Resumo em Inglês:

Abstract: This study aimed to compare the vertical marginal gap of teeth restored with lithium disilicate crowns fabricated using CAD/CAM or by pressed ceramic approach. Twenty mandibular third molar teeth were collected after surgical extractions and prepared to receive full veneer crowns. Teeth were optically scanned and lithium disilicate blocks were used to fabricate crowns using CAD/CAM technique. Polyvinyl siloxane impressions of the prepared teeth were made and monolithic pressed lithium disilicate crowns were fabricated. The marginal gap was measured using optical microscope at 200× magnification (Keyence VHX-5000, Japan). Statistical analysis was performed using Wilcoxon test. The lithium disilicate pressed crowns had significantly smaller (p = 0.006) marginal gaps (38 ± 12 μm) than the lithium disilicate CAD/CAM crowns (45 ± 12 μm). This research indicates that lithium disilicate crowns fabricated with the press technique have measurably smaller marginal gaps compared with those fabricated with CAD/CAM technique within in vitro environments. The marginal gaps achieved by the crowns across all groups were within a clinically acceptable range.

Resumo em Inglês:

Abstract: The aim of the present study was to compare negative impacts of oral conditions in Oral Heath Related Quality of Life (OHRQoL) assessed by the Oral Health Impact Profile-14 (OHIP-14) scores in pregnant women receiving or not comprehensive periodontal treatment. This randomized controlled clinical trial included pregnant women aged between 18 and 35 years old. Participants were randomized in a test group with 96 and a control group with 114 women. Patients in the test group received comprehensive periodontal treatment, supra and subgingival scaling and root-planning and periodontal maintenance appointments. The OHIP-14 was applied before and after treatment. The primary outcome was changes in OHIP-14 scores after follow-up period. The impact of having received or not comprehensive periodontal treatment on the change of the OHIP-14 scores was also investigated. Both groups showed significant reduction in OHIP-14 scores and effect size for the test group was 0.60 and 0.36 for the control group. Multinomial logistic regression analysis showed that participants of the control group had 5.9-fold odds (CI 95% 1.88-18.52) of worsening in OHIP-14 scores and their perception of oral conditions in relation to test group. Comprehensive periodontal treatment during pregnancy can reduce the negative impacts in OHRQoL.

Resumo em Inglês:

Abstract The aim of this study was to investigate the viability of human dental pulp cells from extracted teeth kept at standard room temperature and atmospheric pressure for different periods of time. Twenty-one healthy permanent teeth were used. They were divided into five groups according to the expected time from extraction to processing. One group was tested immediately after extraction; the other groups were each tested at one of the following time points: 30 minutes, 1 hour, 2 hours, and 5 hours post-extraction. Cell morphology was analysed by light microscopy; cell proliferation was analysed using MTT assay and by counting the viable cells in a haemocytometer. Similar results were observed in all groups (p < 0.05). A delay of up to five hours for tooth processing and tissue collection does not preclude the establishment of dental pulp cell cultures, affect the morphology of these cells, or reduce their proliferative potential.

Resumo em Inglês:

Abstract Optical coherence tomography (OCT) has generally been used as a nondestructive technique to evaluate integrities of composite restorations. We investigated marginal and internal adaptations of ceramic inlay restorations with OCT and compared them to results with the silicone replica technique. Round-shaped class I cavities were prepared on 16 human maxillary first premolar teeth. Ceramic inlays were fabricated. Silicone replicas from inlays were obtained and sectioned to measure marginal and internal adaptations with a stereomicroscope (Leica Dfc 295, Bensheim, Germany). Inlays were cemented on respective teeth. Marginal and internal adaptations were then measured with the OCT system (Thorlabs, New Jersey, USA) in 200- μm intervals. Replica and OCT measurements were compared with independent samples t-tests. A paired t-test was used to evaluate the marginal and internal adaptations of each group (p < 0.05). Marginal and internal adaptations were 100.97 ± 31.36 and 113.94 ± 39.75 μm, respectively, using the replica technique and 28.97 ± 17.86 and 97.87 ± 21.83 μm, respectively, using OCT. The differences between the techniques were significant (p = 0.00 and p = 0.01, respectively). On evaluation within the groups, internal adaptation values were found to be significantly higher than the marginal adaptation values for the replica technique (p = 0.00) and OCT (p = 0.00). Therefore, the replica and OCT techniques showed different results, with higher values of marginal and internal adaptation found with the replica technique. Marginal and internal adaptation values of ceramic inlays, whether measured by replica or OCT techniques, were within clinically acceptable limits.

Resumo em Inglês:

Abstract This study aimed to evaluate the in situ degree of conversion, contact angle, and immediate and long-term bond strengths of a commercial primer and an experimental adhesive containing indomethacin- and triclosan-loaded nanocapsules (NCs). The indomethacin- and triclosan-loaded NCs, which promote anti-inflammatory and antibacterial effects through controlled release, were incorporated into the primer at a concentration of 2% and in the adhesive at concentrations of 1, 2, 5, and 10%. The in situ degree of conversion (DC, n=3) was evaluated by micro-Raman spectroscopy. The contact angle of the primer and adhesive on the dentin surface (n = 3) was determined by an optical tensiometer. For the microtensile bond strength µTBS test (12 teeth per group), stick-shaped specimens were tested under tensile stress immediately after preparation and after storage in water for 1 year. The data were analyzed using two-way ANOVA, three-way ANOVA and Tukey’s post hoc tests with α=0.05. The use of the NC-loaded adhesive resulted in a higher in situ degree of conversion. The DC values varied from 75.07 ± 8.83% to 96.18 ± 0.87%. The use of NCs in only the adhesive up to a concentration of 5% had no influence on the bond strength. The contact angle of the primer remained the same with and without NCs. The use of both the primer and adhesive with NCs (for all concentrations) resulted in a higher contact angle of the adhesive. The longitudinal μTBS was inversely proportional to the concentration of NCs in the adhesive system, exhibiting decreasing values for the groups with primer containing NCs and adhesives with increasing concentrations of NCs. Adhesives containing up to 5% of nanocapsules and primer with no NCs maintained the in situ degree of conversion, contact angle, and immediate and long-term bond strengths. Therefore, the NC-loaded adhesive can be an alternative method for combining the bond performance and therapeutic effects. The use of an adhesive with up to 5% nanocapsules containing indomethacin and triclosan and a primer with no nanocapsules maintained the long-term bond performance.

Resumo em Inglês:

Abstract Radiation combined injury, a life-threatening condition, has higher mortality than simple radiation injury. The aim of the present study was to analyze the efficiency of Aloe vera and silver nanoparticles in improving the healing of ulcerated oral mucosa after irradiation. Thirty male Albino mice were divided into five groups: control, radiation, Aloe vera (AV), silver nanoparticles (NS), and AV+NS. The mice were exposed to whole body 6Gy gamma-radiation. After one hour, 20% acetic acid was injected into the submucosal layer of the lower lip for ulcer induction. The animals received topical treatment with the assigned substances for 5 days. Lip specimens were subjected to hematoxylin and eosin and anti alpha-smooth muscle actin immunohistochemical staining. Results demonstrated occurance of ulcer three days post irradiation in all groups except in the AV+NS group where only epithelial detachment was developed. After seven days, data revealed persistent ulcer in radiation group, and almost normal epithelium in the AV+NS group. A significant reduction of epithelial thickness was detected in all groups at the third day as compared to control. At the seventh day, only the AV+NS group restored the epithelial thickness. Area percent of alpha-smooth muscle actin expression was significantly decreased in radiation group at the third day followed by significant increase at the seventh day. However, all treatment groups showed significant increase in alpha-smooth muscle actin at the third day, which decreased to normal level at the seventh day. Our study demonstrated the efficiency of Aloe vera and silver nanoparticles in enhancing ulcer healing after irradiation.

Resumo em Inglês:

Abstract The aim of the present study was to evaluate factors associated with sleep bruxism in five-year-old preschool children. A preschool-based cross-sectional study was conducted with 761 pairs of children and their parents/caregivers. Sleep bruxism was diagnosed using a questionnaire administered to the parents/caregivers, who also answered questionnaires addressing sociodemographic data and parent’s/caregiver’s sense of coherence. Clinical oral evaluations of the children to determine dental caries, traumatic dental injuries, malocclusion and tooth wear were performed by two researchers who had undergone a training exercise (interexaminer Kappa: 0.70 to 0.91; intraexaminer Kappa: 0.81 to 1.00). Descriptive analysis and logistic regression for complex samples were carried out (α = 5%). The prevalence of sleep bruxism among the preschool children was 26.9%. The multivariate analysis revealed that bruxism was associated with poor sleep quality (OR = 2.93; 95 CI: 1.52–5.65) and tooth wear (OR = 2.34; 95%CI: 1.39–3.96). In the present study, sleep bruxism among preschool children was associated with tooth wear and poor sleep quality of the child. In contrast, psychosocial aspects (sense of coherence) were not associated with sleep bruxism.

Resumo em Inglês:

Abstract The purpose of this cross-sectional study was to investigate the effect of different forms of periodontal diseases on Oral Health-Related Quality of Life (OHRQoL). Fifty-two patients with Aggressive Periodontitis (AP) or Chronic Periodontitis (CP) were included: nine patients with Localized Aggressive Periodontitis (LAP), thirty-three patients with Generalized Aggressive Periodontitis (GAP) and ten patients with Generalized Chronic Periodontitis (GCP). Oral Health Impact Profile questionnaires (OHIP-14) were distributed after a clinical examination that measured the following periodontal parameters: tooth loss, bleeding on probing (BoP), probing depth (PD), gingival recession (REC) and clinical attachment level (CAL). The global OHIP-14 score means were 10.6 for LAP, 16.5 for GAP, and 17.5 for GCP. A statistically significant difference (p < 0.01) was observed between the LAP group and the other two groups. There was significantly less bleeding and recession in the LAP group than in the patients with the generalized forms of periodontitis. LAP, GAP and GCP have an impact on patient quality of life when measured using the OHIP-14. Patients with GAP and GCP had poorer OHRQoL than LAP patients.

Resumo em Inglês:

Abstract The aim of this study is to evaluate the action of paramonochlorophenol associated with Furacin followed by calcium hydroxide (CH) dressing in the control of inflammatory root resorption in cases of immediate tooth replantation with delayed endodontic treatment. A total of 28 incisors of 3 male dogs were extracted and replanted after 15 minutes, and randomly divided into 3 groups: Group I (n = 8) - endodontic treatment was performed before the extraction and replantation; Group II (n = 10) - endodontic treatment was performed 30 days after replantation and the root canal was filled with CH dressing; Group III (n = 10) - endodontic treatment was performed 30 days after replantation and root canals received temporary medication of paramonochlorophenol-Furacin followed by CH dressing. The animals were euthanized 90 days after replantation. The histomorphological events analyzed at the epithelial reattachment site were the intensity and extent of acute and chronic inflammatory processes, periodontal ligament (PDL) organization, the intensity and extent of acute and chronic inflammatory processes in the PDL space, root resorption, bone tissue, and ankylosis. Data were submitted to the Wilcoxon Signed Ranks Test for group comparison (α = 5%). In Groups I, II and III the periodontal ligament was regenerated and most of the resorption areas were repaired by newly formed cementum. The depth and extent of root resorption were significantly higher in Group II than in Group III. The use of paramonochlorophenol-furacin followed by CH dressing was more effective in controlling inflammatory root resorption after immediate tooth replantation.

Resumo em Inglês:

Abstract The aim of this study was to compare in vitro the bond strength (BS) between fiberglass posts and flared root canals reinforced with different materials. The roots of 48 premolars were endodontically treated. After one week, the root canals were prepared to simulate an oversized root canal, except for the positive control group (PCG), which was cemented with a prefabricated fiber post (PFP) compatible with the root canal size, simulating an ideal adaptation. The other samples (n=8/group) were used to test alternative restorative techniques for filling root canals: negative control group (NCG [PFP with a smaller diameter than of the root canal]), composite resin group - CRG, bulkfill group - BFG, self-adhesive cement group - SAG, and glass ionomer group - GIG. The posts were cemented and after 1 week, each root was sectioned transversely into six 1-mm thick discs and the push-out test was done to evaluate the BS. Data were analyzed by two-way repeated measures ANOVA and Tukey's tests (α=0.05). The highest BS value was observed for PCG. The NCG and the GIG groups showed the lowest BS values. Root reinforcement with conventional and bulk-fill composite resins showed the highest BS values; however, the bulk-fill resin was the only treatment able to maintain high BS values in all regions of the root canal. The self-adhesive cement showed intermediate results between CRG and GIG. Root reinforcement with bulk-fill composite resin is an effective option for flared root canals before cementation of a prefabricated fiber post.

Resumo em Inglês:

Abstract This study evaluated the shear bond strength (SBS) of self-adhesive resin cements (SARCs) to dentin and their physical-chemical properties. Five commercial SARCs were evaluated [SmartCem®2 – DENTSPLY (SC2); BisCem® – Bisco (BC); SeT PP® − SDI (SeT); Relyx U100® – 3M ESPE (U100) and YCEM® SA - Yller (YCEM)]. The SARCs were evaluated for SBS to dentin (n = 10) after 24 h, 6 months, and 12 months. The dentin demineralization caused by acidic monomers was observed by SEM, and pH-neutralization of eluate was observed for 24 h. Degree of conversion (DC), rate of polymerization (Rp), flexural strength (FS), and elastic modulus (E) were evaluated. Immediate SBS of SC2, SET, U100, and YCEM were statistically higher than that of BC (p < 0.001). After 12 months, all SARCs showed reduced SBS values and U100 showed values similar to those of SET and YCEM, and higher than those of BC and SC2 (p = 0.001). Demineralization pattern of SARCs was similar. At 24h, all SARCs showed no differences in the pH-value, except BC and U100 (p < 0.001). YCEM showed the highest Rp. U100, YCEM, and SC2 showed statistically higher FS (p<0.001) and E (p < 0.001) when compared with SET and BC. U100 and YCEM showed the best long-term bonding irrespective of the storage period. A significant reduction in SBS was found for all groups after 12 months. SBS was not shown to be correlated with physical-chemical properties, and appeared to be material-dependent. The polymerization profile suggested that an increased time of light activation, longer than that recommended by manufacturers, would be necessary to optimize DC of SARCs.

Resumo em Inglês:

Abstract: Susceptible genotypes to periodontal disease are associated with disease onset and progression. The aim of this study was to examine the effect of gene polymorphisms on the risk of further disease progression and the need for further treatment among adults with chronic periodontal disease. Sixty-seven patients diagnosed with chronic periodontitis were grouped according to genotype status and risk of further progression of disease and tooth loss. All individuals were clinically evaluated for probing pocket depth, clinical attachment loss and bleeding on probing at baseline and 45 days after treatment. Blood samples were collected at baseline and genotyping of the polymorphisms in IL-6 (rs1800796) and IL-10 (rs1800872) genes were performed by PCR. Following DNA separation and genotyping, 65.7% of the patients were homozygous carriers of the IL-6 −572G and 49.3% were carriers of the IL-10 −592A allele. Individuals at risk of disease progression ranged from 7.5% to 62.7% based on the criteria used. Carriers of the IL-10 −592A allele were significantly associated with BOP ≥ 30% and therefore exhibited a higher risk of further periodontal breakdown (p = 0.018) with an odds ratio of 1.18. None of the other definitions of disease progression were significantly associated with the examined IL-6 and IL-10 genotypes (p > 0.05). IL-10 polymorphism was associated with an increased risk of further disease progression and the potential need for further treatment following non-surgical periodontal treatment. Susceptible IL-6 genotypes were not associated with the risk of persisting or recurrent disease activity.

Resumo em Inglês:

Abstract: Population-based studies estimating the prevalence of tooth bleaching desire or the percentage of individuals who had performed this treatment are rare. Thus, the aim of this study was to evaluate the desire to perform tooth bleaching and the prevalence of adult individuals who had performed the treatment and investigate the association of these outcomes. A subsample (n = 536) of the 1982 Pelotas birth cohort in southern Brazil was investigated at the ages 15, 24 and 31 by clinical examinations and interviews. The prevalence of bleaching at 31 years was 15.6% [95%CI 12.6–18.9] while 85.9% [95%CI 82.7–88.7] reported they desired the treatment. Multivariate Poisson regression analysis showed that individuals who have visited the dentist within the last year showed a treatment prevalence ratio (PR) 2.31 times [95%CI 1.40–3.83] higher compared with those who had the last dental visit more than a year before the interview. Similarly, individuals with smoking habits presented an elevated PR of 1.60 [95%CI 1.00–2.55], and the low-income trajectory group showed the largest PR of desire for tooth bleaching (1.17 [95%CI 1.07–1.28]). Moreover, individuals from the high-risk caries trajectory group presented a higher prevalence of desire for tooth bleaching than individuals from low caries trajectory group. Individuals who have declared being “dissatisfied” with their dental color presented a prevalence of desire for tooth bleaching 16% greater than “satisfied” ones. Thus, the present findings confirm that tooth bleaching has become a frequently desired dental treatment to improve dental aesthetics in the population and a considerable rate of adults has performed the treatment.

Resumo em Inglês:

Abstract: The aim of this study was to translate and cross-culturally adapt the condition-specific instrument Impact of Fixed Appliances Measure (IFAM), assessing its validity and reliability for use among Brazilian children/adolescents. The IFAM was translated, back-translated, cross-culturally adapted, and pilot-tested. The Brazilian version of the IFAM (B-IFAM) was tested on 161 10-to-18-year-old children/adolescents. Internal consistency was assessed using Cronbach's alpha (α) and test-retest reliability by intraclass correlation coefficients (ICC). Construct validity was conducted using Pearson correlation among the overall and subscales of the B-IFAM. Discriminant validity was evaluated by comparisons of B-IFAM's means and SD with children's/adolescents' sex (Student t-test). Internal consistency was 0.89 for overall score and 0.55–0.86 for subscales. ICC for test-retest reliability was 0.81 for overall score and 0.55–0.78 for subscales. The overall score of the B-IFAM presented large correlation coefficients with most subscales (r = 0.52–0.74), supporting construct validity. Discriminant validity demonstrated statistically significant difference in the overall score, aesthetics, and physical impact subscales among female and male children's/adolescents' (p < 0.05). In the conclusion, the B-IFAM overall score and some subscales demonstrated adequate psychometric properties regarding reliability and validity. The study achieved a specific-condition instrument feasible for use on Brazilian children/adolescents who wear fixed orthodontic appliances.

