Abstract in English:

Abstract Objective: To estimate the incidence of dental caries and associated factors in the school period from six/seven to ten years of age. Material and Methods: A longitudinal study involving 168 children was followed up between 2015 and 2019 in the municipality of Palhoça, Brazil. The dependent variable was the caries incidence rate in the mixed dentition. The independent variables included information regarding demographic and socioeconomic status. Multivariate analyzes were carried out using Poisson Regression with a robust estimator. Variables with p <0.20 in the bivariate analysis were included in the adjusted model. Relative risks were estimated, as well as 95% confidence intervals. Results: Of 168 followed schoolchildren, 32 developed the disease, providing an incidence rate of 19.0%. Female children had a 10% higher risk [RR = 1.10 (95% CI 1.03; 1.18)] of developing caries than males. Also, children born from fathers with ≤ 8 years of schooling at baseline had a 9% higher risk [RR = 1.09 (95% CI 1.01; 1.16)] of developing dental caries compared to fathers with higher education. Conclusion: The incidence of dental caries in a four-year period was 19.0%. Females and children born from fathers with a lower level of education showed higher incidence rates.

Abstract in English:

Abstract Objective: To identify the most prevalent oral lesions based on reports from a pathology institute’s reports and associations between malignant and oral potentially malignant disorders with patient’s demographic variables and the anatomical location. Material and Methods: All 1,298 histopathological reports of oral lesions recorded in the database were reviewed. Demographic variables, anatomical location of the lesion, histopathological diagnosis of the lesions, and their biological behavior were analyzed. Results: Regarding the biological behavior of the identified lesions, benign lesions were predominant (70%), followed by lesions of undetermined behavior (14.3%), malignant lesions (14.2%), absence of histological alteration (1.2%), and finally, oral potentially malignant disorders (0.5%). The anatomical locations of the most prevalent oral lesions potentially malignant disorders and malignant were in the following structures of the oral cavity: gums, buccal mucosa, floor of the mouth and hard palate (p=49.2%), and tongue (p=48.7%). Conclusion: The probability of malignant and premalignant lesions was higher among males (PR= 4.21; 95% CI 2.08-6.22), the increase in age (PR = 1.06; 95% CI 1.05-1.08), and in the tongue region (PR = 5.48; 95% CI 1.67; 17.92). Identification of malignant and potentially malignant oral conditions is higher in older men and in tongue specimens.

Abstract in English:

Abstract Objective: To evaluate the utility of panoramic radiographs in pre-prosthetic screening of edentulous arches. Material and Methods: Panoramic radiographs taken for three years were retrospectively analyzed. Observations from the radiographs shall be categorized and classified into either of the two categories, namely: 'findings with minimal impact on denture fabrication' and 'findings which affect denture fabrication and require further evaluation.' Anatomic variations, jaw pathologies, and residual ridge resorption patterns were assessed. Results: This study included the initial screening of 23,020 panoramic radiographs, out of which 505 (showing either one or both edentulous arches) were included for the study purpose. The age range of the subjects was from 21 to 94 years. 52.6% of the radiographs showed positive findings. More than half of the radiographs belonged to the males (52.5%). Hyperpneumatization of the maxillary sinus, crestal position of the mental foramen, and retained root fragments were the most common entities noted in the radiographs. Changes in the mental foramen were significantly higher in males than females (p=0.002). Conclusion: Observations from this study showed that panoramic radiographs have high utility for screening edentulous arches, and they should be used in routine clinical practice before denture fabrication.

Abstract in English:

Abstract Objective: To study the frequency of self-medication and knowledge about out-of-counter drugs during the COVID-19 pandemic in a group of Iranian dental students. Material and Methods: A descriptive cross-sectional study was conducted among dental undergraduates from September 2021 to November 2021 after receiving ethical clearance from the Kerman Medical University Ethical Committee. A valid and reliable questionnaire, consisting of demographic data and questions about self-medication and knowledge about out-of-counter drugs, was sent to participants via E-mail. Data was analyzed by SPSS 26 software by using a t-test. The P-value was considered at a 0.05% significant level. Results: A total of 88 students participated in the study with a mean age of 21.39±3.71 years. Prevalence of self-medication was found in 53.4%. The most common cause for self-medication was headache. Acetaminophen was the most commonly used medicine for self-medication. Females had more self-medication than males, but there was no significant differences. There was no significant differences between entering year to university and self-medication. Younger students had significantly more self-medication (p=0.007). Knowledge about out-of-counter drugs was moderate. Conclusion: Moderate self-medication as noticed. The out-of-counter drugs were the most used. Although out-of-counter drugs seem relatively safe, their improper use can cause serious side effects. Dental students need to be educated regarding appropriate safe medication and out-of-counter drugs.

Abstract in English:

Abstract Objective: To evaluate the effect of different pressures of an oral irrigation device (OID) and the irrigation solution type on the surface roughness of the giomer restorative material. Material and Methods: In this in vitro study, disk-shaped giomer samples were fabricated and assigned to 5 groups (n=23): Group 1, storage in distilled water (control); Group 2, OID #7 pressure/ water; Group 3, OID #10 pressure/ water; Group 4, OID #7 pressure/ 0.05% CHX; Group 5, OID #10 pressure/ 0.05% CHX. The samples' treatment simulated a one-year application of OID. Surface roughness (Ra) and topography of the giomer were evaluated using profilometry and scanning electron microscopy. The data were analyzed with Paired t-test, Tukey, and ANOVA tests (α=0.05). Results: The Ra of the samples increased significantly after treatment with OID (p<0.001). The roughness increase in groups with a pressure of 10 was higher than those with a pressure of 7 (p<0.001). The effect of pressure on surface changes was significant (p<0.001). However, the solution type and the cumulative effect of these two factors were insignificant (p=0.08 and p=0.43, respectively). Conclusion: Oral irrigation device with both solutions significantly increased the surface roughness and topographic changes of the giomer. The severity of these changes was related to the device’s pressure.

Abstract in English:

Abstract Objective: To analyze the existing state legislation, including not only the ordinary laws, but also their infralegal regulation and the state legislation on Hospital Dentistry. Material and Methods: A survey was carried out in the databases of the Legislative Assemblies of the Brazilian States and the Federal District, as well as the Regional and Federal Councils of Dentistry in Brazil. Subsequently, a survey was carried out in the databases of the Ministry of Health, State Dental Councils and Federal Dental Council in Brazil. Results: Only 8 Brazilian states have legislation in force regarding hospital dentistry, which represents 29.63% of the federative units. Among the Brazilian regions, the Midwest presented the highest prevalence of the laws found (37.50%), followed by the North (25%) and the other regions with the same coverage (12.50%). Also, an orientation and an ordinance from the Ministry of Health, six resolutions from the Federal Council of Dentistry, and a technical note from the National Health Surveillance Agency were found. Conclusion: Several States do not have rules on the subject, making it imperative to create a federal rule that not only imposes the presence of the dentist, but also regulates the proportion of the team, workload, and availability.

Abstract in English:

Abstract Objective: To describe the challenges pediatric dentists face while caring for their patients during the pandemic. Material and Methods: A descriptive qualitative study was conducted with purposefully sampled pediatric dentists. Data were collected through in-depth, semi-structured interviews until the content of the collected data reached theoretical saturation. Data were transcribed verbatim, coded, and analyzed using content analyses. Results: Seven participants (four females and three males) between 29 and 50 years participated in the study. Three themes emerged from the analyses: Anxiety and fear; PPE (Personal Protective Equipment) and its impact on care delivery; and 3) Behavior management. Conclusion: Dental care delivery was challenging for pediatric dentists. They experienced high anxiety levels and modified their services according to the recommended guidelines while making accommodations to lessen patients’ COVID-19-related anxiety. The additional mandated PPE use affected the communication between the dentists and their patients, affecting their dentist-patient bonding.

Abstract in English:

Abstract Objective: To compare the clinical effect of two desensitizing agents used before the application of a bleaching gel based on 35% hydrogen peroxide (HP). Material and Methods: 30 patients were selected, and two desensitizing agents with different mechanisms of action were applied: Fluorine Neutral 2% (FN), which acts by blocking dentinal canaliculi while Potassium Nitrate 5% with 2% Sodium Fluoride (PN/SF) that acts in nerve transmission and blockade. Desensitizers were used before the application of 35% HP. For whitening, three clinical sessions were performed, with an interval of seven days, with three applications of the bleaching gel for 15 minutes, totaling 45 minutes/session. Tooth sensitivity (TS) was assessed with the numerical analog scale, and a spectrophotometer was used to obtain the color variation (ΔE). ΔE were submitted to ANOVA and Tukey test (p<0.05), and TS data were submitted to a two-way ANOVA analysis. Results: For sensitivity experience, the Tukey test indicated differences between PN/SF and the placebo I, but there was no statistically significant difference between FN and the placebo II. The TS was lower when the desensitizing gel was used during the bleaching procedure compared to after treatment, regardless of the desensitizing agents. Conclusion: PN/SF before in-office tooth bleaching can reduce TS intensity, and the use of desensitizing gel before bleaching did not affect the bleaching efficacy.

Abstract in English:

Abstract Objective: To investigate the usefulness, reliability, quality, and content of Portuguese-language YouTube videos on COVID-19. Material and Methods: Three keywords selected on Google Trends were searched on YouTube, and the 60 first videos listed with each term were analyzed. Two calibrated researchers evaluated the reliability (DISCERN Modified Scale), the quality (Global Quality Score - GQS), and the usefulness of videos for the users (COVID-19 Specific Score - CSS). The number of views, likes, and engagement were also analyzed. The data were evaluated by the Mann-Whitney test and Spearman correlation (α=5%). Results: 59 videos were included. The average scores of quality, reliability, and usefulness were 3.0 (±1.1), 3.2 (± 0.8), and 1.5 (± 0.9), respectively. Two-thirds of the videos (64.4%) had low/moderate quality, and the majority (76.2%) were about signs and symptoms. The numbers of views (p=0.005), likes (p=0.006), and engagement (p=0.014) were significantly higher in moderate/good quality videos. The number of comments (p=0.007), duration of videos (p=0.004), and the DISCERN score (p<0.001) were significantly higher in videos made by health professionals. The general quality of the videos was positively correlated to the CSS scores, number of views, likes, and engagement (p<0.05). Conclusion: Most videos had moderate quality and reliability and low usefulness for the users.

Abstract in English:

Abstract Objective: To identify the factors affecting clinical performance among dental students and to help addressing these problems. Material and Methods: A cross-sectional study in which students of third and final year of dentistry participated. Data was collected from June 2022 till September 2022. Data was collected from the third and final year dental students of both public and private dental colleges within the Pakistan using a purposive sampling technique. Results: A total of 372 dental students participated in this study. Thirty eight (31.9%) students belonged to third year while 81 (68.1%) were final year students from government college. For the private dental college, 121 (47.8%) were third year students while 132 (52.2%) were final year students. Majority of the participants were males from both the colleges. 42.9% of government dental students and 26.5% of private dental students agreed on well-preparedness of clinical instructors. 5.5% from private and 21.0% from government dental colleges agreed that adequate personal protective equipment were present in clinical departments. Conclusion: From this study, it is concluded that there should be focus more focus on the factors to enhance clinical skills, supervision of students in clinical practice to help addressing the problems faced during learning and performance in a clinical environment, to produce self-confident, motivated, knowledgeable, skillful and a professional dental graduates.

Abstract in English:

ABSTRACT Objective: To determine the occurrence of hyposalivation in Brazilian adults and its association with individual determinants, such as the use of medications, systemic conditions, smoking, and alcohol consumption. Material and Methods: A cross-sectional study with 402 adults was developed. Information was collected on sociodemographic and general health characteristics, and sialometry was performed with stimulated salivary flow. It indicated low salivary flow when ≤ 0.7 mL/min. Bivariate and multivariate analyses were conducted using a decision tree (p<0.05). Results: The sample was comprised predominantly of women (68.2%) aged ≤ 29 years (25.4%). Most participants did not use medication (56.7%). Among systemic diseases, the most cited was hypertension (25.1%). More than a third of the participants presented hyposalivation (40.3%), being associated with the following variables: age between 50 to 59 years (p=0.011), female sex (p<0.001), menopause (p=0.001), use of alcohol (p=0.033), systemic disease (p=0.002) and medication use (p<0.001). In multivariate analysis, in addition to sex (p<0.001) and hypertension (p=0.005), an association was also found between hyposalivation and diabetes (p=0.014). Conclusion: Factors associated with hyposalivation in adults were sex and the presence of hypertension or diabetes.

Abstract in English:

ABSTRACT Objective: To assess the efficacy of bioactive glass, self-assembling peptide, and ozone-remineralizing agents on the artificial carious lesion. Material and Methods: On the extracted 60 premolar teeth, an artificial carious lesion/demineralization was created. Later, the remineralization of demineralized teeth was done with respective remineralizing agents (Group A: Calcium sodium phosphosilicate (bioactive glass), Group B: Self-assembling peptide, Group C: Ozone remineralizing agents and Group D (Control): De ionized water. The degree of demineralization and remineralization were evaluated using the Vickers Hardness Number. Results: There was a decrease in microhardness from baseline to demineralization in all the groups, and this reduction was found to be statistically considerable. After the remineralization of demineralized samples with respective remineralizing agents, there was an increase in microhardness of 312.38, 276.67, and 254.42 in groups A, B, and C, respectively. In contrast, in Group D, there were no changes. Conclusion: Bioactive glass and self-assembling peptides had higher remineralizing capacities, which can be used to treat early carious lesions.

Abstract in English:

ABSTRACT Objective: To assess the effects of cobalt chloride (CoCl2) as a hypoxia mimicking agent on human umbilical cord mesenchymal stem cells (hUCMSCs) expression of HIF-1α and mTOR for use in regenerative dentistry. Material and Methods: Human umbilical cord mesenchymal stem cells were isolated and then cultured. The characteristics of stemness were screened and confirmed by flow cytometry. The experiment was conducted on hypoxia (H) and normoxia (N) groups. Each group was divided and incubated into 24-, 48-, and 72-hours observations. Hypoxic treatment was performed using 100 µM CoCl2 on 5th passage cells in a conventional incubator (37°C; 5CO2). Then, immunofluorescence of HIF-1α and mTOR was done. Data was analyzed statistically using One-way ANOVA and Tukey’s HSD. Results: Significant differences were found between normoxic and hypoxic groups on HIF-1α (p=0.015) and mTOR (p=0.000) expressions. The highest HIF-1α expression was found at 48 hours in the hypoxia group, while for mTOR at 24 hours in the hypoxia group. Conclusion: Hypoxia using cobalt chloride was able to increase human umbilical cord mesenchymal stem cells expression of HIF-1α and mTOR.

