OBJECTIVES:The objectives of this study were to estimate and compare the 1-year clinical success rates of triple antibiotic paste (TAP), double antibiotic paste (DAP), calcium hydroxide (CH) within regenerative endodontic procedures (REPs) on permanent necrotic immature teeth. MATERIALS AND METHODS:Trials investigating REP success were searched through MEDLINE, Scopus, Embase, Web of Science, GOOGLE Scholar (last update December 2025). Primary study quality was evaluated through the revised Cochrane Risk of Bias tool for Randomised Trials (RoB2). Pooled success rates with 95% confidence intervals (95% CIs) were assessed. Heterogeneity was investigated with the Cochran's Q and quantified with I2: The random-effects model was preferred to the fixed-effect model for I2 > 50%. Sensitivity (study quality, publication bias, study inclusion) and subgroup (scaffold type, world Region) analyses were made. The differences in pooled success rates between protocols were assessed and were evaluated using an equivalence range of -2.5%/+2.5%. The GRADE system was employed to evaluate the Quality of Evidence of the pooled success rates. RESULTS:Twenty-four studies of average quality were included involving 544, 64, 183 patients, for TAP, DAP, CH, respectively. The pooled success rates (tooth survival after 1 year with periapical healing, absence of signs and symptoms of pathology) were TAP 96.7% (95% CI, 94.8%-98.0%), DAP 84.2% (95% CI, 73.2%-92.0%), CH 97.4% (95% CI, 93.9%-99.1%). The pooled differences in success rates were TAP-DAP 12.5% (95% CI, 2.8%-22.1%, TAP superiority demonstrated), TAP-CH -0.7% (95% CI, -0.9%-2.5%, TAP/CH equivalence demonstrated), CH-DAP 13.2% (95% CI, 3.3%-23.0%, CH superiority demonstrated). Secondary analyses corroborated these results, although the overall statistical test power was low due to small sample sizes. The GRADE quality of evidence was high for TAP and CH, and low for DAP, due to substantial imprecision attributed to the small number of studies with small sample sizes. CONCLUSIONS:The lack of direct comparisons between protocols and of a common comparator did not allow for more robust analyses. Nevertheless, the use of TAP and CH as intracanal medicament within REPs resulted equivalent in eradicating the infection and promoting periapical healing in permanent necrotic immature teeth at 1-year follow up, and these protocols resulted superior over DAP. REGISTRATION:PROSPERO registration number: CRD42023484189.

This study analyzed standardized excess mortality due to specific causes during the Covid-19 pandemic across 33 European countries, using Eurostat data (2016-2021) and Our World in Data databases. Causes included circulatory and respiratory diseases, neoplasms, transport accidents, and "other" causes (e.g., diabetes, dementia, ill-defined conditions). Additional variables such as vaccination rates, economic and health indicators, demographics, and government stringency measures were also examined. Key findings include: (1) Most European countries (excluding Central and Eastern Europe), recorded lower than expected excess mortality from circulatory and respiratory diseases, neoplasms, and transport accidents. Ireland had the lowest excess respiratory mortality in both 2020 and 2021; (2) Croatia, Cyprus, Malta, and Turkey showed significant positive excess mortality from "other" causes, potentially linked to public health restrictions, with Turkey as an exception; (3) Regression analysis found that higher human development index and vaccination rates were associated with lower excess mortality. Policy Implications are: (1) Statistically significant positive or negative cause-specific excess mortality may indicate future health trends; (2) The pandemic and government stringency measures negatively affected mortality from "other" causes; (3) Strengthening health system resilience, investing in digital medicine, directing aid to countries with weaker systems, and supporting disadvantaged groups are key recommendations.

