ABSTRACT
Introduction: Patients' negligence and difficult access to healthcare have an impact on the worsening of emergency conditions, which require immediate treatment due to the possibility of exacerbation in a short period of time. Untreated intra- and extraoral abscesses can have serious consequences on the patient's health and in many cases are life-threatening conditions increasing risk of respiratory obstruction, thrombophlebitis, meningitis, mediastinitis and septicemia. Background: The aim of this study is to investigate the impact of the pandemic and the resulting impediments to accessing medical care on the incidence and type of emergencies in the Oral Surgery Department. Material and methods: This was a retrospective study of 85375 patients aged 2 months to 90 years old with diagnosed intra- and extraoral abscesses before COVID-19 pandemic (2018,2019), and during pandemic (2020, 2021) in the Department of Oral Surgery of the Medical University in Lublin. The obtained results were statistically analyzed with the use of a computer program. Conclusions: The fewest patients were admitted in 2020, and the most in 2021, where we can already see the effects of the pandemic. Emergencies occurred most frequently in people aged 21-30, then 31-40. In 365 cases, tooth extraction was performed, and only in 28 cases, root canal treatment was attempted. Conclusions. Oral health service provision has been significantly affected by COVID-19. Patients came to their appointments too late, which in most cases resulted in the necessity of tooth extraction without attempting root canal treatment.
ABSTRACT
Aim: During the coronavirus disease, a palliative approach was recommended for the management of endodontic emergencies. This retrospective cohort study was conducted to investigate the effectiveness of dexamethasone or ibuprofen-acetaminophen combination for pain management in endodontic emergencies. Material(s) and Method(s): One hundred and eight records of patients who presented to the emergency department with dental pain were evaluated retrospectively. Since interventional procedures were not performed during the pandemic period, Specific analgesics/antibiotics for the management of pain were preferred. A follow-up protocol with a questionnaire was developed to observe the effectiveness of palliative treatment and make changes if necessary. All participants received a questionnaire to rate the pain levels 6, 12, 18, 24, 48, and 72 hours after taking the drug. All data were collected from the patient file and assessed. After inclusion and exclusion criteria, 32 patients were included (n = 19, ibuprofen + acetaminophen;n = 13, dexamethasone). Data were analyzed using the chi-square test (P = 0.05). Result(s): In both groups, a significant decrease in pain was experienced immediately after medication and at 6, 12, and 18 hours, with no significant difference (P >.05). However, dexamethasone (Group II) resulted in lower pain levels than ibuprofen\acetaminophen (Group I) at 24 and 48 hours (P <.05) Discussion: Both dexamethasone and ibuprofen-acetaminophen can be good palliative choices in endodontic emergencies in pandemic conditions. However, at 24 and 48 hours, dexamethasone resulted in lower pain levels.Copyright © 2022, Derman Medical Publishing. All rights reserved.
ABSTRACT
The world continues to struggle with the COVID-19 pandemic, and there is concern over the increase in the needs of older people for nursing care. In this study, the relationships of the "tooth condition” with mobility and cognitive function were investigated in 1,000 residents of 14 special elderly nursing homes. In those using well-fitting dentures, the percentage of those capable of independent indoor mobility was highest at 21.6%, and the percentages of those able to communicate (66.2%), understand routines (47.5%), state their own age (36.2%), remember recent events (45.0%), state their own name (85.7%), understand seasons (43.7%), and understand places (46.4%) were significantly higher than in those in other "tooth conditions”. This study clarified the relationships of the "tooth condition” with mobility and cognitive function, and maintaining an adequate "tooth condition” was suggested to contribute to the prevention of a condition requiring long-term nursing care. © 2023 Asian Society of Human Services.