Abstract in English:

ABSTRACT Objective: To identify the salivary metabolites profile of Mucopolysaccharidosis (MPS) types I, II, IV, and VI patients. Material and Methods: The participants were asked to refrain from eating and drinking for one hour before sampling, performed between 7:30 and 9:00 a.m. Samples were centrifuged at 10.000 × g for 60 min at 4°C, and the supernatants (500µl) were stored at −80°C until NMR analysis. The salivary proton nuclear magnetic resonance (1H-NMR) spectra were acquired in a 500 MHz spectrometer, and TOCSY experiments were used to confirm and assign metabolites. Data were analyzed descriptively. Results: Differences in salivary metabolites were found among MPS types and the control, such as lactate, propionate, alanine, and N-acetyl sugar. Understanding these metabolite changes may contribute to precision medicine and early detection of mucopolysaccharidosis and its monitoring. Conclusion: The composition of low molecular weight salivary metabolites of mucopolysaccharidosis subjects may present specific features compared to healthy controls.

Abstract in English:

ABSTRACT Objective: To assess the prevalence of burnout among dental students of public and private institutions in Khyber Pakhtunkhwa and Punjab, Pakistan. Material and Methods: A cross-sectional descriptive survey was conducted at five public and private dental institutions from June 2021 to May 2022. A validated twelve-item closed-ended Burnout Clinical Subtype Questionnaire was distributed among the dental students of two private and two public institutes in Pakistan. The research questions focused on demographic information and students' academic experiences. Data analysis is presented through tables and descriptive methods. Results: A total of 274 dental undergraduate students - second (42.3%), third (35.4%), and final (22.3%) academic year participated in this study. The mean age of the respondents was 21.9, with the range of 20-26 years. Most participants were females (74.1%) compared to the males (25.9%). The findings for burnout syndrome among dentistry students and students in the private and public sectors were not significant. Conclusion: In the current study, burnout levels among dental undergraduates, both private and public, were low.

Abstract in English:

ABSTRACT Objective: To measure the costs of preventive and therapeutic protocols of Photobiomodulation (PBM) for oral mucositis (OM) and their budgetary impact on Brazil’s Ministry of Health (BMH). Material and Methods: A partial economic analysis was performed to estimate the costs using a bottom-up approach from a social perspective. Monetary values were assigned in Brazilian reais (BRL). The costs of the preventive protocol were calculated for five, 30, and 33 consecutive PBM sessions, depending on the antineoplastic treatment instituted. The costs of the therapeutic protocol were calculated for 5 or 10 sessions. The annual financial and budgetary impact was calculated considering the groups of oncologic patients with a higher risk of development of OM, such as those with head and neck and hematological cancer and pediatric patients. Results: The cost of a PBM session was estimated at BRL 23.75. The financial impact of providing one preventive protocol per year for all oncologic patients would be BRL 14,282,680.00, 0.030% of the estimated budget for hospital and outpatient care of the BMH in 2022. The financial and budgetary impacts of providing one treatment for OM for all patients in one year would be BRL 2,225,630.31 (0.005%, most optimistic scenario) and BRL 4,451,355.63 (0.009%, most pessimistic scenario). Conclusion: The budgetary impact of implementing PBM protocols in the Brazilian Healthcare System is small, even in a pessimistic scenario.

Abstract in English:

ABSTRACT Objective: To assess changes in oral health-related behavior and oral health status in Brazilian children in early childhood perceived by their parents/caregivers during social isolation caused by COVID-19. Material and Methods: A cross-sectional study with parents/caregivers of children in southeastern Brazil aged 0-5 years who responded to an online questionnaire about sociodemographic data, dietary changes, oral hygiene, and oral health status of children during the COVID-19 pandemic. Results: Of the 119 parents/caregivers, 54.60% did not observe any changes in eating habits, and 81.50% maintained their children's oral hygiene. Associations were observed between the impact of the pandemic on the family income and changes in eating habits (p=0.02) and between lower family income and dental caries perceived by parents/caregivers (p=0.05). Z tests with Bonferroni correction showed that families with drastic income reduction were more likely to consume lower-cost foods (62.50%) than families with no impact or slight reduction on family income. Parents/caregivers did not identify dental caries (89.10%), toothache (92.40%), and dental trauma (92.40%) in their children. Conclusion: Parents/caregivers of children in southeastern Brazil aged 0-5 years observed behavioral changes in the dietary habits of families whose income was impacted by the pandemic, and their perception of dental caries was significantly associated with family income.

Abstract in English:

ABSTRACT Objective: To assess dentists' knowledge from Minas Gerais, Brazil, about dentoalveolar trauma (DT) and their experiences during the COVID-19 pandemic. Material and Methods: An online questionnaire with 34 questions was applied to collect personal data, professional training, self-assessment of experience/knowledge about DT, experience in care provided during the social distancing, and knowledge/conduct. The specific responses were evaluated based on the guidelines of the International Association of Dental Traumatology (IADT). Descriptive analysis and Pearson's chi-square test were performed. The level of significance was set at p≤0.05. Results: Most professionals (97.7%) had received information on DT, and only 4.6% of the participants considered their knowledge poor or very poor. However, 92.7% felt the need for more information on the subject. Regarding experiences during the pandemic, 55.7% provided trauma care during that period. Forty percent of the consultations were performed in person, and 33.3% of the professionals noted an increase in cases during the pandemic; 56.6% reported that the frequency did not change. The overall mean number of correct answers about DT was 5.29±2.11, indicating an acceptable level of knowledge. The mean percentage of hits for the specific questions was 44.1%. Conclusion: Although the level of knowledge of the dentists evaluated was acceptable, some aspects were deficient, with the need for more information about the IADT guidelines.

Abstract in English:

ABSTRACT Objective: To perform the epidemiological and clinicopathological analyses of odontogenic tumors in Kerman for 20 years. Material and Methods: The present study investigated collected records from pathology departments of the Faculty of Dentistry, Bahonar, and Shafa teaching-medical hospitals for 20 years. Data on odontogenic tumors was recorded based on age, sex, and tumor location in the information forms. The statistical t-test and the Kappa coefficient computer codes were utilized for data analysis. Results: 38 samples of odontogenic tumors were considered in the present study. The mean age of participants was 31.7± 10.3 years. The frequency of tumors was higher in women (63.2%) and in the lower jaw) 78.9%). Among various tumors, ameloblastoma (63.1%) and odontoma (18.4%) were the most common tumors, respectively. The correlation between clinical and histopathologic diagnoses was 71.8% using the kappa coefficient. Conclusion: Ameloblastoma is the most common odontogenic tumor. The incidence of lesions was higher in the mandible, and odontogenic tumors were higher in women. Since the diagnosis of odontogenic tumors is based on radiographic and histologic appearances, clinical physicians and pathologists should collaborate for the definitive diagnosis of the disease.

Abstract in English:

ABSTRACT Objective: To evaluate questions concerning oral medicineand pharmacology-related specialties of asynchronous dental teleconsulting sessions of the Telehealth Brazil Networks Program. Material and Methods: Data were collected from secondary databases of asynchronous dental teleconsulting sessions of the telehealth centers of Minas Gerais from July 2015 to July 2017. The variables for dental underlying fields and the types of questions were evaluated. Descriptive analysis was performed with the SPSS v.22.0 program. Results: 3,920 teleconsulting sessions were referred to the telehealth centers of Minas Gerais during the study period. Regarding oral medicine-related questions (n=745), most (n=469; 62.95%) addressed diagnosis, whereas the underlying field questions mostly regarded fungal, viral, and bacterial infections (17.3%), biopsies (16.4%), developmental defects and dental abnormalities (9.9%), and soft tissue tumors (9.4%). Pharmacology-related questions (n=738) mostly addressed general approaches (n=672; 91.06%), and the most common questions were about underlying fields' prescriptions (44.7%), anesthetics (17.6%), adverse effects of medications and anesthetics (10.2%), and selection of anesthetics for patients with systemic conditions (9.8%). Conclusion: Most teleconsulting sessions regarded conditions or procedures common in primary health care and essential for diagnosis and treatment planning at all care levels, which suggests a need for more academic learning processes for healthcare professionals, especially in dentistry primary fields.

Abstract in English:

ABSTRACT Objective: To assess the relationship between patients' and dentists’ perceptions of shade selection and its impact on satisfaction with the prosthesis. Material and Methods: A single group pre-post study was conducted at the Prosthodontics department of a teaching hospital in India. One hundred ten participants were selected through a systematic random sampling technique with inclusion and exclusion criteria. Patients' attitudes regarding the aesthetics of their maxillary anterior teeth were recorded using a validated questionnaire. Shades for the intended prosthetic crown selected by the dentist and chosen by the patient were recorded separately, and patient satisfaction with the appearance of the final prosthesis was recorded. We used descriptive statistics followed by Pearson’s Chi-square test and a binomial logistic regression model for inferential statistics. Results: 109 participant’s data were available for final analysis. Patients choose lighter shades than the dentist’s selection, which is statistically significant (p=0.000). 73.4% were satisfied with the final prosthesis, and the binomial logistic regression model identified using patient-selected shade for the final prosthesis was significantly associated with patients' satisfaction with the final prosthesis (OR=3.3, p=0.001). Conclusion: The patient's preference should be considered with the dentist's option when selecting a shade to create good esthetics.

Abstract in English:

ABSTRACT Objective: To investigate the effects of two different dentifrice fluoride concentrations on the color stability of the composite. Material and Methods: Twenty-seven specimens (2×4×5 mm) each of microfilled (Gradia, GC, Japan) and nanohybrid (Grandio, VOCO, Germany) composites were prepared. The specimens were randomly divided into six groups (control, Fluoflor caries protection toothpaste with 1450ppm Fluoride (EXW, France), and Fluoflor kids toothpaste with 500ppm Fluoride (EXW, France) (n = 9). The specimens were immersed in a mixture of artificial saliva and toothpaste in a ratio of 1:3 and applied for 60 seconds every 12 hours for 42 days. The control samples were incubated in artificial saliva at 37°C. Primary and secondary color measurements were performed using color parameters (L∗a∗b) with a spectrophotoshade (MHT Optic Research AG, Niederhasli, Switzerland). Data were analyzed using a two-way analysis of variance at a significance level of 0.05. Results: According to the two-way ANOVA analysis, there was no significant difference in color change between the composites and no difference in the level of discoloration between different fluoride concentrations(p>0.05). Also, None of the dentifrices caused clinically significant color changes(∆E˂3.3). Conclusion: No clinically unacceptable color changes were observed in the microfilled and nanofilled composites with different concentrations of fluoride toothpaste.

Abstract in English:

ABSTRACT Objective: To evaluate the prevalence of sharps accidents among dental students in southwest Goiás state, Brazil, and further survey their knowledge of biosafety and post-injury management. Material and Methods: A cross-sectional analytical observational study was carried out in 2018 following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study population included dental students in the 4th and 10th course semester. A pre-formulated self-administered questionnaire containing 14 objective questions was used for data collection. Mean and standard deviation values were calculated. Results: A total of 308 responses were obtained. Overall, 15.9% of the respondents reported having previously experienced accidents with sharps. Most dental students who claimed to know the biological risks to which they are exposed were in the 5th and 8th course semesters, and 67.2% of them reported knowing how to proceed in the event of a sharp accident. Conclusion: A low prevalence of sharps accidents has been reported, and dental students are considered to have a good knowledge of biosafety.

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ABSTRACT Objective: To assess global trends in the publication of studies investigating the association between ankyloglossia and breastfeeding. Material and Methods: An electronic search was performed in the Scopus database without restrictions. Observational studies and clinical trials were included. Bibliometric indices such as publication year, authors, co-authors, journals, field of knowledge, countries, and the most cited keywords were analyzed using the VOSviewer program. Results: The search retrieved 350 studies, and 68 were selected. The first article was published in 2000 in the United States. The United States presented the highest number of publications (n=21), followed by Brazil (n=9) and the United Kingdom (n=9). An increase in publications on this theme was observed in 2013; 2021 was the year with the highest number of publications (n=14). The most common word was “frenulum”. The authors with the highest number of publications were Botze and Dollbert from Israel (n=3), Ghaheri, and Mace from the United States (n=3). Among the journals, “Breastfeeding Medicine” presented the highest number of publications (n=7), followed by the “International Journal of Pediatric Otorhinolaryngology” (n=6), “CODAS” (n=5), “Journal of Human Lactation” (n=4) and “Pediatrics” (n=3); the latter published the top-cited studies, with 412 citations. Conclusion: There has been an increase in recent articles evaluating the correlation between ankyloglossia and breastfeeding, indicating the growing interest of researchers in this field.

Abstract in English:

ABSTRACT Objective: To assess the level of oral cancer awareness and risk factors perception and the relationship between this awareness and the sociodemographic and behavioral characteristics. Material and Methods: This descriptive study was conducted among rural and urban residents in Lagos State, Nigeria. A multi-stage random sampling method was utilized. The sociodemographic and behavioral characteristics of respondents, as well as their knowledge about oral cancer risk factors, were assessed with a validated questionnaire. The bivariate association was done using an independent t-test and one-way ANOVA. Multivariate regression was used to determine the association between predictor variables and oral cancer knowledge scores. The statistical significance level is set at p<0.05. Results: 590 participants between 18 and 82 years (mean age 34.5 ±13.7) completed the survey. The prevalence of cigarette smoking was 25.7%, of which 16 (1.5%) were heavy smokers (20+ cigarettes per day). The prevalence of alcohol consumption was 66.1%, with 57 (9.7%) being heavy drinkers, consuming drinks for 5-7 days of the week. A high proportion of the respondents (>60%) exhibited gaps in their knowledge of oral cancer. Uneducated participants had lower oral cancer knowledge than those with >12 years of formal education (aOR = 5.347; 95% CI: 4.987-6.240). Participants who were smokers had lower oral cancer knowledge compared with non-smokers (aOR = 3.341; 95% CI: 2.147-4.783); Participants who consumed alcohol had more deficient oral cancer knowledge compared with non-drinkers (aOR = 1.699; 95% CI: 1.087-2.655); While heavy smokers aOR = 4.023; 95% CI: 3.615-4.825) and heavy drinkers aOR = 4.331; 95% CI: 3.158-5.939) had lower oral cancer knowledge compared with those who did not abuse both substances. Conclusion: A high proportion of the respondents exhibited gaps in their knowledge of oral cancer in their responses. Delayed diagnosis of oral cancer can be reduced by increasing the awareness and knowledge of the populace about risk factors and also in the recognition of its signs and symptoms.

