Caries Experience before and after COVID-19 Restrictions: An Observational Study

Background: The declaration of COVID-19 as a pandemic by the World Health Organization in 2020 led to the suspension of several clinical practices globally, including dentistry. This study investigates the impact of these restrictions on dental caries experience. Methods: A retrospective cross-sectional study was conducted at Egas Moniz University's dental hospital in the Lisbon Metropolitan Area from June 2019 to June 2021. The study involved 3380 participants who were divided into two cohorts: after and before COVID-19 restrictions. Data collection included a questionnaire, full-mouth clinical examinations, and radiographs (panoramic X-rays, bitewings). Results: Before the COVID-19 restrictions, the prevalence of dental caries was 91.8%, with an average DMFT (decayed, missing, and filled teeth) index of 12.13. Post-restrictions, the prevalence decreased to 84.5%, with a DMFT index of 10.99. There was an increase in missing teeth and a decrease in decayed and filled teeth. Additionally, the frequency of toothbrushing declined among participants. Conclusions: The COVID-19 pandemic restrictions have significantly impacted dental caries experiences and oral health, highlighting a decrease in dental caries, but also a concerning reduction in oral hygiene practices. These results emphasize the importance of customized dental healthcare during public health emergencies to reduce impacts and maintain oral health.

Caries Experience and Risk Indicators in a Portuguese Population: A Cross-Sectional Study

Oral health surveys are essential for assessing the dental caries experience and to influence national policies. This retrospective cross-sectional study aims to analyze dental caries experience for which dental treatment was sought in a reference university dental hospital at the Lisbon Metropolitan Area between January 2016 and March 2020. Full-mouth examination, and sociodemographic, behavior, and medical information were included. Descriptive analyses and logistic regression analysis were applied to ascertain risk indicators associated with dental caries experience. A final sample of 9349 participants (5592 females/3757 males) were included, aged 18 to 99 years old. In this population, caries experience was 91.1%, higher in female participants. Age (OR = 1.01, 95% CI [1.00-1.02], occupation (OR = 2.94, 95% CI [2.37-3.65], OR = 3.35, 95% CI [2.40-4.67], OR = 2.55, 95% CI [1.66-3.91], for employed, unemployed, and retired, respectively), overweight (OR = 1.52, 95% CI [1.18-1.96]), reporting to have never visited a dentist (OR = 0.38, 95% CI [0.23-0.64], and self-reported week teeth status (OR = 2.14, 95% CI [1.40-3.28]) were identified as risk indicators for the presence of dental caries, according to adjusted multivariable logistic analyses. These results highlight a substantial rate of dental experience in a Portuguese cohort and will pave the way for future tailored oral public health programs in Portugal.

Walking Clinic in ambulatory surgery--A patient based concept: A Portuguese pioneer project

INTRODUCTION

Walking Clinic is an innovative, efficient and easily reproducible concept adapted to ambulatory surgery. It consists of a preoperative single day work-up, with a surgeon, an anesthetist and a nurse. The aim of this study was to evaluate patient satisfaction and its determinants.

METHODS

A survey was applied to 171 patients (101 of the Walking Clinic group and 70 not engaged in this new concept). Patient satisfaction was assessed evaluating five major questionnaire items: secretariat (quality of the information and support given), physical space (overall comfort and cleanliness), nurses and medical staff (willingness and expertise), and patients (waiting time until pre-operative consults and exams, waiting time until being scheduled for surgery, surgery day waiting time and postoperative pain control). Furthermore, overall assessment of the received treatment, and probability of patient recommending or returning to our ambulatory unit were also analyzed.

RESULTS

Walking Clinic group had overall better results in the five major questionnaire items assessed, with statistical significance, except for the physical space. It also showed better results regarding the sub-items postoperative pain control, waiting time until being scheduled for surgery and surgery day waiting time.

DISCUSSION

The results confirm better patient satisfaction with this new concept.

CONCLUSION

The Walking Clinic concept complements all the tenets of ambulatory surgery, in a more efficient manner.

Gastric cytoprotective activity of ilicic aldehyde: Structure–activity relationships

A series of sesquiterpene compounds possessing both eudesmane and eremophilane skeletons were tested as gastric cytoprotective agents on male Wistar rats. The presence of an alpha,beta-unsaturated aldehyde on the C-7 side chain together with a hydroxyl group at C-4 is the requirement for the observed antiulcerogenic activity. In an attempt to establish new molecular structural requirements for this gastric cytoprotective activity, a structure-activity study was performed.

