The experience of the rigid lockdown in the dental emergency room and urgency care during COVID-19 pandemic: a transnational multicenter observational study

OBJECTIVE

The COVID-19 pandemic had a major impact on our lives all over the world. Changes have occurred in daily life as well as in all medical services. The aim of the present study was to evaluate the emergency accesses in four universities' emergency services during the lockdown period from March to June 2020 during the COVID-19 pandemic.

SUBJECTS AND METHODS

A cross-sectional study was carried out on 44,787 patients to evaluate the emergency services of university centers. The medical data of Medical Emergency Service Data (MESD) were assessed by five independent operators considering the epidemiological findings for statistics methods.

RESULTS

A lower level of emergency access was reported in March-July compared to the pre-COVID period. The epidemiological data confirmed that female pathologies were more frequent compared to male patients. A fluctuation for almost all urgent healthcare centers was detected, showing one/two peaks per year during the years 2017-2019. The COVID-19 pandemic period did not influence the variety of pathology detected.

CONCLUSIONS

After the lockdown period, the emergency services slowly increased in cases. The pre-COVID period showed an overlapping of the most frequent pathologies compared to the post-COVID period: periodontitis (Bari and Tirana), dental fractures (Bari and Bucharest), odontogenic abscess (Bari, Cluj and Tirana).

Wettability of mg-ha/Chitosan-based membrane surfaces: blood vs. autologous platelet liquid (APL)

OBJECTIVE

The physical and physical chemistry is able to influence the interaction of the scaffolds and bone substitutes with the body fluid and blood. The aim of the present investigation was to evaluate the wettability properties of an Mg-HA Chitosan-based Gel with blood vs. autologous platelet gel.

MATERIALS AND METHODS

A total of 6 study groups were evaluated according to the Mg-HA Chitosan-based Gel thickness (1, 2 and 3 mm) and the fluids (blood vs. autologous platelet gel). The biomaterial wettability was conducted through the sessile drop technique.

RESULTS

The study findings showed a significant difference in contact angle between the APL and blood groups (p<0.05). The MG-Ha Chitosan-based membrane thicknesses seem to produce no significant effects on contact angles measurement for all groups (p>0.05).

CONCLUSIONS

In the present investigation, a similar MG/Ha gel membranes wettability was reported between APL and blood groups. In addition, a high hydrophilicity of MG/Ha gel membranes was reported with a potential advantage in terms of a more effective osteogenic capability in the clinical practice.

Topical hemostatic agents in oral surgery: a narrative review

Sufficient hemostasis during oral surgical procedures is crucial for successful outcomes and to reduce healthcare resource utilization. The purpose of this narrative review is to give a rational insight into the management of bleeding in oral and dental practice through modern drugs. A narrative literature review has been performed on the present topic identifying all articles on Pubmed/Medline and Google Scholars. Acceptable hemostasis during oral surgery is also required to improve visibility and provide a dry operational area. Many oral surgeons, in their daily practice, encounter problems in controlling postoperative bleeding and use a topical hemostatic agent to promote platelet activation or aggregation to form a stable clot.

Volumetric evaluations of the maxillary sinus before and post regenerative surgery

OBJECTIVE

The purpose of this study was to investigate possible differences in the filling of the various recesses of the maxillary sinus after the procedure of sinus floor elevation in relation with the initial volume of the same and if the sinus volume can influence long-term graft dimensions, by using cone beam computed tomography (CBCT) as diagnostic analysis device.

PATIENTS AND METHODS

This study included 32 sinuses corresponding to 16 patients referred for bilateral maxillary sinus augmentation procedures needing to increase the volume of the surgical site with the porcine cortical bone for dental implant placement in the posterior maxilla. The sinuses were analyzed by preoperative and postoperative (15 days and 6 months after sinus surgery) cone beam computed tomography.

RESULTS

No statistically significant relations were observed between initial sinus dimensions and the entity of the contraction of the graft between T1 (15 days after surgery) and T2 (180 days after surgery). The behavior was the same either for the large sinus (> 15.65 cm3) and for the small one (< 15.65 cm3). Instead, about the filling of the various sinus recesses, a linear regression model was used to explain the difference between the mean preoperative and postoperative surgical spaces; in most of the samples, the filling of the anterior recess was ~15% of the total volume of the graft, i.e., the minor one among the main recesses.

CONCLUSIONS

Our findings suggest that: (1) in the procedure of sinus floor augmentation by a lateral approach with deproteinized porcine bone there are no relations between the initial dimensions of the sinus and the long-term dimensional changes of the graft, and (2) that, among the main recesses of the sinus, the anterior one is generally the less filled.

Chronic lip edema and pain secondary to lip augmentation procedure: histological, scanning electron microscopy and X-ray microanalysis evaluation

BACKGROUND

In parallel with the increase in requests for filler injections, reported complications (immediate or delayed and transient or permanent) increased too.

CASE REPORT

In the presented case report, a patient reported a delayed complication of filler injection. The complaints of the patient and the objective evaluation revealed the presence of multiple lip nodules, that were painful both spontaneously and at the touch, after 10 years from a lip filler injection. The surgical excision of the neoformations permitted the complete healing of the lesions. The histological analysis showed a not specific pattern, showing a material encapsulated by a tissue reaction, confirming that the possible cause of the multiple injuries could be attributable to the injection received years earlier.

CONCLUSIONS

The professional who intends to perform filler injections needs a complete training process, both from a theoretical and practical point of view. Also, the patients must be informed of the possible risks associated with each product.

Microleakage and mechanical behavior of conical vs. internal hexagon implant-abutment connection under a cyclic load fatigue test

OBJECTIVE

The aim of the present investigation was to evaluate, by an in vitro simulation, the mechanical behavior of the conical vs. internal hexagon under cyclic load and the microleakage of the prosthetic connection of the fixture.

MATERIALS AND METHODS

A standardized cyclic loading was performed considering the implant with conical connection (diameter 4 mm - length 10 mm) (CS) and internal hexagon connection (diameter 4 mm - length 10 mm) (IH). The toluidine blue infiltration has been evaluated with the paper cone test.

RESULTS

After a total of 5x104 loads, the screw has been removed and the abutment appears solid and stable to the implant fixture for CS, while the IH was unstable. There was no infiltration of the toluidine marker in the connection interfaces of CS implants, while the IH was positive to the paper cone test.

CONCLUSIONS

The study data showed that the conical connection showed higher stability compared to the internal hexagon connection under the loading and it is able to prevent bacterial microleakage. This effectiveness should be considered for the long-term maintenance of the peri-implant soft and hard tissues around the fixture.

Histological aspects of cellulite: shedding light on 100 years of uncertainties

Cellulite is a common topographic condition of the skin manifested as lumpy, dimpled flesh resembling an orange peel on some zones such as the thighs, hips, buttocks and abdomen. The aetiology of this cosmetic issue is multifactorial, with hormonal, anatomical, environmental and genetic factors influencing its origin, although the exact mechanisms which cause this condition are still unknown. In the present work, a bibliographic analysis of the cellulite etiology has been updated and exposed, as well as the multiple classification grade scales established over the decades. In addition, a new method to classify cellulite severity, in which the clinical manifestations are correlated to the histological aspects more frequently found in the patients, has been presented. Several theories regarding its appearance, structure and clinical aspects have arisen with the aim of developing and establishing a valuable therapeutic approach. However, the lack of a consensus regarding the classification of cellulite severity has complicated the developments within this field.