Recently data has become available on excess mortality rates due to specific causes during the Covid-19 pandemic. Using the Eurostat database from 2016 to 2021, deaths attributed to Covid-19 in 2020-2021 and all deaths, as well as deaths due to specific causes including diseases of the circulatory and respiratory systems, neoplasms and transport accidents, were tabulated for 33 European countries. From the Our World in Data database, vaccination rates, economic, health, demographic and government response stringency index variables were also tabulated. Among the key findings were using standardised rates: (1) With the exception of Central and Eastern European countries, in almost all countries, excess mortality rates due to diseases of the circulatory, respiratory systems and neoplasms were negative. Ireland had the lowest excess respiratory rates both years; (2) Significantly positive excess mortality rates appeared in Croatia, Cyprus, Malta and Turkey and were attributed to neoplasms, diabetes, dementia and ill-defined and unknown causes of mortality, respectively. Indications are that these were exacerbated by public health measures (apart from Turkey); (3) In regression analyses the human development index and vaccination rates were important explanations for all excess death rates; (4) Statistically significant positive or negative excess rates for a disease could be flags for increased rates in the future.

OBJECTIVE:Oral cancer is a major public health problem in India, with the highest number of cases and deaths in the world, and Betel Quid (BQ) chewing is responsible for almost 50% of cases. BQ Use Disorder (BUD) prevalence and severity have never been investigated among Indian BQ chewers. METHODS:In total, 1281 adult routine BQ chewers attending five dental healthcare centers were interviewed using a pretested 11-item BUD questionnaire based on the DSM-5 substance use disorder (SUD) diagnostic criteria. Demographic, lifestyle, and other BQ-related variables also were collected. RESULTS:Females were almost 80%, and two-thirds were rural residents. BQ was used prevalently with friends; the average initiation age was 24 years, and two-thirds used BQ daily. Severe and mild-to-moderate BUD was detected in 49% and 45% of individuals, respectively. The average BUD score (range 0-11) was 5.2. Sex-standardized severe BUD prevalence was 54.9% (95% confidence interval, 49.8%-59.7%). Female sex, older age, being married, using BQ with friends, and adding tobacco were inversely associated with severe BUD. Multicollinearity was noted among these factors. CONCLUSION:Severe BUD was highly prevalent in Indian BQ chewers. Intervention programs aimed at assisting chewers to quit the habit should account for this dramatic situation. Appropriate measures should be taken to effectively influence cessation rates.

BACKGROUND:New-onset lichen planus (LP) development following COVID-19 infection/vaccination is reported. Since case series cannot be used to study exposure-outcome associations, we designed this matched case-control study to investigate whether COVID-19-related events and de novo LP are associated. METHODS:Patients with histologically confirmed LP, newly diagnosed at the National Research Center of Dermato-Venereology of Moscow (September 2020-December 2022), were considered. Sex/age/ethnicity-matched controls attending the same Center in the same period for consultations on conditions unrelated to LP were selected. Cases/controls with known LP trigger factors were excluded. COVID-19-related events were: symptomatic COVID-19 (PCR-confirmed), and COVID-19 vaccination (viral vector vaccine) occurred ≤ 1 month before the visit at the Center. The association between COVID-19-related events and LP was assessed with conditional (Mantel-Haenszel method) and unconditional (logistic regression analysis adjusted for sex, age, and smoking) analyses. Subgroup analysis, with COVID-19 infection and vaccination treated separately, and sensitivity analysis on another group of patients with suspected LP, not confirmed histologically, were also made. RESULTS:Fifty-five case-control pairs were considered. Mean age (51 years), sex (56.4% females) and ethnicity (100% whites) distributions were the same in both groups. Conditional and unconditional odds ratios resulted 7.50 (95% Confidence Interval -95CI, 1.72-32.80), 4.45 (95CI, 1.63-12.15), respectively (p < 0.05). Subgroup analysis confirmed the association between symptomatic infection and LP, while sensitivity analysis corroborated the results of the primary analysis. CONCLUSIONS:This observational study, reporting a strong significant association between COVID-19 infection/vaccination and de-novo LP, suggests that COVID-19-related events, especially infection, could act as LP trigger factors.

