Background : Most of the common risk factors for severe outcomes of COVID‐19 are correlated with poor oral health, tooth loss, and periodontitis. This has pointed to a possible relationship between oral and systemic health in COVID‐19 patients. Hence, this study aimed to assess the dental and periodontal status of hospitalized COVID‐19 patients and their associations with the incidence of adverse COVID‐19 outcomes. Methods : We included 128 hospital patients aged between 20 and 97 years and with diagnoses of COVID‐19 in this prospective observational study. Dental and periodontal status was assessed using in‐hospital clinical examinations, including the Decayed, Missing, and Filled Teeth index, periodontal status, and tooth loss patterns (Eichner index). Associations between oral health measures, the severity of COVID‐19 symptoms, and hospitalization endpoints were tested using chi‐square test and incidence rate ratio (IRR) estimation using a generalized linear model with log‐Poisson regression. The regression models used a block‐wise selection of predictors for oral health‐related variables, comorbidities, and patients’ ages. Results : Overall, poor oral health conditions were highly prevalent and associated with critical COVID‐19 symptoms, higher risk for admission in the intensive care unit (ICU), and death. Periodontitis was significantly associated with ICU admission [IRR = 1.44 (95%CI = 1.07–1.95); p = 0.017], critical symptoms [IRR = 2.56 (95%CI = 1.44–4.55); p = 0.001], and risk of death [IRR = 2.05 (95%CI = 1.12‐3.76); p = 0.020] when adjusted for age and comorbidities. The Eichner index (classes B and C) was associated with ICU admission. Conclusions : There was a positive association between deleterious oral health‐related conditions, especially periodontitis, and severe COVID‐19 outcomes in hospitalized COVID‐19 patients. This article is protected by copyright. All rights reserved

The use of alloplastic materials in periodontal regenerative therapies is limited by their incapacity to establish a dynamic dialog with the surrounding milieu. The aim of the present study was to control biomaterial surface bioactivity by introducing aptamers to induce the selective adsorption of fibronectin from blood, thus promoting platelets activation in vitro and bone regeneration in vivo. A hyaluronic acid/polyethyleneglycole-based hydrogel was enriched with aptamers selected for recognizing and binding fibronectin. In vitro, the capacity of constructs to support osteoblast adhesion, as well as platelets aggregation and activation was assessed by chemiluminescence within 24 h. Matrices were then evaluated in a rat periodontal defect to assess their regenerative potential by microcomputed tomography (µCT) and their osteogenic capacity by Luminex assay 5, 15 and 30 d postoperatively. Aptamers were found to confer matrices the capacity of sustaining firm cell adhesion (p = 0.0377) and to promote platelets activation (p = 0.0442). In vivo, aptamers promoted new bone formation 30 d post-operatively (p < 0.001) by enhancing osteoblastic lineage commitment maturation. Aptamers are a viable surface modification, which confers alloplastic materials the potential capacity to orchestrate blood clot formation, thus controlling bone healing.

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