ABSTRACT
Introduction: One of the consequences of COVID-19 is the incidence of mucormycosis in the jaws and subsequent osteomyelitis in patients with undiagnosed or uncontrolled comorbidities, such as diabetes mellitus and associated immunosuppression. Case Report: A 52-year-old male patient with a history of COVID-19 two months ago presented a painful ulcerative lesion of insidious onset in the palatal raphe measuring approximately 2 mm. He referred to numbness of the palatal region of one month of evolution. During the physical examination, purulent content, multiple pustules in the anterior maxillary buccal mucosa, and mobility of upper anterior teeth were observed. The CT revealed isodense bilateral images in maxillary and ethmoidal sinuses, bone sequestrations, and partial loss of anterior vestibular cortical bone. Laboratory tests revealed no abnormality, except for HbH1c: 10.2gr/dl. The patient was hospitalized for control of newly diagnosed diabetes mellitus. Maxillary incisional biopsy was performed, and microscopic analysis showed a mixed inflammatory infiltrate, fibrin deposits with eosinophilic and birefringent ribbon-like hyphae, branched at right angles, compatible with maxillary osteomyelitis secondary to mucormycosis. The treatment started with antifungal and intravenous antibiotics, followed by surgical cleaning under general anesthesia. The patient progressed favorably. Conclusion(s): Immunosuppression resulting from COVID-19 and/or uncontrolled systemic diseases can condition the appearance of rare opportunistic microorganisms causing infections such as mucormycosis. Early diagnosis and treatment make a difference in the morbidity and mortality of patients.
ABSTRACT
Radiotherapy-induced secondary malignancy is a well-known occurrence. During the COVID-19 pandemic, many people have undergone serial computed tomography (CT) imaging, and concerns have been raised regarding radiation-induced malignancies due to frequent scanning. Accordingly, various low and ultra-low-dose CT (LDCT) thorax protocols have been developed to reduce the dose of radiation. Major governing bodies worldwide have established guidelines regarding the indications for CT scans and chest X-rays during the pandemic. We, therefore, aimed to provide facts about the effects of radiation (both diagnostic and therapeutic). Through this article, we intend to break the myths and 'mithya' (misbeliefs) regarding diagnostic radiation and its association with cancer in this COVID-19 era. For this review, we performed a search in Google using specific keywords pertaining to imaging during COVID-19 and radiation risk. We also included the names of various global governing bodies in the Google search. We included only full text articles and guidelines from authentic websites. From this review, we conclude that if we follow the recommendations of various global governing bodies and use CT scan only in cases of moderate to severe COVID-related symptoms, adhere to the principle of 'as low as reasonably achievable' for radiation protection, and use LDCT scan protocols, we can significantly reduce the mean effective radiation dose delivered and the estimated cancer risk.Copyright © 2023 Cancer Research, Statistics, and Treatment. All rights reserved.
ABSTRACT
Introduction: Acromegaly is an uncommon pituitary disorder with an incidence of six per million persons. While hypertension is often encountered in these patients, heart failure rarely is seen with an incidence rate under 10%. We describe a case of an individual who was diagnosed with acromegaly after an acute exacerbation of heart failure with subsequent management requiring an LVAD to perform Transsphenoidal Surgery (TSS). Case Description: 37-year-old male otherwise healthy initially presented to an emergency room and was found to be in acute heart failure exacerbation. Concerning acromegaly features included macrognathia, enlarged hands and feet, swollen phalanges, widened spacing of teeth, and frontal bossing. IGF-1 level was found 455 ng/mL. MRI showed a 10mm macroadenoma. A right heart catheterization showed elevated filling pressures. Cardiac MRI showed no defects or enhancement. Endomyocardial biopsy showed no inflammatory infiltrates or evidence of infiltrative diseases. Patient had an ejection fraction of 15% corroborated by cardiac MRI along with the presence of aortic root dilatation and mitral regurgitation. The patient started on 0.5mg of Cabergoline twice weekly and 120mg weekly Lanreotide injections. Patient stabilized with plans for further close monitoring and outpatient neurosurgical evaluation. The COVID-19 pandemic and insurance gaps led the patient to spend