OBJECTIVE:The COVID-19 pandemic had direct and indirect effects on oral and pharyngeal cancer (OPC) mortality due to high COVID-19 mortality risk among cancer patients, and to the COVID-19 response that caused treatment delays and reduced routine visits. This study investigated the excess OPC mortality in Europe during the early pandemic years. METHODS:Mortality and population data were gathered from the Eurostat database. The 2011-2019 mortality rates were used to estimate the 2020-2021 expected rates through joinpoint trend analysis. The excess mortality rates (observed minus expected mortality) with 95% confidence intervals (95 CIs) were assessed. RESULTS:Statistically significant negative excess age-standardized and crude (age strata <65 and ≥65 years) OPC mortality rates in males and females, in the European Union (EU, 27 countries) and Europe were reported. The estimated OPC missing deaths in EU were 831 (95 CI, 630-985) and 1240 (95 CI, 1039-1394) in 2020 and 2021, respectively, with differences between sexes, age strata, and countries. The OPC deaths in the EU and Europe were 3.6% and 3.5% lower than expected. CONCLUSION:Missing OPC deaths reported in Europe in 2020-2021 could be explained by changes in death certification of OPC patients who developed COVID-19, rather than a real OPC mortality decline.

ObjectivesThe objective of this systematic review and meta-analysis of observational studies was to assess whether herpes simplex virus type 1 (HSV-1) can infect endodontic periapical lesions. Materials and MethodsStudies with cross-sectional design investigating HSV-1 in periapical tissues of patients with symptomatic and asymptomatic acute and chronic apical periodontitis were searched through MEDLINE, Scopus, Embase, Web of Science, and Google Scholar. Pooled HSV-1 prevalence proportion with 95% confidence interval (95CI) in periapical lesions was assessed with both fixed-effect and random-effects models, with/without adjustment for study quality and publication bias. Result robustness was investigated through sensitivity and subgroup analyses. ResultsLiterature search, performed twice, provided 84 items, and eight remained for the meta-analysis; globally, there were 194 patients mostly adults. The pooled HSV-1 prevalence proportions, assessed with various methods, were 6.9% (95CI, 3.8-11.3%, fixed-effect); 6.8% (95CI, 3.6-11.0%, random-effects); 8.1% (95CI, 4.4-14.5%, quality-adjusted); and 4.8% (95CI, 2.0-11.4%; adjusted for small-study effect). ConclusionsThe results indicated that HSV-1 can colonize the periapical tissues of 3%-11% patients with periapical diseases. Such data do not imply a causative role of HSV-1 in disease development and advancement. Well-designed and large-sized prospective cohort studies should be added in the literature panorama.

The data that support the findings of this study are available from the corresponding author upon request. The study was approved by the local institutional ethics review board.

ObjectiveTo identify the teaching-learning process characteristics of Oral Pathology and Medicine (OP&M) related to oral potentially malignant disorders (OPMDs) and oral cancer (OC), in the dental schools' curricula in Mexico, to analyze the approach given to this topic worldwide, and to provide the possible solution strategies.Materials and MethodsQuestionnaires were sent to OP&M deans and professors from public Mexican Universities to explore the curriculum and academic profile of the dental schools. The recommendations gathered from a workshop with expert professors on the challenges in OPMD/OC teaching were reported.ResultsTwenty-two dental schools participated (22 deans, 30 professors). The most widely used strategies were clinical-case resolving (86%) and presentations (73%). Although 77.3% of the programs included maxillofacial lesions, only 40.9% contemplated OPMD/OC. Only 45% of the programs developed community activities for early OC detection. The workshop recommendations were (i) multidisciplinary approach to OPMD/OC teaching, involving OP&M professors in other dental and nondental courses; (ii) implementation of the most effective teaching techniques (currently, problem-based learning and clinical-case presentation) in OP&M curricula; (iii) education of OP&M professors on teaching-learning processes.ConclusionsThese recommendations from the Mexican context, integrated with similar experiences from other countries could contribute to develop a unique, internationally acknowledged OP&M curriculum.