Resumo em Inglês:

Abstract: Bulk-fill composites are claimed to be restorative materials used in deep preparations and effectively photoactivated in layers up to 4 mm. The aim of the present study was to evaluate the degree of conversion, post-gel volumetric shrinkage, and cytotoxicity of six bulk-fill and two conventional composites. Degree of conversion was determined by FTIR spectroscopy; post-gel volumetric shrinkage was determined using the strain gauge method; and cytotoxicity in human fibroblasts was evaluated indirectly by the MTT assay. Data were subjected to one-way ANOVA/Tukey's test (α = 0.05). All materials, including bulk-fill and conventional composites, were classified as non-toxic, with cell viability higher than 70%. Bulk-fill composites exhibited volumetric shrinkage similar to or lower (1.4 to 0.4%) than that of conventional composites (1.7–2.1%). However, only four of the bulk-fill composites were able to sustain a homogeneous conversion at the 4-mm depth. Despite their non-toxicity and shrinkage similar to that of conventional materials, not all commercial bulk-fill materials were able to maintain a conversion as high as 80% of the superficial layer, at the 4-mm depth, indicating some failure in the bulk-fill design of some commercial brands. Therefore, the use of bulk-fill materials in dental practice is advantageous, but special attention should be given to the selection and correct use of the materials.

Resumo em Inglês:

Abstract: The aim of this study was to evaluate the bond strength of different triccalcium silicate cements to retrograde cavity using a push out test. Thirty maxillary central incisors were shaped using #80 hand files and sectioned transversally. Root slices were obtained from the apical 4 mm after eliminating the apical extremity. The specimens were embedded in acrylic resin and positioned at 45° to the horizontal plane for preparation of root-end cavities with a diamond ultrasonic retrotip. The samples were divided into three groups according to the root-end filling material (n = 10): MTA Angelus, ProRoot MTA and Biodentine. A gutta-percha cone (#80) was tugged-back at the limit between the canal and the root-end cavity. The root-end cavity was filled and the gutta-percha cone was removed after complete setting of the materials. The specimens were placed in an Instron machine with the root-end filling turned downwards. The push-out shaft was inserted in the space previously occupied by the gutta-percha cone and push out testing was performed at a crosshead speed of 1.0 mm/min. There was no statistically significant difference in resistance to push out by the materials tested (p > 0.01). MTA Angelus and ProRoot MTA showed predominantly mixed failure while Biodentine exhibited mixed and cohesive failures. The tricalcium silicate-based root-end filling materials showed similar bond strength retrograde cavity.

Resumo em Inglês:

Abstract: The objective of this study was to analyze the epidemiological profile of oral health of Sateré-Mawé indigenous people living in Barreirinha, Amazonas (AM), Brazil, and the Tikuna indigenous people living in the urban area of Manaus (AM), in addition to characterizing the need for endodontic treatment between the two ethnic groups. A total of 138 individuals participated in the study, of whom 98 were Tikuna and 40 were Sateré-Mawé; they were distributed in age groups ranging from seven to 75 years. A very high prevalence of caries was observed in both ethnic groups. For the Sateré-Mawé in the 7–12 age group, the decayed, missing, and filled teeth (DMFT) index presented a mean value of 3.17. Comparing the DMFT index and the need for endodontic treatment in each of the ethnicities, these variables were found to be correlated, because as the DMFT index increases, the chances of needing endodontic treatment increase. The Sateré-Mawé presented a higher prevalence of need for endodontic treatment compared to the Tikuna. The association of comorbidities and the need for endodontic treatment were demonstrated only in the Tikuna, and there was only a correlation of this necessity with the presence of diabetes mellitus (DM) in one case. The need to expand access to oral health in these communities is emphasized, taking into account geographical access and technological, environmental, linguistic, and cultural barriers.

Resumo em Inglês:

Abstract The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0–12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Resumo em Inglês:

Abstract The objective of this study was to evaluate the in vitro effects, including surface morphological characteristics and chemical elemental properties, of different mouthwash formulations on enamel and dental restorative materials, simulating up to 6 months of daily use. Human enamel samples, hydroxyapatite, composite resin, and ceramic surfaces were exposed to 3 different mouthwashes according to label directions — Listerine® Cool Mint®, Listerine® Total Care, and Listerine® Whitening — versus control (hydroalcohol solution) to simulate daily use for up to 6 months. The samples were analyzed using scanning electron microscopy (SEM), infrared spectrophotometry (µ-Fourier transform infrared microscopy), energy-dispersive X-ray (EDX) spectroscopy, and color analysis before and after exposure. No relevant changes were observed in the morphological characteristics of the surfaces using SEM techniques. The physical and chemical aspects of the enamel surfaces were evaluated using mid-infrared spectroscopy, and EDX fluorescence was used to evaluate the elemental aspects of each surface. There was no variation in the relative concentrations of calcium and phosphorus in enamel, silicon and barium in composite resin, and silicon and aluminum in the ceramic material before and after treatment. No relevant changes were detected in the biochemical and color properties of any specimen, except with Listerine® Whitening mouthwash, which demonstrated a whitening effect on enamel surfaces. Long-term exposure to low pH, alcohol-containing, and peroxide-containing mouthwash formulations caused no ultra-structural or chemical elemental changes in human enamel or dental restorative materials in vitro.

Resumo em Inglês:

Abstract: The lack of guidelines for bone augmentation procedures might compromise decision making in implantology. The objective of this study was to perform a retrospective study to verify the outcomes of horizontal bone reconstruction in implant dentistry with different types of materials and amounts of native bone in the recipient bed to allow for a new guideline for horizontal bone reconstruction. One hundred preoperative CT scans were retrospectively evaluated and categorized in accordance to horizontal bone defects as presence (Group P) or absence (Group A) of cancellous bone in the recipient bed. Different approaches were used to treat the edentulous ridge and the outcomes were defined either as satisfactory or unsatisfactory regarding the possibility of implant placement. The percentage distribution of the patients according to the presence or absence of cancellous bone was 92% for Group P and 8% for Group A. In Group P, 98% of the patients had satisfactory outcomes, and the use of autografts had 100% of satisfactory outcomes in this group. In Group A, 37.5% of the patients had satisfactory outcomes, and the use of autografts also yielded 100% of satisfactory outcomes. The use of allografts and xenografts in Group A had 0% and 33.3% of satisfactory outcomes, respectively. Therefore, it seems reasonable to speculate that the presence of cancellous bone might be predictive and predictable when the decision includes bone substitutes. In cases of absence of cancellous bone in the recipient bed, the use of a vitalized graft seems to be mandatory.

Resumo em Inglês:

Abstract: Considering that environmental risk factors substantially contribute to the etiology of orofacial clefts and that knowledge about the characteristics and comorbidities associated with oral clefts is fundamental to promoting better quality of life, this study aimed to describe the risk factors, main characteristics, and comorbidities of a group of patients with cleft lip and/or cleft palate (CL/P) from Rio Grande do Norte (RN), Brazil. Data were obtained from 173 patients with CL/P using a form from the Brazilian database on Orofacial Clefts. Most patients were male with cleft lip and palate and had a normal size and weight at birth; presented few neonatal intercurrent events; and had anemia and respiratory and cardiovascular diseases as main associated comorbidities. They also required timely surgical rehabilitation and multidisciplinary care to stimulate their neuropsychomotor development. In addition, a high frequency of familial recurrence and of parental consanguinity was evidenced in the studied population, especially for the cleft lip and cleft palate type. Other relevant findings were the considerable maternal exposure to alcohol, infections, smoking, and hypertension, as well as low supplementation with vitamins and minerals and deliberate consumption of analgesics, antibiotics, and antihypertensives during pregnancy. Characterization of the CL/P patient profile is essential for the planning of health services and integration among the health professionals involved in the diagnosis and treatment of these malformations. Our results reinforce the need for additional research to confirm the association between environmental factors and the development of orofacial clefts.

Resumo em Inglês:

Abstract: Data about total fluoride intake in children living in a tropical semi-arid climate city is scarce, thus we conducted this study. Fifty-eight children aged two to five years, living in a Brazilian tropical city with optimally fluoridated water were selected. Dietary samples were collected using the duplicate diet method on two non-consecutive days in the children's home toothpaste was determined by subtracting the amount of fluoride recovered after brushing from the amount placed on the toothbrush. The mean total dose (SD) of fluoride intake was 0.043(0.016) mg F·kg-1·d-1, with the major (60.6%) contribution from water. The factors associated with the ingestion of fluoride from toothpaste were fluoride concentration of the toothpaste (p = 0.03) and the use of kids toothpaste (p = 0.02). The findings suggest that children have a low fluoride intake, measured by at-home meals and use of fluoride toothpaste; drinking water is the main source of fluoride ingestion.

Resumo em Inglês:

Abstract: The effects of several ceramic surface treatments on bond strength of a polymer-infiltrated ceramic network and resin composite as repair material were evaluated. CAD-CAM blocks of a polymer-infiltrated ceramic network (Vita Enamic) were sliced and subjected to aging process, followed by embedding in acrylic resin. The bonding/repair area was treated as follows (n = 30): C– without treatment; UA– universal adhesive application; FM– 10% hydrofluoric acid and silane application; OM–airborne-particle abrasion with aluminum oxide and silane application; RP– tribochemical silica coating; and CA– surface grinding and application of universal adhesive. Composite resin cylinders were made on the treated surface. Specimens from each group were assigned randomly to two subgroups (n = 15) considering storage condition: Baseline (shear tests after 48 hours) or Storage (tests after 6 months under distilled water). The treated surfaces were analyzed by goniometry, roughness, and SEM. Two-way ANOVA and 1-way ANOVA were applied to analyze the bond data and roughness / contact angle data, respectively, followed by Tukey's test (α = 5%). Surface treatments and storage conditions affected bond strengths (p < 0.01). Surface grinding (CA) followed by universal adhesive promoted the highest value of bond strength (14.5 ± 4.8 MPa for baseline, 8.5 ± 3.4 MPa for storage) and the roughest ceramic surface. Grinding with silicon carbide paper (simulating diamond bur) followed by the application of a universal adhesive system is the best option for repairing fractures of the polymer-infiltrated ceramic network.

Resumo em Inglês:

Abstract The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three South American cities, and also to assess the association of these variables with sociodemographic data and with the clinical presence of plaque and gingival inflammation. Five-hundred and fifty adult subjects from each city (Porto Alegre, Brazil; Tucumán, Argentina; Santiago, Chile) received full mouth examinations to determine visible plaque and gingival index. A structured questionnaire on demographics, habits, attitudes and knowledge of oral health was also administered. The data were analyzed according to dental visit frequency, toothbrushing frequency, interproximal tooth cleaning frequency, subjects’ perception of gum bleeding, and proportion of subject sites with VP and bleeding sites. Analysis of the association among the variables was performed using either a chi-square test or Fischer's exact test. Toothbrushing twice a day or more was reported by 84.2% of the subjects, but only 17.7% reported daily interdental cleaning, and 60.2% reported visiting a dental clinic only in an emergency. Only 2.97% had no bleeding sites, whereas 33.7% had 50% or more bleeding sites. Regular interdental self-cleaning and a dental visit every 3-6 months was associated with less plaque and less gingival bleeding. More than 12 years of education was associated with healthier habits, less bleeding and plaque scores. In conclusion, the oral health behavior of South American adult subjects from these cities is below the international recommendations, especially in relation to interdental cleaning and regular dental visits.

Resumo em Inglês:

Abstract It is largely known that some oral diseases can be diagnosed based upon their clinical manifestation combined with the patient's medical history and generally not depending on examination. This is the case of some bone diseases such as osteoradionecrosis of the jaw (ORNJ), osteomyelitis of the jaw (OMJ), and medication-related osteonecrosis of the jaw (MRONJ). The present study aimed to analyze the histopathological features of these specific bone diseases in order to evaluate similarities and differences. Forty-four bone specimens resected from each bone disease (22 cases of ORNJ, 6 cases of OMJ, and 16 cases of MRONJ) were analyzed by two experienced oral pathologists without prior knowledge of the diagnosis, considering bone tissue condition, inflammation, vascularization, and the presence of microorganisms. In addition, the examiners formulated a diagnostic hypothesis for each specimen. Many histopathological similarities were found among the diseases, especially considering the presence of necrotic bone, inflammation, and microorganisms. Statistically significant differences were detected in empty bone lacunae, which was decreased in ORN (p = 0.042), and considering neutrophil count, which was low in the MRONJ group (p ≤ 0.001). The Kappa coefficient was calculated and agreement was detected based on the histopathological parameters, but not for diagnostic suggestion (p=0.23). In conclusion, histopathological aspects of ORNJ, OMJ, and MRONJ do not permit a conclusive diagnosis, emphasizing the necessity of a detailed clinical report.

Resumo em Inglês:

Abstract Concentrated growth factor (CGF) is an autogenuous product that contains highly concentrated number of platelets and can be derived from venous blood by selective centrifugation. It has been speculated that local growth factors in human platelets (insulinlike growth factor, IGF; transforming growth factor, TGF-b; platelet derived growth factor, PDGF) would enhance healing of grafts and also counteract resorption. The osteogensis effect of CGF and acellular dermal matrix (ADM) for alveolar cleft defects was evaluated in this study. Twenty alveolar cleft patients were divided randomly into two groups. One group underwent guided bone regeneration (GBR) using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting combined with CGF (CGF group). Cone beam computed tomography (CBCT) images were obtained at 1 week and 6 months following the procedure. Using Mimics 17.0 software, the bone resorption rate and bone density improvement rate were calculated and compared between the two groups. Although not significant between ADM and CGF in bone resorption rate, the bone density improvement in cases with CGF(61.62 ± 4.728%) was much better than in cases with ADM (27.05 ± 5.607%) (p = 0.0002). Thus, CGF could be recommended to patients with alveolar cleft as a better choice.

Resumo em Inglês:

Abstract This study aimed to investigate slow crack growth (SCG) behavior of a zirconia ceramic after grinding and simulated aging with low-temperature degradation (LTD). Complementary analysis of hardness, surface topography, crystalline phase transformation, and roughness were also measured. Disc-shaped specimens (15 mm Ø × 1.2 mm thick, n = 42) of a full-contour Y-TZP ceramic (Zirlux FC, Amherst) were manufactured according to ISO:6872-2008, and then divided into: Ctrl – as-sintered condition; Ctrl LTD – as-sintered after aging in autoclave (134°C, 2 bar, 20 h); G – ground with coarse diamond bur (grit size 181 μm); G LTD – ground and aged. The SCG parameters were measured by a dynamic biaxial flexural test, which determines the tensile stress versus stress rate under four different rates: 100, 10, 1 and 0.1 MPa/s. LTD led to m-phase content increase, as well as grinding (m-phase content: Ctrl – 0%; G – 12.3%; G LTD – 59.9%; Ctrl LTD – 81%). Surface topography and roughness analyses showed that grinding created an irregular surface (increased roughness) and aging did not promote any relevant surface change. There was no statistical difference on surface hardness among different conditions. The control group presented the lowest strength values in all tested rates. Regarding SCG, ground conditions were less susceptible to SCG, delaying its occurrence. Aging (LTD) caused an increase in SCG susceptibility for the as-sintered condition (i.e. G < G LTD < Ctrl < Ctrl LTD).

Resumo em Inglês:

Abstract This study aimed to evaluate the influence of different ethanol concentrations on dentin roughness, surface free energy, and contact angle between AH Plus and the root canal dentin. One hundred human maxillary anterior teeth were split longitudinally and 200 dentin specimens were polished to make the surface flatter and smoother. An acrylic bar was positioned between two dentin specimens and impression material was added to create a block, simulating an instrumented root canal space. Specimens were removed from the mold and cleaned in an ultrasonic bath for 10 min. Thereafter, dentin specimens were divided into four groups (n = 50) according to the drying methods used: a) wet: vacuum only, b) paper points: vacuum + absorbent paper points, c) 70% alcohol: 70% alcohol (1 min) + vacuum + absorbent paper points, and d) 100% alcohol: 100% alcohol (1 min) + vacuum + absorbent paper points. A rugosimeter and a goniometer were used to verify the roughness (Ra) and to measure the surface free energy and the contact angle between the AH Plus sealer and the root canal dentin. ANOVA and Tukey tests (α = 0.05) were used for statistical analysis. The 70% and 100% ethanol groups showed significantly decreased roughness as well as increased surface free energy in the root canal dentin when compared to the wet and paper point groups. In addition, ethanol significantly reduced the contact angle between the AH Plus sealer and the root canal dentin. Ethanol solutions (70% and 100%) provide better wettability of AH Plus sealer on dentin surfaces.

Resumo em Inglês:

Abstract The dentine hypersensitivity (DH) is able to impair the oral health related quality of life (OHRQoL). However, there isn't any specific validated questionnaire to be used in Brazil. The objective was to adapt and to validate the English version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) for use in Brazil. DHEQ-15 was cross-culturally adapted into the Brazilian-Portuguese language and then validated in a cross-sectional study with 100 participants recruited at a University clinic. Study sample comprised 2 groups: 100 individuals with DH, and 100 individuals without. The instrument was self-administered twice 7 to 10 days apart. The participants answered a global rating of oral health. The psychometric properties of the Brazilian version of DHEQ-15 were verified through internal consistency (Cronbach's α) and test-retest reliability (intraclass correlation coefficient - ICC), convergent (Spearman correlation) and discriminant (Mann-Whitney test) validity. The significance threshold was set at p<0.05. Sample comprised 69 men and 131 women, of mean age 30.4y. The Brazilian DHEQ-15 demonstrated very good internal consistency (α = 0.945). Test-retest reliability revealed excellent reproducibility (ICC = 0.959, p < 0.001). There was statistically significant correlation between the scores obtained on all DHEQ-15 domains and the global rating of oral health (p<0.001). Participants with DH scored significantly higher than those without DH (p<0.001). This study provides evidence supporting the cross-cultural validity of the Brazilian version of DHEQ-15 for use in Brazil.

