Tooth Loss and Caries Experience of Elderly Chileans in the Context of the COVID-19 Pandemic in Five Regions of Chile.

Risk factors associated with tooth loss have been studied; however, the current status of the epidemiological profiles and the impact of the pandemic on the oral health of the elderly is still unknown. This study aims to determine the experience of caries and tooth loss among elderly Chilean citizens in five regions and to identify the risk factors associated with tooth loss. The sample includes 135 participants over 60 years old assessed during COVID-19 lockdown. Sociodemographic variables such as education and RSH (Social Registry of Households) were obtained through a teledentistry platform called TEGO. The history of chronic diseases such as diabetes, obesity, depression and dental caries reported by DMFT index scores were incorporated. The statistical analysis included Adjusted Odds Ratios (ORs) to assess risk factors associated with the lack of functional dentition. Multivariate hypothesis testing was used to compare the mean equality of DMFT and its components between regions (p-value < 0.05). Individuals with RSH ≤ 40% were at higher risk of having no functional dentition with OR 4.56 (95% CI: 1.71, 12.17). The only mean difference between regions was the filled tooth component. Tooth loss was associated with multidimensional lower income, where the elderly belonging to the 40% most vulnerable population had a higher prevalence of non-functional dentition. This study highlights the importance of implementing a National Oral Health Policy that focuses on oral health promotion and minimally invasive dentistry for the most vulnerable population.

Distribución nerviosa intradiscal en articulaciones temporomandibular humanas mediante técnica de tinción de Sihler: un enfoque cadavérico descriptivo / Nerve distribution in human temporomandibular articular disc using Sihler staining technique: a cadaveric descriptive approach

Introducción: La expresión variable en la sintomatología de los trastornos temporomandibulares (TTM) es un desafío para el clínico; así, el origen del dolor y la estructura comprometida no son fáciles de identificar. El disco articular está directamente vinculado a la función mandibular y, en condiciones patológicas, puede verse alterada su posición y consecuentemente su zona de carga. Si bien la presencia de terminaciones nerviosas y los troncos nerviosos potencialmente involucrados en su inervación han sido identificados, la forma en que los nervios se distribuyen al interior del disco no se ha precisado aún. El objetivo de este estudio fue describir la distribución nerviosa del disco articular de la articulación temporomandibular en cadáveres humanos. Material y método: Se realizó disección anatómica de ocho discos articulares de articulaciones temporomandibulares del lado derecho de cadáveres conservados. Los discos articulares fueron sometidos al método de tinción de Sihler y observados bajo lupa estereoscópica y transiluminación. Se realizó fotografía estandarizada y se dividió el disco en 5 zonas (medial, lateral, anterior, posterior, central) caracterizando la distribución nerviosa. Resultados: Se observó presencia de estructuras nerviosas en todas las zonas excepto en la zona central. Las estructuras nerviosas discurren como troncos simples o múltiples en dirección antero-posterior con un número variable de colaterales en las áreas lateral y medial del disco, comunicando la zona retrodiscal con la porción posterior del músculo pterigoideo lateral en todas las muestras. Conclusión: Existe un patrón de inervación común en los discos estudiados. El disco se encuentra inervado en su periferia por troncos nerviosos que presentan un trayecto anteroposterior. La comunicación entre distintas regiones anatómicas por continuidad nerviosa, así como el patrón de inervación del disco, podrían explicar situaciones de dolor local y referido en TTM

Introduction: Variable expression of symptomatology in temporomandibular disorders (TMD) is a challenge for clinician, because source of pain is not easy to identify. Articular disc is directly linked to the mandibular function and in pathological conditions can be altered its position and consequelty its zone of load. The aim of this study was to describe the intradiscal nerve distribution of temporomandibular joint disc in human cadavers. Although the presence of sensitive nerve terminals in the disc and the nerve trunks potentially involved have been identified, the way the nerves are distributed inside disc remains unprecised. Material and method: Anatomical dissection of 8 articular discs of the temporomandibular joints on the right side of preserved cadavers was performed. The articular discs were subjected to the Sihler staining method and then observed under a stereoscopic loupe and transillumination, A standardized photograph was perform by arbitrarily dividing the disk into 5 zones (medial, lateral, anterior, posterior, central) and characterized thebnerve distribution. Results: Presence of nerve structures was observed in all areas except the central zone. Nerve structures run as a single or multiple trunk in anterior-posterior direction with a variable number of collateral in lateral and medial areas of disc, comunicating retrodiscal zone and posterior zone of lateral pterigoid muscle in all samples. Conclusion: It can be identified a common inervation pattern in all discs. The disc is innervated in its periphery by nerve trunks that present an anterioriposterior path. The communication between different anatomical regions by nervous continuity, as well as the innervation pattern of the disc, could explain situations of local pain and referred in TMD