Abstract in English:

ABSTRACT Objective: To assess the impact of Molar Incisor Hypomineralization (MIH) and confounding factors on oral health-related quality of life (OHRQoL) according to the perception of 8 to 10-year-old children and their parents/caregivers. Material and Methods: A cross-sectional study including 403 students aged 8-10 years was carried out, in which OHRQoL was measured using the Child Perceptions Questionnaire administered to both children and parents/caregivers. The diagnosis of MIH was performed according to the previously proposed index. Dental caries experience, malocclusion, and sociodemographic factors were evaluated as confounders. Cluster analysis and Poisson regression with robust variance (p<0.05) were performed. Results: The prevalence of MIH was 13.4%. Parents/caregivers of children with MIH in incisors showed a higher impact prevalence in the emotional well-being domain (PR=1.92; 95%CI=1.16-3.19). Children with hypoplasia had a higher prevalence of negative impact on OHRQoL in the oral symptoms domain (PR=1.51; 95%CI=1.03-2.23). According to the perception of parents/caregivers, dental caries experience had a negative impact on the quality of life of students in the emotional well-being domain (PR=4.19; 95%CI=1.06-16.49) and in the total questionnaire score (PR=3.21; 95%CI=1.06-9.71). Conclusion: According to the perception of parents/caregivers, children with MIH in incisors showed a greater impact on OHRQoL. Additionally, the presence of hypoplasia affected the self-perception of OHRQoL in children, and caries experience influenced the OHRQoL of children, as perceived by parents/caregivers.

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Abstract Objective: To evaluate mandibular dimorphic parameters for sex determination by using panoramic radiographs and comparing the results with another equation. Material and Methods: In this analytical-descriptive study, the mandible variables, including the ramus height, the coronoid height, the mental height, and the distance between the right and left condyle, were measured in 326 panoramic radiographs. The discriminant function of the statistical method has previously been used to evaluate the diagnostic value of sex. The level of significance was considered 0.05. Results: The detection function obtained was statistically significant in quantitative correlation (p<0.001) with 99% agreement. Moreover, good sensitivity (81.72%), specify (80.25%), and moderate to good predictive values (PPV: 62.29 and NPV:91.6) were found. Among the mandibular parameters, chin height, ramus height, coronoid height, and distance between two condyles showed the highest gender dimorphism. Conclusion: Chin height, and ramus height have the most quality in gender dimorphism. A unique gender discrimination function has been obtained from the results.

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Abstract Objective: To compare the use of sealants in permanent molars between public and private dentists in Brazil. Material and Methods: This was a cross-sectional and analytical web survey study. The convenience sample consisted of dentists in Brazil who answered a pre-tested online form released via social media between July and October 2021. Descriptive analysis was performed using absolute and relative frequencies (%) and associations using the Chi-square test (p<0.05). Results: Brazilian professionals participated in the study (n=2,244). Comparing the professionals from the public service with those from the private service, the former had a higher positive perception of the use of sealants as a preventive (92.4% vs. 81.1%, p<0.00l) and therapeutic procedure (90.7% vs. 82.4%, p=0.00l), higher percentage of non-invasive (91.7% vs. 83.8%, p<0.00l) and invasive (22.8% vs. 12.0%, p< 0.001) techniques. Professionals from the private service reported more frequently that they did not use sealants than those from the public service (14.0% vs. 4.8%, p<0.00l). Resin sealant (97.7% vs. 94.9%, p=0.0l5) and Flow resin (62.0% vs. 54.3%, p=0.013) were the most used by professionals in the private service. The use of glass ionomer cement was not associated with the type of service (75.1% vs. 77.2%, p=0.172), nor was the use of adhesives (0.6% vs. 1.4%, p=0.195) or resin with Giomer technology (1.9% vs. 2.2%, p=0.856) (p>0.05). Conclusion: The percentage of use of sealants among dentists in Brazil is high, especially among professionals in the public service, and the most used materials were resinous sealants and glass ionomer cement.

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Abstract Objective: To identify the prevalence, severity, hypersensitivity, and distribution of Non-carious cervical lesions (NCCL) among university students in Brazil. Material and Methods: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Results: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Conclusion: The prevalence of NCCL was 15.1% and abfraction was the most frequent lesion. Premolars were the teeth most affected by non-carious cervical lesions.

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Abstract Objective: Dentistry from the Universidade Federal de Alfenas who were enrolled in the seventh period and who took the Integrated Clinic I Discipline (ICID) in the emergency remote learning model (ERLM). Material and Methods: This is a qualitative and descriptive study. The information was collected through questionnaires applied by the Professors during the ICID. Subsequently, the professor evaluated the treatment developed in virtual form by each student regarding its logical sequence and the most appropriate treatment for each case. The results of the answers were transcribed and submitted to lexicographical textual, Descending Hierarchical Classification, and Similitude analysis in the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) program. Results: The students described the online situational treatment planning in five essential steps: adequacy of the oral environment, restorative need, prosthetic need, rehabilitation by prosthesis on the implant, and corrective orthodontic treatment. Conclusion: It was observed that the students who enrolled in ICID presented well-integrated planning during ERLM, despite the COVID-19 pandemic hindering these students' contact between theoretical teaching and the integrated practices in dentistry offered by the educational institution.

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Abstract Objective: To summarize data of clinical trials that used silver diamine fluoride (SDF) to prevent and treat caries lesions and dentinal hypersensitivity. Material and Methods: Six electronic databases were searched in May 2022. The concentration of SDF, type of usage (alone/combined), dentition, anterior/posterior teeth, tooth region, dental tissue, number of the treated surfaces, the intervention environment, participants' age, frequency and duration of SDF application, purpose, and outcome were the extracted variables. The type of study, year of publication, authors, journals, and country were also investigated. Results: From 8860 articles, S3 were selected. Most were randomized (n=38), that applied 38% SDF (n=43), alone (n=44), on multiple surfaces (n=44), only in dentin (n=36), of the crown (n=46) of anterior and posterior (n=36) primary teeth (n=39). The studies were preferably carried out outside the clinic (n=3l), only in children (n=33), with reapplication of SDF (n=30), but did not inform the duration of application (n= 19). SDF was most used to treat (n=46) only caries lesions (n=50). They were published between 2001 and 2022, mainly in the Journal of Dentistry (n=10). China (n=19) and Lo E.GM (n=19) were the countries and authors that published the most, respectively. Conclusion: The silver diamine fluoride 38% alone was most used to treat caries lesions in the dentin of the crown of all primary teeth, preferably applied on multiple surfaces, requiring re application, and outside the clinic.

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Abstract Objective: To assess factors associated with knowledge, attitudes, and practices (RAP) related to teledentistry among dentists in Jakarta during the COVID-19 pandemic. Material and Methods: This cross-sectional study used a self-administered online questionnaire with a purposive sampling technique. Survey items comprised knowledge of, attitude toward, the practice of, and barriers to teledentistry. The Chi-square, Mann-Whitney, and Spearman correlation tests were used to determine factors associated with RAP of teledentistry. Results: A total of 183 dentists in Jakarta completed the questionnaire. The findings showed that 95.6% of the surveyed dentists had good knowledge, 83.1% expressed positive attitudes, and 60.7% practiced teledentistry during the COVID-19 pandemic. Most participants (86.3%) expressed a willingness to practice teledentistry in the future. The three most significant barriers that obstruct dentists from practicing teledentistry are patient compliance and satisfaction regarding the dentist's physical presence, a low population education level, and a lack of technological infrastructure. A statistically significant relationship was found between teledentistry practice and age, marital status, working experience, and training regarding teledentistry. A positive correlation was found between knowledge of and attitude toward teledentistry. Conclusion: Dentists in Jakarta have a high understanding of, positive attitudes toward, and good practices for teledentistry. Factors related to teledentistry practice were age, marital status, work experience, and training experience in the last two years.

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ABSTRACT Objective: To assess the methodological quality and characteristics of systematic reviews (SRs) of interventional studies in orthodontics and assess how the certainty of the evidence is reported using the GRADE approach. Material and Methods: Six electronic databases were searched, followed by a hand search of the reference lists of eligible studies (PROSPERO #CRD42020180852). The required study design was randomized and nonrandomized studies of interventions published between January 2019 and May 2020. The Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool was used for the quality appraisal of the included SRs. Paired reviewers independently screened the studies, extracted data, and appraised the methodological quality. Results: The study included 46 SRs; 19.5% had moderate to high methodological quality, and the remaining had low to critically low methodological quality. Fifty-four percent of the reviews assessed the certainty of evidence using the GRADE approach, and 34.8% followed all GRADE criteria. Conclusion: Most reviews had a good judgment of the AMSTAR2 items, although some critical items contributed to decreased overall quality. Half of the reviews used the GRADE approach to assess the certainty of the evidence, and this approach should be included in future systematic reviews of interventions.

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Abstract Objective: To evaluate the knowledge of Physical Education students about tooth avulsion (TA) in both dentitions before and after receiving an informative leaflet (IL). Material and Methods: The questionnaire contained information about TA in dentition and its management and was applied to the Physical Education students before and after reading an IL. Results: A total of 118 students, 96.61%, attended a first aid course, and 17.80% received information about TA. Most students (88.98%) never had an experience with TA, and 90.68% considered its management important. The other questions, before and after reading the IL, respectively, were: would not perform deciduous tooth replantation (42%; 88%); knew how to handle the avulsed permanent tooth (APT) (38%; 92%); knew how to clean the APT (50%; 99%); knew that permanent tooth replantation (PTR) must be immediate (15%; 95%); knew the ideal time to seek for the dentist right after TA without performing PTR (6%; 83%); knew how to store APT (31%; 97%). Conclusion: The knowledge of Physical Education students in this research revealed a limited understanding of dental tooth avulsion. After receiving an informative leaflet, the students showed a significant improvement in knowledge about traumatic avulsion management, including tooth replantation and proper actions.

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ABSTRACT Objective: To assess the relationship between the mother's educational level and family income on the dental caries experience of their children. Material and Methods: A cross-sectional study was conducted at the Department of Pediatric Dentistry, University of Babylon, Iraq. The sample comprised 100 children aged 5-15 years. Data was collected in two parts: first, a self-administered questionnaire was obtained from mothers: Mother's age, level of education, family income, child age, and gender. Another part included the clinical examination of dental caries that was measured for mothers and their children using the DMFT/dmft index for permanent and primary dentition sequentially. The collected data were statistically analyzed using mean ± standard deviation (SD mean and standard deviation, t-test, and F-test. Results: The sample showed 60% were boys and 40% were girls, 86% with dental caries. Mothers with a high level of education and high monthly income have significantly lower dental caries experiences than their children (p<0.05). In contrast, there was a significant difference between the two age groups (p=0.000), a considerable difference between the level of family monthly income and dmft (p=0.01), and there was a correlation value between the caries index DMFT value of the children and their mother with mother's education level. Conclusion: Many dental caries were reported among Babylon City/Iraq children. Mothers with high educational levels and family monthly income were correlated to lower dental care for their children than those with low educational levels and economic status, so they need to focus on oral health knowledge and encourage prophylactic intervention and preventive measures for the population.

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ABSTRACT Objective: To analyze the molecular composition of a sample of Baltic amber taken from an amber bracelet, verify the presence or absence of compounds beneficial to human health, and discuss the therapeutic potential of this fossil resin. Material and Methods: For this, a qualitative analysis was performed by gas chromatography coupled with mass spectrometry (GC-MS system), which can perform an automated separation into individual components of amber. Results: The samples comprised terpenes and terpenoids: monoterpenoids, sesquiterpenoids, diterpenoids, hydronaphthalene, succinic acid, and isopimaric acid. These have therapeutic potential for several diseases, inhibit several stages of the inflammatory process, and improve the symptoms caused by it. Conclusion: The amber of this sample tested is formed by terpenes and terpenoids, substances with anti-inflammatory and analgesic. However, an in-depth study is needed on the release and absorption of substances in human skin or their actual effectiveness.

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ABSTRACT Objective: To investigate associations/correlations between bone alterations and vitamin D status in children through data mining analyses based on observational studies. Material and Methods: Searches in PubMed, Scopus, Web of Science, and Embase databases were performed to recover studies, published until October 2022, with healthy children, which investigated the vitamin D status, related or not to undesirable bone alterations linked to bone quality (bone mineral density and bone mineral content), fracture or anthropometry. Country, study design, area of expertise (medicine, nutrition, dentistry, others), bone outcome, 25-hydroxyvitamin D data (serum or intake levels), the exams for bone diagnosis, and the results were analyzed in the VantagePointTM software. Results: Of 20,583 studies, 27 were included. The USA (n=9; 33.3%) had the highest number of publications. Cross-sectional (n=11; 40.7%), case-control (n=9; 33.3%), and cohort studies (n=7; 25.9%) contemplated the medicine and nutritional areas without any study in dentistry. Studies about bone quality (n=21; 77.8%), analyzed through dual-energy X-ray absorptiometry (DXA; n=14; 51.8%), with association (n=16; 59.2%) between the low serum levels of 25-hydroxyvitamin D and undesirable bone alterations (n=14; 51.8%) were the most prevalent. Conclusion: Most studies were conducted in the medical area and showed an association between low bone quality and low levels of 25-hydroxyvitamin D, verified through DXA.

