing and painting with antiseptic solutions without IPIA. In total, 100 patients were includedin the study, randomized into 2 groups: one was applied IPIA and another group a conventional skin preparation.The outcome measurements included ease-of-use as assessed by a questionnaire, preparation time comparison,estimated skin preparation expense, adverse reactions, and rate of SSI. All the patients were visited daily up to 7 dayspostoperation or until discharge, and then 14 and 30 days postoperatively for monitoring the occurrence of SSI.Results: Of the 100 patients undergoing elective intra-abdominal surgery enrolled in the study, 51 were males and49 females, with the mean age of 63.5 ± 11.3 years. The majority of the patients had undergone colorectal cancercolectomies or rectal resections. There was no mortality. Seven patients (7%) had postoperative SSI (4 patients inthe control group and 3 patients in the IPIA group, 4% vs. 3%, p = 0.45). The bacterial cultures revealed Gramnegative-bacilli in all of the patients with SSI. The preparation time for the skin preparation was 5.48 ± 2.49 min inthe control group and 2.65 ± 1.55 min in the IPIA group (p = 0.002), without statistical significance of expenses.Conclusion: IPIA was demonstrated to be as safe and effective as conventional antiseptic solutions as a skinpreparation to prevent SSI following colorectal surgery. With good ease of use, IPIA proved more convenient thana scrubbing preparation as well as offered better cost effectiveness by significantly reducing the time and cost ofthe skin preparation.

Bactericidal activity of three different antiseptic ophthalmic preparations as surgical prophylaxis

Purpose In the era of antibiotic resistance, there is an increased interest in antiseptic solutions that might represent a reliable option for ocular surface disinfection. The objective of this study is to compare for the first time three different antiseptic ophthalmic preparations to assess their in vitro antimicrobial activity. Methods The antiseptic activity of three commercial ophthalmic solutions, IODIM (povidone-iodine 0.6% in hyaluronic acid vehicle—Medivis, Catania, Italy), OZODROP (nanoemulsion with ozonated oil—concentration not specified—FBVision, Ophthalmic Pharmaceuticals, Rome, Italy), and DROPSEPT (chlorhexidine 0.02% and vitamin E 0.5% Tocopherol Polyethylene Glycol 1000 Succinate—TPGS, Sooft Italia, Montegiorgio, Italy), was tested in vitro on six reference strains by time-killing assays. Viable cells were evaluated after 1, 15, 30 min; 2, 6, and 24 h exposure by seeding 100 µl of the suspension (or appropriate dilutions) on LB agar or Sabouraud-dextrose agar. All plates were incubated at 37 °C for 24 h and evaluated by manually counting the colonies. Results IODIM solution showed a very rapid microbicidal activity: the number of viable cells for all the tested strains was under the detection limit (less than 10 CFU/ml) already after 1 min exposure, and this result was maintained at every incubation time. The rapid antimicrobial activity of povidone-iodine was not replicated when testing the other two antiseptics. Conclusions The study reports the great efficacy in reducing bacterial load in a very short time of povidone-iodine 0.6% compared with other antiseptic preparations.

Antibacterial and Antifungal Capacity of Three Commercially Available Mouthwashes with Different Concentrations of Chlorhexidine

Chlorhexidine was introduced almost seven decades ago and has a myriad of applications in dentistry. Few studies have evaluated the antimicrobial and antifungal capacity of different concentrations of chlorhexidine mouthwashes. Therefore, the aim of this study, was to evaluate in vitro, the antibacterial and antifungal capacity of three commercially available mouthwashes in Costa Rica, with different concentrations of chlorhexidine, 0.12%, 0.06%, and 0.03%. The experimental method selected was the Kirby-Bauer method to evaluate the antibacterial and antifungal effect of each compound by measuring the inhibitory effect on Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, and Candida albicans strains, exposed to the antiseptic solutions. All samples showed some degree of antibacterial and antifungal effect. Even though we provide in vitro results, our findings are of relevance since all the species used in our experiment are microorganisms that may be present in dental plaque. Our results further support evidence that oral hygiene regimens may include mouthwashes with low doses of chlorhexidine and maintain reasonable antibacterial and antifungal efficacy.

MILKING ANTISEPTICS AGAINST BACTERIA MULTIDRUG-RESISTANT BOVINE MASTITIS

This work aims to verify the in vitro action of antiseptics used in the pre- and post-dipping against multidrug-resistant bacteria from bovine mastitis. Antiseptic solutions in the concentration of use of iodine, chlorhexidine and sodium hypochlorite were tested against Staphylococcus aureus (n=12), Staphylococcus sciuri (n=1), Staphylococcus lentus (n=1), Streptococcus sp. (n=1), Enterococcus faecalis (n=1), Enterococcus casseliflavus (n=1), Kocuria kristinae (n=2), Kocuria varians (n=1). Was verified the Minimal Inhibitory and Bactericidal Concentration. The cytotoxicity test complemented the work. It was found that the Minimal Inhibitory Concentration and Minimal Bactericidal Concentration of the iodine, sodium hypochlorite and chlorhexidine was effective in the values recommended for use, however the presence of organic material reduced the activity of the tested products. Chlorhexidine showed higher efficiency of the other disinfectants.

Prospects of using ultrasound therapy in combination with preparation possessing antiseptic effect in complex treatment of periodontitis

Ultrasound is able to have a multifaceted therapeutic effect in periodontitis. In therapeutic doses, it affects a variety of local tissue reactions, stimulates compensatory, restorative, protective and adaptive mechanisms.Ultrasound in dosages used in clinical practice does not have an independent, direct antibacterial effect. In this regard, in the treatment of periodontitis, where the microbial factor plays an important role, it is advisable to use antiseptic solutions as a contact medium for ultrasonic effects. The study of the comparative effectiveness of low-frequency and high-frequency ultrasonic effects in combination with the domestic antiseptic preparation miramistin, which, with high antibacterial effectiveness, is characterized by the absence of adverse side effects, in the treatment of periodontitis, is of significant scientific and practical importance.