Anti-inflammatory activity and effect on gastric acid secretion of dehydroleucodine isolated from Artemisia douglasiana

The effect of Dehydroleucodine (DhL) on gastric acid secretion in rats was investigated at a dose of 40 mg/kg, while its anti-inflammatory effect was investigated in two experimental models: arthritis induced by Freund's adjuvant carrageenan- and cotton pellet-induced granuloma. DhL did not inhibit gastric acid secretion, suggesting that its anti-ulcerogenic effect can be attributed to its action on the mucosa defense factors. On the other hand, DhL inhibited both chronic and acute adjuvant carrageenan-induced inflammation phases, being most effective in the chronic phase. In the granuloma test, DhL also inhibited inflammation. It is suggested that the anti-inflammatory activity of DhL may be attributed to interference with multiple targets on the level of transcription factors, such as NF-kappaB, and cytokines.

Bioconversion of ilicic alcohol and derivatives with cultures of filamentous fungi

Aspergillus niger cultures monohydroxylate ilicic alcohol in C-3 in a cis position with respect to the methyl groups at C-4 and C-10, and trans position with respect to the hydroxyl group of C-4. Furthermore, Aspergillus niger cultures reduce ilicic aldehyde to its corresponding alcohol.

The sesquiterpene lactone dehydroleucodine reversibly inhibits Allium cepa L. root growth

Here, we prove that dehydroleucodine, a sesquiterpene lactone, at low concentrations (25-100 microM) slowed down the Allium cepa L root growth by 22-70% respectively neither affecting cell viability nor cell size. Removal of the drug after 24 h incubation restored the normal growth rate of the roots. Higher concentrations (200 microM) of dehydroleucodine were deleterious for the roots. As cell size did not change, it is most likely that dehydroleucodine affected some event of cell division cycle making it longer. Thus, dehydroleucodine could be a useful tool to slow down cell proliferation.

Antioxidant activity of Artemisia douglasiana besser extract and dehydroleucodine

The charge (relative concentration) of antioxidants in aqueous extract and dehydroleucodine (DhL) from Artemisia douglasiana Besser was determined employing a procedure based on the quenching of luminol-enhanced chemiluminescence. Total reactive antioxidant potential (TRAP) and total antioxidant reactivity (TAR) values were determined. The data reported in the present work indicate that the extract of Artemisia douglasiana Besser and DhL showed antioxidant capacity. This activity is more pronounced in the extract, suggesting the presence of several antioxidants in Artemisia douglasiana.

Enhancement of tessaric acid production in Tessaria absinthioides cell suspension cultures

The total production of the sesquiterpene tessaric acid (TA) by cell cultures of Tessaria absinthioides at day 25 of the culture period reached 0.086 mg g^-1 DW, with intracellular accumulation accounting for 0.059 mg g^-1 DW. Dimethylsulfoxide-induced permeabilization of the cells effected both total production and extracellular accumulation of the sesquiterpene to reach levels of 148% and 271%, respectively. Cultures treated with elicitor preparations of Verticillum sp., Monodyctis cataneae, Acremonium sp., and Aspergillus niger produced TA at levels of 281%, 197%, 149%, and 139%, respectively. Treatment of cell suspension cultures with cis-(-)-jasmonic acid (5 μM) increased production to 267%, whereas jasmonic acid pretreatment and subsequent elicitation raised external tessaric acid to 702%.

Gastric anti-ulcer activity of several alpha,beta-unsaturated carbonyl compounds in rats

The gastric cytoprotective activity of several molecules containing an alpha,beta-unsaturated carbonyl system is reported. We attributed this gastroprotective activity to the presence of a non-hindered Michael acceptor in the molecules assayed and suggested that the mechanism of protection would involve, at least in part, a nucleophilic attack of the sulphydryl group of the gastric mucosa to the beta carbon of the Michael acceptors of the compounds assayed.

The sesquiterpene lactone dehydroleucodine (DhL) affects the growth of cultured epimastigotes of Trypanosoma cruzi

Here, we report an inhibitory effect of a sesquiterpene lactone dehydroleucodine (DhL) on the growth of Trypanosoma cruzi in culture. At concentrations of the drug between 5 and 10 microg/ml in the medium,the parasites remained alive for at least 4 days. Higher concentrations of DhL were lethal for the parasites within a few hours. The effect of DhL is irreversible. Morphological changes induced by DhL were also observed in the parasites. The effect of DhL was blocked by the presence of reducing substrates such as glutathione or dithiothreitol, but these agents were not able to reverse the effect of DhL if added 2 days after the start of drug exposure.

