Recommendations for a safe restart of elective aerosol-generating oral surgery procedures following the COVID-19 pandemic outbreak: An Italian multicenter study.

Among healthcare workers, oral and maxillofacial surgeons are some of the most exposed to coronavirus disease (COVID-19). The aim of this retrospective study was to develop suggestions for continuing the work of oral and maxillofacial surgeons using a safe protocol for elective and urgent aerosol-generating procedures that could prevent the onset of new clusters. Based on the results obtained and a guidelines review of those Asian countries that had promptly managed the current pandemic, the following safety protocol was developed.

Bone marrow nucleated cell concentrate autograft in temporomandibular joint degenerative disorders: 1-year results of a randomized clinical trial.

OBJECTIVE: to assess the reliability of bone marrow nucleated cell (BMNc) intra-articular injection in patients with degenerative temporomandibular joint disorders (TMDs), and to compare its efficacy with that of hyaluronic acid (HA). MATERIALS AND METHODS: this study was designed as a randomized, controlled trial of parallel groups. Patients affected by degenerative joint mandibular disorders were enrolled in this prospective clinical trial and randomly divided into two groups. The HA group underwent temporomandibular joint (TMJ) arthrocentesis and HA injection, whilst patients in the BMNc group were inoculated with BMNc inside the joint after lavage. Outcome measures were: assessing pain at rest and during motion, joint noises, chewing efficiency, and maximum interincisal opening. A postoperative MRI scan was performed and compared with the preoperative one, while examining for cartilage regeneration. Clinical and radiological data were collected from baseline to 12 months follow-up. RESULTS: Thirty patients, 15 for each group, complaining of different degrees of unilateral TMD with internal derangement, were enrolled and treated. In both groups, significant clinical improvements were detected after the procedure up to 1 year postoperatively. The BMNc group presented significantly better pain relief than the HA group after 6 months (p = 0.028) and 12 months (p = 0.000). No significant differences were observed in terms of joint noises. In terms of chewing efficiency, the BMNc group showed positive significant differences after 12 months (p = 0.000). Maximum interincisal opening presented significantly better values in the BMNc group after 6 months (p = 0.001) and 12 months (p = 0.000). No MRI evidence of cartilage regeneration was reported. CONCLUSION: intra-articular TMJ BMNc injection improved clinical outcomes in TMD treatment. The Results of this first human-model study are promising but further studies are needed to determine whether BMNc can represent the best treatment for TMDs.