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Abstract To evaluate the effect of different surface treatments on the marginal misfit and retentive strength between Y-TZP crowns and an epoxy resin. Forty (40) epoxy resin (G10) abutments (height: 5mm, conicity: 60, finish line: large chamfer) with equal dimensions were milled and included in polyurethane to simulate the periodontal ligament. Next, 40 Y-TZP crowns (thickness: 1mm) were milled (Cerec in Lab) and randomly divided into four groups (n=10) according to the surface treatment: GS(glaze spray), GP(glaze powder/liquid), P(zirconia primer) and RS(tribochemical silica coating). The conditioned surfaces were cemented with dual self-adhesive cement, light cured and submitted to thermomechanical cycling (2x106, 100N, 4Hz, 5°/55°C). Marginal misfit was analyzed by a stereomicroscope and SEM. Retentive strength test was performed (1mm/min) until crown debonding. Glaze layer thickness was also performed to GS and GP groups. Marginal misfit data were analyzed by Kruskal Wallis and Dunn tests; one-way ANOVA and Tukey (5%) analyzed the tensile strength data. The marginal misfit of the GS (48.6±19.9μm) and GP (65.4±42.5μm) were statistically lower than the RS (96±62.9μm) and P (156±113.3μm) (p=0.001). The retentive strength of the GP (470.5±104.1N) and GS (416.8±170.2N) were similar to the P (342.1±109.7N), but statistically higher than those of the RS (208.9±110N). The GS and GP glaze layer was 11.64μm and 9.73μm respectively. Thus, glaze application promoted lower marginal discrepancy and higher retentive strength values than conventional techniques.

Resumo em Inglês:

Abstract We aimed to analyze the effects of family income trajectories on the increase in dental caries from childhood to young adulthood. Data from the 1993 Pelotas (Brazil) birth cohort study, in which dental caries was measured at ages 6, 12, and 18 years, were analyzed. Family income of 302 participants was assessed at birth, and at 4, 11, 15, and 18 years of age. Mother's education, toothbrushing frequency, dental visiting, dental caries in primary dentition, and birth weight were covariates. A latent class growth analysis was conducted to characterize trajectories of time-varying variables. The influence of income trajectories on the increase in dental caries from age 6 to age 18 was evaluated by a generalized linear mixed model. After adjustment, the increases in numbers of decayed and missing teeth (DMT) from age 6 to age 18 were associated with family income trajectory. The incident rate ratios (IRR) of DMT compared with the group of stable high incomes were 2.36 for stable low incomes, 1.71 for downward, and 1.64 for upward. The IRR of teeth being filled in stable low-income groups compared with stable high-income groups was 0.55. Family income mobility affected treatment patterns of dental caries. Differences across income trajectory groups were found in the components of dental caries indices rather than in the experience of disease.

Resumo em Inglês:

Abstract To evaluate the impact of dental caries among Brazilian individuals with special health care needs (SHCN) on their families’ oral health-related quality of life (OHRQoL). A cross-sectional study was carried out with a population-based sample of 227 subjects who were enrolled from the ACOLHER-PNE project conducted at the Fluminense Federal University. Parents/caregivers answered the Brazilian version of the 14-item Family Impact Scale (B-FIS) to assess the impact on family's quality of life (QoL). The main independent variable was dental caries experience, diagnosed according to the World Health Organization (WHO) criteria. The DMFT/dmft score was categorized into 0 = caries free; 1–2 = low; 3-4 = moderate; and ≥ 5 = high experience. Mother's schooling, age, sex, SHCN conditions, and socioeconomic factors were the other independent variables. QoL was measured through FIS domains and total score. Statistical analyses was performed using the Kruskal Wallis and Mann Whitney U tests and Poisson regression (p<0.05). The impact values observed in moderate and high caries experience were significantly higher than those found in subjects without caries and low level of parental emotions. Parents’ years of schooling showed more impact on total score and on parental emotions. Older subjects showed significantly higher impact on total score and in all domains. The multivariate model demonstrated that families of older subjects (> 8 years old) experience a higher impact level compared to younger subjects (PR: 2.43; 95%CI: 1.80–3.29, p = 0.001). High caries experience and other socioeconomic factors were not associated with a greater negative impact on parents’ QoL.

Resumo em Inglês:

Abstract This research explored the potential of Camellia sinensis-derived teas and active compounds to be used as treatments to prevent dentin wear. Human root dentin slabs were randomly assigned to 5 groups (n = 10) as follows: distilled water (DW, control), epigallocatechin-3-gallate (EGCG), theaflavin gallate derivatives (TF), commercial green tea (GT), and commercial black tea (BT). The samples were submitted to a pellicle formation and an erosive cycling model (5x/day, demineralization using 0.01 M hydrochloric acid/60 s) followed by remineralization (human stimulated saliva/60 min) for three days. The samples were treated for 5 min using the test group solutions between the erosive cycles. Dentin changes were assessed with profilometry analysis and FT-Raman spectroscopy. The data regarding wear were analyzed by ANOVA followed by Tukey's test (p < 0.05). EGCG, TF derivatives, and both regular teas significantly suppressed erosive dentin loss (38–47%, p < 0.05). No obvious changes in the Raman spectra were detected in the specimens; however, the DW group had a minor relationship of 2880/2940 cm−1. The phenolic contents in both green and black tea and the important catechins appear to have protective effects on dentin loss.

Resumo em Inglês:

Abstract To investigate how the hydrofluoric acid (HF) concentrations applied to a lithium disilicate glass-ceramic (EMX) affects the surface morphology and microtensile bond strength (μTBS) of ceramics to dentin, using light-cured resin cements with or without UDMA. Sixty-three EMX square ceramic blocks were etched for 20 seconds using different HF concentrations (1%, 5% and 10%) and luted to dentin using two types of resin cement combinations: BisGMA/TEGDMA and BisGMA/TEGDMA/UDMA (n = 10). Each bonded EMX-dentin block was sectioned to obtain 1 mm2 sticks for μTBS evaluation. Half of the sticks were tested after 24 hours and the other half was assessed after 6 months of water storage. Data were statistically assessed using split-plot three-way ANOVA and multiple comparisons were performed using the Tukey's post hoc test (α = 0.05). One EMX sample from each HF concentration was analyzed using field-emission scanning electron microscope (FE-SEM) to characterize the etching pattern. According to the FE-SEM images, increasing the concentration of HF from 1 to 5 and then to 10% led to increased removal of glassy matrix and greater exposure of lithium disilicate crystals. The 10% HF concentration yielded higher μTBS when compared to 1% for BisGMA/TEGDMA formulation (p < 0.05); whereas HF 1% and 5% showed similar μTBS values when compared to 10% HF for BisGMA/TEGDMA/UDMA resin matrix (p > 0.05) at both storage times. Water aging decreased the μTBS values (p < 0.05), except when 10% HF was associated with BisGMA/TEGDMA resin cement. Resin cement formulation and hydrofluoric acid concentrations can interfere with the immediate and long-term glass-ceramic bond strength to dentin.

Resumo em Inglês:

Abstract The aim of this study was to evaluate the effects of proanthocyanidin (PA) and chlorhexidine (CHX) on the bond strength (BS), failure pattern, and resin-dentin interface morphology of the endodontic sealers EndoREZ and AH Plus after 24 h and 6 months of water storage. A total of 120 prepared bovine roots were divided into six groups: AH Plus, CHX+AH Plus, PA+AH Plus, EndoREZ, CHX+EndoREZ, and PA+EndoREZ. Dentin was treated for 1 or 5 min with 2% CHX or 15% PA, respectively. Roots were filled and stored in water for 24 h or 6 months (n = 10). Root slices were subjected to push-out test and scanning electron microscopy (SEM). Data were compared using two-way ANOVA and student's t-test (α = 5%). BS decreased over time for AH Plus and untreated EndoREZ (p < 0.05). At 24 h, AH Plus had higher BS than EndoREZ (p < 0.001), with no differences among treatments for both sealers (p > 0.05). At 6 months, EndoREZ had higher BS values for CHX and PA than control (p < 0.05). AH Plus had higher BS than EndoREZ (p < 0.001), while with CHX or PA, similar BS was observed in both sealers (p > 0.05). Cohesive and mixed failures were observed in all groups. SEM revealed sealer tags in the root dentin. In conclusion, BS decreased with time and AH Plus had higher BS than EndoREZ in untreated dentin; however, CHX or PA enhanced long-term BS of EndoREZ. Overall, dentin treatment affected failure pattern and resin-dentin interface morphology, particularly for EndoREZ.

Resumo em Inglês:

Abstract Nicaraguan legislation has established that fluoride concentrations in salt should be 200–225 mg/kg, but no report describes fluoride concentrations in salt marketed in this country. We evaluated the fluoride concentrations in 33 packages of salt of 11 brands (n = 3 each) purchased in Managua, Nicaragua. According to the package information, 9 of the 11 brands were fluoridated. Six aliquots of each package were weighed (mean 2.5 ± 0.3 g; n = 198) and dissolved in 0.025 g/ml water. Duplicates of 1.0 ml of solutions prepared were buffered (1:1; v/v) with TISAB II. Fluoride concentrations were determined with ion-specific electrode, calibrated with standard solutions (0.25–16.0 μg F/ml) mixed (1:1; v/v) with TISAB II added to 0.025 g (p.a.) NaCl/ml. The mean (± standard deviation, n = 3) fluoride concentrations of two fluoridated brands were in accord with Nicaraguan law (209.8 ± 48.0 and 211.4 ± 26.0 mg F/kg), and those of five brands were below the mandated range (131.0 ± 34.3, 180.6 ± 12.3, 184.6 ± 34.8, 190 ± 47.2, and 199.0 ± 18.9 mg F/kg); two brands contained only traces of fluoride. The two non-fluoridated brands had traces of fluoride. The findings show that the surveillance system for the salt fluoridation program in Nicaragua should be improved, as most salt analyzed violated the requirements of the national legislation.

Resumo em Inglês:

Abstract: The aim of this study was to evaluate in vitro the antifungal, antibiofilm and antiproliferative activities of the extract from the leaves of Guapira graciliflora Mart. The phytochemical characterization of the extract was performed using electrospray ionization mass spectrometry (ESI-MS). The antimicrobial activity of the extract and its fractions was evaluated using the broth microdilution method against species of Candida. The inhibition of C. albicans biofilm was evaluated based on the number of colony-forming units (CFU) and metabolic activity (MTT). The antiproliferative activity of the extract and its fraction was evaluated in the presence of human tumor and non-tumor cells, and the cytotoxicity of the extract was determined on the RAW 264.7 macrophage line – both using the sulforhodamine B method. The phytochemical characterization indicated the presence of the flavonoids rutin and kaempferol. The extract and the methanol fraction exhibited moderate antifungal activity against C. albicans, C. krusei, and C. glabrata, and strong activity against C. dubliniensis. In the biofilms at 24 and 48 hours, the concentration of 12500 µg/mL of the extract was the most effective at reducing the number of CFU s/mL (44.4% and 42.9%, respectively) and the metabolic activity of C. albicans cells (34.6% and 52%, respectively). The extract and its fractions had no antiproliferative effect on the tumor lines tested, with mean activity (log GI50) equal to or greater than 1.71 µg/mL. Macrophage cell viability remained higher than 80% for concentrations of the extract of up to 62.5 µg/mL. G. graciliflora has flavonoids in its chemical composition and demonstrates potential antifungal and antibiofilm activity, with no evidence of a significant change in the viability of human tumor and non-tumor cell lines.

Resumo em Inglês:

Abstract: Based on aroeira's (Myracrodruon urundeuva) antimicrobial activity and a future trend to compose intracanal medication, the aim of this study was to assess in vivo inflamatory tissue response to the extracts by edemogenic and histological analysis containing inactivated facultative and anaerobic microorganisms. For edema quantification, eighteen animals were divided into three groups (n = 3, periods: 3 and 6 hours) and 0.2 mL of 1% Evans blue per 100 g of body weight was injected into the penile vein under general anesthesia. After 30 min the animals received a subcutaneous injection in the dorsal region of aqueous or ethanolic extract of aroeira or saline (control) containing inactivated bacteria. Samples were collected, immersed in formamide for 72h, and evaluated by spectrophotometry (630 m). For histological analysis, polyethylene tubes with the extracts were implanted in the dorsal of 30 male rats. Analysis of the fibrous capsule and inflammatory infiltrate were performed after 7 and 30 days. The aqueous extract group induced less edema in both postoperative periods compared to the other groups, but the differences were not significant (p > 0.05). Tissue repair was significantly better after 30 days than after 7 days (p < 0.01). The aqueous solution showed less inflammatory response than the ethanolic solution (p < 0.05), with tendency for better results than control after 7 days. After 30 days, the response to both extracts was similar to control. The aqueous and ethanolic aroeira extracts containing inactivated microorganisms showed a trend for better results than saline, even when associated with microorganisms, and facilitated the tissue repair process.

Resumo em Inglês:

Abstract: The aim of this study was to evaluate the antimicrobial action of different endodontic pastes against Enterococcus faecalis ATCC 29212, isolated from the urinary tract, and compare the action with E. faecalis ATCC 4083, isolated from the root canal. For this purpose, dentin blocks were infected for 21 days with both bacteria at different time-intervals to ensure there would be no cross contamination. After this period, blocks were immersed in the test medications for 7 days, according to the following groups: CH/S, CH/P, CH/CMCP, CH/CHX, CH/DAP and TAP. Images of the samples were captured with a confocal microscope and the percentage of live cells was computed by means of the Bioimage program. The ATCC 29212 strain was shown to be more resistant to CH/SS, Calen, CH/DAP, and TAP than the ATCC 4083 strain. The antimicrobial action of the medications against each strain were divergent concerning the order of susceptibility. The authors concluded that the strains behaved in a different manner: in general, those extracted from the urinary tract were more resistant to the tested medications. Therefore, when E. faecalis must be used for in vitro research in endodontics, we suggest the use of ATCC 4083 strain to obtain results that are closer to the clinical reality.

Resumo em Inglês:

Abstract The influence of inorganic filler content of resin-based luting agents (RBLAs) on color change (ΔE00), CIEL*a*b* (individual color coordinates), and translucency parameters (TP) of simulated ceramic laminate veneer (CLV) was investigated. RBLAs with low, intermediate, and high inorganic filler content (55%, 65%, and 75% mass fractions, respectively) were prepared. Feldspar ceramic (Vitablocs Mark II) specimens (1.2 mm × 0.8 mm, A1C shade) were bonded to simulated composite resin substrates (1.6 mm × 1.2 mm, A2D shade) using three experimental and a commercial (RelyX Veneer) RBLA (translucent shade). The ΔE00 was calculated by CIEDE2000 color difference metric under three conditions (before, immediately after, and 24 h after luting). The TP was calculated using CIEL*a*b* color coordinates measured over white and black backgrounds. Surface morphology of the RBLAs was analyzed. One-way and two-way analyses of variance with a post-hoc Tukey’s test were used respectively to calculate TP, CIEL*a*b* coordinates, and ΔE00 (α= 0.05). Overall, the tested RBLAs presented clinically visible ∆E00 values under the three conditions evaluated. For all RBLAs, higher ∆E00 values were observed between measurements obtained before and immediately after luting. Different inorganic filler content did not significantly increase the opacity of the ceramic-luting agents-resin composite set. The variation in inorganic filler content did not influence significantly the TP of simulated CLV; although all of the experimental RBLAs tested yielded ∆E00 above the perceptibility threshold. The L*, a*, and b* individual color coordinates were cementation-dependent.

Resumo em Inglês:

Abstract Orofacial pain and temporomandibular dysfunction may cause chronic facial pain, which may interfere with the emotional state and food intake of patients with eating disorders (ED), such as anorexia nervosa (AN) and bulimia nervosa (BN). Sixty-four patients were assigned to four groups: Group A (AN – restricting subtype): 07; Group B (AN – purging subtype ): 19; Group C (BN): 16; and Group D (control): 22. Complaints of pain are more prevalent in individuals with eating disorders (p<0.004). There are differences between the presence of myofascial pain and the number of hospitalizations (p = 0.046) and the presence of sore throat (p=0.05). There was a higher prevalence of masticatory myofascial pain and complaints of pain in other parts of the body in ED patients; however, there was no difference between ED subgroups. There was no difference in the number of self-induced vomiting between ED patients with and without myofascial pain.

Resumo em Inglês:

Abstract Attention-deficit/hyperactivity disorder (ADHD) is characterized by inappropriate levels of hyperactivity, impulsivity, and/or inattention. Individuals with ADHD may present limitations with regard to executive functions and performing activities that involve planning and/or attention/concentration. The aim of the study was to investigate the association between dental caries and signs of ADHD in a representative sample of schoolchildren. A representative sample of 851 schoolchildren aged seven to 12 years was randomly selected from public and private schools. Data acquisition involved a clinical dental examination for cavitated permanent and deciduous teeth using the DMFT/dmft indices. Neuropsychological evaluations, including the assessment of intelligence (Raven’s Colored Progressive Matrix Test) and executive functions (Corsi Tapping Blocks tests and Digit Span test) were also performed. Parents/caregivers and teachers answered the SNAP-IV Questionnaire for the investigation of signs of inattention and hyperactivity in the family and school environment. Parents/caregivers also answered questionnaires addressing socioeconomic and socio-demographic characteristics. Descriptive analysis of the variables and Poisson regression with robust variance were performed. Parental reports of signs of inattention (PR: 1.28; p < 0.05) and hyperactivity (PR: 1.15; p < 0.05) were associated with a greater occurrence of caries. A better performance on the backward order of the Corsi Tapping Blocks tests (PR: 0.94; p < 0.05) and higher level of mother’s schooling were associated with a lower frequency of caries. A better performance on executive function tasks was a protective factor against dental caries, whereas children considered inattentive and/or hyperactive by their parents had a higher prevalence rate of dental caries.

Resumo em Inglês:

Abstract Osteoporosis is an insidious and increasingly prevalent disease that can cause fractures and affect patients’ quality of life. The current study comparatively evaluates patients with and without loss of bone mass in terms of salivary calcium, viscosity, and pH. A controlled cross-sectional study was conducted in two groups of 32 postmenopausal women subjected to a bone densitometry scan and later referred for dental management at the Federal University of Minas Gerais, Brazil. The patients were assigned to two groups: Group 1 - patients with low bone mineral density (BMD) and Group 2 - patients without bone mineral changes. The following salivary parameters were evaluated: calcium concentration, flow rate, viscosity, pH, and average total protein. An oral examination was performed for assessment of DMFT variables and tongue coating. Data were analyzed using descriptive and inferential statistics, adopting a p-value < 0.05. The patients’ mean age was 60 years (± 7.35). Salivary flow, pH, and viscosity were similar among the groups. Average total protein was 14.8 mg/mL and 19.0 mg/mL in Groups 1 and 2, respectively. Tongue coating and salivary calcium levels were significantly higher in Group 1 (p < 0.001). Salivary calcium is an important screening tool and may eventually be used for the diagnosis of bone mineral changes.