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ABSTRACT Objective: To investigate factors associated with the experience of dental caries in children in early childhood in two socially distinct centers in the city of São Luís, Maranhão, Brazil. Material and Methods: A cross-sectional study was conducted in two socially distinct daycare centers (private and public). The children were assessed regarding their caries experience, and their parents/guardians were prepared regarding socioeconomic information, parents/guardians' habits, and children's habits. Descriptive and inferential statistics were used. Association tests and multivariate analyses were performed to analyze independent variables and outcomes (type of daycare center and caries experience) using a p-value of 5%. Results: The sample consisted of 89 children aged up to 5 years of both sexes. The type of daycare center was associated with some socioeconomic data, such as family income (p<0.01) and parents' education (p=0.05). Data on oral hygiene and children's habits, such as breastfeeding, also remained associated with the type of daycare center. There was an association between income and DMFT (PR=8.48 - 95%CI 2.26;31.78). Conclusion: The socioeconomic profile of parents/guardians and breastfeeding were associated with the prevalence of caries in deciduous teeth in children aged 10 to 48 months.

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ABSTRACT Objective: To identify online recommendations from pediatric and pediatric dentistry associations of the Americas regarding the pacifier habit. Material and Methods: A search was conducted on the associations' website (November/2021 to March/2023) to the questions: (1) Recommend using a pacifier?, (2) What care?, (3) Advantages and (4) disadvantages, (5) Ideal age, and (6) methods for habit removal. Results: Among the 36 American countries, 21 were represented on websites, social media, and official guides. The most significant portion of pediatric dentistry associations (23.81%) does not recommend the use of a pacifier if the infant is exclusively breastfeeding, and recommends avoiding the offer of a pacifier in the first days of life to facilitate the establishment of breastfeeding. Some pediatric (29.63%) associations suggested that use reduces the risk of sudden infant death syndrome. Most pediatric dentistry associations (85.71%) and some pediatric associations (22.22%) linked pacifier use to breastfeeding difficulties and the occurrence of orthodontics. Most of the 20 pediatric dentistry associations stated that the habit should be removed by a maximum of three years of age (90.48%). The most reported recommendations were behavior modification techniques and positive reinforcement. Conclusion: Most pediatric dentistry associations recommend the care and disadvantages of pacifiers and the ideal age to remove them. The few pediatric associations that provide information address indications, care, advantages and disadvantages of pacifiers, age, and methods for removing them.

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ABSTRACT Objective: To evaluate the prevalence of dental caries in children from 18 months to 5 years of age in eastern (near urban centers) and western (far from urban centers) Parakanã, verify the influence of proximity to non-indigenous cultures, and compare with other ethnicities and non-indigenous. Material and Methods: The universe of children was examined by one researcher in a cross-sectional study. Descriptive analysis and the Mann-Whitney test (p<0.05) were performed. Results: It was observed that 68.8% (N = 53) of children from 18 to 36 months of age presented dmft = 0 (without caries), while 12.5% (N = 6) of children of five years of age presented this condition. For children between 18 and 36 months, the average dmft values were 0.74 (SD=1.91) for eastern children and 1.25 (SD=1.65) for western children. At five years of age, the average dmft values were 4.35 (SD=3.29) and 3.75 (SD=2.05) for eastern and western, respectively. Mann-Whitney test (p<0.05) showed no difference between East and Western children. When compared with non-indigenous Brazilian children, the values behaved similarly. Conclusion: Knowledge of the epidemiological profile of dental caries in Indigenous Parakanã children is relevant both in planning oral health actions for this population and for aggregating information, which is still scarce for Indigenous.

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ABSTRACT Objective: To estimate the serum levels of non-radiologic biomarkers, Insulin-like Growth Factor-1 (IGF-1), and Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) to potentially identify the pubertal growth spurt in skeletal Class II malocclusion subjects. Material and Methods: Eighty subjects (M-38, F-42) with skeletal Class II malocclusion in the age range of 11-18 years were recruited for the cross-sectional study. Human serum IGF-1 and IGFBP-3 were quantitatively assessed by enzyme-linked immunosorbent assay, and the cervical stage (CS) was evaluated from a lateral cephalogram. Results: Gender-wise comparison of the mean serum IGF-1 levels revealed that the initial peak was detected at CS2 in both genders, [males (87.87 ng/mL), females (78.49 ng/mL)]. However, there was a cognizable difference in the second peak of the mean serum IGF-1 levels between males (CS5, 68.58 ng/mL) and females (CS4, 74.63 ng/mL). Mean IGFBP-3 serum levels in male subjects were high in CS4 (47.24 ng/mL) with a further spike in CS6 (50.54 ng/mL), and in female subjects, it was found to be highest in CS3 (51.95 ng/mL) and then in CS5 (49.68 ng/mL). Conclusion: Mean IGF-1 levels exhibited both sexes' prepubertal and late pubertal spikes. Mean IGFBP-3 levels revealed a pubertal and a late pubertal spike in both sexes, with an earlier growth trend observed specific to females compared to males.

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ABSTRACT Objective: To evaluate the knowledge of pedodontists and residents in the face of pediatric medical emergencies. Material and Methods: This descriptive-analytical study was conducted on pedodontists and residents participating in the Congress. The knowledge evaluation tool was a researcher-made questionnaire with acceptable validity and reliability. The questionnaire consisted of seven sections on information and education, prevention, office staff readiness, practical abilities, cardiopulmonary resuscitation skills and intravenous access, medicines, and emergency treatment equipment. After completing the questionnaires, the data were analyzed using SPSS 21. Chi-squared test, t-test, ANOVA, correlation test, and linear regression were used for data analysis (P<0.05). Results: The study examined 150 specialists, 88 residents, and 62 pedodontists. The level of knowledge of specialists and pedodontic residents in the face of pediatric medical emergencies was 35.3% (moderate) and 31.7 (weak), respectively. The specialists' scores on the entire questionnaire and areas of information, medicine, and equipment were significantly higher than those of residents. Moreover, participation in lectures and reading papers significantly increased general awareness. Conclusion: The results indicated that specialists' awareness and pedodontic residents about pediatric medical emergencies during dentistry were at a different level, necessitating more practical and theoretical training.

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ABSTRACT Objective: To determine the unstimulated salivary flow, pH, and buffering capacity and their associations with systemic conditions and medication use in independently living aged. Material and Methods: This cross-sectional study included 72 participants with a minimum of 60 years recruited in Belo Horizonte, Brazil. A questionnaire was used to collect age, sex, presence of systemic diseases, and medications in continuous use. Salivary data collection was performed to determine unstimulated salivary flow, pH, and buffering capacity. Descriptive, bivariate, and multivariate analyses were performed (p<0.05). Results: Most of the sample had at least one systemic disease (81.9%) and used at least one medication (79.2%). Female participants (p=0.01), those with five or more systemic diseases (p<0.01), and hypertension (p=0.04) had reduced salivary flow. Participants with systemic diseases (p=0.02), taking any medication (p=0.04), in a polypharmacy regimen, and presenting hypertension (p=0.02) had more acidic salivary pH. Participants with diabetes had average salivary buffering capacity (p=0.02). In the adjusted multiple regression models, no explanatory variable was significantly associated with the salivary outcomes. Conclusion: Systemic alterations and medication use appear to be related to salivary changes in older adults. Integrative assessment of older adults is fundamental to identifying and controlling the factors that may modify their salivary characteristics.

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ABSTRACT Objective: To evaluate a 0.5% sodium hypochlorite (SH) protocol in reducing Candida spp. levels in complete dentures (CD) and palate and denture stomatitis (DS) remission. Material and Methods: Twelve CD wearers diagnosed with Candida-associated denture stomatitis (CADS) had their initial situation (Candida spp. levels and DS score) recorded (baseline). Then, participants were instructed to soak dentures once a day (10 minutes) in 0.5% SH. Candida spp. levels and DS scores were reassessed after 15, 30, and 60 days of SH denture cleanness. Biofilms from the denture base and palate were seeded in CHROMagar Candida. After incubation, colony-forming units were calculated. The palate was photographed at each time point, and DS was assessed according to Newton's classification. Data of Candida spp. levels were analyzed by 2-way repeated measures ANOVA followed by the Holm-Sidak test, and DS scores data were accessed by Friedman's 2-way ANOVA by ranks (α=0.05). Results: 0.5% SH significantly reduced Candida spp. levels after treatment compared to baseline (p<0.001) for both sites. Although at baseline, Candida spp. counts were higher on the denture base (p<0.001), no significant differences were observed between the collected areas within the other time points (p<0.05). Also, 0.5% SH effectively reduced clinical signs of DS after treatment (p<0.05). Conclusion: The protocol tested effectively decreased Candida spp. levels on the denture base and palatal mucosa and effectively reduced the signs of DS.

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ABSTRACT Objective: To characterize drug hypersensitivity associated with dental treatments. Material and Methods: Data from 5,302 dental patients extracted from the Faculty of Dental Medicine were used to investigate drug use history, drug hypersensitivity, and associations with oral health outcomes. The chi-square test was used, and values of p ≤ 0.05 were considered statistically significant. Results: The frequency of patients’ self-reported drug hypersensitivity was 26.42% (n = 1,401). The highest frequencies were for opioid/narcotic analgesics (20.84%, n = 292), antibiotics (18.13%, n = 961), and non-steroidal anti-inflammatory drugs (10.46%, n = 141). Most of the patients (68.65%, n = 3,640) reported using medications, mostly for cardiovascular disease (43.1%, n = 1,569), for psychiatric/neurological disorders (39.75%, n = 1,447), drugs that affect the endocrine system (32.55%, n= 1,185), and drugs for pain (24.92%, n = 907). Higher drug hypersensitivity frequencies were associated with older White female subjects (p<0.0001). Associations were also identified between drug hypersensitivity and history of the following dental procedures: tooth extractions (p=0.003), root canal treatment (p=0.0004), prosthodontic treatments (p<0.0001), and orthodontic treatments (p=0.007). Conclusion: A high frequency of self-reported drug hypersensitivity in dental patients was found, with a higher occurrence in older White women and those with a history of more extensive and invasive dental care.

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ABSTRACT Objective: To assess the orientation of dental practitioners in understanding the probable relationship between COVID-19 and periodontal infection and the measures they took toward periodontal health during the pandemic. Material and Methods: A cross-sectional questionnaire-based survey was conducted, including registered dentists in Moradabad. The questionnaire provided was a self-administered, closed-ended questionnaire with 26 questions, shared via an online survey link utilizing Google Forms. The data collected was tabulated and statistically evaluated. Results: The participants implemented many preventive measures in their daily lives against COVID-19, such as hand washing, frequent hand sanitization, face shields, mouth masks, social distancing not, being in overcrowded places, using HEPA filters and different combinations of protective measures against COVID-19. 82.23% of participants learned from the official websites of organizations like the Ministries of Health, WHO, and professional organizations about COVID-19. Conclusion: Most participants endorsed oral hygiene measures and the use of mouthwashes by their patients, yet a significant number of dental surgeons needed to be made aware of a probable correlation between COVID-19 infection and chronic periodontitis.

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ABSTRACT Objective: To assess the effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (ACP) containing bonding agents on dentin shear bond strength and remineralization potential. Material and Methods: This in vitro study evaluated 45 extracted human premolars. The teeth were decoronated, and the tooth crown was split into buccal and lingual halves. The specimens were then flat-grounded by a 180-grit abrasive. The specimens were then randomized into three groups (n=15). Adper Scotchbond Multi-Purpose (SBMP) primer and adhesive were used for bonding in the control group. ACP in 10wt% and 20wt% concentrations was added to SBMP adhesive and used in groups 2 and 3, respectively. After the application of primer and adhesive and light-curing them for 10 s, a transparent silicon cylinder was placed on a dentin surface and cured for 10 s; then, the cylinder was filled with composite resin and was cured for the 40s from each side. The specimens underwent 3000 thermal cycles, and a universal testing machine measured the SBS. To assess the remineralization quality, a total of 6 dentin samples (2 specimens for group) were prepared and underwent X-ray diffraction, attenuated total reflection Fourier-transform infrared spectroscopy, and scanning electron microscopy-energy dispersive X-ray analysis. One-way analysis of variance was used to analyze the data. The level of p<0.05 was considered significant. Results: No significant difference in dentin shear bond strength was noted between the groups (p>0.05) - the addition of ACP to SBMP adhesive enhanced dentin remineralization. Increasing the ACP concentration from 10% to 20% increased the formation of hydroxyapatite. Conclusion: Adding amorphous calcium phosphate confers remineralizing property to SBMP adhesive without compromising its shear bond strength to dentin.

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ABSTRACT Objective: To evaluate the possible renal and hepatic alteration by root canal filling pastes in mice. Material and Methods: Fifty-four mice were divided into nine groups and received one polyethylene tube implant containing two filling pastes (CTZ or calcium hydroxide pastes). Empty polyethylene tubes were used as a negative control. All tubes were implanted subcutaneously in the back of the mice. After time intervals of 7, 21, and 63 days, 1.5 mL of blood was collected by cardiac puncture, and serum samples were used for serological testing. Urea, creatinine, aspartate transferase (AST), alanine transferase (ALT), alkaline phosphatase (ALP), and gamma-glutamyltransferase (GGT) were evaluated. Data were analyzed by 2-way ANOVA (p<0.05). Results: When comparing CTZ and calcium hydroxide pastes and empty tubes and experimental time intervals, no significant differences in the results were found for any of the biochemical parameters analyzed (p>0.05). No differences were observed in the interactions (material*experimental time intervals) and the biochemical parameters analyzed (p>0.05). Conclusion: CTZ and calcium hydroxide pastes did not cause hepatic and renal alterations in mice, demonstrating the pastes' safety.

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ABSTRACT Objective: To evaluate the clinical and radiographic response of pulp-dentin complex after selective caries removal with or without pulp lining in primary teeth. Material and Methods: Twenty-four primary molars with deep occlusal caries lesions and without pulpal alterations were selected from children, both genders, aged between 5 and 9 years old. After selective caries removal, the teeth were divided into three groups: without cavity liner (Group I), calcium hydroxide cement - CH (Group II), and Mineral trioxide aggregate - MTA (Group III). The final restoration was performed with resin-modified glass ionomer cement. Clinical and radiographic assessments were conducted at 6-month follow-up. The Kappa test determined intraexaminer reliability. Fisher's exact test evaluated intergroup comparisons (p<0.05). Results: All teeth showed clinical and radiographic success at the 6-month follow-up without statistically significant differences (p>0.05). Conclusion: Selective caries removal without cavity lining was acceptable for deep caries lesions in primary teeth.