two years off his medicines and he was unable to be seen by his medical team. Patient was seen by our system after recurrent hospitalizations for heart failure at our sister hospital, AICD was unable to be placed due to the patient's anatomy, he was placed on wearable cardiac defibrillator and required milrinone infusion for progression to end-stage heart failure with cardiac cachexia. At our institution, the patient was evaluated for Orthotopic Heart Transplant (OHT) but due to active GH secreting macroadenoma there was concern for OHT failure without TSS. Decision was made to utilize LVAD as Bridge-to-Transplant for OHT so the patient could be stabilized and safely undergo TSS. The patient tolerated surgeries well and is currently on the active transplant list. Discussion(s): Heart failure is an uncommon presentation of severe acromegaly requiring multidisciplinary management. We describe a case of a patient who initially presented with heart failure too unstable for surgery. Due to the COVID-19 pandemic the patient's disease progressed resulting in end-stage heart failure requiring LVAD placement for further treatment. We would like to draw attention to the use of LVAD placement in acromegalic patients who develop severe cardiovascular disease who are not candidates for OHT.Copyright © 2023
ABSTRACT
The socioeconomic context and population vulnerability are directly associated with violence in the country. In Brazil, the Criminal Code provides the illicit act and punishes the aggressor who offends the physical aggression from a person. Interpersonal violence is an illegal act and is associated with the vulnerability of victims. Therefore, the study of the epidemiological profile of victims of interpersonal violence is needed to alert the population about their susceptibility. The present study aimed to design the epidemiological profile of victims of bodily injury from interpersonal violence in the region of Maringa, in the state of Parana, and to study the characterization of dental injuries in terms of permanent weakness and deformity. Four thousand nine hundred sixty-two reports performed between 2018 and 2020 were analyzed using descriptive statistics. Data collected included: sex, age, marital status, the region affected by the bodily injury, type of dental trauma, and responses to "weakness" or/and "permanent deformity". During the period studied, there was a prevalence of female victims (57.8%), white skin color (80.2%), aged between 21 and 30 years (24.9%), single (54.9%), and the most affected region was the upper limbs (32.1%). Regarding bodily injuries with dental involvement, 67 cases were reported, male victims were prevalent (60.3%), and dental fracture was highlighted with 54.4% of examined injuries. The implementation of the Forensic Dentistry Centre took place in August 2019 at the Medico-Legal Institute of Maringa. Also, with the interruption of expert activities in 2020 - due to the COVID-19 pandemic - relevant outcomes regarding permanent weakness were observed. The epidemiological profile of victims is characterized by the female sex, white skin color, the age group from 21 to 30 years old, and singles. Regarding dental trauma, male victims, and dental fractures were prevalent. Furthermore, there was an increase in the classification of "permanent weakness", as well as a slight increase in cases of "further assessment required" for permanent deformity.Copyright © 2023 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.
ABSTRACT
Introduction. The connection between the health of the oral cavity and general health is well known, because oral diseases can impair general health, but the health of the oral cavity can also be impaired due to the existence of a systemic disease. The structures of the oral cavity can be affected directly by the disease or indirectly due to the influence of drugs or due to the patient's behavior. Oral manifestations affect hard dental tissues, supporting tissues and oral mucosa. The changes that occur can lead to pain and discomfort, cause concern for the child and parents, and can be completely asymptomatic. Doctors of dental medicine are often the first to suspect the presence of a disease during a routine examination, because the area of the oral cavity is easily accessible for early detection of pathological changes. That way, they can directly influence the course and therapy of the systemic disease by early recognition and referring the patient to further tests. Aim of the lecture is to present oral manifestations of gastrointestinal diseases, diabetes, blood diseases, bacterial diseases and viral diseases with a special focus on COVID-19.