Oral DiseasesVolume 29, Issue 4 p. 1887-1888 LETTER TO THE EDITOR In defense of open scientific discussion. Reply to Dr. McMahon Giovanni Lodi, Corresponding Author Giovanni Lodi [email protected] orcid.org/0000-0002-0218-8292 Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milano, Italy Correspondence Giovanni Lodi, Università degli Studi di Milano, via Beldiletto 1, 20142 Milano, Italy. Email: [email protected]Search for more papers by this authorGulshan Sunavala-Dossabhoy, Gulshan Sunavala-Dossabhoy orcid.org/0000-0001-9204-6513 LSU Health Sciences Center in Shreveport and Feist Weiller Cancer Center, Shreveport, LA, USASearch for more papers by this authorStefano Petti, Stefano Petti orcid.org/0000-0001-9996-8860 Department of Public Health and Infectious Diseases, Sapienza University, Rome, ItalySearch for more papers by this author Giovanni Lodi, Corresponding Author Giovanni Lodi [email protected] orcid.org/0000-0002-0218-8292 Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milano, Italy Correspondence Giovanni Lodi, Università degli Studi di Milano, via Beldiletto 1, 20142 Milano, Italy. Email: [email protected]Search for more papers by this authorGulshan Sunavala-Dossabhoy, Gulshan Sunavala-Dossabhoy orcid.org/0000-0001-9204-6513 LSU Health Sciences Center in Shreveport and Feist Weiller Cancer Center, Shreveport, LA, USASearch for more papers by this authorStefano Petti, Stefano Petti orcid.org/0000-0001-9996-8860 Department of Public Health and Infectious Diseases, Sapienza University, Rome, ItalySearch for more papers by this author First published: 09 March 2023 https://doi.org/10.1111/odi.14560Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume29, Issue4May 2023Pages 1887-1888 RelatedInformation

Adjuvant radioactive iodine (RAI) is administered to thyroid cancer patients following thyroidectomy for remnant tissue ablation and metastatic disease management. Patients are prepared with thyroid hormone withdrawal (THW) or recombinant human thyroid stimulating hormone (rhTSH). Long-term salivary gland dysfunction (LT-SGD) is a common, dosage-dependent, RAI adverse effect. Although rhTSH preparation seems to reduce LT-SGD, this effect could be due to lower RAI activity generally used in rhTSH-prepared patients. Therefore, this meta-analysis investigated the effect of preparation type on LT-SGD development. Literature search (PubMed, Medline, EmBase, Cochrane, Web of Science, LILACS, Google Scholar) was performed four times (January-November 2022) and studies reporting LT-SGD incidence >= 1 year after RAI in patients prepared with rhTSH/THW were identified. The LT-SGD risk ratio (RR) was estimated with various models considered for sensitivity analysis (fixed-effect, random-effects, study-quality adjusted, publication-bias adjusted, individualpatient-data meta-analysis adjusted for RAI). Subgroup analysis according to RAI activity (<3.7/>= 3.7 GBq) also was performed. Literature search resulted in five studies (321 rhTSH, 632 THW patients). The pooled RRs according to various models were 0.65 (95% confidence interval -95CI, 0.49-0.86; fixed-effect); 0.62 (95CI, 0.38-1.02; random-effects); 0.72 (95CI, 0.54-0.96; quality adjusted); 0.76 (95CI, 0.58-0.99; publication-bias adjusted); 0.0.80 (95CI, 0.55-1.14; individual-patient-data meta-analysis). The pooled RRs stratified for RAI activity were 0.26 (95CI, 0.05-1.30) for <3.7 GBq; 0.75 (95CI, 0.57-0.98) for >= 3.7 GBq. The number of patients needed to be prepared with rhTSH to prevent one case of LT-SGD ranged between seven and thirty-seven. There is moderate-quality scientific evidence that rhTSH preparation may consistently protect salivary gland function.

