RESUMO Introdução: A osteoartrite (OA) é uma doença degenerativa progressiva caracterizada pela degradação gradual da cartilagem, remodelação do osso subcondral, sinovite e dor crônica. Essa condição afeta várias articulações grandes e pequenas, incluindo a articulação temporomandibular (ATM). No entanto, abordar a OA, particularmente na prevenção ou redução da progressão da doença, é um desafio devido à sua heterogeneidade de sua apresentação clínica e em exames de imagem. A literatura sugere cada vez mais que essa heterogeneidade envolve diferentes fenótipos ou subpopulações, discerníveis por variações na fisiopatologia e nas manifestações estruturais da doença. Mesmo dentro da ATM, esses fenótipos podem apresentar características clínicas, parâmetros laboratoriais, marcadores bioquímicos e critérios de imagem distintos. Pesquisas recentes propuseram a ressonância magnética como padrão de referência para OA da ATM, destacando sua concordância substancial com alterações histopatológicas. Os fenótipos baseados em ressonância magnética oferecem um caminho promissor para a compreensão da progressão da doença e da resposta ao tratamento, fornecendo potencialmente informações valiosas para o prognóstico e o planejamento do tratamento. Objetivo: Este artigo apresenta o ROAMES-TMJ (Rapid OsteoArthritis MRI Eligibility Score for TMJ) para avaliar a elegibilidade estrutural de indivíduos para inclusão em ensaios clínicos de OA de ATM. Introdução (OA cartilagem subcondral crônica pequenas ATM . (ATM) entanto subpopulações clínicas laboratoriais distintos histopatológicas tratamento Objetivo ROAMESTMJ ROAMES TMJ Rapid (ATM

ABSTRACT Introduction: Osteoarthritis (OA) is a progressive degenerative disease characterized by the gradual degradation of cartilage, remodeling of subchondral bone, synovitis, and chronic pain. This condition impacts various large and small joints, including the temporomandibular joint (TMJ). However, addressing OA, particularly in impeding or reducing disease progression, is challenging due to its clinical and imaging heterogeneity. Authors are increasingly suggesting that this heterogeneity involves different phenotypes or subpopulations, discernible by variations in the disease’s pathophysiology and structural manifestations. Even within the TMJ, these phenotypes may display distinct clinical features, laboratory parameters, biochemical markers, and imaging criteria. Recent research has proposed MRI as a reference standard for TMJ OA, highlighting its substantial agreement with histopathological changes. MRI-based phenotypes offer a promising avenue for understanding disease progression and treatment response, potentially providing valuable insights for prognosis and treatment planning. Objective: This article introduces the ROAMES-TMJ (Rapid OsteoArthritis MRI Eligibility Score for TMJ) to assess the structural eligibility of individuals for inclusion in TMJ OA clinical trials. Introduction (OA cartilage bone synovitis pain joints TMJ. . (TMJ) However subpopulations diseases s manifestations features parameters markers criteria changes MRIbased based response planning Objective ROAMESTMJ ROAMES Rapid trials (TMJ

Dental emergencies may represent a challenge to clinicians, that sometimes may even need to treat patients with COVID-19. Aim In this sense, we aim to report our experience in an urgent dental care setting during COVID-19 pandemic, providing a profile of patients and staff involved in attendance appointments. To address that, a retrospective analysis was conducted based on charts of the Urgent Dental Care Clinic. Data obtained from patients were extracted considering the period between July 2020 and December 2020. Final data were compiled, and continuous variables were expressed as mean ± standard deviation (SD). Categorical variables were presented as n (%). Results A total of 92 patients (39 ±16.59 years) were attended with prevalence of female. Most patients (n = 83; 94.3%) answered that they did not have any symptoms since COVID-19 outbreak in March up to 21st day prior the appointment and searched for treatment with pain as the main complaint (n = 59; 64.1%). Drug prescriptions and advice were sufficient on several occasions (n = 19; 22.4%), eliminating the need for dental procedures. Recementation and temporary restorations were the most frequent clinical choice in this cohort (n = 19; 20.7). Regarding dental staff, COVID-19 symptoms after attendance were reported only seven times (3.4%) by 5 different persons. Conclusion All patients treated in the emergency department during the COVID-19 pandemic were asymptomatic and pain was their main complaint. Importantly, occupational transmission was not detected during the study period, which highlights effectiveness of our prevention strategies. clinicians COVID19. COVID19 COVID 19. 19 sense COVID-1 appointments Clinic 202 compiled SD. SD . (SD) %. % (%) 9 39 (3 1659 16 59 ±16.5 years female 83 94.3% 943 94 3 st 64.1%. 641 64.1% 64 1 64.1%) 22.4%, 224 22.4% , 22 4 22.4%) procedures 20.7. 207 20.7 20 7 20.7) 3.4% 34 (3.4% persons Importantly strategies COVID1 COVID- (SD (% ( 165 ±16. 8 94.3 64.1 6 22.4 2 20. 3.4 (3.4 ±16 94. 64. 22. 3. (3. ±1