Resumo em Inglês:

Abstract Given the growing trend towards medical indications for continuous use of anticoagulants, the number of patients on these medications continues to rise. The management of patients on oral anticoagulants requiring oral surgical procedures has aroused much controversy. Changes in an anticoagulation regimen are associated with an increased risk of thromboembolism. However, it seems logical and advantageous for the patients’ health if surgery could be performed without any change to the anticoagulation therapy. In dentistry, high-power lasers have been poorly explored in this field. The hemostatic properties of high-power lasers could be helpful during oral soft tissue surgeries in anticoagulated patients. The aim of this study was to compare bleeding time in anticoagulated rats after lingual frenectomy performed with a scalpel or diode laser with bleeding time in healthy animals. Twenty-four male Wistar rats were assigned to four groups (n = 6): (CS) Control-Scalpel Surgery; (AS) Anticoagulated-Scalpel Surgery; (CL) Control-Laser (diode laser 810 nm/1.5 W) Surgery; and (AL) Anticoagulated-Laser Surgery (diode laser 810 nm/1.5 W). Warfarin administration was used to induce anticoagulation. Blood was blotted every 30 seconds with filter paper until bleeding stopped to verify bleeding time. Two blinded researchers performed the surgeries and collected the bleeding time data. Diode laser surgery led to complete hemostasis in rats during and after lingual frenectomy. Zero bleeding was assessed during surgeries and after diode laser surgeries in anticoagulated rats. Laser-induced hemostasis offered an alternative solution to the controversial issue of intraoperative and postoperative bleeding control in patients on anticoagulation therapy.

Resumo em Inglês:

Abstract The aim was to investigate the angiogenic effects of concentrated growth factors on human dental pulp cells and human umbilical vein endothelial cells. Cells were treated with concentrated growth factor extracts. The CCK-8 assay and cell cycle assay were conducted to evaluate cell growth. Cell migration was evaluated by the Transwell migration assay. Angiogenesis-associated mRNA and protein expression levels were determined using quantitative real-time PCR and Western blotting, respectively. A tube formation assay was conducted to evaluate the angiogenic capacity in vitro. The data showed that compared with the control, concentrated growth factor extracts significantly promoted dental pulp cell proliferation and differentiation and endothelial cell proliferation and migration in a dose-dependent manner (p < 0.05). Concentrated growth factor extracts also promoted the tube-like structure formation of endothelial cells in vitro. The RT-PCR and Western blot results showed that concentrated growth factor extracts upregulated the expression of angiogenesis-related genes – chemokine receptor-4, platelet-derived growth factor, and vascular endothelial growth factor – in dental pulp cells. In conclusion, concentrated growth factors showed proangiogenic effects on dental pulp cells and endothelial cells and have good application potential for dental pulp revascularization.

Resumo em Inglês:

Abstract This in vitro study evaluated the fatigue strength of different ceramic materials indicated for monolithic restorations. Disc-shaped specimens were made according to ISO 6872 from five different ceramic materials: feldspathic ceramic (FC), polymer-infiltrated ceramic network (PIC), lithium disilicate glass-ceramic (LD), zirconia-reinforced lithium silicate glass-ceramic (ZLS), and high translucent tetragonal zirconia polycrystals doped by yttrium (YZ-HT). After obtaining the mean of each material (n = 5) from monotonic load-to-failure tests, specimens (n = 20) were subjected to fatigue tests (staircase method) using a biaxial flexural setup (piston-on-three-balls), to determine the fatigue strength. The parameters used for fatigue tests were: 100,000 cycles at 10 Hz, initial load of ~ 60% of mean load-to-failure, and step size of 5% of the initial load (specific for each ceramic material). Kruskal-Wallis and Bonferroni’s test (α = 0.05) were used to analyze the fatigue strength data. Fatigue strength (MPa) of the materials was statistically different among each other as follows: YZ-HT (370.2 ± 38.7) > LD (175.2 ± 7.5) > ZLS (152.1 ± 7.5) > PIC (81.8 ± 3.9) > FC (50.8 ± 1.9). Thus, it can be concluded that, in terms of fatigue, high translucent polycrystalline zirconia is the best choice for monolithic restorations as it bears the highest load before cracking/fracturing.

Resumo em Inglês:

Abstract Free gingival grafting, the most predictable technique to increase the keratinized gingiva, leaves an open wound on the palate and the resulting discomfort during the healing phase is a significant concern. This study was intended to evaluate the effect of topical erythropoietin on healing of the donor site. Twelve patients lacking an attached gingiva at two sites in the mandible were included. In the test group, 1 mL of gel containing erythropoietin at a concentration of 4,000 IU mL-1 was applied to the donor site, whereas the control group was treated with 2 mL of the gel alone. On the second day after surgery, the same procedure was repeated. H2O2 was used to evaluate the amount of epithelialization. Clinical healing was compared using photographs and direct examination. The EPO group showed significantly better keratinization only on day 21. Comparison of clinical healing based on direct examination revealed significantly better healing in the test group on day 28. Furthermore, inflammation in the test group was lower than in the control group on the same day. Topical application of EPO improves palatal wound healing during the third and fourth weeks after free gingival graft procedures.

Resumo em Inglês:

Abstract The objective of the present study was to evaluate the effect of different surface treatments and polymerization protocols on the bond strength of brackets to enamel, and the degree of conversion of the bonding agents. 120 bovine crowns were embedded in acrylic resin blocks and sanded. Next, the blocks were randomly assigned into 12 groups. Metal brackets were bonded to enamel according to the “surface treatment” factor (A: Phosphoric Acid; ATxt: Phosphoric Acid + Transbond XT Primer®; Tse: Transbond Plus Self Etching Primer®; and SBU: Scotchbond Universal®) and “polymerization” factor (R20: Radii-Cal®/20 seconds; V20: Valo Cordless®/20 seconds; and V3: Valo Cordless®/3 seconds). All samples were stored for 6 months (water, 37ºC) and then subjected to a shear bond strength test (SBS). Bond failures were classified according to the Adhesive Remnant Index (ARI) and analyzed with the Kruskal-Wallis and Mann-Whitney tests (5%). Using the same factors, 120 resin discs were made to assess the degree of conversion (DC) of the monomer. Data from the SBS (MPa) and DC (%) were analyzed by analysis of variance (2 factors) and Tukey’s test (5%). For the SBS, the factors “polymerization” (R20 = 8.1B; V20 = 13.2A; V3 = 5.2C, p = 0.0001) and “surface treatment” (A = 3.1C; ATxt = 13.6A; Tse = 12.3A; SBU = 6.3B, p = 0.0001) were statistically significant among groups. The highest adhesion value were found for the ATxt/V20 group (22.2A) and the lowest value for the A/R20 group (1.2E). Regarding ARI, score 2 was the most prevalent in groups A, ATxt, V20 and V3, while score 4 was the most prevalent in the Tse, SBU and R20 groups, with no significant difference between them (p = 1.0). Regarding DC, the factors “polymerization” (R20 = 66.6A; V20 = 58.4B; V3 = 45.1C, p = 0.0001) and “surface treatment” (A = 52B, ATxt = 59.7A, Tse = 51.4B, SBU = 63.8A, p = 0.0001) were statistically significant. Tse was more sensitive to the variations in polymerization protocols than the other surface treatments. Treatment A did not present suitable bond strength or degree of conversion.

Resumo em Inglês:

Abstract The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.

Resumo em Inglês:

Abstract To evaluate peri-implant bone loss (PIBL) and stability around submerged and non-submerged dental implants in patients with and without type 2 diabetes mellitus (T2DM). Thirty-five T2DM and non-diabetic (NT2DM) patients were included in this study. Demographic data were recorded using a questionnaire and PIBL was measured on digital radiographs. Resonance frequency analysis (RFA) was carried out for each implant at the time of fixture placement and at 3 months in both groups. P values less than 0.05 were considered statistically significant. One hundred and eighteen dental implants with a mean height of 10 to 12 mm and 3.3 to 4.1 mm in diameter were placed. The comparison of the mean RFA values at baseline and at 3 months was statistically significant (p = 0.008) in T2DM patients. The inter-group mean RFA values at baseline and at 3 months were not significant (p > 0.05). PIBL was significantly high in T2DM as compared to NT2DM patients at each follow-up (p < 0.05). At 2, 3, and 7 years, non-submerged dental implants showed significantly high PIBL in T2DM patients as compared to NT2DM individuals (p<0.05). The results of the present clinical study demonstrate increased PIBL around non-submerged single-tooth implant-supported restorations in T2DM patients, which may be due to the immune inflammatory status.

Resumo em Inglês:

Abstract The aim of this study was to compare the effects of hydroxyapatite (HA), deproteinized bovine bone (DPB), human-derived allogenic bone (HALG), and calcium sulfate (CAP) graft biomaterials used with titanium barriers for bone augmentation to treat peri-implant defects in rat calvarium treated by guided bone regeneration (GBR). Thirty-two female Sprague-Dawley rats were divided into four groups: DPB, HALG, HA, and CAP. One titanium barrier was fixed to each rat’s calvarium after the titanium implants had been fixed. In total, 32 titanium implants and barriers were used. Ninety days after the surgical procedure, all the barriers were removed. After decalcification of bone tissue, the titanium implants were removed gently, and new bone regeneration in the peri-implant area was analyzed histologically. Immunohistochemical staining of vascular endothelial growth factor (VEGF) was also performed. There were no statistically significant between-group differences in new bone regeneration or VEGF expression after 3 months. According to the results of the histological and immunohistochemical analyses, none of the grafts used in this study showed superiority with respect to new bone formation.

Resumo em Inglês:

Abstract The aim of this study was to check the in vitro accuracy of ICDAS criteria on digital images compared to visual examination for the diagnosis of occlusal caries against a micro-CT gold standard. ICDAS was scored in 40 extracted permanent molars by means of visual inspection and stereomicroscopic images. Visual examinations were performed in duplicate and at a one-week interval by three different calibrated examiners. The analysis of digital images by ICDAS criteria was also performed in duplicate, 1 month after visual examinations. The detection methods were compared by means of sensitivity, specificity, area under the curve, predictive positive and negative values, and accuracy for two different thresholds (1- sound vs. carious teeth; 2- tooth requiring operative vs. non-operative treatment). Sensitivity and accuracy values for threshold 1 in the visual ICDAS and image-based ICDAS methods were high for sensitivity (0.93 and 0.97) and for accuracy (0.83 and 0.85), but low for specificity (0.55 for both methods). Specificity values for threshold 2 were 0.77 and 0.82, while sensitivity was 0.33 and 0.28 for each method. Spearman’s rank correlation coefficient was 0.53 and 0.43 (p<0.05) for visual and image-based ICDAS compared to the gold standard scores. Both visual and image-based ICDAS scores were similar to each other in terms of diagnostic accuracy when compared to the micro-CT gold standard. Low specificity for the presence of caries and sensitivity for the detection of caries requiring operative treatment were found.

Resumo em Inglês:

Abstract The present study aimed at understanding the relationship between periodontitis and socio-contextual and individual determinants of health. Data from “The First Uruguayan Oral Health Survey, 2011”, which included 223 and 455 individuals with 35–44 and 65–74 years old respectively, were used. A stratified, multistage cluster sampling design was adopted (cities with ≥ 20.000 residents). Periodontitis was assessed using the modified Community Periodontal Index (CPI) and clinical attachment loss (CAL) (periodontal pocket and CAL ≥ 4 mm). Independent variables included contextual socioeconomic status (SES) measured by proportion of houses with Unsatisfied Basic Needs (UBN) and individual demographic and behavioral factors. Logistic regression multilevel models were generated. Living in contexts with a higher UBN was associated with higher odds for periodontitis in both age groups, even when adjusting for individual level variables (odds ratio [OR] = 1.51, 95%CI = 1.42–1.60 and 1.31, 95%CI = 1.21–1.42, respectively). Being male or heavy smoker increased the odds of periodontitis in this population for both age groups. Social structure impacts periodontal disease by modifying individual socioeconomic situations: in better socioeconomic context, UBN acts increasing the protector role of socioeconomic situation but in a poverty context the role is attenuated. Conclusions for this study are that periodontitis varies across contextual socio-demographic groups being higher in the population with a lower SES, challenging health authorities to integrate oral health into national non-communicable diseases programs.

Resumo em Inglês:

Abstract The aim of this study was to verify the influence of school environment and individual factors on oral health related quality of life (OHRQoL) in a representative sample of Brazilian schoolchildren. A cross-sectional study was conducted with 1,134 12-year-old schoolchildren from Santa Maria, Southern Brazil. Clinical variables were obtained from examinations carried out by calibrated individuals. In addition, parents/guardians answered a semi-structured questionnaire about sociodemographic characteristics. Contextual variables were obtained from the city’s official database, including the mean income of the neighborhood in which the school was located and the Basic School’s Development Index (IDEB) of the school. The Brazilian version of the Child Perception Questionnaire (CPQ11–14) was used to access OHRQoL. Data analysis was conducted using multilevel Poisson regression. Children studying in schools with a higher classification on the IDEB presented a lower CPQ11–14 mean score (rate ratio 0.80, 95%CI 0.74–0.88) than those studying in schools with a lower IDEB. Regarding individual variables, children with carious cavities, malocclusion, and gingival bleeding presented higher CPQ11-14 mean values than their counterparts. The same was observed in children from families with low socioeconomic status. School environment, and individual clinical and socioeconomic factors were associated with schoolchildren’s OHRQoL.

Resumo em Inglês:

Abstract Oral mucositis is a painful condition that occurs in patients who have undergone haematopoietic stem-cell transplantation (HSCT) and has a huge impact on their quality of life. The objective of this study was to examine the extent to which interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α) are associated with oral health quality of life among patients who underwent HSCT. A. C. Camargo Cancer Center patients were evaluated over 20 months at 4 different time-points: a) at patient admission (M1); b) on the day of infusion of HSC (M2); c) 12 and 20 days after the first day of the conditioning regimen for autologous and allogeneic transplantation, respectively (M3); and d) 30 days after the first day of the conditioning regimen (M4). Mucositis clinical evaluations were performed using World Health Organization (WHO) criteria. Oral health quality of life was measured using the Oral Health Impact Profile short form (OHIP-14), Oral Mucositis Quality of Life (OMQoL) and Patient-Reported Oral Mucositis Symptom (PROMS) scales. Correlations between clinical data and quality of life scores were examined. STATA 11.0 was used to perform the statistical analyses (5% level of significance). Eighty-two patients participated in the study; 62.2% were male, 28.05% had multiple myeloma, and the mean age was 48.49 years (SD 13.76). Higher scores (worse quality of life) were observed as mucositis scores increased, but the results were not significant. The OMQoL had a high correlation with OHIP-14 (0.8377), but the correlation between the PROMS scale and the OHIP-14 was lower (0.6643). Higher concentrations of IL-6 and TNF-α were associated with worse quality of life, according to all indices (p < 0.05). Oral mucositis was associated with quality of life scores (p < 0.01).

Resumo em Inglês:

Abstract Temporomandibular disorders (TMD) are a highly prevalent, painful musculoskeletal condition affecting the masticatory system, and are frequently associated with migraines (M) and other diseases. This study aimed to investigate the association between painful TMD and M with other painful conditions and systemic diseases, such as cervicalgia, body pain (BP), ear-nose-throat disorders, musculoskeletal disorders, diabetes, cardiopulmonary diseases and gastritis/peptic ulcer. Methods: This was a cross-sectional study conducted in a sample of 352 individuals. Participants were stratified into three groups according to the presence of painful TMD and M: controls [individuals free of TMD and any headache (HA)]; TMD only (presence of painful TMD, but free of any HA); and TMD+M (presence of painful TMD and M). TMD was classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - Axis I. Nonspecific physical symptoms (NSPS) were assessed by RDC/TMD - Axis II. The International Classification of Headache Disorders - II criteria, second edition, were applied to identify and classify primary HA. Other painful conditions and systemic diseases were assessed by volunteers’ self-report. The prevalence of all assessed conditions was higher in the TMD+M group. Multiple regression models showed that cervicalgia was associated with the TMD only group (p<0.05), whereas gender (p<0.05), cervicalgia (p<0.05), BP (p<0.05) and NSPS (p<0.05) were significantly associated with the TMD+M group. Our results suggest that individuals with a comorbidity (TMD associated with M) have a more severe condition than those presenting only painful TMD.

Resumo em Inglês:

Abstract This prospective observational study sought to investigate the incidence of intraoperative pain (IOP) among emergency endodontic patients and to construct an IOP prediction model that includes preoperative pain level (PPL). All patients who underwent emergency endodontic treatment at Gazi University, Ankara, Turkey, during the spring term of 2016 were considered for inclusion in the study. Demographic and clinical variables and PPL were recorded. Local anesthesia was provided to all patients before beginning routine endodontic treatment. IOP was defined as the condition of requiring supplementary anesthesia before the working length was established and exhibiting persistent moderate or severe pain despite supplementary anesthesia. Data from 85% and 15% of 435 patients (178 men, 257 women; mean age: 35 years) were used to develop predictive models by multiple logistic regression analysis and to test external validity of the models, respectively. Two multiple logistic regression models achieved good model fits. Model 1 included age, pulpal diagnosis, and arc (p < 0.05). In addition to these variables, Model 2 included periapical diagnosis and PPL (p < 0.15). Models 1 and 2 showed accuracies of 0.76 and 0.75, sensitivities of 0.74 and 0.77, and specificities of 0.76 and 0.74, respectively for the modeling data (internal validity), and accuracies of 0.82 and 0.80, sensitivities of 0.83 and 0.67, and specificities of 0.81 and 0.81, respectively for the control data (external validity). The IOP incidence was 10.3%. IOP in patients undergoing emergency endodontic treatment can be successfully predicted by using models that account for demographic and clinical variables, including PPL.

Resumo em Inglês:

Abstract This is a cross-sectional study that aimed to estimate maxillary sinus floor (MSF) pneumatization in single missing tooth of posterior maxilla, by using cone-beam computed tomography (CBCT). CBCT images were analyzed bilaterally and divided into 2 groups: edentulous site (EdS) - edentulous single region of upper second premolar, first or second molars; Tooth site (TS) - contralateral region homologous to the EdS region, with tooth present. Variables evaluated were: sinus height (SH), estimated sinus pneumatization (eSP: ∆ EdS - TS), healed ridge height (HR) and presence of localized sinus pneumatization (LSP) in molars teeth at TS. HR were categorized according to therapeutic option for posterior maxilla. 183 CBCT scans were included and it was observed that EdS presented a higher SH than the TS (p < 0.001) showing an eSP of 0.9 ± 2.93 mm. First molars presented the highest SH for both sides, although significant differences were detected when compared to second molars. First molars were mostly affected by LSP at TS (36 out of 43). Individuals with LSP at TS presented lower HR than the ones without LSP (p < 0.05). 54% of the cases presenting LSP obtained HR < 5 mm, which indicates sinus lift surgery. The present study showed that tooth loss in posterior maxilla favors sinus pneumatization and the identification of LSP at molar roots seems to indicate a greater necessity for sinus lift surgeries.