ABSTRACT
Objective: To evaluate the prevalence of dry socket as a postoperative complication in cases where there was intense local pain in the preoperative state, during the preventive mandatory social isolation (PMSI) for the COVID-19 pandemic in Argentina. Method(s): This was a descriptive study, which included 1209 walk-in patients at the emergency and orientational service at Buenos Aires University School of Dentistry during the PMSI from March 20 to June 20, 2020, with indication for dental extraction as well as intense acute pain at the surgical site. The presence of dry socket was exploratoryly associated with the variables age, sex, smoking and chronic medication use. Result(s): 1209 patients were operated, resulting in a total 1372 dental extractions. Average patient age was 41 years. The prevalence found in this study was 1.06%. Conclusion(s): The prevalence of dry socket was 1%, not being higher than other experiences where pain was not considered a condition prior to extraction.Copyright © 2023 Duke University Press. All Rights Reserved.
ABSTRACT
Featured ApplicationThe present cross-sectional analysis aimed to evaluate the level of interest in oral and dental needs and teledentistry applications among the elderly, as well as whether COVID-19 pandemic outbreaks were influenced by real-time surveillance, using Google Trends. As the number of elderly dental patients continues to increase, there is a growing need for specific interventions that address the biological and psychological issues of this population. Teledentistry represents a healthcare delivery system that can overcome these problems, although the oral and dental care provision methods involved are still unknown to most people. Indeed, there is a need to raise awareness of the indications for teledentistry, the available interventions, and the potential benefits for the oral and dental care of elderly patients.Considering the increasing need for oral and dental care in the elderly, teledentistry has been proposed to improve the education of elderly patients in oral health maintenance and risk factor control, identify patients' concerns in advance, facilitate monitoring, and save time and money. The present cross-sectional analysis of Google search data through real-time surveillance with Google Trends aimed to determine Google users' interest in oral and dental needs and teledentistry applications in the elderly, and to compare search volumes before and after the COVID-19 outbreak. Extracted CVS data were qualitatively analyzed. Pearson and Spearman correlation analyses were performed between searches for "elderly” and "teledentistry”, and all the oral and dental needs and teledentistry applications. The Mann–Whitney U test compared search volumes in the 36 months before and after the beginning of the COVID-19 pandemic. Google users' interest in the elderly and related oral and dental needs was diffusely medium–high, while teledentistry and its applications were of lower interest. Interest in teledentistry and its applications was strongly related to interest in the older population, which is consistent with the assumption that older adults represent the population segment that could benefit most from these tools. A positive correlation was also found between searches for "Elderly” and searches for almost all oral and dental needs typical of the geriatric population. Search volumes increased significantly after the outbreak of the COVID-19 pandemic. More information about teledentistry should be disseminated to increase knowledge and awareness, especially among older patients, about its indications, applications, and advantages.
ABSTRACT
The world is becoming more diverse as the population of older adults continues to increase. According to the CDC, approximately 36% of the population belongs to a racial or ethnic minority group. Older adults are living longer and are expected to comprise an estimated 24% of the population by 2060. The older population is more likely to experience greater health challenges that include oral complications. Oral diseases such as tooth decay, tooth loss, gum disease, dry mouth, oral cancer and precancer, as well as chronic diseases are the most common. While there has been significant improvement in life expectancy, oral health, and overall health in the United States, there is a greater prevalence of oral disease and health disparities in minority and poor populations. Social determinants of health such as education, income, race, and access to care are contributing factors that are related to these health disparities among older adults. African Americans and other older adult people of color are disproportionately affected. Health literacy, dental coverage, and living conditions are other health disparities that contribute to the oral health of older adults. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
ABSTRACT
The proceedings contain 71 papers. The topics discussed include: experience of learning human anatomy and histology during COVID-19 pandemic in Kharkiv National Medical University;using musculoskeletal modelling to investigate the functional significance of craniofacial form variation within the genus homo;a morphometric analysis of the cranial fossae in patients with scaphocephaly;exploring the thalamus in young adolescents with psychotic experiences;to replace or not replace that is the question: addressing fate decisions during minipig tooth replacement;anatomy of termination of popliteal artery: a multidetector CT angiographic study;anatomical variation between populations of British red squirrels: the potential impact of supplementary feeding;revealing the biomechanics of the masticatory muscles in the eastern grey squirrel (Sciurus carolinensis) using multibody dynamics analysis;and myoepithelial and immune cell dynamics in the ovine mammary gland during postnatal development.
