ABSTRACT
Purpose: This study explores the association between alveolar bone loss, tooth loss and severity of COVID-19. Material(s) and Method(s): In this retrospective cohort study, we included patients with confirmed COVID-19 who have had a dental panoramic radiograph within a maximum period of 5 years, providing information about alveolar bone loss and tooth loss. The severity of COVID-19 was determined based on the WHO clinical progression scale: (1) Mild/Ambulatory;(2) Moderate/Hospitalized;(3) Severe/Intensive care unit (ICU) or death. Result(s): 1730 patients were identified with COVID-19 from until October 31, 2020 in the Isala Hospital. Of these patients, 389 ever visited the OMFS department. 133 patients have had an orthopantomograph within a maximum period of 5 years and were included for analysis. The results showed a significant association between alveolar bone loss and COVID-19 severity (p = 0.028). Patients with alveolar bone loss had 5.6 times higher odds to be admitted to ICU or died, compared to ambulatory patients (OR: 5.60;95%CI: 1.21;25.99;P = 0.028). More tooth loss was significantly associated with COVID-19 severity (p = 0.047). Per tooth lost, patients had 4.2% higher odds for severe than mild COVID-19 (OR: 1.04;95%CI: 1.00;1.09;P = 0.047) and 6.0% higher odds for severe than moderate COVID-19 (OR: 1.06;95%CI: 1.01;1.11;P = 0.017). When adjusting for confounders in multivariate analyses, the significant associations of COVID-19 with alveolar bone loss and tooth loss were no longer present. Conclusion(s): In this retrospective explorative pilot study, alveolar bone loss and tooth loss are associated with the severity of COVID-19, however they are not independent risk factors. The current study could contribute to the design of further studies on the relationship between oral health and COVID-19.Copyright © 2021 The Authors
ABSTRACT
Background: Recent scientific evidence states that a subset of COVID-19 patients have a risk of increased bleeding tendency. This case report presents a 38-year-old woman with periodontitis, generalized stage III, grade C with an abnormal post-operative blood clot formation, who tested positive for COVID-19 5 days after a standard periodontal surgery. nature.com/articles/s41598-020-80010-z. Description of the procedure: After initial periodontal treatment and re-evaluation, we proceeded to the surgical phase including: 1. regenerative procedure with EMD 15 2. regenerative procedure with EMD 44 3. open flap debridement 13-23 4. shortened flap 34-37. Outcomes: Periodontal surgical procedures (1) and (2) proceeded without any complications and were considered standard. On day 1 after the third periodontal surgery (3), the patient was called for post-operative control. The patient had no complaints.On day 2 post-operative, the patient reported by email excess of bleeding in the oral cavity from the operated area, simultaneously with fever and loss of taste. A photo taken by the patient confirmed the abnormal blood clot. On day 3, in compliance with COVID-19 protocols, the patient was seen urgently in our clinic while her COVID-19 symptoms had started to decline. During the appointment, the bleeding tendency was less acute than the day before. Further suturing for precaution was decided. The same day the patient received a COVID-19 PCR test. On day 4 post-operative, the report of the PCR test was confirmatory for COVID-19 and the patient reported no further complaints of intraoral bleeding. Conclusions: After considering the normal response of the initial treatment and the well documented good post-operative healing pattern of the periodontal tissues for this patient, we concluded that the abnormal bleeding tendency was associated with an active phase of COVID-19. Clinicians should be aware that during the first days after a periodontal surgery patients could have bleeding complications due to an active phase of COVID-19. labblog.uofmhealth.org/lab-report/ subset-of-covid-19-patients-have-increased-bleeding-risk.
ABSTRACT
Purpose This study explores the association between alveolar bone loss, tooth loss and severity of COVID-19. Materials and methods In this retrospective cohort study, we included patients with confirmed COVID-19 who have had a dental panoramic radiograph within a maximum period of 5 years, providing information about alveolar bone loss and tooth loss. The severity of COVID-19 was determined based on the WHO clinical progression scale: (1) Mild/Ambulatory;(2) Moderate/Hospitalized;(3) Severe/Intensive care unit (ICU) or death. Results 1730 patients were identified with COVID-19 from until October 31, 2020 in the Isala Hospital. Of these patients, 389 ever visited the OMFS department. 133 patients have had an orthopantomograph within a maximum period of 5 years and were included for analysis. The results showed a significant association between alveolar bone loss and COVID-19 severity (p = 0.028). Patients with alveolar bone loss had 5.6 times higher odds to be admitted to ICU or died, compared to ambulatory patients (OR: 5.60;95%CI: 1.21;25.99;P = 0.028). More tooth loss was significantly associated with COVID-19 severity (p = 0.047). Per tooth lost, patients had 4.2% higher odds for severe than mild COVID-19 (OR: 1.04;95%CI: 1.00;1.09;P = 0.047) and 6.0% higher odds for severe than moderate COVID-19 (OR: 1.06;95%CI: 1.01;1.11;P = 0.017). When adjusting for confounders in multivariate analyses, the significant associations of COVID-19 with alveolar bone loss and tooth loss were no longer present. Conclusion In this retrospective explorative pilot study, alveolar bone loss and tooth loss are associated with the severity of COVID-19, however they are not independent risk factors. The current study could contribute to the design of further studies on the relationship between oral health and COVID-19.