Resumo em Inglês:

Abstract This study assessed the difference in the number of visits made to a dental care clinic and the time spent providing specific dental treatment for children with and without molar incisor hypomineralization (MIH). Children aged 8 to 16 years who presented at the Pediatric Dental Unit of the Obafemi Awolowo University Teaching Hospital Complex, in Ile-Ife, Nigeria, were eligible for the study. A comprehensive medical and dental history was taken, and each child was clinically examined, diagnosed, and treated according to a drawn-up plan. The time taken to establish a diagnosis and to provide specific treatments (scaling and polishing, restoration, pulpectomy, extraction, and placement of stainless steel crowns) and the number of visits made to complete the treatment plan were recorded for each child. Differences in the number of visits, time expended to make a diagnosis and to treat children with and without MIH were analyzed. The average time for diagnosis (p = 0.001) and the average time for placing amalgam restorations (p = 0.008) were significantly longer in children with MIH than in those without it. Children with MIH made more visits to the clinic (p < 0.001).There was no significant difference in the average time for scaling and polishing (p = 0.08), glass ionomer cement restorations (p = 0.99), composite restorations (p = 0.26), pulpectomy (p = 0.42), tooth extraction (p = 0.06), and placement of a stainless steel crown (p = 0.83) in children with and without MIH. In conclusion, children with MIH required more time for oral health care. Placing amalgam restorations took significantly longer than placing tooth bonding restorative materials in children with MIH than in those without it.

Resumo em Inglês:

Abstract The objective of this study was to investigate microtensile bond strength (MTBS) and interfacial adaptation (IA) of bulk-fill restorative systems bonded to dentin in Class-I-preparations. Box-shaped preparations (4-mm-long, 3-mm-wide, 2-mm-high) made in extracted molars, and Teflon matrix with the same dimensions positioned over the occlusal surface were restored, providing a total of 4-mm composite depth using three bulk-fill restorative systems: Tetric EvoCeram Bulk Fill with Tetric N-Bond (TEC/TNB), SureFil SDR Flow with XP Bond (SDR/XPB) and Filtek Bulk Fill Flowable Restorative with Scotchbond Universal (FBF/SBU); or incrementally restored with a conventional restorative system: Herculite Classic with OptiBond FL (HER/OBF). The specimens were sectioned into beams and the MTBS measured after 24-hours or one-year storage. For evaluation of IA, round-tapered tooth preparations (3-mm-diameter, 1.5-mm-deep) were made, restored with each material and their cross-sectional images were obtained after 24-hours using optical coherence tomography (OCT). The gap percentage for each restoration system was calculated using image analysis software. MTBS for both storage periods: HER/OBF=TEC/TNB=SDR/XPB>FBF/SBU (ANOVA, Tukey’s post-hoc, P<0.05) differed significantly among groups, which values were significantly reduced after one-year. SDR/XPB showed comparatively lesser gap formation at the tooth-interface after 24 hours (ANOVA, Dunnett’s T3 post-hoc, P<0.05). For deeper restorations, bond strength of TEC/TNB and SDR/XPB can be equal to that of HER/OBF after 24-hours and one-year; however, in a shallower preparation, SDR/XPB showed greater initial interfacial adaptation.

Resumo em Inglês:

Abstract The aim of the present study was to compare the clinical and radiographic periodontal parameters in prediabetes, type 2 diabetes mellitus (T2DM), and non-diabetic patients. Forty-one patients with prediabetes (Group 1), 43 patients with T2DM (Group 2), and 41 controls (Group 3) were included. Demographic data were recorded using a questionnaire. Full-mouth clinical (plaque index [PI], bleeding on probing [BOP], probing depth [PD], clinical attachment loss [CAL], missing teeth [MT]) and radiographic (marginal bone loss [MBL]) parameters were measured on digital radiographs. In all groups, hemoglobin A1c (HbA1c) levels were also measured. P values less than 0.05 were considered statistically significant. The mean age and HbA1c levels of participants in Groups 1, 2, and 3 were 53.4±3.5, 60.1 ± 0.6, and 56.6 ± 2.5 years and 6.1%, 8.4%, and 4.8%, respectively. The mean duration of prediabetes and T2DM in patients from Groups 1 and 2 were 1.9 ± 0.3 and 3.1 ± 0.5 years, respectively. PI, BOP, PD, MT, CAL, and MBL were significantly higher in Groups 1 (p < 0.05) and 2 (p < 0.05) than in Group 3. There was no statistically significant difference in these parameters in Groups 1 and 2. Periodontal parameters were worse between prediabetes and T2DM patients compared with controls; however, these parameters were comparable between prediabetes and T2DM patients.

Resumo em Inglês:

Abstract Sickle cell anemia, a genetic disease caused by a mutation in the beta-globin gene, can present oral manifestations such as delayed tooth eruption and hypomineralized enamel and dentin. The aim of the present study was to evaluate the prevalence and severity of developmental defects of enamel (DDE) and delayed tooth eruption in children with sickle cell anemia. The sample comprised 56 male and female children with sickle cell anemia aged 6 to 12 years and treated at the Hematology and Hemotherapy Center of Pernambuco, Brazil. The data were collected according to the WHO criteria for DDE and tooth eruption. The prevalence of DDE was 58.2% and increased with age, affecting 43.8% of children aged 6 to 8 years and 66.7% of those aged 10 to 12 years (p>0.05; Pearson’s chi-square test). There was no significant association between DDE and sex; the most prevalent type of DDE was diffuse opacity (6.2%). Tooth eruption was delayed in 18 children (32.1%). The delay increased with age and was detected in 11.8% of children aged 6 to 8 years, in 20.0% of those aged 8 to 10 years and in 54.2% of those aged 10 to 12 years (p<0.05; Pearson’s chi-square test). Delayed tooth eruption was higher in males (36.7%, p>0.05). The prevalence of DDE was high, increased with age and was similar between sexes, while delayed eruption was higher in males and showed a significant association with age.

Resumo em Inglês:

Abstract The aim of this study was to evaluate the influence of a novel ultrasonic tip as an auxiliary method for removing filling material from flattened/oval-shaped canals. The null hypothesis tested was that this method does not influence removing the filling material in flattened/oval-shaped canals. Forty-five mandibular incisors were selected and randomly divided into three experimental groups (n = 15) according to different protocols for removing root canal filling material. Group R: Reciproc R25/.08, Group RC: Reciproc R25/.08 + Clearsonic tip, and Group CR: Clearsonic tip + Reciproc R25/.08. The teeth were scanned pre and post-operatively by means of a micro-computed tomography system. Data were analyzed using non-parametric Kruskal-Wallis and Dunn tests (p < 0.05). The percentage of residual root canal filling material between the experimental groups was examined. Statistically significant differences between the experimental groups were found in the root canal. Group R had the highest percentage of residual root canal filling material when compared with Groups RC and CR. The lowest percentage of residual root canal filling material was observed in Group CR. In the apical third of the root canal, statistically significant differences were found between the different protocols. The use of the ClearSonic tip followed by the Reciproc 25/.08 file to remove filling material resulted in the lowest percentage of residuals in the whole root canal and in the apical third.

Resumo em Inglês:

Abstract The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers’ level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1–4.8), older children (OR = 1.8; 95%CI: 1.1–3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0–6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category.

Resumo em Inglês:

Abstract The aim of this study was to evaluate the biostimulation (BS) effect of the gallium-aluminum-arsenide (GaAlAs) diode laser by histopathology with an experimental osteoarthritis (OA) model in the temporomandibular joints (TMJ) of rabbits, in the early period. GaAlAs diode laser is used for pain reduction in TMJ disorders. Twenty-four adult male New Zealand white rabbits were randomly divided into three equal groups: Control Group (CG), Study Group 1 (SG-1), and Study Group 2 (SG-2). Mono-iodoacetate (MIA) was administered to the right TMJs of all rabbits. The rabbits did not undergo any treatment for four weeks to allow the development of osteoarthritis. In SG-1, laser BS was applied to the rabbits at 940 nm, 5 W, and 15 J/cm2 in continuous wave mode at 48-hour intervals for 14 sessions; and in SG-2, laser BS was applied with the same parameters at 24-hour intervals for 28 sessions. Laser BS was not applied to the rabbits in CG. All rabbits were sacrificed simultaneously. The TMJ cartilage, osteochondral junction, chondrocyte appearance, and subchondral ossification were evaluated histopathologically. There was no statistically significant difference between the groups in terms of cartilage, osteochondral junction, chondrocyte appearance, and subchondral ossification values (p > 0.05). The laser BS protocol used in the study had no positive histopathological effects on TMJ OA in the early period.

Resumo em Inglês:

Abstract This study evaluated the effects of hyaluronic acid (HA) on bone repair of human dental sockets. Thirty-two lower first premolars were extracted from 16 patients (2 per patient) for orthodontic reasons. Following the extractions, one socket was randomly filled with 1% HA gel, while the other was allowed to naturally fill with blood clot. After 30 and 90 days of surgery, patients underwent cone beam computed tomography. Five central orthoradial slices were captured from each socket. The gray intensity was measured in each image and results were reported as mean percentage of bone formation. The buccolingual alveolar ridge width was measured and dimensional changes were compared between the postoperative intervals. The pattern of alveolar trabecular bone was evaluated through the fractal dimension. Treated sockets showed a higher percentage of bone formation and fractal dimension values (58.17% and 1.098, respectively) compared with controls (48.97% and 1.074, respectively) in the 30-day postoperative period (p < 0.05). After 90 days, there was no significant difference between groups. Additionally, no significant difference was found between groups regarding the alveolar dimensions (p > 0.05). Use of 1% HA gel after tooth extraction accelerates bone repair in human dental sockets.

Resumo em Inglês:

Abstract Urokinase-type plasminogen activator (uPA) and its receptor (uPAR) act in the proteolysis of basement membrane and extracellular matrix structures, facilitating tumor invasion. The purpose of this study was to evaluate the relationship between these proteins and clinicopathological parameters in squamous cell carcinoma of the oral tongue (SCCOT). Sixty cases of SCCOT were submitted to immunohistochemistry and analyzed semiquantitatively at the invasion front and in the tumor core. The results were associated with lymph node metastasis, clinical stage, locoregional recurrence, clinical outcome and histological grade of malignancy. A higher expression of uPA was observed in cases of tumors of high-grade versus low-grade malignancy (p = 0.010). Moreover, the cases with the worst pattern of invasion presented an overexpression of uPA (p = 0.011). The presence of locoregional recurrence was associated with uPAR (p = 0.039), and the expression of both biomarkers was much higher at the invasion front than in the tumor core (p < 0.001). The results suggest uPA and uPAR are involved in the progression and aggressiveness of SCCOT, mainly at the tumor-host interface.

Resumo em Inglês:

Abstract This study analyzed the influence of different retreatment protocols on amount of remaining filling material and amount of new sealer after endodontic retreatment. Forty mandibular molars with curved mesial roots were prepared with ProTaper Universal system, and filled with AH Plus sealer mixed with 0.1% rhodamine B and gutta-percha. After 7 days, the specimens were randomized according to the retreatment protocol (n = 10): ProTaper Retreatment System (PTR); PTR+Orange Oil (PTR+OO); PTR+Passive Ultrasonic Irrigation (PTR+PUI). No retreatment was performed in the control group (CG). After retreatment, the root canals were filled with AH Plus mixed with 0.1% fluorescein and gutta-percha. Samples were evaluated under confocal laser scanning microscopy and analyzed using Image J software. Data were analyzed using Kruskal-Wallis and Dunn tests (p < 0.05). Regarding presence of residual filling, the Kruskal-Wallis test indicated no differences among the different retreatment techniques in the perimeter and the isthmus analyses (p > 0.05); however, PTR+PUI was associated with a lesser amount of residual filling material in the canal area analysis (p < 0.05). In evaluating the new filling, the perimeter analysis showed a lesser amount of new endodontic sealer in the PTR group (p < 0.05). Moreover, the PTR+PUI group presented a significantly greater amount of new endodontic sealer in the canal area analysis (p < 0.05). There was no difference among groups in the isthmus analysis (p > 0.05). It can be concluded that PTR associated to PUI yielded better results in removing root canal filling material from the canal area. However, none of the protocols resulted in root walls completely free of remnants.

Resumo em Inglês:

Abstract Dental caries in 5-to-8-year-old children with cow's milk protein allergy (CMPA) and lactose intolerance (LI), their treatment needs, and the consumption of milk-based products and milk derivatives by these patients were investigated. A cross-sectional study was undertaken with 200 children in southern Brazil in 2017. The clinical examination was based on the World Health Organization criteria and a questionnaire was sent to parents or legal guardians to collect information on the children's food intake, pre-existing systemic diseases, medication use, and CMPA and LI. Standardization was performed to verify concordance among examiners (kappa = 0.96). Caries prevalence was 67.50% in children with CMPA or LI, but 34.37% in those without these conditions. The mean dmft (decayed, missing, and filled teeth) index in children with CMPA or LI was 1.75 ± 1.84, significantly higher than among non-allergic or lactose-tolerant children (0.83 ± 1.60) (p < 0.001). In children with CMPA or LI, the mean for treatment needs was 1.58 ± 1.50. Lactose-free milk was the most frequently consumed food among allergic/intolerant children (65.00%), with a mean dmft of 2.00 ± 2.08, higher than that obtained for those without CMPA/LI (0.82 ± 0.87), showing no significant difference (p = 0.129). Although dental caries and treatment needs in primary dentition were associated with CMPA or LI, children's intake of replacement foods did not pose any risk for the development of carious lesions. Statistically significant differences were obtained for the prevalence and severity of dental caries. This shows the need for treatment of children with CMPA or LI, who had the worst caries prevalence and severity rates.

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Abstract Despite the large number of published studies about oral candidiasis and associated risk factors, reports of large single-center retrospective studies on the prevalence of oral candidiasis, risk factors, and the oral candidiasis types diagnosed more frequently in oral diagnostic reference centers are scarce. The objective of the present study was to retrospectively survey the demographic and clinical profiles of 1,534 patients diagnosed with candidiasis and treated at the Center for Diagnosis of Oral Diseases (CDOD), Pelotas Dental School, Federal University of Pelotas between 1997 and 2014. Using a retrospective, cross-sectional, epidemiological design, data on race, gender, age, systemic diseases, oral candidiasis type and location, symptoms, and harmful habits such as smoking and alcohol consumption were collected. The statistical analysis was performed using STATA version 13.1. Risk factors for chronic atrophic candidiasis (CAC) were evaluated using Poisson regression with robust variance (p ≤ 0.05). The majority of patients with oral candidiasis seen at the CDOD over the 18-year period of analysis were Caucasian women, aged 51–60 years, nonsmokers, and nondrinkers, with no systemic disease, and who wore some form of dental prostheses. CAC was the single most common clinical type of candidiasis detected, and the most frequently affected oral site was the palate. These data from a large single-center in Brazil agree with previous evidence about the clinical and demographic profiles of patients with oral candidiasis.

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Abstract The aim of the present study was to evaluate the prevalence and impact of malocclusion on oral health-related quality of life (OHRQoL) among schoolchildren aged 8 to 10 years and their parents in Diamantina, a town in the southeast of Brazil. A cross-sectional study was conducted with a sample of 390 randomly selected children who were subjected to a clinical oral examination. The Dental Aesthetic Index was used to diagnose malocclusion and the need for orthodontic treatment. The Child Perceptions Questionnaire (CPQ (8–10)) was used to evaluate the impact of malocclusion on OHRQoL. The children's parents answered the Brazilian Economic Criterion Questionnaire for the socioeconomic classification. Data analysis involved the nonparametric Kruskal-Wallis test and Spearman's correlation coefficients. The variables were grouped into a hierarchy of categories ranging from distal to proximal determinants. Poisson regression analysis with robust variance was performed at each level to correlate the total CPQ (8–10) score with the independent variables. The prevalence of malocclusion was 78.7%. Crossbite remained significantly associated with a negative impact on OHRQoL (PR = 1.28; 95%CI:1.17–1.39; p < 0.001). The prevalence of malocclusion was high in the sample investigated and exerted a negative impact on OHRQoL.

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Abstract The objective of this study was to assess the effect of a UV light-based auxiliary illumination on adhesive remnant (AR) removal after orthodontic debonding. Sixty human molars were divided according to the adhesive used for bonding: O-opaque; LF-low fluorescence; and HF-high fluorescence. After debonding, the teeth were subdivided according to the AR removal method: No UV light or With UV light. After AR removal, the teeth were polished. Direct visual analysis, scanning electron microscopy (SEM) and time quantification for AR removal analyses were performed (Fisher-Freeman-Halton, Fisher’s exact, chi-square trend, ANOVA, and independent t-tests; α = 5%). Concerning the adhesives, there was no significant difference among direct visual, SEM and time analyses for AR removal (p ≥ 0.05). Regarding AR removal methods, a similarity among the subgroups was verified for direct visual and SEM analyses (p≥0.05). However, a significant trend was verified for the with UV light method to produce greater marks, and the no UV light method, to produce a greater rate of samples with AR before polishing (p = 0.015). AR removal with light was significantly quicker in comparison with the no UV light method (p < 0.0001). The use of UV light may aid orthodontists in removing AR more thoroughly and in less time. However, they should receive special training to apply this technology, and should never dismiss the final polishing procedure.

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Abstract This study aimed to investigate the effects of different doses of systemic melatonin application on new bone formation during mandibular distraction osteogenesis (DO) in rats. Mandibular DO was performed on 30 adult female Sprague-Dawley rats, which were randomly divided into three groups: control group (CNT), melatonin dose 1 (MLT-D1), and melatonin dose 2 (MLT-D2). A five-day latent waiting period and a ten-day distraction phase followed the surgery. After the surgery, rats from the MLT-D1 and MLT-D2 groups received 25 and 50 mg/kg melatonin, respectively, at 7, 14, 21, 28, and 35 days. The animals were euthanised 28 days after distraction, i.e. at 43 days after surgery. Histological and histomorphometric analyses revealed that the distracted bone area was completely filled with new bone formation in all three groups. The MLT-D2 group exhibited the most new bone formation, followed by MLT-D1 and CNT. The melatonin groups had more osteoclasts than the CNT (p < 0.05). The number of osteoblasts was higher in the melatonin groups than in the CNT group, and the MLT-D2 had more osteoclasts than the MLT-D1 group (p < 0.05). Finally, the osteopontin (OPN) and vascular endothelial growth factor (VEGF) levels were higher in the melatonin groups than in the CNT group, and the MLT-D2 had higher OPN and VEGF levels than the MLT-D1 (p < 0.05). This study suggests that systemic melatonin application could increase new bone formation in DO.