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ABSTRACT Objective: To assess the influence of perceived stress during the COVID-19 pandemic over awake bruxism (AB) and sleep bruxism (SB). Material and Methods: Observational web-based research carried out in a state in the Brazilian Northeast. The sample was composed of dental students from seven faculties, divided into three groups: beginning (1-4 semesters), middle (5-7), and end (8-10). An online questionnaire was constructed: Socio-demographic, Perceived Stress Scale (PSS-10), Self-reported AB and SB, and COVID-19 Fear Scale. Data were collected from April to June 2021 by sending the questionnaire through WhatsApp®, e-mail, and Instagram®. After bivariate analyses, a multiple logistic regression model was performed to discriminate variables for perceived stress and AB and SB. Hosmer and Lemeshow and chi-square tests were used to check the model's goodness of fit. Results: A total of 391 dental students participated in this research - most women (69.8%), unmarried (69.8%), family income less than three minimum wages (60.9%), self-reported physical activity (63.3%). Perceived stress was low to moderate (72.1%), SB was 39.6%, AB was 49.6%, and low COVID-19 fear was 81.1%. COVID-19 fear (3.03), being female (2.47), and using psychotropic (2.53) increases the chance of being stressed. Perceived stress can predict AB in models 1 (p=0.008) and 4 (p=0.039). There was no significance for perceived stress and SB. Conclusion: Perceived stress during the COVID-19 pandemic influenced awake bruxism.

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ABSTRACT Objective: To analyze oral health services for pregnant women in the primary health care of a Brazilian metropolis, based on the performance of dentists who integrate these services. Material and Methods: Exploratory, descriptive and cross-sectional study was conducted through qualitative and quantitative approaches. A semi-structured questionnaire was used for data collection. This study was conducted in a Brazilian metropolis and included all dentists working in primary health care. The compliance analysis was performed considering access, adherence, group activity and individual dental care dimensions. Open questions were analyzed using the content analysis method and the closed questions were performed using frequency estimates. Bivariate statistics (Chi-square, Fisher's Exact Test, α<0.05) were analyzed through STATA. Results: 260 dentists agreed to participate in this study. Strategies to facilitate the scheduling of pregnant women to dental treatment occur in 93.9% of oral health teams, the main one being the scheduling and/or referral performed by the family health team. In terms of access and adherence to treatment, all variables in these dimensions showed relevant compliance results. The group activity dimension presented moderate compliance percentages, whereas individual care obtained high results, except for referral to radiography. Conclusion: The oral health service was compliant regarding access and adherence to treatment, but showed limitations in individual care and collective activities. Recommendations include improving oral health team coverage and permanent education programs.

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ABSTRACT Objective: To determine the prevalence and risk factors associated with dental caries in Brazilian preschool children aged 2 to 5 years. Material and Methods: The following independent variables were evaluated: dental caries, dental trauma, and malocclusions. Data were analyzed using the Mann-Whitney test and Poisson regression (p<0.05). Results: The prevalence of dental caries in preschoolers was 55.1%. Child age, family income, maternal education, and tooth color alteration from trauma were significantly associated with dental caries (p<0.05). The final adjusted multivariate model showed a significant association between maternal education and dental caries; children of mothers with low education were 1.89 times more likely to have caries (PR: 1.89; 95%CI: 1.40-2.55) (p<0.01). Children with tooth color change from trauma were more likely to have dental caries (PR: 1.69; 95%CI: 1.22-2.34 (p=0.001). Conclusion: Child age, family income, maternal education, tooth discoloration and discoloration color are risk factors for the development of caries disease in children. Also, children of mothers with low educational levels have a higher chance of developing dental caries.

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ABSTRACT Objective: To assess and analyse the pattern of dental treatment services and their characteristics provided to children by evaluating the clinical use of materials and prevalence in material research in a major postgraduate paediatric tertiary care hospital in India over three years. Material and Methods: Institutionally approved retrospective analysis was conducted by auditing the clinical records of 2644 patients who visited and had treatment in the Outpatient and Inpatient Department of Paedodontics and Preventive Dentistry from January 2017 to December 2019. Clinical logbooks of postgraduate students were analysed by crosschecking with the department's data warehouse. Results: Out of the 2644 children who had treatment, more than two-thirds of them were in the age group of 4-7 years old. Around 5.6% of the patients were specially-abled children. Extraction (33.5%) was the most common treatment, followed by restorative treatment (29.1%). Endodontic treatment had a prevalence of 19.8%, with a reduced prevalence of preventive treatment care (0.5%). Patients who had traumatic tooth management included 2.8% of the study population. The prevalence of preventive care was found to be 2.1%. The teaching curriculum with theoretical and clinical skill practices was under the country's assigned authority. Conclusion: Despite advancements in paediatric dentistry, more children had extraction treatment with less observed utilization of preventive care. The widening of the training prospectus includes comprehensive care and an amplified focus on preventive care in the academic curriculum of paediatric postgraduates, which is the need of the hour.

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ABSTRACT Objective: To assess sleep quality and stress level and to analyze their effect on the academic performance of undergraduate dental students. Material and Methods: A cross-sectional descriptive survey was conducted among 234 undergraduate dental students at Bhubaneswar. Pittsburgh Sleep Quality Index (PSQI), consisting of 18 items rated on a 4-point Likert scale, assessed sleep quality. Kessler Psychological Distress Scale (K10) evaluated the stress level. Google Forms collected demographic details and marks obtained in their previous examination. Chi-square, Mann-Whitney U, Kruskal-Wallis tests, and Spearman correlation coefficient were used for analysis (p≤0.05). Results: Mean PSQI and K10 scores were 4.87±4.5 and 17.60±8.5, respectively. 38% of students had poor sleep quality, and mean actual sleep hours were 8.01±1.7. One-fourth (24.8%) of subjects had moderate to severe stress. Sleep quality significantly differed among the various academic years (p=0.001). A post-hoc test showed a difference between 1st and 2nd-year students and 1st and 4th-year students. A statistically significant difference between genders regarding the components of the K10 scale was observed. A non-significant positive correlation between total marks and K10 score and a negative correlation between marks and global PSQI score was found. Conclusion: Sleep quality and stress harm the academic performance of dental students.

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ABSTRACT Objective: To assess children's self-reported distress during dental procedures and investigate risk factors. Material and Methods: A total of 163 children (3–10 years old) were included from a clinical trial on diagnostic strategies for evaluating restorations in primary teeth. Treatment plans were elaborated based on the clinical examination performed at the baseline of the study. Dentists performed 742 dental procedures, and an external evaluator collected children's self-reported distress through the Wong Backer Facial Scale (WBFS) and dentists' opinions about children's behavior during the treatment. Kruskal-Wallis Test was performed to compare the distress and the dentists' perception of the different dental procedures, and multilevel ordered logistic regression analysis was conducted to the evaluate association between explanatory variables and the outcomes. Results: More complex procedures caused more distress in children (p=0.017), with a 5.5 times higher risk than simple operative treatments. Similarly, dentists reported children's worse behavior (p<0.001). Older children (older than 7 years) reported less distress than younger children (OR 0.52; CI 0.30-0.87; p=0.014). Patients reported greater distress in the first consultations, reducing the chance of higher scores by 16% in the next interventions. Conclusion: Children experience higher levels of distress during their first treatment appointments. More complex operative procedures and the child's age below 7 years were risk factors associated with greater distress during dental treatment.

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ABSTRACT Objective: To determine the prevalence of the need for orthodontic treatment, anxiety, and probable sleep bruxism and its association in adolescents. Material and Methods: A cross-sectional study was conducted with 294 adolescents aged between 11 and 16 years. Orthodontic treatment need was determined using the Dental Health Component of the Index of Orthodontic Treatment Needs (IOTN-DHC). Anxiety symptoms were assessed using the Brazilian version of the Multidimensional Anxiety Scale for Children (MASC). The probable sleep bruxism was identified based on the American Academy of Sleep Medicine (AASM) questionnaire. Descriptive data analyses were performed. Simple logistic regression models were applied between each independent variable and the outcome (anxiety score). Variables with p<0.20 in the individual (raw) analyses were studied in a multiple logistic regression model, with p≤0.05 remaining in the final model. Based on the regression models, the prevalence ratios were estimated with the respective 95% confidence intervals. Results: 68.7% of the adolescents had probable sleep bruxism, and 35.4% had a moderate or severe normative need for orthodontic treatment. Adolescents aged up to 12 years (OR=1.82; CI: 1.10-3.02), females (OR=2.67; CI: 1.64-4.34), and with a moderate or severe need for orthodontic treatment according to the IOTN-DHC (OR=1.76; CI: 1.06-2.90), are more likely to have a higher anxiety score. The prevalence of adolescents with a moderate or severe need for normative orthodontic treatment by the IOTN-DHC is 35.4% (95%CI: 29.9-40.8%), while the perceived need for treatment by the IOTN-AC is 14.0% (95%CI: 10.0-17.9%). Adolescents with a high degree of anxiety were more likely to have probable sleep bruxism (OR=3.64; CI: 1.06-12.50). Conclusion: Female adolescents up to 12 years of age and with a moderate or severe need for orthodontic treatment are more likely to have higher levels of anxiety; adolescents with a high degree of anxiety are more likely to have probable sleep bruxism.

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ABSTRACT Objective: To perform a bibliometric analysis on deciduous and permanent eruption publications to discuss the global trends and prospects on the topic. Material and Methods: A systematic search was conducted on the Scopus database. The characteristics of the publications, including co-cited authors, organizations, countries, most cited sources, publications, and keyword co-occurrence, were analyzed using VOSviewer software version 1.6.18. Results: After applying exclusion criteria, 492 studies were included in the analysis. The majority of research centers were located in Europe. "Archives of Oral Biology" emerged as the most frequently cited journal. The United States and Brazil were the most frequently cited countries in the publications. Notable co-authors included Kuchler E. C. and Hägg U. The most frequently cited keywords were associated with oral pathologies, tooth development, odontogenesis, and genetics. The most recent papers were published in journals focused on oral diseases. Conclusion: This bibliometric analysis highlights that the future of research in this field is likely to be focused on the investigation of tooth eruption in both deciduous and permanent teeth, with an emphasis on genetics, tooth development, timing of tooth eruption, and syndromic conditions. While well-accepted in the fields of Pediatrics and Orthodontics, there is a growing interest in this topic within oral biology and pathology journals in the Americas, with the United States and Brazil leading in terms of publications and citations.

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ABSTRACT Objective: To evaluate the pulpal temperature changes due to the polymerisation of resin and glass ionomer-based materials in dentine thicknesses in immature permanent teeth with open apices. Material and Methods: Forty extracted sound human third molar teeth with open apices were included. The width of the cavities prepared on the occlusal surface was 4×5 mm. The depth was 2 mm in the resin groups. 4 mm in the groups in which glass ionomer liner was applied before composite restoration. The coronal parts of the samples were then placed on an acrylic plate with three gaps for feeding-extraction needles and the thermocouple. The temperature changes were recorded. The data was analyzed by SPSS. Statistical significance was accepted as p<0.05. Results: The temperature increase in the group of 1 mm remaining dentin thickness revealed higher results than the values detected from the 2 mm group (1.01 °C) (p=0.00). The mean values (1.49 °C, 1mm) of temperature changes in only glass ionomer applied group were lower than the avarage values (2.210°C, 1mm) determined in the polymerization process of resin composites with light-emitting diode devices. Conclusion: In a remaining dentin thickness of 1 mm in teeth with open apices, using a glass ionomer liner might be a useful effort for protecting the pulp from the heat generated by polymerisation devices.

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ABSTRACT Objective: To compare the accuracy of working length determination between cone beam computed tomography (CBCT) and electronic apex locator by measuring the actual working length of teeth. Material and Methods: A total of 150 single-rooted tooth assessed by radiograph undergoing root canal therapy were selected. The process was repeated to obtain a buccolingual and mesiodistal section of all teeth. The measurement line was considered from the reference occlusal plane following the center of the canal to the terminus. All information regarding the accuracy of cone-beam computed tomography and apex locator was noted in a pre-designed proforma. Results: CBCT consistently demonstrated high accuracy across all tooth types in both jaws. The electronic apex locator exhibited varying precision, with greater accuracy observed in the mandible. Statistical analyses revealed significant differences in electronic apex locator accuracy among tooth types in the maxilla (p=0.042), emphasizing the importance of specific clinical considerations. Conclusion: Cone beam computed tomography emerges as a reliable diagnostic tool for accurate working length determination, especially in complex cases, while the electronic apex locator remains valuable with careful consideration of potential variations in accuracy. An individualized approach, considering tooth type, jaw location, and clinical context, is crucial for precise working length determination in endodontic practice.

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ABSTRACT Objective: To analyze the phobia and social anxiety of brushing their teeth among high school students in Palopo City, Indonesia, during COVID-19. Material and Methods: Social phobia was obtained with the MINI-Spin questionnaire and anxiety with the GAD-7 questionnaire. The questionnaire consists of 15 questions with a Likert scale. Primary data type with logistic regression analysis. Results: The results of the logistic regression analysis showed that men are more likely to brush their teeth twice a day than women (OR=2.01; 95CI 1.3-2.9). Subjects who reported not having social phobia were not significantly (OR = 0.9; 95CI 0.6-1.4) more likely to brush their teeth twice a day than those who tended to have social phobia. Subjects who reported no significant anxiety (OR = 0.7; 95CI 0.5-1.5) were more likely to brush their teeth twice a day than those who tended to have anxiety. Conclusion: The frequency of brushing teeth in students who do not have a relationship is more likely to brush their teeth twice a day than students who tend to have phobias and social anxiety. Regarding the relationship between brushing teeth frequency and gender criteria, there is a relationship between female students brushing their teeth twice a day more often than male students during COVID-19.

