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).

Milk yield and estrous behavior during eight consecutive estruses in Holstein cows fed standardized or high energy diets and grouped according to live weight changes in early lactation.

Cows managed for extended lactation go through several estruses before rebreeding. The aims of this study were (1) to quantify the effect of the first 8 estruses after calving on milk yield, milking frequency, and estrous behavioral activity, and (2) to determine the effects of early lactation live weight gain (LWG) as an indication of energy balance on milk yield, plasma insulin-like growth factor 1 (IGF-1) concentration, estrous behavioral activity, interval from calving to first estrus, between-estrus intervals, and pregnancy risk. Milk yield, live weight, and estrous behavioral activity were measured daily in 62 Holstein cows, 17 primiparous and 45 multiparous, managed for an 18-mo calving interval. Blood plasma obtained at wk 3, 5, 12, and 24 after calving was analyzed for IGF-1. Estrus was detected by use of milk progesterone profiles combined with visual observations (i.e., mounting behavior and other). The cows were divided into 2 groups: the cows having a negative LWG in each of the first 5 wk postpartum and the cows having a positive LWG in at least 1 of the first 5 wk after calving. The results indicate a similar decrease of 0.56 kg of milk per day of estrus during each of the 8 consecutive estruses. The activity level was 17 ± 1 movements per hour higher during the 8 estruses compared with the basic activity level. More cows expressed mounting behavior at estrus 8 than at estrus 2 (63.3 and 45.9%, respectively). The negative LWG cows had lower IGF-1 and higher milk production than the positive LWG cows. Both LWG groups had similar interval from calving to first estrus, on average 55 d. To conclude, the decrease in milk yield during estrus is marginal and similar in consecutive estruses. Moreover, estrous behavior is more highly expressed in the later estruses compared with the earlier estruses. Reproductive parameters (frequency of mounting, pregnancy risk, interval to first estrus, and between-estrus intervals) were not influenced by the live weight change during early lactation.

A modified surgical technique for inferior alveolar nerve repositioning on severely atrophic mandibles: case series of 11 consecutive surgical procedures.

BACKGROUND: To emphasize the characteristics and possible pitfalls of nerve reposition in cases of severe bone resorption in the posterior mandibular area, and to modify hard- and soft-tissue manipulation accordingly. METHODS: We analyzed retrospectively, 7 patients in which we performed full arch lower jaw rehabilitation. The patients presented for oral rehabilitation having a minimal residual bone above the mandibular canal and had undergone inferioral veolar nerve (IAN) displacement with modified surgical technique for fixed prosthetic rehabilitation. RESULTS: Eleven procedures of nerve repositioning were performed on severely atrophic mandibles. The average age of the patients was 43.29 years (12.37 SD). Residual bone above the mental foramen ranged between 0.5 mm and 1.5 mm, with an average of 0.93 mm (0.35 SD). In total, 32 dental implants were inserted into the area simultaneously with nerve displacement. The average follow-up time was 35.71 months(41.75 SD), ranging between 7 and 120 months. CONCLUSIONS: Severe atrophic cases require special attention due to the loss of keratinized tissue around the crestal area.The use of a modified surgical approach and specific surgical instruments provides a safer working environment for the operator and ensures optimal results.

Inferior alveolar nerve transposition and reposition for dental implant placement in edentulous or partially edentulous mandibles: a multicenter retrospective study.

The aim of this study was to evaluate the success and complications following inferior alveolar nerve (IAN) transposition/reposition for dental implant placement in edentulous or partially edentulous mandibles. This was a multicenter retrospective study; patients who had undergone IAN transposition/reposition at four surgical clinics were retrospectively evaluated. Adverse effects, especially neural disturbances, were recorded and followed. Overall, 68 IAN reposition and 11 nerve transposition procedures were performed in 57 patients (only three patients reported on smoking). The residual bone above the IAN was an average 3.88±1.98mm. A total of 232 dental implants were inserted in the area after transposition/reposition of the nerve. The average follow-up time was 20.62±9.79 months, ranging from 12 to 45 months. One implant loss was observed during the follow-up period. Four patients reported prolonged transient neural disturbances immediately following surgery (5% of the operations). The duration of neural disturbances after the surgery ranged from 1 to 6 months. No permanent neural damage was reported. Thus, within this study's limitations, it can be concluded that IAN transposition and reposition are useful adjunct techniques for managing severely atrophic edentulous or partially edentulous mandibles with dental implants. The risk of neural dysfunction appears to be low.