Department of Interdisciplinary Dentistry, Pomeranian Medical University, Szczecin, Poland.
J Periodontal Res. 2022 Oct;57(5):933-941. doi: 10.1111/jre.13034. Epub 2022 Jul 15.
The present review examined the available evidence on possible involvement of gingival tissues in SARS-CoV-2 infection. Gingival tissue possess SARS-CoV-2 entry and transmission factors, among them ACE2 (angiotensin-converting enzyme 2) and TMPRSS2 (transmembrane protease serine 2), which are the principal mediators of the virus cell invasion. Clinical observations reveal SARS-CoV-2 RNA in periodontal tissues and crevicular fluid, suggesting that the periodontium may act as an entry point for the virus and/or as a dissemination site. The preliminary observations prove infection potential of gingival crevicular fluid and shed epithelial cells from the periodontium. There are also findings on potential associations between periodontitis and Covid-19 (coronavirus disease 2019). PubMed and Scopus databases were used to search for suitable keywords such as: SARS-CoV-2, Covid-19, oral virus infection, gingival crevicular fluid, oral mucosa, periodontium, gingiva, ACE2, TMPRSS2, Furin, diagnosis, topical treatment, vaccine and the related words for relevant publications. Data extraction and quality valuation of articles were performed by the author. The review addressed seven major domains: periodontal structures as SARS-CoV-2 infection site, the periodontal changes under SARS-CoV-2 infection, potential associations between periodontitis and Covid-19, periodontal oral care in Covid-19, crevicular fluid as potential transmission factor and preventive measures. The search process in PubMed and Scopus was updated up to 31 March 2022. Finally 68 articles were retrieved for the final analysis, from the initial database searches. According to the inclusion criteria articles in English language without any date restriction were included. The included studies were mostly original articles, and published in 2020 and 2021 with the aim to describe Covid-19 and SARS-CoV-2 infection in periodontology. As a conclusion it can be stated that gingival tissues may play a role in SARS-CoV-2 infection.
本综述探讨了牙龈组织是否可能参与 SARS-CoV-2 感染的现有证据。牙龈组织具有 SARS-CoV-2 进入和传播的因素，包括 ACE2（血管紧张素转换酶 2）和 TMPRSS2（跨膜丝氨酸蛋白酶 2），它们是病毒细胞入侵的主要介质。临床观察发现牙周组织和龈沟液中存在 SARS-CoV-2 RNA，这表明牙周组织可能是病毒进入的切入点和/或传播部位。初步观察结果证明了牙龈沟液和牙周脱落上皮细胞的感染潜力。也有研究发现牙周炎与 COVID-19（2019 年冠状病毒病）之间存在潜在关联。作者使用 PubMed 和 Scopus 数据库搜索了合适的关键词，如 SARS-CoV-2、COVID-19、口腔病毒感染、龈沟液、口腔黏膜、牙周组织、牙龈、ACE2、TMPRSS2、Furin、诊断、局部治疗、疫苗和相关出版物的相关词。作者对文章进行了数据提取和质量评估。本综述涉及七个主要领域：牙周结构作为 SARS-CoV-2 感染部位、SARS-CoV-2 感染下的牙周变化、牙周炎与 COVID-19 之间的潜在关联、COVID-19 期间的牙周口腔护理、龈沟液作为潜在传播因素和预防措施。在 2022 年 3 月 31 日之前，在 PubMed 和 Scopus 中进行了搜索过程更新。最终从最初的数据库搜索中检索到 68 篇文章进行最终分析。根据纳入标准，纳入了英语语言且无任何日期限制的文章。纳入的研究主要是原始文章，发表于 2020 年和 2021 年，旨在描述牙周病中的 COVID-19 和 SARS-CoV-2 感染。总之，可以认为牙龈组织可能在 SARS-CoV-2 感染中起作用。