ABSTRACT
The biological system of the oral cavity provides a number of protective mechanisms that fight pathogenic factors that arise due to a decrease in local immunity. This problem is found in patients after Covid-19. There is a violation of the blood supply to all organs and systems, including the mucous membrane of the oral cavity. As a result, patients have an increased risk of ulcers, plaques, fungal infections of the oral cavity, cracks, and spot hemorrhages. Due to a decrease in immune reactions in the oral cavity, the risk of caries in all groups of teeth increases, the permeability of enamel increases, and mineral substances exit from the hard tissues of the tooth.
ABSTRACT
Purpose: Intraoral defects in the maxilla cause communication with the nasopharyngeal complex. The surgically removed palate can have a devastating effect on the appearance and speech of the patient. Obturators allow patients to eat and drink without any suspicion of food entering the oroantral cavities/ pharynx during mastication. This clinical report describes fabrication of a closed hollow bulb obturator using the two-piece double flask technique. Method(s): After the final teeth arrangement was completed, teeth over the defect were removed and separately processed using heat cure acrylic resin. Both the segments are combined by autopolymerizing acrylic resin to form a single hollow-bodied obturator. Conclusion(s): This technique uses a double flasking method of the two segments to control the thickness of the bulb in the defect area, thus decreasing the weight of the obturator.Copyright © 2020 Ubiquity Press. All rights reserved.
ABSTRACT
Since the beginning of the COVID-19 pandemic, the number of people wearing masks in everyday life has increased. At the same time, there has been a noticeable rise in the amount of patients with bad breath (foe-tor ex ore), gingivitis, caries, and xerostomia. The appearance of these symptoms and diseases caused by wearing a mask is designated by the term mask mouth. The aim of this article is to establish the link between wearing protective masks and deteriorating oral health. From the conducted research, it has been es-tablished that wearing a surgical mask over a long period of time leads to reduced air exchange in the mask and "recycling" of exhaled air. This leads to inhalation of air with increased CO2 content and increase in pCO2 in the blood, which is subsequently compensated by rapid and deep breathing in most cases through the mouth. The goal is to exhale the accumulated CO2. As the mask reduces air exchange, the level of CO2 in the mask remains relatively high. Prolonged breathing through the mouth often leads to xerostomia. Saliva is known to have protective functions against the development of bacteria in the oral cavity through its an-tibacterial properties. Xerostomia can be a prerequisite for the development of various diseases of bacterial origin, such as gingivitis. Furthermore, oral respiration leads to an increase in temperature and CO2 in the air in the mask and a decrease in pH in the oral cavity, which are optimal conditions for biofilm formation, plaque buildup, development of most bacteria, e.g., S. mutans, which is the main cause of caries.Copyright © 2022, Bulgarian-American Center. All rights reserved.