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Abstract The aim of this study was to evaluate the effect of acute administration of nicotine and ethanol on tooth movement in rats. Two hundred rats were divided into eight groups: S: saline; N: nicotine; E: ethanol; NE: nicotine and ethanol; SM: saline with tooth movement; NM: nicotine with tooth movement; EM: ethanol with tooth movement; and NEM: nicotine and ethanol with tooth movement. All the solutions were applied for 32, 44, or 58 days, according to the subgroup. Orthodontic movement (25 cN) was initiated 30 days after solution administration in the groups with tooth movement. The rats were euthanized 2, 14, or 28 days after initiation of tooth movement. Tooth sections were stained using picrosirius and tartrate-resistant acid phosphatase (TRAP). The data were compared by ANOVA using Tukey’s HSD and Games-Howell. On day 28 of tooth movement, the NEM group had a lower percentage of type I collagen compared to the SM group (p = 0.0448), and the S group had a higher number of osteoclasts/μm2 compared to the N group (p = 0.0405). Nicotine and ethanol did not affect the tooth movement rate, regardless of induction of orthodontic movement. Nicotine influenced the number of osteoclasts by decreasing their quantity when dental movement was not induced. When nicotine was associated with ethanol, it interfered in the maturation of collagen fibers during orthodontic movement.

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Abstract This study aimed to evaluate the influence of breastfeeding and pacifier use on the occlusal status of preschool children. A cross-sectional study was conducted with children (n = 489) aged 2–5 years in private and public schools in Pelotas, South Brazil. Mothers answered a questionnaire on demographic, socioeconomic and behavioral variables, including breastfeeding and non-nutritive sucking habits. Malocclusion was classified as normal/mild and moderate/severe, according to WHO criteria. The association between breastfeeding and pacifier use with malocclusion was tested using multivariate logistic regression. The prevalence of malocclusion was 37.83% (95%CI 33.52–42.14), and 57.87% of the children used a pacifier. A total of 46.01% of the sample was exclusively breastfed for 6 months, and 24.74% were never breastfed. Malocclusion was associated with pacifier use, and with both non-exclusively breastfed and never breastfed. After adjustments for demographic and socioeconomic variables, the children who used a pacifier and were never breastfed (OR = 19.08; 95%CI 8.54–42.63), or who used a pacifier and were not exclusively breastfed (OR = 13.74; 95%CI 6.11–30.92), showed worse occlusal conditions, compared with the children who were exclusively breastfed and never used a pacifier. Pacifier use modifies the relationship between breastfeeding and occlusal status.

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Abstract This study evaluated the three-year lifespan of the bond to dentin of experimental self-etch adhesives containing benzodioxole derivatives – 1,3-benzodioxole (BDO) and piperonyl alcohol (PA) – as co-initiator alternative to amines. Adhesive resins were formulated using Bis-GMA, TEGDMA, HEMA, camphorquinone and different co-initiators: BDO, PA or ethyl 4-dimethylamino benzoate (EDAB – amine). An experimental self-etch primer was used to complete the two-step, self-etch adhesive system. Clearfil SE Bond (CSE) was used as commercial reference. Bond strength to human dentin was assessed by microtensile bond strength (µTBS) test, and failure mode was classified. Morphology of the dentin bonding interface was assessed via scanning electron microscopy (SEM). Irrespective of the dental adhesives evaluated, µTBS was higher after 24 hours compared with that after 1.5 and 3 years (p ≤ 0.001). However, adhesives with BDO and PA as co-initiators showed significantly higher bond strength than the bonding resin with EDAB (p ≤ 0.002), independent of the time evaluated. The commercial adhesive CSE showed similar bond strength compared with the other groups (p ≥ 0.05). Mixed failures were mainly observed after 24 hours, while adhesive failures were more frequently observed after 1.5 and 3 years. No notable differences in homogeneity and continuity along the bonded interfaces were detected among the materials in the SEM analysis. In conclusion, benzodioxole derivatives are feasible alternative co-initiators to tertiary amine in camphorquinone-based self-etching dental adhesive formulations.

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Abstract The aim of this study was to identify the immunoexpression of methallothionein in oral squamous cell carcinoma as well as to address the correlation with clinical features, histological grade and patient survival. Samples were collected from 93 patients with tongue squamous cell carcinoma who presented for follow-up. Immunohistochemical expression of methallothionein in all groups was performed. The scoring system has previously been published by Tsurutani in 2005, which is based on intensity and distribution of staining. We used Kappa index to evaluate the degree of observers’ agreement under metallothionein immunostaining and histological grade. Associations between methallothionein expression and clinical parameters (age, gender, smoking, tumor size, lymph node metastasis and disease stage) were examined for statistical significance using the chi-squared test. The overall survival rates were estimated by the Kaplan-Meier method and the relationship between protein expression and survival was compared using the log-rank test (p < 0.05). Our results showed no statistically significant association between methallothionein immunostaining and the selected clinicopathological variables. Immunohistochemistry results showed positive nuclear immunostaining for metallothionein in 62,37% (58/93) and negative for metallothionein 37,63% (35/93). The degree of examiners agreement by Kappa varied from substantial to perfect and both metallothionein immunostaining and histological grade were explored. The present study suggests that positive methallothionein expression found in tongue squamous cell carcinoma may not help to predict survival in the analyzed samples, as well as no relation between the protein and histological grade and clinical features was observed. In conclusion, the present study suggests that metallothionein is not associated with tongue squamous cell carcinoma clinicopathological characteristics and aggressiveness.

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Abstract This study evaluated the effect of adding the hydrophobic monomer 1,12 dodecanediol dimethacrylate (DDDMA) to experimental sealants with and without thermocycling on degree of conversion (DC), water sorption (WS), water solubility (WSB), color stability (ΔE), and micro-shear bond strength (μSBS). Five experimental and one commercially available sealant (Bisco - BIS) were tested. The experimental sealants were formulated by mixing different percentages of DDDMA monomers and urethane dimethacrylate (UDMA). The photoinitiator system was composed by camphorquinone (CQ) and tertiary amine 4-ethyl benzoate dimetilamiono (EDBA). Ethanol was used as a solvent. The experimental groups were named sequentially according to the monomeric content (DDDMA/UDMA): S40/40 (40/40), S50/30 (50/30), S60/20 (60/20), S70/10 (70/10) and S80/0 (80/0). Data were analyzed separately by one-way ANOVA, followed by Tukey’s test (p<0.05). The values of DC ranged from 94.59% (S40/40) to 54.02% (S80/10). BIS showed the highest WS value (p<0.05) and S40/40, S50/30, S60/20 and S80/0 showed the lowest WS values of all tested sealants. WSB values ranged from 7.88 µg/mm3 (BIS) to 13.27 µg/mm3 (S70/10). The highest ΔE value was 11.05±2.88 for BIS and the highest μSBS value was found for S60/20. No significant difference was observed in bond strength between sealants and bovine enamel after thermocycling. Adding DDDMA to the composition of surface sealants can improve its performance, once the monomer increased the degree of conversion and the color stability.

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Abstract The aim of this article was to evaluate the influence of biological and sociobehavioral factors on the development of malocclusions in children. This is a cross-sectional study nested in a cohort of 350 children who participated in a community intervention study. After six years, an active search identified 290 children with occlusal abnormalities. Socioeconomic status, linear growth, and nutritional status of the child at birth and at the time of measurement, as well as dietary and sucking habits, were investigated. Malocclusions were evaluated across three spatial planes - anteroposterior, vertical, and transverse. The prevalence of these anomalies was 64.5%, primarily in the anteroposterior plane. The logistic regression analysis revealed that pacifier use for 60 months or more, stunting as measured at age six, and reduced gain in head circumference from birth to six years of age, were significantly associated with the development of malocclusion in childhood. Head circumference and linear growth are associated with occlusal anomalies in infants, independent of pacifier sucking.

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Abstract The aim of this study was to evaluate the effect of ethanol on the bond longevity of a universal adhesive system to bovine dentin, under different modes of adhesive application and artificial aging. Bovine dentin was exposed, and the smear layer was standardized by sandpaper polishing. Specimens were randomly divided into 2 groups: ethanol (E) and non-ethanol (N). Groups were subdivided according to adhesive mode of application into etch-and-rinse (Er) and self-etching (S). Resin blocks were built onto the treated surface, and the specimens were stored in deionized water at 37°C for 48 h. Half of the specimens (n = 10) were subjected to thermomechanical aging (A for aged and Na for non-aged). Resin/dentin beams were obtained and subjected to microtensile test in a universal testing machine. Data were analyzed using a three-way ANOVA and Tukey’s tests (α = 5%). There was interaction among the three factors (p=0.0003). The use of ethanol resulted in higher values, except for the Er and Na groups (E_Er_Na = N_Er_Na). The mode of application was similar, except for the N and A groups (N_S_A > N_Er_A). For the A groups, the values were lower, except in the cases using ethanol, in which the results were not affected. The study concluded that the use of ethanol resulted in higher microtensile bond strength values, even after aging. The mode of adhesive application did not influence the results.

Resumo em Inglês:

Abstract The aim of this study is to evaluate the expression of cytokines in response to mineral trioxide aggregate (MTA) plus selenium in germ-free mice with experimental furcal perforation. The first left maxillary molar was opened, and the furcal area was perforated and treated with post-MTA-Se (experimental group). The same surgical intervention was performed for the maxillary right first molar, which was treated with MTA (control group). Fifteen mice were sacrificed 7, 14, and 21 days after furcal perforation, and periapical tissue samples were collected. The mRNA expression levels of the cytokines TGF-β, TNF-α, IFN-γ, HPRT, IL-10, IL-4, RANK, RANKL, IL-1, and IL-17 were assessed by using real-time polymerase chain reaction. In the experimental group, at 21-days post-MTA-Se sealing, the mRNA levels of TNF-α and IL-10 were upregulated compared with those in the control group (p < 0.05). Futher assessment revealed basal mRNA expression levels of IL-1α, IFN-γ, RANK, RANKL, IL-17A, IL-4, and TGF-β, over long experimental times, in both the experimental and control groups (p > 0.05). In conclusion, MTA+Se sealing favoured increased expression of IL-10 and TNF-α at later time points (day 21).

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Abstract This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

Resumo em Inglês:

Abstract To evaluate the impact of the GaAlAs diode laser with energy densities of 160 J/cm2, 320 J/cm2, and 640 J/cm2 on the periodontal tissues under continuous orthodontic force application and on the rate of orthodontic tooth movement in rats with type-2 diabetes mellitus. The intensity of primary alveolar bone formation was also investigated through the immune-positive osteocytes for OPN antibody. Forty adult male Wistar rats were divided into eight groups of 5 rats: normoglycemic (N), 160 J-laser-normoglycemic (160 J-LN), 320 J-laser-normoglycemic (320 J-LN), 640 J-laser-normoglycemic (640 J-LN), diabetic (D), 160 J-laser-diabetic (160 J-LD), 320 J-laser-diabetic (320 J-LD), and 640 J-laser-diabetic (640 J-LD) rats. Diabetes mellitus was induced by a single intravenous injection of 40 mg/kg monohydrated-alloxan. An orthodontic force magnitude of 20cN was applied. The laser parameters were continuous emission of 780-nm wavelength, output power of 20mW, and fiber probe with a spot size of 0.04 cm in diameter. Radiographic, histomorphological, and immunohistochemical analysis were performed after a period of 21 days. The photobiomodulation using the energy density of 640 J/cm2 strongly stimulated the alveolar bone formation and contributed the reorganization of the soft periodontal tissues, followed by the 320 J/cm2. Extensive alveolar bone loss, intense infiltration of inflammatory cells, and degradation of the PDJ tissue were mainly found in the D and 160 J-LD groups. The rate of orthodontic tooth movement was represented by the interdental distance between the cementoenamel junctions of the right mandibular first and second molars . This distance was larger in the diabetic groups (D: 39.98±1.97, 160 J-LD: 34.84±6.01, 320 J-LD: 29.82±1.73, and 640 J-LD: 35.47±4.56) than in the normoglycemic groups (N: 21.13±1.19; 160 J-LN: 22.69±0.72, 320 J-LN: 22.28±0.78, and 640 J-LN: 24.56±2.11). The number of osteopontin-positive osteocytes was significantly greater in the 640 J-LD (14.72 ± 0.82; p < 0.01) and 640 J-LN (13.62 ± 1.33; p < 0.05) groups than with D (9.82 ± 1.17) and 160 J-LD (9.77 ± 1.10) groups. Therefore, the energy density of 640 J/cm2 provided the best maintenance and integrity of the periodontal tissue microarchitecture under continuous orthodontic force when compared with the other dosages, mainly in the uncontrolled diabetic rats. The interdental distance was greater in the D and 160 J-LD groups due to presence of severe periodontitis caused by diabetes plus the mechanical stress generated by continuous orthodontic forces, implying, thus, an insufficient biostimulatory effect for the dosage of 160 J/cm2.

Resumo em Inglês:

Abstract This study investigated factors that affect the use of complete conventional mandibular dentures (CCMD) by patients of the Brazilian Public Health Service. For this, two hundred and thirty one subjects who received CCMD in the Primary Health Care of the Public Health Service in Belo Horizonte – Brazil were evaluated and divided in Group 1 – irregular/non-wear; Group 2 – regular wear. Multivariate logistic regression analysis was used to create predictive models for CCMD non-wear and included socio-demographic and biological variables, technical quality of CCMD, and user satisfaction. The prevalence of CCMD non-wear was 41.10%. The mean score of CCMD quality was 54.97 (0–100). Not wearing the CCMD was significantly associated with user satisfaction and technical quality (p < 0.05). The lack of retention of the CCMD was the most important factor in the evaluation of satisfaction and quality. The final predictive model (specificity = 92.65%; AROC = 0.8759) for not wearing the CCMD retained the variables CCMD stability (OR = 0.888; 95%CI = 0.827–0.954), freeway space (OR = 0.916; 95%CI = 0.860–0.976), satisfaction with speech (OR = 0.694; 95%CI = 0.612–0.786), and irregular CCMD edges (OR = 3.185; 95%CI = 1.478–6.864). Socio-demographic and biological variables were not associated with patients not wearing the CCMD, whereas technical quality and user satisfaction were strongly associated.

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Abstract The aim of this study was to determine if multiple processing (heat-pressing) of a dental ceramic influences flexural strength, hardness, and microstructure. Ninety bar-shaped specimens (15 mm × 4 mm × 2 mm) of a pressed ceramic (Vita PM9) were fabricated and randomly divided into 6 groups (n = 15) according to the factors “number of pressings” (C1, C2, and C3, fired 1, 2, and 3 times, respectively) and “mechanical cycling” (M). Half of the specimens were mechanically cycled (106 cycles, 45 N, 3.4 Hz, in water) and all specimens were tested for 3-point bending (0.5 mm/min, load 1000 kgf) and Vickers hardness (19.6 N for 20 s). X-ray diffraction was used to characterize the phases and scanning electron microscopy to characterize the microstructure. The flexural strength data was statistically analyzed with Weibull analysis, ANOVA, and Tukey test. Hardness data was evaluated by 2-way ANOVA and Fisher test. All tests were performed with a significance level of 0.05. Two-way ANOVA revealed that neither “number of pressings” (p=0.085) or “mechanical cycling” (0.055) significantly affected flexural strength. But Weibull analysis showed significant difference for Weibull moduli and characteristic strength between groups. For hardness, a statistical difference was seen for the interaction “Number of pressings * Mechanical cycling”, (p = 0.016). Hardness decreased in the following order: C1 (775±17.2), CM3 (751±101), CM2 (735±45), C3 (701±82), CM1 (671±82), and C2 (663±92). Fewer defects were observed with an increased number of firings. Therefore, the possibility of recycling PM9 ceramic does not interfere in the evaluated mechanical properties and improves microstructure.

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Abstract The aim of this study was to evaluate the cytotoxic effect, degree of conversion (% DC), Vickers hardness (VH), and surface morphology of composite resins. Eleven resins, nine bulk-fill resins, and two conventional resins were evaluated. Each material was sampled to evaluate DC (using FTIR), VH, cytotoxicity (using MTT and Neutral Red - NR test), surface morphology (using SEM and AFM), and organic filler (using EDS). All statistical tests were performed with SPSS and the level of significance was set at 0.05. MTT revealed that the materials presented low or no cytotoxic potential in relation to the control. Opus was the resin with the lowest cell viability at a 1:2 concentration at 72 h (32%) and at 7 days (43%), but that significantly increased when the NR test was applied at a 1:2 concentration after 7 days. Thickness and surface subjected to polymerization had no influence on DC, and differences were observed only between the materials. In the microhardness test, statistical differences were observed between the evaluated thicknesses. The bulk-fill resins analyzed in this study exhibited low and/or no cytotoxicity to L929 cells, except for Opus, which showed moderate cytotoxicity according to the MTT assay. When the NR test was used, results were not satisfactory for all composites, indicating the need for different methodologies to evaluate the properties of these materials. The assessed resins demonstrated acceptable physicomechanical properties.

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Abstract This randomized clinical trial evaluated the insertion torque (IT), primary, and secondary stability of dental implants with different surface treatments during the osseointegration period. Nineteen patients with bilateral partial edentulism in the posterior mandibular region were randomly allocated to two implant brand groups and received implants with different surface treatments in the opposite site of the arch: Osseotite and Nanotite or SLA and SLActive. During implant placement, the maximum IT was recorded using a surgical motor equipped with a graphical user interface. The implant stability quotient (ISQ) was assessed immediately after the IT, and was measured weekly via resonance frequency analysis during 3 months. The data were analyzed by a one-way ANOVA, the Bonferroni test, paired t tests and Pearson’s correlation coefficient. The IT values were similar (p > 0.05) for all implant types ranging from 43.82 ± 6.50 to 46.84 ± 5.06. All implant types behaved similarly until the 28th day (p > 0.05). Between 35 and 56 days, Osseotite and SLActive showed lower ISQ values (p < 0.001) compared to Nanotite and SLA implants. After 56 days, only Osseotite maintained significantly lower ISQ values than the other implants (p < 0.05). After 91 days the ISQ values were significantly higher than the baseline for all four implant types (p < 0.001). The ISQ and IT values were significantly correlated at the baseline and at the final evaluation for Osseotite, Nanotite, and SLActive implants (p < 0.001). After 91 days, ISQ and IT values were only significantly correlated for the Osseotite implants (p < 0.05). All implants types exhibited acceptable primary and secondary stability.

