Objetivo: a finalidade desse trabalho é, através de uma revisão de literatura recente, apresentar características clínicas da doença pelo Coronavírus (COVID-19), as vias de transmissão conhecidas, abordar como o Cirurgião-Dentista (CD) pode identificar casos suspeitos e, principalmente, apresentar medidas preventivas para controlar e minimizar a infecção no serviço odontológico. Material e Métodos: foi realizada uma pesquisa de busca bibliográfica na base de dados MEDLINE (National Library of Medicine, USA - NLM), com as palavras-chave COVID-19 and dental practice, de 12 a 16 de março de 2020, e três artigos publicados no ano corrente foram disponibilizados. Foram critérios de inclusão artigos em suas versões completas e gratuitas, na língua inglesa. Resultados: a COVID-19 apresenta como principais sintomas clínicos febre, tosse, espirros e catarro, em casos considerados leves. As principais vias de transmissão são a direta e por contato. A fim de identificar casos suspeitos o CD deve medir a temperatura corporal do paciente e aplicar um breve questionário. O profissional deve realizar com frequência a lavagem das mãos antes e após o atendimento e usar equipamentos de proteção individual. São recomendados com bochechos com Peróxido de Hidrogênio 1% e Lodopovidona a 0,2% ao tratamento, Clorexidina 0,12% não é eficaz. Conclusão: em momentos de surtos de doenças, surgem novos desafios aos quais os profissionais devem responder com cuidado ainda maior com a biossegurança, ética, zelo e treinamento atualizado e periódico
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused several problems in healthcare systems around the world, as to date, there is no effective and specific treatment against all forms of COVID-19. Currently, drugs with therapeutic potential are being tested, including antiviral, anti-inflammatory, anti-malarial, immunotherapy, and antibiotics. Although antibiotics have no direct effect on viral infections, they are often used against secondary bacterial infections, or even as empiric treatment to reduce viral load, infection, and replication of coronaviruses. However, there are many concerns about this therapeutic approach as it may accelerate and/or increase the long-term rates of antimicrobial resistance (AMR). We focused this overview on exploring candidate drugs for COVID-19 therapy, including antibiotics, considering the lack of specific treatment and that it is unclear whether the widespread use of antibiotics in the treatment of COVID-19 has implications for the emergence and transmission of multidrug-resistant bacteria.
Objective: The purpose of this paper is to discuss the surgical methods available for the treatment of MRONJ, pointing out their advantages and limitations. Methodology: An integrative review of the literature was performed by searching the PubMed virtual database using the MeSH term "bisphosphonate associated osteonecrosis of the jaw/surgery" and including 26 publications. Results: Surgical intervention is presented as a treatment option in an attempt to reduce disease progression with the recognition that this early intervention may predict beneficial outcomes for the patient. Surgical approaches confer superior treatment outcomes over conservative treatments, with success rates of 80-90% and 10-62%, respectively. To establish treatment, consideration should be given to therapy for removing nonhealing exposed bone, which can be accomplished through curettage, sequestrectomy, and surgical resection. When approaching soft tissue, different flaps can be performed, according to their indications. Conclusion: Surgical treatment has shown maintenance of mucosal coverage, improved quality of life, and quick resumption of antiresorptive therapy for all stages of the disease, with high rates of therapeutic success. However, continued efforts should be encouraged to investigate the best treatment for this pathology.
Introduction: Medication-related Osteonecrosis of the Jaw (MRONJ) is a condition that may affect patients undergoing oral surgery procedures that use antiresorptive drugs. It is essential that the Doctor of Dental Surgery (DDS) is familiar with the pathology and how to diagnose, prevent and approach it. Objectives: To perform a literature review on MRONJ and to guide the DDS on how to manage the affected patients. Methodology: a systematized search was conducted on the PubMed virtual database using the terms: "diphosphonates", "dentist's practice pattern", "dentists", "dentist's role" and "Bisphosphonate-Associated Osteonecrosis of the Jaw". 29 articles in English, published in the last 5 years, were included. Results and discussion: MRONJ is characterized by exposed and necrotic bone that persists for more than 8 weeks and happens in patients taking antiresorptive agents. It is multifactorial and its severity depends on the dosage, route of administration, and treatment duration. Its management must be multidisciplinary to improve the patient's quality of life. The DDS must focus on prevention. Every patient should have their oral health evaluated before starting antiresorptive therapy and be informed of its risks and benefits. Most DDSs do not feel confident to adequately manage these cases, even though information on MRONJ is more widespread among younger DDSs and recent graduates. Conclusion: MRONJ is a harmful condition for the patient and it is the DDS's responsibility to know how to treat and prevent it, by having adequate knowledge of this pathology and making decisions based on the latest scientific evidence.
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