Effect of dehydroleucodine in experimental colitis in rats and mice

Dehydroleucodine (DhL), a sesquiterpene lactone (SQL) of the guaianolide type isolated from Artemisia douglasiana Besser, shows a pharmacological cytoprotective effect and significantly prevents the formation of gastric and duodenal lesions induced by various necrotising agents in rodents. The effects of DhL, on two models of experimental colitis were examined. Colitis was produced in male Wistar rats by rectal instillation of 5 and 10% acetic acid, following the methods of Eliakim et al. and Le Duc et al., respectively. In mice colitis was produced by rectal instillation of 0.1 ml of 2,4,6-trinitrobenzene sulphonic acid (5 mg in 50% ethanol) (TNB) as previously described by Chin et al. In this study, the administration of DhL 40 mg kg(-1)(1 h before the induction of colitis) significantly decreased mucosal damage. This effect was consistent in both models. The protection provided by DhL was accompanied by significant decreases in diarrhoea and colon weight; and histologically normal mucosa without ulceration and mucus production were observed. This study shows that both TNB and acetic acid colitis can be pharmacologically controlled by DhL. Our results suggest that the protective activity of DhL in experimental colitis is mediated, at least in part, through the increase of glycoprotein synthesis, anti-inflammatory effect and inhibition of COX-2 induction, and by inhibiting the degranulation of cells containing monoamines.

Anti-inflammatory activity of acetophenones from Ophryosporus axilliflorus

Seven acetophenone derivatives were isolated from the aerial parts of Ophryosporus axilliflorus (Griseb.) Hieron. These compounds were subjected to the carrageenan-induced mouse paw edema test where tremetone (7) showed extremely anti-inflammatory activity. Furthermore, the non-benzofuran acetophenones 5 and 6, showed a significant response.

Growth-inhibitory activities of benzofuran and chromene derivatives toward Tenebrio molitor

Growth-inhibitory activities of selected natural benzofurans (4-9), trans-cinnamic acid derivatives (10-13), chromene compounds (14 and 16), and some semisynthetic derivatives were determined in last instar larvae of Tenebrio molitor via topical administration in Me2CO. The most inhibitory of the tested compounds were 3-gamma, gamma-dimethylallyl-p-coumaric acid (10) and the benzofuran derivative 12-(p-cumaroyloxy)-tremetone (5), the former compound acting on the pupae and the latter on the last instar larvae. Several developmental deficiencies were observed, and some structure-activity relationships are discussed.

Acute and chronic antiinflammatory effects of plant flavonoids

The antiinflammatory activities of 30 flavonoids isolated from several plants of the Compositae family were investigated using carrageenan-induced mouse paw edema and cotton pellet-induced rat granuloma. Compounds were administered with a unique dose of 75 mg/kg i.p. in the acute test with carrageenan and 25 mg/kg/day in the chronic granuloma test. Flavonoids inhibit the development of the induced granuloma, mostly when a catechol or guaiacol-like B ring is contained in the compound structure, jaceosidin being the most active flavonoid screened. Flavonoids significantly inhibited the maximum edema response in the acute test. We conclude that several of the isolated flavonoids tested here showed antiinflammatory effects, depending on the experimental model used.

Gastric cytoprotective activity of dehydroleucodine in rats. Role of nitric oxide

Previously we reported that dehydroleucodine (DhL), a sesquiterpene lactone, shows gastric and duodenal cytoprotective activity. The mechanism is not mediated by antiacid secretory action; DhL stimulated mucus production and indomethacin pretreatment reduced cytoprotective action. In the present study we demonstrated that the gastric cytoprotective effect is antagonized by the nitric oxide (NO) synthase inhibitor, NG-nitro-L-arginine. The inhibitory action of NG-nitro-L-arginine is reversed by L-arginine, but not D-arginine. The findings suggest that NO is involved in the gastroprotection induced by DhL.

Gastric cytoprotective activity of dehydroleucodine in rats. Role of prostaglandins

Previously, we reported that dehydroleucodine (DhL), a sesquiterpene lactone, protected the gastric mucosa of rats from absolute ethanol-induced lesions in a dose-dependent fashion. The mechanism is not mediated by an antiacid secretory action and DhL stimulated mucous production. In the present study, we report the effect of DhL on the mucosal production of prostaglandin E (PGE) and the mucosal release of PGE2 in rats stomach. DhL in acute treatment does not modify these values decreased by previous treatment with indomethacin or absolute ethanol. However, DhL in subchronic treatment significantly enhanced the mucosal production of PGE and the mucosal release of PGE2. Also, indomethacin pretreatment resulted in a significant reduction of the cytoprotective action of DhL. These results indicate the participation of endogenous prostaglandins in DhL protection against ethanol damage. Moreover, we suggest that the gastric protective activity of DhL against ethanol induced gastric mucosal damage is mediated, at least in part, through PGE and PGE2 in subchronic treatment.