Journal of the European Academy of Dermatology and VenereologyEarly View LETTER TO THE EDITOR New-onset pemphigus vulgaris and pemphigus foliaceus following COVID-19 infection and vaccination, systematic review of case reports and a causal hypothesis S. Petti, Corresponding Author S. Petti [email protected] orcid.org/0000-0001-9996-8860 Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy Correspondence S. Petti, Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy. Email: [email protected]Search for more papers by this authorP. G. Arduino, P. G. Arduino Department of Surgical Sciences, University of Turin, Turin, ItalySearch for more papers by this author S. Petti, Corresponding Author S. Petti [email protected] orcid.org/0000-0001-9996-8860 Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy Correspondence S. Petti, Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy. Email: [email protected]Search for more papers by this authorP. G. Arduino, P. G. Arduino Department of Surgical Sciences, University of Turin, Turin, ItalySearch for more papers by this author First published: 16 June 2023 https://doi.org/10.1111/jdv.19271Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat REFERENCES 1Koneczny I. A new classification system for IgG4 autoantibodies. Front Immunol. 2018; 9: 97. 2Tavakolpour S. Pemphigus trigger factors: special focus on pemphigus vulgaris and pemphigus foliaceus. Arch Dermatol Res. 2018; 310: 95–106. 3Irrgang P, Gerling J, Kocher K, Lapuente D, Steininger P, Habenicht K, et al. Class switch towards non-inflammatory, spike-specific IgG4 antibodies after repeated SARS-CoV-2 mRNA vaccination. Sci Immunol. 2023; 8:eade2798. 4Buhre JS, Pongracz T, Künsting I, Lixenfeld AS, Wang W, Nouta J, et al. mRNA vaccines against SARS-CoV-2 induce comparably low long-term IgG fc galactosylation and sialylation levels but increasing long-term IgG4 responses compared to an adenovirus-based vaccine. Front Immunol. 2023; 13:1020844. 5Aram K, Patil A, Goldust M, Rajabi F. COVID-19 and exacerbation of dermatological diseases: a review of the available literature. Dermatol Ther. 2021; 34:e15113. 6Arduino PG, Gambino A, Broccoletti R. SARS-CoV-2 infection does not seem to worsen the clinical course of patients with oral autoimmune disease. Oral Dis. 2022; 28: 2593–4. 7Sprow G, Afarideh M, Dan J, Feng R, Keyes E, Grinnell M, et al. Autoimmune skin disease exacerbations following COVID-19 vaccination. Front Immunol. 2022; 13:899526. 8Joly P, Horvath B, Patsatsi Α, Uzun S, Bech R, Beissert S, et al. Updated S2K guidelines on the management of pemphigus vulgaris and foliaceus initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol. 2020; 34: 1900–13. 9Kridin K, Schmidt E. Epidemiology of pemphigus. JID Innov. 2021; 1:100004. 10Peryer G, Golder S, Junqueira D, Vohra S, Loke YK. Chapter 19: Adverse effects. In: JPT Higgins, J Thomas, J Chandler, M Cumpston, T Li, MJ Page, et al., editors. Cochrane handbook for systematic reviews of interventions version 6.3. London: Cochrane; 2022 Available from: https://training.cochrane.org/handbook/current/chapter-19 Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

BACKGROUND AND OBJECTIVES:This meta-analysis of observational studies (PROSPERO registration number CRD42021236054) sought to investigate strength and generalizability of the association of herpes simplex virus type 1 (HSV-1) in subjects with plaque-induced gingivitis and periodontitis, since the data from literature are contrasting.MATERIAL AND METHODS:Case-control and cross-sectional studies, investigating HSV-1 in subgingival plaque/crevicular fluid and periodontal status, were searched through MEDLINE via PubMed, Scopus, Web of Science and Google Scholar. From each study the crude odds ratio (OR) with 95% confidence interval (95CI) was extracted, and the pooled OR was assessed for periodontitis, chronic and aggressive, and gingivitis. The meta-analytic method was chosen based on the level of heterogeneity. The generalizability of results, determined by the meta-analysis bias, was investigated through secondary analyses including sensitivity analyses for study quality, publication bias, and study inclusion, and subgroup analyses for quality of scientific journals that published the primary studies, world Region, subgingival plaque sampling method and study design.RESULTS:Twelve studies were included (738 cases, 551 controls). The pooled ORs were 4.4 (95CI, 1.9-10.2) for any periodontitis; specifically, 2.8 (95CI, 1.0-8.3) for chronic periodontitis, 11.8 (95CI, 5.4-25.8) for aggressive periodontitis and 4.8 (95CI, 2.1-11.0) for gingivitis. These estimates were statistically significant, excluding for chronic periodontitis, resulting marginally significant (p = .05). Secondary analyses on any and aggressive periodontitis, and, partly, chronic periodontitis corroborated the results, while the material was insufficient for secondary analyses on gingivitis.CONCLUSIONS:The results obtained indicated that HSV-1 is associated with periodontitis, while data about gingivitis are inconclusive. HSV-1 investigation in subgingival plaque could help assess periodontitis risk and severity and, if causal association were confirmed, could contribute to its control.