ABSTRACT
Osteoradionecrosis has considerable morbidity and can adversely affect the quality of life of patients who undergo radiotherapy as part of the treatment for their head and neck cancer. This can be reduced by a thorough dental assessment and extractions of teeth with poor prognosis prior to radiotherapy, ideally at least ten days before radiotherapy commences. Aim and objectives: The dental department at Charing Cross Hospital has an established pathway to assess patients prior to radiotherapy. The aim of the audit was to evaluate whether during the coronavirus pandemic there was timely dental assessment prior to radiotherapy and extractions carried out in sufficient time before start of radiotherapy in accordance with the Royal College of Surgeons 2012 guidelines. Method(s): Data was collected retrospectively from patient records over two eight monthly periods (May 2019 -Jan 2020 prior to the pandemic and April 2020 - November 2020 during the pandemic). Parameters analysed included: the number of patients referred;time interval between referral and assessment;number of patients requiring extractions and time interval between extraction completion and commencement of radiotherapy. Result(s): Seventy-six patients with head and neck cancer were referred for dental assessment over the audit period. The most recent audit showed 96.4% of patients were assessed within ten days of referral. Extractions were undertaken on 63.6% of patients, 92.9% were in excess of ten days before radiotherapy, 42.9% over 20 days. Conclusion(s): National guidelines for extractions are being met in 92.9% of cases and the majority in excess of minimum timing recommended. The dental clinic is providing quality care for this patient group as measured by this audit, showing a positive service outcome.Copyright © 2021 The Authors
ABSTRACT
Introduction: Osteomyelitis is an infection of the bone that usually affects immunocompromised individuals with multiple comorbidities. Maxilla and the mandible are at risk because of close contact with primarily contaminated spaces of the oral cavity and maxillary sinus that can harbor subclinical infection and a thin mucosal layer that adheres to the periosteum. Recently, odontogenic osteomyelitis has become rare due to better oral hygiene, stomatological care, and the widespread use of antibiotics. During the pandemic of the SARS-CoV-2 virus, the availability of medical care was limited, and the number of complicated infections rose. Case report: We present two cases of odontogenic osteomyelitis of the mandible in healthy individuals that were complicated with relapses and SARS CoV-2 coinfection. The first patient was a 30-year-old otherwise healthy female who developed localized osteomyelitis after extraction of the tooth 38. She was asymptomatic but tested positive for SARS-CoV-2. The second patient was a COVID-19-positive 29-year-old male with no previous illnesses, whose odontogenic abscess and neck edema compromised the airway, requiring urgent tracheotomy. After two weeks he developed a relapse of the infection and osteomyelitis of mandibular ramus with the formation of sequestrum. Coinfection with SARS CoV-2 virus could aggravate osteomyelitis by causing immune dysfunction and depletion of CD-4 and CD-8 lymphocytes. The osteomyelitic site is hypoperfused because of tissue edema and the inability of intraosseal spaces to expand. Endothelial le-sions and increased coagulation in COVID infection could contribute to hypoperfusion and the spread of the infection. Currently, it is impossible to claim that SARS CoV-2 infection aggravated the clinical status of our patients, but further studies are needed about the impact of SARS CoV-2 infection on other organs and illnesses, especially in mild and asymptomatic cases.
ABSTRACT
The importance of protecting the eyes from infectious agents in patients' blood and saliva during dental surgery has long been known, but the global COVID-19 pandemic has made this even more important. The use of ATP bioluminescence to investigate the contamination of dental goggles during the surgical removal of impacted teeth in the present study indicates their importance for protecting the eyes from aerosols from the front, from above, and from the sides.Copyright © 2021 The Author(s)
ABSTRACT
Introduction: Varicella zoster virus is a highly infectious alpha-herpesvirus, pathogenic only to humans. The primary infection of varicella zoster virus causes chickenpox, which is contagious and primarily infects children and adolescents in India. Following the primary infection, the virus remains dormant in sensory root ganglia. Activation of the dormant virus in later stages of life causes herpes zoster infection which may vary from subclinical infection to typical zoster, scattered vesicles, zoster sine herpete or disseminated zoster, which depends on the individual's immune status. Case report: In this case series, we present two patients with herpes zoster involving the mandibular branch of the trigeminal nerve. Cytology revealed characteristic features of the infection including nuclear moulding, multinucleated giant cells and ballooning degeneration. Conclusion(s): More recently, patients presenting with herpes zoster have been reported to have sub-clinical Covid-19 infection, suggesting a possibility that herpes zoster might be an indicator for latent Covid-19. Timely detection and treatment of this infection can reduce the risk of post herpetic neuralgia.Copyright © 2022 Sciendo. All rights reserved.
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