Gastric cytoprotective activity of 2-cyclopenten-1-one and related compounds

The cytoprotective activity of the isolated functional groups of several sesquiterpene lactones is reported. Among them the highest activity is shown by alpha-methylen-gamma-butyrolactone and 2-cyclopenten-1-one. The activity shown by those Michael acceptors with a beta carbon hindered by an alkyl substituent was always lower or almost null. A three-way mechanism of action is proposed: a) reduced glutathione synthesis, b) prostaglandin synthesis and c) mucosal glycoprotein synthesis.

Mucus synthesis and sulfhydryl groups in cytoprotection mediated by dehydroleucodine, a sesquiterpene lactone

The aerial parts of Artemisia douglasiana have been used in folk medicine as a cytoprotective agent against the development of peptic ulcer. Dehydroleucodine [1], its active principle, significantly prevents the formation of gastric lesions induced by the exposure of the rats to absolute ErOH. It was found in this study that (a) pretreatment of rats with 1 (40 mg/kg, po) caused a significant increase in glycoprotein synthetic activity, approximately sevenfold as large as that of the control; and (b) pretreatment of the rats with the thiol reagent N-methylmaleimide (NEM) significantly diminished the cytoprotection provided by 1. However, the protective effect of 1 was not totally abolished by pretreatment with a combination of indomethacin and NEM, indicating additional mechanisms are involved in the cytoprotective action of 1.

Structure-activity relationship in the gastric cytoprotective effect of several sesquiterpene lactones

The structural requirements for the gastric cytoprotective activity of several sesquiterpene lactones are reported. A theoretical-experimental study on the potentially active centers is carried out. The biological evaluation of reduced analogues and the simulation of the molecular interactions between these compounds and an endogenous cysteine residue suggest that the presence of a non sterically hindered Michael acceptor seems to be an essential structural requirement for the cytoprotective activity in this family of compounds. This observation suggests that cytoprotection is mediated through a Michael reaction between the sulfhydryl-containing peptides of the mucosa and Michael acceptors present in the molecules under study. This mechanism of action is in addition to and distinct from the one proposed in our previous paper, namely, that these sesquiterpenes stimulate endogenous synthesis of prostaglandins.

Dehydroleucodine prevents ethanol-induced necrosis in the rat gastric mucosa. A histological study

The aerial part of Artemisia douglasiana Besser (6) has been used in folk medicine as a cytoprotective agent against the development of peptic ulcer. The dehydroleucodine (DhL), its active principle, significantly prevents the formation of gastric lesions induced by the exposure of the rats to absolute ethanol orally administered. The stomachs of control and experimental rats (after ethanol and pretreated with DhL) were removed, opened along the greater curvature and studied under stereo microscope and with light and scanning electron microscope. Absolute ethanol produced focal visible hemorrhagic lesions, extensive hyperemia, vascular stasis, cell disruption, and necrosis of the mucosa. Abundant mass of mucus was observed with scanning. The stomachs of rats pretreated with DhL showed a reduction of lesions. No hemorrhage and hyperemia were observed. The epithelia of the mucosa had a cobblestone appearance, similar to control rats and was covered by a fine layer of mucus. The mechanism of the protective action of DhL is unknown although it seems to be related to endogenous prostaglandins (PG).

The gastric cytoprotective effect of several sesquiterpene lactones

The aerial part of Artemisia douglasiana, used in folk medicine as a cytoprotective agent against the development of peptic ulcer, was studied, its active principle dehydroleucodine [1] isolated, and its pharmacological properties analyzed. In order to establish whether or not the reported activity is particular to sesquiterpene lactones, the study of the cytoprotective activity of several related guaianolides and pseudoguaianolides from plants was undertaken. Ludartin [3], 8-angeloyloxy-3-hydroxyguaia-3(15),10(14),11(13)-trien-6,12- olide [4], hymenin [5], mexicanin I [6], helenanin [7], and 9-O-desacetylsparthulin-2-O-angelate [8] were found to exhibit protection. Desacetoxymatricarin [2] did not show cytoprotective activity. The results obtained from the different sesquiterpene lactones studied suggest that the presence of the alpha-methylene-gamma-lactone moiety is, in principle, a requirement for the observed antiulcerogenic activity.