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ABSTRACT Objective: To assess the effect of beverages on the color change of glazed monolithic zirconia ceramic. Material and Methods: This in vitro study evaluated 18 A2-shade disc-shaped monolithic zirconia specimens measuring 10 x 2 mm. All specimens were sintered, coated with a thin layer of glaze paste, heated in a vacuum furnace, and were subjected to 5000 thermal cycles at 5 and 55 °C. The specimens were then randomized into three groups (n=6) for immersion in orange juice, tea, and distilled water for 135 minutes/day for 24 days and incubated. The color of specimens was measured before and after immersion by a spectrophotometer, and the color change (∆E) was calculated according to the CIE L*a*b* color space. Data were analyzed using one-way ANOVA and Tukey’s post-hoc test (alpha=0.05). Results: All three groups experienced a color change after immersion (p<0.05). The ∆E was maximum in tea (2.05±1.04) and minimum in orange juice (0.81±0.57). Significant differences were noted between orange juice and tea (p<0.001), and distilled water and tea (p<0.001) in ∆L, and orange juice and tea (p=0.023), and distilled water and tea (p=0.030) in ∆E. Conclusion: The results indicated that tea caused maximum color change and maximum reduction in lightness (L*) in glazed monolithic zirconia ceramic; however, the color change was within the clinically acceptable range (∆E<3.7).

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ABSTRACT Objective: To evaluate the knowledge of dental professionals and attitudes regarding dental caries management according to minimal intervention dentistry (MID). Material and Methods: Sixty-four dentists working in the public health service of Vitória da Conquista, Brazil, were invited to answer an online questionnaire structured into four domains. Descriptive data analysis and the association between demographic aspects and knowledge about MID for caries management were performed by Fisher's exact test (α=5%). Results: Among the 53 respondents (82.8% response rate), 67.9% were women aged 31-40 years (39.6%), working in primary health care (75.5%) and general practice (64.2%). Although professionals claimed to know MID for caries management (81.1%), considering its performance in their clinical practice (58.5%), regular knowledge was verified (84.9%), which is associated with self-assessment of the benefit provided by the technique (p=0.013). Uncertainties regarding the use of fluoride to inactivate lesions and dental sealants for prevention and treatment were highlighted. Hesitancy in disagreeing with statements related to incorrect etiology and traditional caries management was also observed. The main barriers identified for MID use were insecurity and the unavailability of adequate instruments/materials in the service. Conclusion: Although professionals have demonstrated regular knowledge about the benefits of MID in managing dental caries lesions, there is a lack of knowledge and attitudes related to the technique and barriers to its use in clinical practice.

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ABSTRACT Objective: To identify the clinical presentation of molar incisor hypomineralization (MIH) and hypomineralization of second primary molars (HSPM), including the distribution patterns of presence and severity of lesions, and to investigate the association of risk factors during the pre-and postnatal period with the presence of lesions. Material and Methods: This cross-sectional study was conducted with 160 individuals (72 with MIH/HSPM and 88 without lesions). The symmetry analysis regarding the presence and severity of MIH/HSPM was evaluated in pairs of homologous and opposite teeth. Sociodemographic and medical information was obtained using a detailed questionnaire. Data were analyzed by means of chi-square tests, Student’s t-test, and logistic regression (p<0.05). Results: Symmetry of presence and severity of hypomineralization lesions were present in homologous permanent teeth in 53.8% and 70.5% of cases, respectively, with statistically significant results only for the symmetrical pattern of severity of MIH lesions in the maxillary first molars (p=0.016) and mandibular first molars (p=0.02). Otherwise, a non-symmetric presence was statistically significant in homologous second primary molars (p=0.002) and opposite primary and permanent teeth (p≤0.001). An association between MIH/HSPM and systemic diseases during pregnancy and children medication was found (p<0.05); however, no evidence was found between these and MIH/HSPM severity. Conclusion: The symmetric pattern of severity of MIH lesions was statistically significant in permanent homologous teeth. Risk factors during pre and postnatal periods may be related to MIH/HSPM; however, these do not seem to interact with severity.

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ABSTRACT Objective: To verify whether an infiltrant resin used to inactivate white spot lesions (WSL) on enamel can resist the abrasive challenges promoted by tooth brushing with different dentifrices. Material and Methods: WSL was induced on bovine enamel samples (pH cycling) and then treated with an infiltrant resin (ICON). Afterward, half of the sample was protected. The other half underwent an abrasive challenge using an electric toothbrush with soft bristles., using dentifrices with different abrasiveness (n=10): Group 1: Colgate Maximum Cavity Protection; Group 2: Sensodyne Repair & Protect; Group 3: Colgate Sensitive Pro-Relief; Group 4: Colgate 2 in 1 Watermelon Flavor; e Group 5: Colgate Luminous White Advanced. The wear profile after brushing was evaluated by confocal laser scanning microscopy (µm), and the enamel/resin interface was observed in scanning electron microscopy (SEM). Profilometry data were analyzed using one-way ANOVA followed by Tukey's test (α=5%). Results: Brushing produced more significant wear on group 5 (3.96±0.26) when compared to groups 1 (3.45±0.21), 2(3.22±0,4) and 4(3.11±0.34). Data from Group 3 (3.82±0.6) was similar to G5 but higher than G1, G2, and G4. SEM analysis showed that the adhesive interface remained intact in all groups after the abrasive challenge. Conclusion: Dentifrices with a higher relative dentin abrasiveness produced more significant wear of the infiltrant, but the composite/enamel interface was not altered after the abrasive challenges.

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ABSTRACT Objective: To determine whether there is a lack of diffusion in the knowledge of selective removal of carious tissue (SRCT) and to examine whether cognitive biases influence professionals in their decision to implement SRCT. Additionally, this study seeks to identify whether the lack of knowledge diffusion and cognitive biases act as barriers to the adoption of SRCT in practice. Material and Methods: A series of questions was administered to dental professionals aiming to assess their knowledge of SRCT, their opinions on its use, and whether they incorporated this technique. Some questions were designed to identify potential factors influencing their decision-making process. The data was presented in terms of frequency percentages and analyzed using association tests (p>0.05). Results: Out of 568 respondents, fifty-four individuals (9.5%) were not in favor of SRCT, while eighty-nine did not implement it in their practice. Professionals who were less inclined to use SRCT included those who had not studied it, endodontists, specialists unrelated to dentistry/pediatric/dental clinic, and dentists who had completed their degrees more than four years ago. Cognitive biases, such as outcome bias, overconfidence bias, and bias against new beneficial therapies, were found to be influenced by SRCT knowledge, specialized fields, postgraduate education, and the duration of professional training. Regarding the removal of carious tissue at pulp walls in very deep cavities, 158 respondents answered correctly, while 410 respondents provided incorrect responses. Conclusion: A deficiency in the dissemination of SRCT knowledge was identified. Cognitive biases exerted a significant influence on decision-making concerning the removal of carious tissue. These two findings contribute to the limitation in translating SRCT into clinical practice.

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ABSTRACT Objective: To evaluate the cost-effectiveness of single-tooth rehabilitation options with dental implants associated with a prosthetic crown (I+C) compared to a fixed partial denture (FPD). Material and Methods: A rapid review was carried out to identify the costs (expressed in US$) and effectiveness (expressed through success rate). Bibliographic searches retrieved 1,447 records, of which 19 studies of type randomized clinical trials were selected to collect cost and effectiveness data. Markov economic models were used to simulate hypothetical 15-year cohorts with 2000 patients using cost and effectiveness data from the rapid review under the perspective of private practice. Results: The average costs of I+C and FPD treatments were US$ 3,432.23 and US$ 3,322.52, respectively. The average effectiveness of I+C was 88.33%, with a mean follow-up time of 9.33 years, and FPD had an average yearly success rate of 82.14%, with a mean follow-up time of 11.89 years. The I+C treatment has an incremental cost-effectiveness ratio (RCEI) of US$ 170.88 compared to FPD. Conclusion: Both I+C and FPD rehabilitation options are cost-effective; I+C rehabilitation has a higher cost and greater effectiveness, being the recommended option if the patient with no contraindication.

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ABSTRACT Objective: To analyze morphometric measurements in dry jaws, chins, and hip bones to contribute to clinical predictability in the reconstruction of grafted areas. Material and Methods: The sample comprised 619 anatomical specimens. Anatomical structures were measured at predetermined points using a digital vernier caliper. Measurements of average thickness and linear dimensions of the coronoid process, as well as the average thickness of the mentum and iliac crest points, were obtained. Results: The average morphometric measurements of anatomical structures revealed that male individuals exhibit larger values than female individuals, with a mean difference of 1.57 mm. The mean estimated bone volume of the iliac crest and iliac fossa was 21,347.19 mm3 and 21,125.56 mm3 for the left and right sides, respectively. The coronoid process displayed a smaller thickness (2.11 mm) and linear measurement (5.77 mm) in its upper portion and a larger thickness (3.63 mm) and linear measurement (14.51 mm) at its base, on average. In the mentum, the greatest average thickness was found at the midline, with a value of 12.90 mm. Conclusion: The surgeon can predict the amount of bone that can be obtained from donor areas, as well as the predominant type of bone in each area, aiming to optimize its clinical application. It is important to highlight that both the iliac crest and iliac fossa provide a significant bone volume in comparison to intraoral areas.

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ABSTRACT Objective: To evaluate oral conditions' impact on school adolescents' quality of life. Material and Methods: This is a cross-sectional, school-based, descriptive, and analytical study. The study's final sample comprised 1,010 adolescents aged between 14 and 19. The dependent variable of oral health-related quality of life (OHRQoL) was measured using the OHIP-14 questionnaire. The independent variables were oral conditions assessed through clinical examination and a questionnaire for the socioeconomic indicators. Descriptive analyses, chi-square, and binary logistic regression were performed, and the significance level adopted was 5%. Results: The impact of oral conditions on OHRQoL was reported by approximately 34% of adolescents. The prevalence of dental caries was 26.2%, periodontal disease 45.8%, dental trauma 38%, and malocclusion was 29.7%. Of the variables analyzed, only sex (p<0.001) and caries experience (p=0.012) were associated with OHRQoL, showing that females are 1.87 times more likely to affect their quality of life than males, and those with caries were 1.46 times more likely to have an impact on the OHRQoL. Conclusion: The sex and experience of caries might be associated with decreasing the quality of life.

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ABSTRACT Objective: To evaluate the impact of endodontic treatment with photobiomodulation on oral health-related quality of life (HRQoL). Material and Methods: Seventy participants with single-rooted teeth and a diagnosis of asymptomatic apical periodontitis were selected and randomized into two groups: control group (CG, n = 35), root canal treatment without additional treatment, and experimental group (EG, n = 35), root canal treatment associated with antimicrobial photodynamic therapy and low-level laser therapy. OHRQoL was assessed using the Oral Health Impact Profile Questionnaire (OHIP-14) at baseline and 7 and 30 days after treatment. Data were subjected to Wilcoxon, Mann-Whitney tests, and linear regression using the generalized estimating equation model, using the Statistical Package for Social Science software with a significance level of 5%. Results: No statistically significant differences were found between groups regarding sociodemographic and clinical characteristics (p>0.05). There was also no difference in the OHRQoL between the CG and EG (p>0.05). However, there was a statistical difference in OHIP-14 scores between baseline and the 7- and 30-day follow-up intervals in both groups for all domains (p<0.05). Conclusion: Root canal treatment, with or without photobiomodulation, significantly improved the OHRQoL of participants after 7 and 30 days of treatment.

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ABSTRACT Objective: To evaluate the knowledge of parents or guardians about dental trauma in children during the COVID-19 pandemic. Material and Methods: After signing the Free and Informed Consent, the children's parents answer the online questionnaires about dental trauma during the COVID-19 pandemic. The data was analyzed using Kruskal-Wallis and Mann-Whitney tests. Results: Of a total of 89 questionnaires, only 84 were answered, and 75.3% experienced dentoalveolar trauma, of which 65.5% exhibited fractures. Most affected teeth (92.2%) were deciduous, and 7.8% were permanent. Furthermore, 53.73% of the trauma involved anterior teeth, only 7.46% affected posterior teeth, and 4.48% included anterior and posterior teeth. Most participants (74.2%) had never received information about dental trauma, and 25.8% had received prior instruction. Many (74%) did not take the affected tooth or fragment to the emergency room. Following the accidents, 38.2% feared brushing their children's teeth, and 28.1% did not. Conclusion: Dentoalveolar trauma in children is common and occurs more often at home or school. Dental trauma affected the deciduous teeth, especially the anterior teeth. Many parents lack knowledge on how to respond to and care for dental trauma in children. Providing informative guidance to parents and guardians is essential for preventing and managing childhood dental injuries, even during the COVID-19 pandemic.

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ABSTRACT Objective: To compare postoperative pain, tenderness, edema, and medication use after foraminal enlargement in a single visit, using 2.5% sodium hypochlorite (NaOCl) and 2% chlorhexidine gel (CHX). Material and Methods: Seventy patients with single-rooted teeth with apical periodontitis were randomized into two groups according to the irrigation protocol: control (NaOCl - 35 patients) and case (CHX - 35 patients). Pain intensity was assessed using the visual analog scale (recorded every day for seven days, on the 14th and 30th days after treatment). Edema was assessed by two independent evaluators on the 2nd, 3rd, and 7th days after treatment using photographs. Data were analyzed using Chi-square, Fisher's Exact, and Mann-Whitney U tests in SPSS. Results: There was a statistically significant difference in postoperative pain and tenderness between the groups on the 2nd day (p<0.05). There was no difference between the groups for edema (p=1.00) and use of medication (p=0.77). Conclusion: Chlorhexidine resulted in more significant postoperative pain and tenderness after foraminal enlargement.

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ABSTRACT Objective: To verify the association between bullying and awake and sleep bruxism in school teenagers. Material and Methods: A cross-sectional study was conducted from March to June 2018 with adolescents aged 14 to 19 of both sexes enrolled in the state school system of a city in Pernambuco. Students who participated in the stages of data collection and filled out the questions about bullying and bruxism were considered eligible. Those with disabilities or dysfunctions that made it impossible to fill out the questionnaire themselves were excluded. For data collection, an instrument with questions from the National Survey of Adolescent Health (PeNSE) and the "Research Diagnostic Criteria for Temporomandibular Dysfunction" (RDC/TMD) questionnaire was used. Results: A total of 2,500 adolescents participated in this study. The prevalence of possible awake bruxism among the adolescents was 20.6%, the prevalence of possible sleep bruxism was 21.9%, and 23% of the adolescents reported having experienced bullying. About 2 of 10 male students had possible sleep bruxism (SB), while a fourth of the female students had the condition (p=0.004; OR=1.1). As seen in the awake bruxism, feelings of sadness, school bullying, and cyberbullying had significant correlations with possible SB (p<0.001, OR=2.4; p<0.001, OR=1.9 and p=0.01, OR=1.7, respectively). Conclusion: The association between possible awake and sleep bruxism and bullying in school adolescents was verified, regardless of sex, age, income, and mother's education.

