Pivoting Dental Practice Management during the COVID-19 Pandemic-A Systematic Review.

Background and Objectives: The aims of this systematic review were to identify additional infection control measures implemented in dental practice globally to prevent cross-infection and evaluate the psychological impacts of the pandemic among dental professionals. Materials and Methods: A sequential systematic literature search was conducted from December 2019 to 30 April 2020 through PubMed, CINAHL, Scopus, Google Scholar, Embase, and Web of Science databases. The search yielded the following results: "COVID-19" (n = 12,137), "Novel corona virus" (n = 63), "COVID-19 and dentistry" (n = 46), "COVID-19 and oral health" (n = 41), "Novel Corona virus and Dentistry" (n = 0), "dental health and Novel Coronavirus" (n = 26), and "dental practice and Novel Coronavirus" (n = 6). Results: After a careful review and eliminating articles based on inclusion and exclusion criteria, the final review included 13 articles. Management of infection control is discussed extensively in the literature and remains the main theme of many Coronavirus Disease 2019 (COVID-19) articles on dentistry. Telephone triage using a questionnaire, hand hygiene, personal protective equipment (PPE) for clinical and nonclinical staff, a preprocedural mouth rinse, and aerosol management have been discussed and implemented in few countries. Three studies recommended that elective treatments for patients with a temperature of >100.4 F or 38 °C should be postponed or performed in an airborne infection isolation room (AIIR) or negative-pressure room. Limiting the number of patients in the waiting area, the removal of shared objects, proper ventilation, and physical distancing were highly recommended. Psychological distress among dental professionals in relation to existing medical conditions and self-efficacy has been discussed. Conclusions: Although the COVID-19 pandemic has had a substantial impact on the dental profession worldwide, our review highlights many practice management approaches to adopt the new norm. More research highlighting evidence-based safety practices and multisectoral collaboration is required to help dental professionals make informed decisions and make the profession safe, both for the patient and dental professionals.

Osteoporosis and bisphosphonate-related osteonecrosis of the jaw bone.

The aim of this longitudinal study is to present data from 76 female patients treated with bisphosphonates (BPs) for postmenopausal osteoporosis and referred to the Unit of Oral Diagnosis and Day Surgery of the University of Milano for diagnosis and treatment. All patients received a thorough oral examination. The diagnosis of osteonecrosis of the jaw bone (ONJ) was made from radiographic and clinical findings. 9% of individuals had BRONJ at first visit. Patients with dental or periodontal abscess were significantly more likely to develop BRONJ (OR: 2.9, 95% CI 0.5-15.9). Patients with osteoporosis receiving BPs may develop BRONJ, especially in the presence of an active infectious process in the mouth. Clinicians should carefully follow up on individuals receiving bisphosphonates therapy to avoid the occurrence of osteonecrotic lesions.