Resumo em Inglês:

Abstract The aim of the present study was to verify if clinical signs of gingivitis such as color changes, edema, and bleeding in the anterior region influence the OHRQoL of adolescents. We followed a cross-sectional convenience sample of 67 adolescents aged 11 to 16 years receiving dental treatment at the Federal University of Santa Maria (UFSM), in southern Brazil. The participants were evaluated for the following clinical variables: edema, gingival color alteration, and marginal bleeding of the gingival tissues, collected at 6 sites per tooth in the anterior region of the mouth. Socioeconomic variables were collected through questionnaires and OHRQoL was evaluated through the Brazilian version of the Children Perception Questionnaire (CPQ 11-14) short form. A Poisson regression model was used to verify associations between clinical variables and general CPQ11-14 scores. In the unadjusted analysis, edema, color alterations, and marginal bleeding in the anterior region were associated with worse scores of OHRQoL. Edema and marginal bleeding remained associated after adjusting for clinical and sociodemographic variables. Adolescents with higher levels of marginal bleeding and edema in the anterior region had higher mean CPQ11-14 scores. Therefore, the presence of bleeding and gingival edema in the anterior region can be considered clinical signs of gingivitis that are associated with a worse OHRQoL in adolescents.

Resumo em Inglês:

Abstract Smokers have a risk of developing periodontal disease. Matrix metalloproteinases (MMP) play a significant role in periodontal tissue destruction. In this study possible relationship between smoking and gingival tissue expression of gelatinases in chronic periodontitis patients relative to periodontally healthy subjects was investigated. Forty chronic periodontitis patients (20 smokers and 20 non-smokers) and forty periodontally healthy subjects (20 smokers and 20 non-smokers) were enrolled. The clinical periodontal measurements recorded, and gingival tissues harvested after that. After histologic evaluation, matrix metalloproteinases -2 and -9 expressions were analyzed immunohistochemically. In nonsmokers, higher expression of metalloproteinases -2 and -9 detected in chronic periodontitis group compared to the periodontally healthy group. In the smoker chronic periodontitis group, the expression of metalloproteinases-2 was lower than nonsmoker chronic periodontitis group. Statistically significant differences detected between smoker and nonsmoker periodontally healthy groups in metalloproteinases-2 expression. For metalloproteinases-9 expression, smoker chronic periodontitis group has lower values than nonsmoker chronic periodontitis group. In periodontally healthy group smokers showed higher metalloproteinases -9 expressions than non- smokers. Present findings support the role of gelatinases in chronic periodontitis pathogenesis. Based on the current results we conclude that smoking alters the expression of gelatinases in gingival tissues.

Resumo em Inglês:

Abstract The aim of this study was to investigate the influence of preheating and post-curing methods on diametral tensile strength (DTS), flexural strength (FS), knoop microhardness (KHN), and degree of conversion (DC) of an experimental fiber-reinforced composite (FRC). Specimens (30 wt% of 3-mm-short E-glass fiber, 22.5 wt% of methacrylated-based resin and 47.5 wt% of filler particles) were subjected to: P – photocuring at 1500 mW/cm2 for 40 s (control); P/M – photocuring and microwave post-curing (540W/5 minutes); P/A – photocuring and autoclave post-curing (120°C/15 minutes); PH-P – preheating (60°C) and photocuring; PH-P/M – preheating, photocuring and microwave post-curing; and PH-P/A – preheating, photocuring and autoclave post-curing. Specimens for DTS (Ø 3 x 6 mm) and FS (25 x 2 x 2 mm) were tested at Instron 5965. KHN employed a 50g load for 30s. DC was measured using FTIR spectroscopy. Statistical analysis employed: factorial analysis, normality test, one-way ANOVA and Tukey’s HSD test, independent T-test and the Dunnett test. Interaction between factors was not significant (P>0.05). Preheating promoted significantly higher values of FS and KHN (p = 0.0001). Post-curing promoted significantly higher values for KHN (p = 0.0001). For DTS (p = 0.066) and DC (p= 0.724) no statistical difference was found between groups. SEM images showed that preheating promoted better interaction between glass fibers and resin matrix. Preheating increased FS, KHN and DTS, and post-curing increased KHN. DC was not affected by both methods. Preheating and post-curing methods can be used to improve some mechanical properties of FRCs’ but degree of conversion remains unaffected.

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Abstract Several instruments have been used to measure oral health-related quality of life (OHRQoL). The Oral Health Impact Profile (OHIP) questionnaire was based on the concept that sequential events related to oral diseases can cause discomfort, functional limitations and consequently, result in dysfunctions and even disabilities. There are few studies in the literature that structurally analyze the instruments to verify whether they measure the requirements to which they were designed to. The objective of the study was to evaluate the internal structure of the OHIP-Edent questionnaire. The OHIP-Edent was administered to 54 edentulous patients’ wearers of conventional complete dentures. For structural analysis, an exploratory factorial analysis (EFA) was carried out. After determining the internal consistency of the model (Cronbach’s alpha = 0.88), the fit was checked using the root mean square error approach (value 0.04), the comparative fit index (value 0.982) and the Tucker-Lewis index (value 0.976). After analysis of the 19 questions and the seven domains proposed in the OHIP-Edent questionnaire, the hypothetical factorial model showed three dimensions denominated “Physical Impact”, “Psychological Impact” and “Social Impact”. In this sample of conventional complete denture wearers, the OHIP-Edent seems adequate to measure the “Physical Impact”, “Psychological Impact”, and “Social Impact” of the OHRQoL. The confirmatory factorial analysis confirmed the model and, through adjustment indexes, it was verified that the three dimensions have convergence and consistence adequate in order to characterize the OHRQoL construct with validity.

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Abstract The aim of this study was to evaluate the immunohistochemical expression of receptor activator of nuclear factor kappa-B ligand (RANKL) and of osteoprotegerin (OPG), important proteins correlated with osteoclastogenesis, in central giant cell lesions (CGCL) and peripheral giant cell lesions (PGCL) and to compare their expression with the histological and clinical parameters for quantification of multinucleated giant cells (MGC) and their nuclei, lesion size, and recurrences. Twenty cases of each lesion type were selected to quantify the number of MGCs and nuclei/mm2 of connective tissue. The immunoreactivity of RANKL and OPG was expressed as a percentage of the marked area in the stroma. Clinical data were collected from pathoanatomical and medical reports. No statistical differences were found for the number of MGCs (p = 0.24) between PGCL and CGCL, but the number of nuclei within the MGCs was higher in CGCL (p = 0.01). RANKL expression was higher in CGCL than in PGCL (p = 0.04) and all recurrent lesions showed higher RANKL and OPG expressions than nonrecurrent lesions. We report higher RANKL expression and a greater number of nuclei in CGCL, which may explain the difference in clinical behaviour between these lesions and their pathogenesis.

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Abstract The aim of this study was to analyze the efficiency of experimental light-curing resin cements (ERCs) with a ternary photo-initiator system containing diphenyliodonium hexafluorphosphate (DPI) and different amines on retention of glass-fiber posts to dentin (GFP). ERCs formulations: a 1:1 mass ratio of 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenylpropane and triethyleneglycol dimethacrylate. Camphorquinone was used as initiator. Six experimental groups were established according to the amine used: [ethyl-4-(dimethylamino)benzoate-EDMAB or 2-(dimethylamino)ethyl methacrylate-DMAEMA] and the concentration of DPI (0, 0.5 mol%, 1 mol%). The resin cements Variolink II (dual- and light-cured versions) were used as commercial reference. Eighty recently extracted bovine incisors (n = 10) were selected for this study. The roots were prepared and the fiber posts were cemented with the resin cement specified for each experimental group. Specimens from coronal, middle, and apical thirds of the root were subjected to push-out bond strength test 24 hours after bonding. Data were subjected to split-plot ANOVA and the Tukey test (p = 0.05). ERCs containing DPI showed statistically significant higher bond strengths compared with ERCs without DPI. ERCs containing DPI were statistically similar to VARIOLINK II – dual-cured and superior to VARIOLINK II – light-cured (except for EDMAB – 1DPI in the medium third and DMAEMA – 1DPI in the coronal third). Different amines did not influence post retention. The apical root region showed the lowest bond strength for the groups EDAB-0DPI, DMAEMA-0DPI and VARIOLINK II light-cured. Light-cured ERCs containing DPI were efficient for GFP retention to radicular dentin, with similar behaviour to that of dual-curing commercial resin cement.

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Abstract The impact of oral rehabilitation on masticatory function and oral health-related quality of life (OHRQoL) may vary with the experience of the individual with tissue loss. Our hypothesis is that patient-centered outcomes vary among adults who have experienced large defects in the maxilla due to congenital or acquired conditions even after oral rehabilitation to restore aesthetics and function. This study compared OHRQoL, perceived masticatory ability, maximum bite force (MBF), and symptoms of pain and depression among subjects with acquired (edentulous maxilla) and congenital (cleft lip and palate) loss of oral tissues in the maxilla after dental treatment. A gender-matched sample (n = 60) of cleft lip and palate (CLP), maxillary denture wearers (DENT) and controls (CONT) was recruited. OHRQoL was assessed using OHIP-14. Chewing was evaluated through a masticatory ability questionnaire and by MBF. The RDC/TMD Axis II questionnaire was used to assess symptoms of pain and depression. Data were analyzed by Fisher's test, Kruskal Wallis test, and Spearman correlation coefficients. CLP showed higher OHIP-14 and depression scores than DENT and CONT (p < 0.05). Sub-analysis by OHIP-14 items (%FOVO) showed higher prevalence of psychological impact for CLP and of functional impacts for DENT. The number of foods difficult to chew, of food textures difficult to chew, and avoided foods were similar between CLP and DENT. OHIP-14, MBF, and depression scores showed significant correlation (p < 0.05). The results suggest that adults with treated CLP or maxillary DENT have chewing impairment and lower MBF than healthy subjects, with different psychological and functional impacts.

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Abstract The aim of this study was to evaluate stress distribution in an occlusal veneer according to the restorative material, restoration thickness, and cement layer thickness. A tridimensional model of a human maxillary first molar with an occlusal veneer preparation was constructed using a modeling software of finite element analysis. The model was replicated 9 times to evaluate the factors: restoration thickness (0.6, 1.2, and 1.8 mm) and cement layer thickness (100, 200, and 300 μm). Then, each model received different restorative materials (High Translucency Zirconia – [YZHT], Lithium Disilicate – [LD], Zirconia Reinforced Lithium Silicate – [ZLS], Feldspathic – [F], and Hybrid Ceramic – [HC]), totaling forty-five groups. An axial load (600 N) was applied on the occlusal face for static structural analysis. Solids were considered isotropic, homogeneous, and linearly elastic. Contacts were considered perfectly bonded. Fixation occurred in the dental root and a mechanical static structural analysis was performed. Descriptive statistical analysis and one-way ANOVA (α =10%) were performed for tensile stress peak values in the restoration and cement layer. The difference between groups was compared using the Tukey's test with 10% significance to match the percentage of the mesh convergence test. According to the results, the cement layer thickness did not influence stress distribution in the restoration (p ≥ 0.10). The thicker the restoration, the higher the tensile stress concentration in the restoration. The graphs showed higher stress concentration in the YZHT, followed by LD, F, ZLS, and HC. Also, the restorative material influenced stress concentration on the cement layer, which decreased according to the sequence HC>YZHT>ZLS>LD>F. HC stood out for causing the least stress concentration in the restoration. Cement layer thickness did not interfere in the mechanical performance of the restorations.

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Abstract The objective of this study was to evaluate and compare the cytotoxicity and genotoxicity on human fibroblast cell lines of sodium hypochlorite (NaOCl), chitosan and propolis as root canal irrigating solutions. Human fibroblast cells were exposed to chitosan, propolis and NaOCl for 4 and 24 h. Cell viability was assessed by 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide, and oxidative DNA damage was assessed by determination of 8-hydroxydeoxyguanosine (8-OHdG) level with an ELISA kit. The data of cell cytotoxicity were analysed statistically using a test of one-way analysis of variance at a significance level of p < 0.05. In the NaOCI group, the 8-OHdG level was higher than in the chitosan group, but there was no statistical difference when compared with the other groups (p < 0.05). It was determined that the irrigation solutions were cytotoxic, depending on the dose and time. NaOCl was the most toxic solution after both 4 and 24 h of exposure (p < 0.05). Chitosan and propolis may be alternatives to NaOCl for irrigation solutions, because they are both less toxic and produce less oxidative DNA damage.

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Abstract The present study aims to evaluate the longitudinal effects of induced experimental infections in gnotoxenic animals on the expression of inflammatory chemokines and their receptors in periradicular tissues. The null hypothesis tested was that Enterococcus faecalis and Fusobacterium nucleatum had no effect on CCR5, CCL5, CXCL10, CCL2/MCP-1, CXCR2 and CCR1 expression. Two groups of five animals (n = 5) aged between 8 and 12 weeks were used in this study. The animals were anaesthetized, and coronary access was performed in the first molar on the right and left sides. Microorganisms were inoculated into the left molar, and the right molar was sealed without contamination to function as a control. Animals were sacrificed 7 and 14 days after infection, and periapical tissues were collected. The cytokine mRNA expression levels were assessed using real-time PCR. The chemokine mRNA expression levels demonstrated that the experimental infection was capable of inducing increased chemokine expression on day 7 compared to that on day 14, except for CCR5 and CCL5, which showed no changes. The gnotoxenic animal model proved to be effective and allowed evaluation of the immune response against a known infection. Additionally, this study demonstrates that gene expression of chemokines and their receptors against the experimental infection preferentially prevailed during the initial phase of induction of the periradicular alteration (i.e., on day 7 post-infection).

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Abstract The aim of this study was to evaluate the influence of radiation therapy on root canal sealer push-out bond strength (BS) to dentin and the sealer/dentin interface after different final irrigation solutions (NaOCl, EDTA, and chitosan). Sixty-four maxillary canines were distributed into two groups (n=30): non-irradiated and irradiated with 60 Gy. Canals were prepared with Reciproc-R50 and subdivided (n=10) for final irrigation (NaOCl, EDTA, chitosan) and filled. Three dentin slices were obtained from each root third. The first slice of each third was selected for BS evaluation, and the failure mode was determined by stereomicroscopy. SEM analysis of the sealer-dentin interface was performed in the remaining slices. Two-way ANOVA and Tukey's tests (α=0.05) were used. Lower BS (P<0.0001) was obtained after irradiation (2.07±0.79 MPa), regardless of the final irrigation solution used. The NaOCl group (P<0.001) had the lowest BS in the irradiated (1.68±0.72) and non-irradiated (2.39±0.89) groups, whereas the EDTA (irradiated: 2.14±0.77 and non-irradiated: 3.92±1.54) and chitosan (irradiated: 2.37±0.73 and non-irradiated: 3.51±1.47) groups demonstrated a higher BS (P<0.05). The highest values were observed in the coronal third (3.17±1.38) when compared to the middle (2.74±1.36) and apical ones (2.09±0.97)(P<0.0001). There were more cohesive failures and more gaps in irradiated specimens, regardless of the final solution. The present study showed that radiation was associated with a decrease in BS, regardless of the final solution used, whereas chitosan increased BS in teeth subjected to radiation therapy.

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Abstract: This study aims to evaluate the clinicopathological features, TNM status, AJCC staging and behavior of squamous cell carcinoma of the tongue (SCCT) in patients older than 45 years. The files of the Department of Pathology of the Hospital General de México were reviewed and all cases of SCCT in patients older than 45 years were selected. Clinicopathological features, treatment, follow-up, microscopic diagnosis, and IJCC and TNM staging were retrieved. Complete data from 60 cases were evaluated. They were more common in males (mean age = 63.9 years). Unexpectedly a high rate of tumors (38.3%) were in the base of the tongue (BT). Moderately and poorly differentiated SCCT were the most common. 16.7% presented lymph node invasion, 15% were recurrent tumors and BT carcinomas recurred more frequently. A high rate (81.7%) were stage II and 48.3% were low-risk patients. SCCTs in the studied population displayed different clinico-pathological and behavioral features compared with worldwide data. Our results suggest that BT tumors should be treated more aggressively than those in the mobile tongue. BT located tumors were more frequent than previously published. Additional frequency studies will define outcomes in age cohorts with a consensus cut-off for young and elderly populations. More population-based studies should be performed in Latin American regions to acquire accurate data on SCC incidence in elder subpopulations and to identify precisely the etiological factors in these patients.

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Abstract: Not only laymen but also dentists generally believe that extraction of acutely infected teeth should be avoided until the infection subdues by using systemic antibiotics. The aim of this study was to compare perioperative complications in routine extractions of acutely infected teeth with extractions of asymptomatic teeth. This prospective study was performed with 82 patients. Severe pain on percussion of the relevant tooth was considered as basic criteria for acute infection. The acutely infected teeth were labeled as the study group (n = 35) and the asymptomatic teeth as the control group (n = 47). The extractions were done using standard procedures. The amount of anesthetic solution used and duration of extractions were recorded. Postoperative severe pain and exposed bone with no granulation tissue in the extraction socket were indications of alveolar osteitis (AO). The level of statistical significance was accepted as 0.05. Symptoms that could indicate systemic response, including fever, fatigue, and shivering were not found. There was no statistically significant difference between groups in terms of AO, amount of anesthetic solution used, and duration of extraction. The presence of an acute infection characterized by severe percussion pain is not a contraindication for tooth extraction. Infected teeth should be extracted as soon as possible and the procedure should not be postponed by giving antibiotics.