Aim This study aimed to systematically review existing literature regarding the association between dental procedures—such as tooth extractions and periodontal therapy—and occurrence of medication-related osteonecrosis of the jaw (MRONJ) in individuals using bone-modifying drugs. Methods Search strategies were performed in PubMed, Scopus, Web of Science and Cochrane Library for a timeframe ending in December 2021. Study selection, data extraction and risk of bias were analyzed independently by two researchers. Three meta-analyses were performed, estimating the crude risk ratio (RR), the adjusted odds ratio (OR) and the adjusted hazard ratio (HR) for the association between tooth extraction and MRONJ. Results Of the 1,654 studies initially retrieved, 17 were ultimately included. The majority of patients with MRONJ in these studies were female, with a mean age of 64 years. Zoledronic acid was the most commonly used drug among patients with MRONJ, and cancer was the most frequent underlying health condition. Regarding the performed meta-analyses, crude and adjusted analyses demonstrated that tooth extraction increased the risk for MRONJ by 4.28 (95% confidence interval [95%CI]: 1.73–10.58), the OR for MRONJ by 26.94 (95%CI: 4.17–174.17), and the HR for MRONJ by 9.96 (95%CI: 4.04–24.55). Conclusion It was concluded that performing dental procedures, especially tooth extraction, in patients using bone-modifying drugs increased the risk of MRONJ occurrence and, therefore, should be avoided. Further studies, using adjusted data, are warranted.

RESUMO JUSTIFICATIVA E OBJETIVOS: As disfunções temporomandibulares (DTM) são um grupo de condições caracterizadas por alteração dos movimentos e função da região orofacial e um dos maiores sintomas relatados é a dor. Como estas disfunções têm sido descritas de forma crescente entre diversas faixas etárias, o objetivo deste estudo foi avaliar a presença de sintomas de DTM e seus possíveis fatores associados em idosos de uma cidade do sul do Brasil. MÉTODOS: Estudo transversal de base domiciliar com amostra probabilística por conglomerado incluindo 282 idosos com idade ≥60 anos da cidade de Veranópolis/RS. Um exame clínico de saúde bucal e questionário estruturado foram aplicados. Sintomas de DTM foram avaliados pelo Índice Anamnésico de Fonseca (IAF) e categorizados em “Sem DTM” e “Com DTM”, sendo que o último incluiu aqueles com sintomas compatíveis com DTM, moderada ou grave. Associações foram avaliadas pelos testes de Qui-quadrado ou Mann-Whitney por distribuição de frequências. Análises bi e multivariadas foram realizadas utilizando-se regressão de Poisson com variância robusta para verificar associações. RESULTADOS: A prevalência de idosos que relataram sintomas de DTM foi de 30,5% (n=86). No modelo multivariado final, idosas do sexo feminino apresentaram maior razão de prevalência (RP) para sintomas de DTM, apresentando 62,8% maior RP (p=0,040) de ter, pelo menos, sintomas leves de DTM quando comparados a idosos do sexo masculino. O número de dentes presentes, necessidade de prótese ou outras variáveis demográficas não estiveram associadas com a presença de sintomas de DTM. CONCLUSÃO: Os achados do presente estudo demonstraram prevalência de sintomas de DTM em idosos de aproximadamente 30%, com maior associação com o sexo feminino. Apesar de relevantes para delineamento de estratégias de saúde para idosos, os achados do presente estudo devem ser interpretados com cautela por sua natureza observacional e transversal.

ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorders (TMD) are a group of conditions characterized by changes in the movements and function of the orofacial region and one of main reported symptoms is pain. As it has been increasingly described among different age groups, this study aimed to evaluate the presence of symptoms of TMD and their possible associated factors in older people from a city in southern Brazil. METHODS: A cross-sectional household-based study using a per cluster sampling strategy was performed including 282 older adults aged ≥60 years in the city of Veranópolis/RS. A clinical oral examination and a structured questionnaire were applied. TMD symptoms were evaluated with Fonseca Anamnestic Index (FAI) questionnaire and divided into those “without TMD” and “with TMD” (the later including those reporting mild, moderate and severe TMD symptoms). Associations were performed by the chi-square or Mann-Whitney tests based on frequency distribution. Bi and multivariate analyses were performed using Poisson regression with robust variation to verify associations. RESULTS: Prevalence among older adults that reported symptoms of TMD was 30.5% (n=86). In the final multivariate model, female older adults presented higher prevalence ratio (PR) for symptoms of TMD, presenting 62.8% (p=0.040) higher PR to at least mild symptoms of TMD when compared to older adult men. Number of teeth, need for dental prosthesis or other demographic variables were not associated with symptoms of TMD. CONCLUSION: The results demonstrated a prevalence of TMD symptoms in the seniors of approximately 30%, which was most associated with females. Despite its relevance in public health strategies focused on older adults, these findings should be interpreted with caution due to their observational and cross-sectional nature.