Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Intensive Care Unit, Department of Acute Medicine, University Hospitals of Geneva, Geneva, Switzerland.
Clin Exp Dent Res. 2022 Oct;8(5):1021-1027. doi: 10.1002/cre2.610. Epub 2022 Aug 6.
During the pandemic of COVID-19, the scientific community tried to identify the risk factors that aggravate the viral infection. Oral health and specifically periodontitis have been shown to have a significant impact on overall health. Current, yet limited, evidence suggests a link between periodontal status and severity of COVID-19 infection.
The present pilot study aimed to assess whether younger patients (≤60 years) that have been hospitalized in the intensive care unit (ICU) for severe COVID-19 infection were susceptible to severe periodontitis.
All dentate patients ≤60 years of age diagnosed with COVID-19 and surviving hospitalization in the ICU were considered for inclusion. Susceptibility to periodontitis was determined by assessing radiographic bone loss (RBL) in recent dental radiographs (posterior bitewings, periapical, and panoramic X-rays). RBL in % was obtained from the most affected tooth and patients were classified into: Stage I, RBL ≤ 15%; Stage II, RBL = 15%-33% and Stage III/IV, RBL ≥ 33%. The grade was defined using the RBL to age ratio on the most severely affected tooth. Patients were attributed to: Grade A, ratio <0.25; Grade B, ratio 0.25-1 and Grade C, ratio >1. Patients classified into Stage III/IV and Grade C were considered highly susceptible to periodontitis.
Of 87 eligible patients, 30 patients were finally assessed radiographically and/or clinically; from the remaining 57 patients, 16 refused participation for various reasons and 41 could not be reached. Based on the radiographic assessment, all patients were periodontally compromised. Half of them were classified with Stage III/IV and Grade B or C; 26.7% were classified with Stage III/IV and Grade C.
The present pilot study showed that about half of the patients suffering from severe forms of COVID-19 infection in need of ICU admission suffered also from severe periodontitis, and about one-fourth of them were highly susceptible to it.
在 COVID-19 大流行期间，科学界试图确定加重病毒感染的风险因素。口腔健康，特别是牙周炎，已被证明对整体健康有重大影响。目前，有限的证据表明牙周状况与 COVID-19 感染的严重程度之间存在关联。
本初步研究旨在评估因严重 COVID-19 感染而住院重症监护病房（ICU）的年轻患者（≤60 岁）是否易患严重牙周炎。
所有≤60 岁且被诊断患有 COVID-19 并在 ICU 住院存活的有牙患者均被考虑纳入。通过评估最近的牙科射线照片（后牙咬合片、根尖片和全景 X 射线）中的放射状骨丧失（RBL）来确定对牙周炎的易感性。RBL 以%表示，从受影响最严重的牙齿获得，并将患者分为：I 期，RBL≤15%；II 期，RBL=15%-33%；III/IV 期，RBL≥33%。使用最严重受影响牙齿的 RBL 与年龄比值来定义等级。患者分为：A 级，比值<0.25；B 级，比值 0.25-1；C 级，比值>1。将 RBL 与年龄比值分类为 III/IV 期和 C 级的患者被认为对牙周炎高度易感。
在 87 名符合条件的患者中，最终有 30 名患者进行了放射学和/或临床评估；在其余 57 名患者中，有 16 名因各种原因拒绝参与，41 名无法联系到。根据放射学评估，所有患者的牙周状况均受损。其中一半患者被分类为 III/IV 期和 B 或 C 级；26.7%的患者被分类为 III/IV 期和 C 级。
本初步研究表明，约一半因 COVID-19 感染需要 ICU 住院治疗的严重形式而住院的患者也患有严重的牙周炎，其中约四分之一的患者对其高度易感。