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ABSTRACT Objective: To assess the comprehension of dentists in Primary Health Care (PHC) regarding the interplay between obesity and periodontitis and evaluate the presence of practical approaches for managing these patients. Material and Methods: For this cross-sectional study, 187 general dental practitioners from different regions of Brazil were selected by convenience. A specific instrument was developed to assess the knowledge and practices of PHC dentists concerning this topic. The data underwent descriptive and analytical statistical analyses, followed by Poisson regression analysis with robust variance to test associations. Results: Regarding knowledge, most dentists have a limited understanding of the link between obesity and periodontitis, despite 43% recognizing the higher susceptibility of individuals with obesity to oral issues. About 20% of professionals considered their knowledge “adequate." Better knowledge was observed among dentists who worked only in the public sector, which has concluded some post-graduation (p<0.05). Regarding the professional's practical conduct, around 57% of the dentists do not diagnose obesity, and 64% of the professionals do not refer these patients to a nutritionist. Conclusion: The study's outcomes underscore the prevailing lack of awareness among this sampled group of dental practitioners concerning the association between obesity and periodontitis. Furthermore, it was observed that multidisciplinary treatment for obese patients within the realm of PHC is generally underperformed.

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ABSTRACT Objective: To evaluate the prevalence of pre-eruptive intra-coronal resorption (PEIR) lesions in the pediatric population. Material and Methods: 8341 impacted teeth were evaluated regarding PEIR lesions via panoramic radiographs of 968 patients aged 2-18 who applied between 2021 and 2022. The number of affected teeth, the number of the tooth, the degree of the lesion, the location of the defect, and the presence of ectopic position were recorded. PEIR lesions are categorized based on the thickness of the affected dentin: Grade 1 (less than 1/3), Grade 2 (between 1/3 and 2/3), and Grade 3 (more than 2/3). All analyses were performed with IBM SPSS 23.0, and p value 0.05 was considered significant. Results: The number of teeth with PEIR defects was 71 (0.86%), while the number of patients with PEIR defects was 58 (5.99%). Mandibular premolars (42.3%) are the most commonly defective teeth, followed by mandibular molars (39.5%). The majority of defects were classified as Grade 1. In patients with Grade 3 lesions, no more than one defect was observed. There was a significant relationship between the degree of the defect and the number of defects observed. Conclusion: Detecting defective teeth in pediatric patients' control radiographs is critical for early treatment. This study emphasized that the prevalence of defective teeth is high in pediatric patients, and pediatric dentists should be cautious about these defects.

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ABSTRACT Objective: To investigate the potential impact of the pandemic on the number of sexological forensic examinations among children and adolescents in a state capital of Northeastern Brazil, as well as to outline the profile of victims and perpetrators. Material and Methods: Cross-sectional study with retrospective analysis of medical-legal/forensic dental examinations conducted from March 2019 to March 2023, focusing on cases of sexual intercourse/sexual assault suffered by children and adolescents examined in the municipality of João Pessoa, Brazil. Results: Of the 1254 reports included, 370 occurred during the pre-pandemic period, 272 during the critical pandemic, 280 during the stabilization, and 332 during the post-pandemic. One thousand and eighty-eight cases involved females, and 692 affected children, with the pre-pandemic period showing the highest number of occurrences. 86.36% of perpetrators were male and acted alone, and 51.20% had a relationship with the victim. Three hundred and fifty-one cases occurred at the victim's residence. No statistically significant association was found among cases across the pandemic periods. Conclusion: Despite the apparent decrease in cases of child sexual violence, it does not necessarily imply a real reduction due to widespread underreporting during COVID-19. The predominant profile of victims is composed of girls aged 11-14 years, with the victim's and perpetrator's residence being the most common locations of sexual violence occurrence, with the perpetrator being a male individual with familial relationship.

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ABSTRACT Objective: To assess the temperature variation of gutta-percha removal with stainless steel and two NiTi instruments using infrared thermography and thermocouples. Material and Methods: 45 single-rooted teeth were divided into three groups (n = 15) according to the following gutta-percha removal instruments: Largo Peeso (L), Protaper Retreatment (PR), and Reciproc (R). Thermal analysis was conducted using a FLIR T650sc infrared thermography camera and three thermocouples. For infrared thermography assessment, the infrared camera was programmed to acquire thermograms every 15 seconds before the gutta-percha removal started until temperature normalization. Root temperature was assessed in the thermograms using FLIR tools software v6.4 with the straight-line tool along the long axis of the tooth and in the cervical, middle, and apical thirds of each tooth. The temperature from the thermocouples was recorded and registered for each root third. Inferential statistical analysis Kruskal-Wallis and post hoc Tukey tests were used. Results: For the infrared thermography camera, the highest median temperature value was found 15 seconds after guttapercha removal for the L technique (20.3°C), which presented the highest temperatures at all studied times. For thermocouples, the highest temperature was found in the middle third during gutta-percha removal with L (20.7°C). PR and R presented similar patterns of root temperature. Conclusion: Stainless-steel L temperature reaches values above 10°C; however, the exposure time was too short to cause injuries to the periodontium.

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ABSTRACT Objective: To investigate the trends of research on niobium (Nb) in dentistry to determine its use in dental materials. Material and Methods: Electronic searches were carried out in six databases. Studies that evaluated niobium alloys in dentistry in vitro, in situ, and in vivo (humans and animals) were included. Data on publication year, authors, country, journal, study design, application area, niobium alloy, study approach, assay type and results (positive, negative and null compared to controls) were grouped and analyzed in VantagePoint™ and Excel. Descriptive analyses of frequency, cross-tables and co-occurrence matrices were performed. Results: After screening, 315 studies published between 1977 and 2021 were included, with an increase in publications between 2011 and 2021 (n = 209; 66.3%). “Doi, H” was the top author (n = 9; 2.8%), and Brazil was the most productive country (n = 70; 22.2%). “Dental Materials” was the major contributing journal (n = 24; 7.6%), and most studies were carried out in vitro (n = 266; 84.4%), under implant surfaces (n = 162; 51.4%), followed by dental prostheses (n = 77; 24.4%) and restorative materials (n = 27; 8.6%). The most common niobium was a ternary alloy (n = 147; 46.7%), which was mainly tested in vitro via structural characterization or material improvement (n = 131; 41.6%). Mechanical assays (n = 114; 36.2%) were the most prevalent. Positive effects of niobium were found in 264 articles (83.8%), and negative effects were found in 13 articles (4.1%). Conclusion: The number of studies on niobium has increased over time, resulting in improvements in the mechanical properties of materials used in dental practice.

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ABSTRACT Objective: To analyze the supply of input and procedures, non-invasive and micro-invasive, for dental caries lesions in Primary Care in Brazil, comparing the Brazilian geographic regions in three different periods. Material and Methods: Historical series study based on secondary data extracted from the 1st Cycle (2012), 2nd (2014), and 3rd cycle (2018) of the External Evaluation of the National Program for Access and Quality of Primary Care. The proportions of Oral Health Teams offering non-invasive (fluor) and micro-invasive (sealants) supplies and procedures between Brazilian geographic regions were compared using the Chi-square test, using the Z Test adjusted by the Bonferroni method, and between the years (2012, 2014, and 2018) using the Cochran Q test (p<0.05). The percentage variation between the proportions per cycle was calculated. Results: The availability of inputs of fluor gel in Brazil increased between 2014 (91.6%) and 2018 (94.1%) (p<0.001), but statistically only in the Northeast and North (p<0.001). The offer of the topical fluorine procedure increased between 2012 (78.8%) and 2018 (87.4%) (p<0.001) in Brazil, with the most significant increase in the North (+7.5%) and Northeast (+22.0%). There was greater availability of inputs of sealants in Brazil between 2012 (56.8%) and 2018 (69.5%) (p<0.001) in Brazil, and more significant expansion in the Northeast (+43.4%). There was a greater offer of the sealing procedure in Brazil between 2014 (98.6%) and 2018 (98.5%), compared to 2012 (94.7%) (p<0.001), with more significant expansion in the North (+5.8%). Conclusion: There was an increase in the supply of input and procedures, non-invasive and micro-invasive, in Primary Care in Brazil. Despite maintaining regional inequalities, they were reduced, with greater expansion in the North and Northeast regions between the years evaluated.

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ABSTRACT Objective: To assess the oral health-related quality of life (OHRQoL) of children and adolescents with autism spectrum disorder (ASD) through parental/caregiver perceptions. Material and Methods: Children and adolescents aged 4-18 years enrolled in an ASD center at Manaus, AM, Brazil, were assessed for dental caries by clinical examination. A trained and calibrated examiner performed all exams. The "Parental-Caregiver Perceptions Questionnaire" (PCP-Q) and the "Family Impact Scale" (FIS) were used to assess OHRQoL. Data analysis was performed using descriptive statistics and the Mann-Whitney U test. Results: Fifty-one children/adolescents of both sexes participated in the study. The mean age of patients was ten years (3.0), and most were male (76.5%). Forty-five (88.2%) mothers had more than nine years of schooling, and 28 (54.9%) earned equal to or less than two Brazilian minimum wages. The global PCP-Q score ranged from 0 to 25, with a mean value of 7.41 (6.64). The impact score values were significantly higher in individuals with caries experience in primary dentition (p<0.05). No significant differences in OHRQoL scores existed regarding family income and maternal schooling. Conclusion: According to parental/caregiver perceptions, children and adolescents with ASD had a higher impact on the PCP-Q functional limitation domain. Caries experience in primary teeth contributed to higher mean scores in all PCP-Q domains.

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ABSTRACT Objective: To investigate the relationship between eye-tracking visual parameters and the precision of diagnoses and management for traumatic dental injuries (TDIs) in anterior teeth, utilizing CBCT to understand how visual observation is linked to cognitive processing. Material and Methods: A total of nineteen calibrated endodontic postgraduate residents participated in this study. They were subjected to an eye-tracking technology to analyze their interaction and interpretation of CBCT images. CBCT scans of maxillary teeth affected by TDIs were collected from individuals seeking treatment at the endodontic division of KAUD. Seven TDI cases were viewed through the Experiment Centre software, integrated with a SensoMotoric Instruments (SMI) eye-tracking device (Sensomotoric Instruments, Teltow, Germany), capturing the participants’ eye movements as they analyzed CBCT image views. Clinical details were provided for each case, and residents formulated their diagnoses and management. The association between the parameters of eye-tracking behavior and the accuracy of both diagnosis and management was examined using the Mann-Whitney test. Results: A longer duration spent scanning the entire CBCT scan and a prolonged time until pathology detection were associated with accurate diagnosis and treatment decisions. However, a significant association was not found between longer time spent on areas of interest or the number of revisits with the accurate diagnosis and management. Conclusion: This study demonstrates that detailed examination of CBCT scans enhances diagnostic precision and management for traumatic dental injuries, underscoring the potential of targeted training to improve diagnostic accuracy. Future research with larger and more diverse samples is recommended to confirm these findings.

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ABSTRACT Objective: To analyze the remaining dentin thickness and crack formation after retreatment, comparing three file systems. Material and Methods: Using a standard root length of 18 mm, forty-five single-rooted teeth were decoronated and obturated after being randomly divided into three groups. Solite RS3, Solite RS3 Black, and Solite RE Black retreatment file systems were employed to remove the gutta-percha following a nano-CT scan performed before preparation. A post-operative nano-CT scan was performed to determine the amount of dentin thickness and crack that remained, and both scans were superimposed. One-way ANOVA and subsequent post-hoc tests were employed to ascertain statistical significance for both intra-group and inter-group variations. Results: Solite RE Black removed lesser dentin compared to the other two retreatment file systems (p<0.05). There were no significant differences in crack formation amongst all retreatment file systems (p>0.05). Conclusion: Solite RE Black retreatment file system proved to have more dentin conservation and less crack propagation during retreatment. Excessive tooth structure loss can compromise the long-term success of endodontically treated teeth, increasing the risk of cracks and potential vertical root fractures.

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ABSTRACT Objective: To evaluate the changes in the work routine of Brazilian pediatric dentists (PD) during the COVID-19 pandemic. Material and Methods: Dentists specializing in pediatric dentistry, working in public or private services, and attending children or adolescents were included. Data collection was performed through a self-administered online questionnaire. Demographic information such as gender, age, work experience time, city size, and place of work was collected; if specific preventive measures were adopted during the pandemic; if there was an increase in service prices and additional costs; and how did the search for urgent or elective dental care take place during 2020 and 2021. A descriptive analysis was performed. Results: A total of 270 PD answered the questionnaire, of which 52.6% interrupted elective care during the pandemic, more than half (51.1%) reduced the number of patients per shift, and more than 70% increased weekly hours. Regarding the financial aspect, 94.7% of participants reported having additional costs, and 51.8% increased the cost of their appointments. In 2020, 72.0% reported a decrease in searches for elective appointments and 58.7% an increase for urgent care. Conclusion: The COVID-19 pandemic affected the search for appointments and the routine of Brazilian PD. For many, the potential financial impact was due to additional costs, periods without patients, and price correction of appointments.

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ABSTRACT Objective: To determine the effect of Augmented Reality (AR) - based toothbrushing on oral hygiene practices among 6-8yrs old children of Mysuru City. Material and Methods: A concurrent parallel examinerblinded study was conducted on 6-8yrs old children. The participants were divided into two groups: a) the Conventional brushing group and b) the AR-assisted brushing group. Oral hygiene parameters were assessed at the baseline. The conventional group was given a manual toothbrush. The AR-assisted group received a Colgate Magik toothbrush. Both groups were followed up for two weeks. The acceptance of using AR-assisted brushing was recorded via feedback. The pre-post comparison within the group was carried out using a paired t-test. Results: An improvement in oral hygiene status with a significant reduction in the AR-assisted brushing group (p<0.0001) was observed. The percentage reduction in plaque and gingival bleeding scores was also higher in the AR-assisted brushing group. Conclusion: Augmented reality guided toothbrushing is an effective method to teach positive oral hygiene behavior in children.