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Abstract: The effects of tooth brushing could affect the long-term esthetic outcome of composite restorations. This study evaluated the effect of two different emission spectrum light-curing units on the surface roughness, roughness profile, topography and microhardness of bulk-fill composites after in vitro toothbrushing. Valo (multiple-peak) and Demi Ultra (single-peak) curing lights were each used for 10s to polymerize three bulk-fill resin composites: Filtek Bulk Fill Posterior Restorative (FBF), Tetric EvoCeram Bulk Fill (TET) and Surefil SDR Flow (SDR). After 30,000 reciprocal strokes in a toothbrushing machine, the roughness profile, surface roughness, surface morphology, and microhardness were examined. Representative SEM images were also obtained. When light-cured with the Demi Ultra, SDR showed the most loss in volume compared to the other composites and higher volume loss compared to when was light-cured with Valo. The highest surface roughness and roughness profile values were found in SDR after toothbrushing, for both light-curing units tested. FBF always had the greatest microhardness values. Light-curing TET with Valo resulted in higher microhardness compared to when using the Demi Ultra. Confocal and SEM images show that toothbrushing resulted in smoother surfaces for FBF and TET. All composites exhibited surface volume loss after toothbrushing. The loss in volume of SDR depended on the light-curing unit used. Toothbrushing can alter the surface roughness and superficial aspect of some bulk-fill composites. The choice of light-curing unit did not affect the roughness profile, but, depending on the composite, it affected the microhardness.

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Abstract: Novel biomarkers for screening, diagnosis and monitoring the treatment of nasopharyngeal carcinoma (NPC), one of the most common cancers in Vietnam, are urgently required. Increasing evidence suggests that microRNA-141 (miR-141) is associated with NPC, owing to its ability to affect the expression of genes that modulate tumorigenesis. Unfortunately, research on miR-141 expression in Vietnamese patients is limited. Therefore, the objective of the current study was to evaluate miR-141 expression and assess whether miR-141 might be a potential biomarker for diagnosis of NPC in Vietnamese patients. Total RNA isolated from 40 NPC biopsy samples and 37 non-cancerous samples was analyzed by quantitative reverse-transcription PCR. The miR-141 expression levels were compared between NPC biopsy and non-cancerous samples. The frequency of miR-141 detection was 37.50% and 10.80% in the NPC and non-cancerous samples, respectively (p = 0.0143). The miR-141 expression was 5.27 times higher in tumor samples than non-cancerous samples. Additionally, the RR (Relative risk) and OR (Odds ratio) were 1.83 (95%CI = 1.2576–2.6675, p = 0.0016) and 4.95 (95%CI = 1.4625–16.7541, p = 0.01), respectively. In conclusion, miR-141 was up-regulated in the biopsy samples and thus may be a potential biomarker for NPC in the Vietnamese population.

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Abstract: The objective of this study was to evaluate the psychometric properties of the Multidimensional Health Locus of Control – Form C (MHLC-C) scale applied to a sample of adult Brazilian patients with different pain conditions. The scores were then identified and compared on each of the subscales and profiles regarding locus of control. The sample consisted of 1,149 adult individuals (79% women; mean age: 36.6 years) of which 334 reported not feeling pain in the prior 24 hours, 386 reported pain in the prior three months, 250 reported recurring pain for the prior three months or longer, and 179 reported continuous pain for the prior three months or longer. A confirmatory factor analysis was performed. The invariance of the MHLC-C was tested on independent samples. The weighted global score was calculated for each of the factors and tested using ANOVA (α = 5%). Individuals were classified according to the eight health locus of control (HLC) profiles. The factors fit the data adequately after the model was refined. A higher score for the Health Professionals HLC was found among individuals reporting less than three months of pain. The “believer in control” profile was the most prevalent among the groups, while the least prevalent profile was the “pure chance” profile. The MHLC-C was found to be valid and reliable for assessing locus of control among people with different pain conditions. Only the Health Professionals HLC factor exhibited significantly different results for these individuals. The “believer in control” profile was the most prevalent among the pain conditions considered.

Resumo em Inglês:

Abstract: This cross-sectional study aimed to evaluate the asynchronous dental teleconsulting of Telehealth Brazil Networks Program in Minas Gerais. Data were collected from secondary databases of the Clinical Hospital of the Universidade Federal de Minas Gerais (CH/UFMG) and Medical School of UFMG (MS/UFMG), from July 2015 to July 2017. The variables analyzed were telehealth center, sex and profession, date and time questions and answers, response time in days, whether the issue was duly addressed, whether the teleconsulting was attended, post status, professional's satisfaction, conduct adopted after teleconsulting, dental specialty area, and type of issues. Sociodemographic data from the Intermediate Geographical Regions (IGR) of Minas Gerais, including the Municipal Human Development Index (MHDI) and Gini Index were also collected. The results were analyzed using SPSS v.22.0. In total, 3,920 teleconsulting were recorded, with increasing demand in the study period. Most were requested by dentists (93.3%) and female professionals (78.6%), during office hours (78.6%), and related to general conducts (72.1%). Almost all were attended (99.7%), with a maximum response time of two days (75.0%). A low feedback on satisfaction and resolution of issues (missing data of 57.2% and 70.2%, respectively) was recorded. Only 5.2% had information on whether patients were referred. The most common inquires were of issues about Pathology/Stomatology specialties (19.0%) and Pharmacology/Anesthesiology (18.8%). The response occurred within the expected time, with prevalent issues in basic dental areas and general conducts. Feedback from professionals must be encouraged to allow a better analysis and improvements of the program.

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Abstract: The oral health status of children with special health care needs (SHCN) can affect their quality of life wich domains of the Brazilian version of the Early Childohood Oral Health Impact Scale (B-ECOHIS). A cross-sectional study was conducted in children with SHCN (aged 1 to 9 years), who underwent an oral examination for the assessment of dental caries severity. Parents/caregivers answered two questionnaires, one on oral health-related quality of life (OHRQoL) - B-ECOHIS, and one on socioeconomic characteristics. Statistical analyses were performed using the Kolmogorov-Smirnov test, Mann-Whitney U-test, Poisson regression, Point-biserial correlation coefficient, and Cronbach's alpha. A total of 128 children participated in the study and OHRQoL was affected in 68.75% of them. The function domain in the Child Impact Section (CIS) had a higher mean value. Caries severity was associated with worse quality of life (p=0.001). Severe dental caries was associated with a negative impact on the OHRQoL of disabled children and of their families. The impact of untreated dental caries and severity of dental caries was associated with the CIS domains (except for the self-image/social interaction domain).

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Abstract: The aim of this study was to investigate the effect of a placebo, intracanal diode laser application, and low-level laser therapy (LLLT) on the change of the total amount of calcitonin gene-related peptide (CGRP) in the gingival crevicular fluid (GCF) (split-mouth study design). GCF sampling was performed on a contralateral tooth and experimental tooth (root canal-treated tooth) of thirty-nine patients. The patients were divided into three groups (n = 13), as follows: placebo (mock laser application), intracanal laser application, and LLLT. GCF sampling was repeated at the same sites (experimental and control teeth) one week after root canal treatment. The data were analyzed using the Pearson's correlation analysis and the independent-samples t-tests (p=0.05). In the placebo group, the total CGRP level changes in the GCF before and after treatment was significantly higher for experimental teeth than for control teeth (p<0.05). However, there was no significant difference between experimental and control teeth in the intracanal laser application and LLLT groups (p > 0.05). Intracanal laser application and low-level laser therapy have immunomodulation effects linked to the modulation of the total amount of CGRP in the GCF.

Resumo em Inglês:

Abstract This study aimed to compare the longevity of different conventional restorative materials placed in posterior primary teeth. This systematic review was conducted following the PRISMA statement and registered in PROSPERO (CRD42016035775). A comprehensive electronic search without date or language restrictions was performed in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, Turning Research Into Practice (TRIP) and Clinical Trials databases up to January 2017, selecting randomized clinical trials that assessed the longevity of at least two different conventional restorative materials performed in primary molars. Seventeen studies were included in this systematic review. Pairwise and network meta-analyses were performed and relative risks and 95% confidence intervals (CI) calculated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Restorations of primary molars with conventional glass ionomer cement showed increased risk of failure than compomer, resin-modified glass ionomer cement, amalgam, and composite resin. Risk of bias was low in most studies (45.38% of all items across studies). Pediatric dentists should avoid conventional glass ionomer cement for restoring primary molars.

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Abstract The presence of residues within the root canal after post-space preparation can influence the bond strength between resin cement and root dentin when using fiberglass posts (FGPs). Currently, there is no consensus in the literature regarding what is the best solution for the removal of debris after post-space preparation. This systematic review involved “in vitro” studies to investigate if cleaning methods of the root canal after post-space preparation can increase the retention of FGPs evaluated by the push-out test. Searches were carried out in PubMed (MEDLINE) and Scopus databases up to July2017. English language studies published from 2007 to July 2017 were selected. 475 studies were found, and 9 were included in this review. Information from the 9 studies were collected regarding the number of samples, storage method after extraction, root canal preparation, method of post-space preparation, endodontic sealer, resin cement, cleaning methods after post-space and presence of irrigant activation. Five studies presented the best results for the association of sodium hypochlorite (NaOCl) and ethylenediamine tetra-acetic acid (EDTA), while in the other 4 studies, the solutions that showed improved retention of FGPs were photon-induced photoacoustic streaming (PIPS), Qmix, Sikko and EDTA. The results showed heterogeneity in all comparisons due to a high variety of information about cleaning methods, different concentrations, application time, type of adhesive system and resin cements used. In conclusion, this review suggests that the use of NaOCl/EDTA results in the retention of FGPs and may thus be recommended as a post-space cleaning method influencing the luting procedure.

Resumo em Inglês:

Abstract Polymethyl methacrylate (PMMA) has been considered a suitable material for cranioplasty. However, no consensus has been reached concerning the best material for cranioplasty with regard to minimizing complications. Thus, this systematic review and meta-analysis aimed to compare the complication rates of PMMA with those of autologous bone and titanium mesh. This review was registered with PROSPERO (CRD42016042725). Systematic searches were conducted on PubMed/MEDLINE, Scopus, and Web of Science. The focus question was, “Do PMMA prostheses used in cranioplasty have complications rates similar to those of autologous bone and titanium mesh?” A meta-analysis of complication rates was performed on the basis of dichotomous outcomes assessed by risk ratio (RR) with corresponding 95% confidence intervals (CI). From 1014 data sources, 11 articles were selected according to eligibility criteria. These articles involved 1,256 individuals and 1,278 cranioplasties using autologous bone (n = 408), PMMA (n = 379), or titanium (n = 151). The follow-up period ranged from 63 days to 54.3 months. No difference was observed between the complication rates of PMMA and autologous bone (p = 0.94; RR, 0.98; 95%CI, 0.54–1.75) or between PMMA and titanium (p = 0.38; RR, 1.59; 95%CI, 0.57–4.48). Sub-analysis of the reasons for craniotomy (trauma/non-trauma) was conducted, which revealed no significant difference (p = 0.91; RR, 0.95; 95%CI, 0.37–2.42). The meta-analysis indicated that the use of PMMA yields complication rates that are near those of autologous bone and titanium mesh.

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Abstract The etiopathogenesis of oral lichen planus (OLP) is still not fully elucidated, and it is believed that its development could involve a neuro-immune-endocrine profile. This systematic review investigated the relationship between cytokines, cortisol, and nitric oxide (NO) in the saliva of OLP patients. An electronic search was conducted in Pubmed/Medline, Scopus, LIVIVO, and Web of Science databases with no restriction of language to identify studies published up to December 2017. Data extraction was performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A total of 140 articles were retrieved, and 32 articles fulfilled the inclusion criteria (cytokines = 17; cortisol = 9; NO = 6). The most studied cytokines in the saliva of OLP patients were interleukins IL-4, IL-6, IL-8, IFN-ү, and TNF-α, which were higher in OLP patients than in healthy controls (HC). Salivary cortisol was found to be higher in OLP than in HC in most (55.5%) of the selected studies, and all studies related to NO found higher levels of this marker in OLP than in HC. Despite controversial results, our review suggests that OLP patients have an increased inflammatory response, as indicated by the proinflammatory profile of salivary cytokines. In addition, we conclude that salivary cytokine and NO measurements may have significant diagnostic and prognostic potential for monitoring disease activity and therapeutic responses in OLP.

Resumo em Inglês:

Abstract This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and long implants placed after maxillary sinus augmentation. This systematic review has been registered at PROSPERO under the number (CRD42017073929). Two reviewers searched the PubMed/MEDLINE, Embase, LILACS, and Cochrane Library databases. Eligibility criteria included randomized controlled trials, comparisons between short implants and long implants placed after maxillary sinus augmentation in the same study, and follow-up for >6 months. The Cochrane Collaboration’s tool for assessing the risk of bias in randomized trials was used to assess the quality and risk of bias of the included studies. The search identified 1366 references. After applying the inclusion criteria, 11 trials including 420 patients who received 911 dental implants were considered eligible. No significant difference was observed in the survival rate [p = 0.86; risk ratio (RR): 1.08; 95% confidence interval (CI): 0.46–2.52] or in the amount of marginal bone loss (p = 0.08; RR: −0.05; 95%CI: −0.10 to 0.01). However, higher rates of biological complications for long implants associated with maxillary sinus augmentation were observed (p < 0.00001; RR: 0.21; 95%CI: 0.10–0.41), whereas a higher prosthetic complication rate for short implants was noted (p = 0.010; RR: 3.15; 95%CI: 1.32–7.51). Short implant placement is an effective alternative because of fewer biological complications and similar survival and marginal bone loss than long implant placement with maxillary sinus augmentation. However, the risk of mechanical complications associated with the prostheses fitted on short implants should be considered.

Resumo em Inglês:

Abstract Distraction osteogenesis (DO) relies on the recruitment and proliferation of mesenchymal stem cells (MSC) to the target site, where they differentiate into osteoblasts to promote bone formation. Nevertheless, MSC recruitment appears to be slow and limits bone formation in DO defects. Thus, this systematic review aims to evaluate the ability of locally applied MSC to enhance bone formation in DO preclinical models. Databases were searched for quantitative pre-clinical controlled studies that evaluated the effect of local administration of MSC on DO bone formation. Eligible studies were identified and data regarding study characteristics, outcome measures and quality were extracted. Nine studies met the inclusion criteria. Autogenous and xenogenous MSC were used to promote DO bone formation. These included bone marrow-derived MSC, adipose tissue-derived MSC and MSC derived from human exfoliated deciduous teeth. Meta-analysis was not possible due to heterogeneities in study designs. Local MSC implantation was not associated with adverse effects. In 4 out of the 5 studies, locally delivered undifferentiated bone-marrow MSC had a positive effect on DO bone formation. Few studies evaluated the therapeutic effects of MSC from other sources. The adjunct use of biologically active molecules or forced expression of key genes involved in osteogenesis further boosted the ability of bone-marrow MSC to promote DO bone formation. While risk of bias and heterogeneity limited the strength of this systematic review, our results suggest that the use of MSC is safe and may provide beneficial effects on DO bone formation.

Resumo em Inglês:

Abstract The aim of this study was to conduct a systematic review and meta-analysis to assess the clinical outcomes of dental implants placed in previously early and late implant failed sites. An electronic literature search was conducted in several databases for articles published up to February 2018. Human clinical trials that received at least one implant in a previously failed site were included. Hence, the PICO question that was aimed to be addressed was: Do patients undergoing implant replacement (second and third attempts) in previous failed sites have survival rates similar to implants placed at first attempts? A random effects model was used to calculate survival weighted means and corresponding 95% Confidence Intervals (CI) among studies. Eleven studies of low to moderate methodological quality were included in this review. Implants placed in sites with history of one and two implant failures had a weighted survival rate (SR) of 88.7% (95%CI 81.7-93.3) and 67.1% (95%CI 51.1-79.9), respectively. Implants placed in sites with a previous early failure revealed a weighted SR of 91.8% (95%CI 85.1-95.6). First implants presented higher SR than implants placed in sites with one or two previous implant failures. In contrast, implants placed in sites with one and two implant failures had similar SR. Within its limitations, this review suggests that replacement implants have moderate SR. Larger prospective studies with well-defined criteria for early and late implant failure are necessary to confirm and expand on these results.

Resumo em Inglês:

Abstract Botulinum toxin type A is effective in reducing excessive gingival display caused by hyperfunctional upper lip elevator muscles; however, this effect is transient. This study aimed to determine the duration of the effectiveness of botulinum toxin type A on a gummy smile. A systematic search was conducted using Medline (PubMed), Scopus, and Web of Science electronic databases, from 1970 to March 2017 with no language restriction; the search included studies evaluating adult patients with excessive gingival display who were treated with botulinum toxin and were followed-up for at least 3 months. OpenGrey and Clinical Trial Registry were also consulted. Quality assessment was applied to determine the level of evidence and bias, and a meta-analysis was performed. Of 2181 full texts, 71 were obtained, with 3 prospective studies meeting the selection criteria. The gingival display was significantly reduced to baseline with 2, 4, and 8 weeks of treatment. The gingival display considerably reduced at the baseline-2-week comparison (–4.44 mm using raw data and–4.05 mm using the standard difference) and increased throughout the weeks of follow-up. There is scant evidence to determine the duration of the effectiveness of toxin type A on a gummy smile. The effect tends to be stable until at least 8 weeks of follow-up, and the gingival exposure may not return to baseline within 12 weeks of follow-up. Well-designed randomized clinical trials with a minimum of 6 months of follow-up are necessary to strengthen the evidence.

Resumo em Inglês:

Abstract The aim of the present study was to evaluate the association between metabolic syndrome (MS) and periodontitis (PD), through a systematic review and meta-analysis. Original observational studies assessing the association between MS and PD in adults, published before May 11th (2017), were identified through electronic searches of MEDLINE, EMBASE and Cochrane Library databases. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was used. For studies to be included, they had to mention the criteria used to diagnose MS and to have used at least one clinical measure to diagnose PD. There was no language restriction. Three reviewers independently identified eligible studies for possible inclusion in the systematic review and meta-analysis. The quality of the studies was evaluated by the Newcastle-Ottawa scale for observational studies. A random model meta-analysis was conducted. The strategies used to investigate heterogeneity were sequential analysis, subgroup analysis, univariate meta-regression and sensitivity analysis. Thirty-three studies met the inclusion criteria for the systematic review, and 26 had enough information to be included in the meta-analysis, totaling 52,504 patients. MS and PD were associated with an odds ratio of 1.38 (95%CI 1.26–1.51; I2 = 92.7%; p < 0.001). Subgroup analysis showed that complete periodontal examination (I2 = 70.6%; p < 0.001) partially explained the variability between studies. The present findings suggest an association between MS and PD. Individuals with MS are 38% more likely to present PD than individuals without this condition. Prospective studies should be conducted to establish cause and effect relations between MS and PD.