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ABSTRACT Objective: To assess the influence of the COVID-19 pandemic and sociodemographic factors on stress, anxiety, and depression levels among dental students. Material and Methods: This observational study employed a census approach featuring a quantitative, descriptive, and analytical cross-sectional analysis. The research was conducted within a university center in northeastern Brazil from March to May 2021. Two questionnaires were administered: the Depression, Anxiety, and Stress Scale (DASS-21) and another survey focusing on sociodemographic factors. Pearson's chi-square test was employed to examine potential associations between the variables, and multiple logistic regression models were fitted, with a significance level set at 5%. Results: The study included 128 dentistry students, predominantly female, with a high monthly family income. The data revealed normal levels across the three DASS subscales. A significant association was observed between anxiety and sex (X2 = 10.37; p = 0.03). The depression subscale exhibited associations with ethnic group (X2 = 47.46; p<0.01), area of residence (X2 = 12.44; p = 0.03), and appropriate study space (X2 = 11.48; p = 0.04). Urban residents were 4.29 times more likely to experience depression than their rural counterparts (OR = 4.29; 95%CI 1.28-14.42). Conclusion: While psychological profiles were as expected, targeted interventions for vulnerable groups are crucial. Future research should use longitudinal designs and assess tailored interventions' effectiveness to enhance mental health outcomes among students.

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ABSTRACT Objective: To assess the fluoride concentration of bottled waters from municipalities in northeastern Brazil. Material and Methods: Bottled mineral waters were purchased in two periods at different commercial places of four large municipalities (João Pessoa, Campina Grande, Patos, and Cajazeiras) in the Paraíba state. The municipalities selected to present the following annual average temperature: João Pessoa 26.5 °C, Campina Grande 23.3 °C, Patos and Cajazeiras 27.5 °C. Fluoride concentration was determined using a combined ion-specific electrode. Readings (in mV) were conducted in triplicates for each standard solution and converted into fluoride concentration (mg F/L) using the Excel® software. Results: A total of 72 samples from six brands of bottled water were analyzed. The fluoride concentrations of all samples were low (0.11-0.21mg/L) but higher than those reported on the label and varied among different batches of the same brand. Conclusion: The fluoride levels in bottled water vary among brands, and these actual values are not stated in the labels.

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ABSTRACT Objective: To assess the agreement among three different online drug-drug interaction (DDI) checkers for the detection of psychotropic drug interactions among dental patients in the state of Minas Gerais, Brazil. Material and Methods: Between January and December 2017, a cross-sectional study was conducted in Minas Gerais with data on pharmaceutical claims of psychotropic drugs prescribed by dental practitioners. Data from the Pharmaceutical Management System provided the drug dispensing history of the patients, allowing the identification of those on concomitant medication use. The occurrence of DDI was determined by entering the name of the drugs taken by each patient into Merative Micromedex®, Medscape®, and DrugBank. The degree of agreement among the three DDI online checkers was analyzed using the Fleiss' kappa test. Results: Overall, 797 dental patients were found to be taking some psychotropic medication with other drugs simultaneously. The number of patients with DDI varied according to Micromedex® (n= 366), Medscape® (n= 473), and DrugBank (n= 736). The agreement between the DDI checkers was poor (Fleiss' kappa: 0.165; p<0.001). Conclusion: The online DDI checkers assessed in this study showed variations in their ability to detect interactions and poor agreement among them.

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ABSTRACT Objective: To address disparities in oral healthcare to allow prioritization of individuals with higher vulnerability. The model seeks to develop a methodology for identifying and classifying vulnerability among CEO users using socioeconomic indicators. Additionally, it aims to establish criteria for access prioritization based on vulnerability profiles, ultimately ensuring that those in greater need receive the specialized oral healthcare they require. Material and Methods: The proposed method leverages two key indicators: the Municipal Social Vulnerability Index (IVS) and the CEO Social Vulnerability Indicator (CEO IVS). CEO IVS is calculated based on CEO user socioeconomic data and compared to the municipality's IVS. The model utilizes a scoring system to classify users' vulnerability levels, allowing for the identification of those most in need of specialized care. The Equality Production Trend Indicator (ITPE-CEO) assesses the alignment between CEO and municipal vulnerability levels, aiding access prioritization. Conclusion: This equity-focused model offers a practical approach to address disparities in oral healthcare access. Vulnerability profiles and socioeconomic factors empower local managers to allocate resources effectively, ensuring that individuals with higher vulnerability receive timely and specialized care. The proposed model promotes inclusivity and responsiveness to community needs, contributing to achieving equitable oral healthcare for all.

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ABSTRACT Objective: To review the literature unprecedentedly to identify the dentistry students' knowledge of pediatric patients who suffered violence. Material and Methods: A systematic review was conducted using PubMed, Web of Science, LILACS, SciELO, Google Scholar, and OpenGrey electronic databases up to November 2021. The "Grey Literature" was verified through Google Scholar and Open Grey searches to avoid any selection bias. There was no restriction on the date of publication or language. Results: The systematic search yielded 2.756 studies in the first selection phase, but only twenty-two articles were included. All selected articles were published between 1998 and 2021 and used a questionnaire to evaluate the dentistry students' knowledge regarding child maltreatment cases. Brazil was the country that had the most studies included (10 articles). Despite the majority of the students presenting insufficient knowledge about child maltreatment, evidence from this research showed that every form of approach by professionals toward child maltreatment should be considered important. Conclusion: Therefore, there are deficiencies regarding the teaching-learning methodology, reinforcing the need for improvements in Dentistry undergraduate curricula.

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ABSTRACT Objective: To identify and study the existing literature on the efficacy and safety of midazolam compared to inhalation of nitrous oxide in children undergoing dental treatment. Material and Methods: Electronic resources such as PubMed Central, Cochrane Database of Systematic Reviews, Lilacs, Science Direct, and SIGLE were thoroughly searched. The title scan was used to find randomised controlled trials reviewed for inclusion by reading the abstract. Studies comparing the sedative, behavioural, and anxiolytic effects and safety in children undergoing dental treatment under midazolam and nitrous oxide inhalation were included. The Cochrane Reviews system software, Revman 5.4.1, was used to assess the quality of the included studies. Results: 11328 articles were identified by screening the electronic databases, of which 10906 were eliminated after titles were read and duplicates were removed. Ten full-text articles were examined, of which three were excluded as they did not match the eligibility criteria. Hence, a total of 7 studies were included. Midazolam and nitrous oxide inhalation were not statistically different in terms of the success of treatment and behaviour modification. However, midazolam showed a deeper level of sedation and resulted in amnesia in more children when compared to nitrous oxide sedation. All of the included studies were found to have a high risk of bias. Conclusion: Though all the studies included showed an increased risk of bias, midazolam and nitrous oxide inhalation seem equally effective sedative agents for controlling behaviour in children undergoing dental treatment. Midazolam shows a deeper sedation level when given orally and produces a higher rate of anterograde amnesia.

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Abstract Objective: To evaluate the effectiveness of “non-surgical periodontal therapy (NSPT)” on periodontal and renal parameters in periodontitis patients diagnosed with chronic kidney disease. Material and Methods: The review protocol has been registered in Prospero (CRD42020150938). Up to November 2019, we searched the PUBMED database without language constraints. We included randomized controlled (parallel-group or cross-over) trials with CKD and chronic periodontitis in adults aged 18 years and above. Three review authors independently assessed the studies. Three review writers gathered data and simultaneously assessed the risk of bias for individual trials using traditional Cochrane procedures. Results: Studies showed high variability. Three randomized clinical trials (RCT) were excluded because of high heterogeneity; meta-analysis could not be performed. Conclusion: Non-surgical periodontal therapy effectively improves periodontal and renal parameters. However, a meta-analysis could not be performed because of the high heterogeneity among the studies.

Abstract in English:

ABSTRACT Objective: To investigate the success of implants, the increase of bone integration, and the effect of nanostructure/nanoparticles as Titanium-based implant materials on the success of implants. The present study evaluated the implant success rate of Titanium-based implant materials. Material and Methods: PICO: Population (dental implant), intervention (coated titanium implant surface), comparison (uncoated titanium implant surface), and outcome (bone-implant contact) were considered as a search strategy tool and study inclusion criteria. Searches for systematic literature were conducted on databases from Scopus, Science Direct, PubMed, ISI, Web of Knowledge, and Embase until 12 December 2022. Modified CONSORT Criteria (Reporting guidelines for preclinical in vitro studies on dental materials) were used to evaluate the quality of studies. The fixed effect model and inverse-variance method were used to calculate the 95% confidence interval for mean differences. Stata/MP V. 17 software was used to conduct the meta-analysis. Results: After reviewing the abstracts of 97 articles, studies not related to the inclusion criteria were excluded, and ten studies were selected from the remaining 39 studies after reviewing the full text. The mean difference in boneimplant contact between coated and uncoated dental implants was 0.25 (MD, 0.25 95% CI 0.01, 0.49;p=0.04). Conclusion: The titanium implant surface with nano coating can increase bone-implant contact and cause bone integration.

Abstract in English:

ABSTRACT Objective: To assess the relationship between celiac disease and the prevalence of dental caries in children and adolescents and also evaluate if dental enamel defects in celiac children predispose to dental caries. Material and Methods: Searches were performed in the following databases: PubMed, Scopus, Cochrane Library, Latin American and Caribbean Literature on Health Sciences, and OpenGrey. The risk of bias was assessed using the Newcastle-Ottawa Scale. DMFT/dmft and DMFS/dmfs data of observational studies that compared the prevalence of caries between children and adolescents with celiac disease and healthy individuals. Meta-analysis was performed using a random effects model. Heterogeneity between studies was estimated using Cochran’s Q test, and inconsistency was measured using I2 statistics. Results: Of the 121 studies retrieved, 17 were selected, and 12 were included in the meta-analysis. The prevalence of caries in the primary dentition (dmft) did not differ between celiac patients and controls [SMD = -0.35; 95% CI (-0.83; 0.13); p = 0,15; I2 = 89%]. There was also no difference in the prevalence of caries in permanent teeth (DMFT) between groups [SMD = -0.44; 95% CI (-1.02; 0.14); p = 0.14; I2 = 95%]. Conclusion: Celiac disease is not a determinant factor in the development of dental caries in children and adolescents compared to the control group.

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ABSTRACT Objective: To understand the susceptibility to single nucleotide polymorphisms in the promoter region of Interleukin-4 (IL-4) and Interleukin-13 (IL-13) in patients with and without periodontal disease. Thus, a systematic review of available studies on the subject was performed. Material and Methods: A protocol was conducted for registration in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021246646. For this search, studies were selected from the Scopus, Web of Science, Virtual Health Library, Embase, Cochrane Library, and PubMed databases. The selection criteria consisted of case-control and cohort studies published in English that had data on IL-4 and IL-13 genetic polymorphisms in patients with and without periodontal disease in the same study. The obtained studies were managed by EndNote Program™ X7 version and the Rayyan Platform. Regarding the risk of bias, we used the Newcastle-Ottawa Scale, which classified the studies using high-quality methodology. Results: After the selection process, three studies presented the eligibility criteria. No relation between IL-13 and susceptibility to periodontal disease was found. IL-4 gene (IL-4 -590C/T; IL-4-34C/T; rs2243248) was associated with susceptibility to the development of periodontitis. Conclusion: An association between IL-4 and the susceptibility of periodontitis was verified. Further case-control studies are needed to create more concrete conclusions on the subject.

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ABSTRACT Objective: To evaluate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of adhesive restorative materials to healthy and caries-affected dentin. Material and Methods: 04 electronic databases and 02 additional searches were assessed. In vitro studies considering sound or caries-affected human or bovine dentin (population), use of aPDT before restorative treatment (intervention), use of other dentin disinfection techniques (comparison), and bond strength to dentin (outcome) were included. The risk of bias for in vitro studies was used as a method to check the evidence. The method used to present and synthesize results was data extraction. Results: The total number of included studies was 11, including 550 permanent teeth. Bond strength was evaluated mainly through the shear bond strength (SBS) test, with dentin affected by caries being the substrate most frequently used in studies. Six studies demonstrated that aPDT with methylene blue (MB) negatively affected the SBS values of resin-modified glass ionomer cement (RMGIC) to dentin. Regarding risk of bias assessment, all studies were at high risk of bias. Conclusion: The effects of aPDT on adhesion to dentin vary depending on the type of substrate and the photosensitizer used. Mainly, MB negatively affected the SBS values from RMGIC to dentin. The conclusion should be interpreted considering the high risk of bias in the studies.

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ABSTRACT Objective: To evaluate the clinical longevity of Class I and II composite resin restorations with and without using sonic energy through a systematic literature review and meta-analysis. Material and Methods: Five databases were consulted: PubMed, Cochrane Library, Web of Science, Scopus, VHL-LILACS, and BBO and gray literature. The search was carried out in January 2024. The inclusion criteria comprised clinical trials evaluating the success/longevity of composite resin restorations with and without sonic energy. RoB and ROBINS-I assessed the risk of bias. The meta-analysis analyzed the number of restorations with alpha USPHS scores. Heterogeneity was assessed (I2 index, p<0.05). Certain evidence was assessed using the GRADE tool. Results: A total of 8,582 studies were identified, including four studies, 2 RCTs, and two controlled clinical trials, with moderate and low risk of bias, respectively. No difference was observed in the longevity (p>0.05) for: anatomical shape (CI=1.05 [0.95,1.15]; I2=0%; p=0.37); color stability (CI=1.02 [0.93,1.13; I2=0%, p=0.65); marginal adaptation (CI=1.05 [0.95,1.16]; I2=%; p=0.38); postoperative sensitivity (CI=1.01 [0.93,1.10]; I2=0%; p=0.80); secondary caries (CI=1.01 [0.93,1.10]; I2=0%; p=0.80); marginal discoloration (CI=1.05 [0.95,1.16]; I2=0%; p=0.38), surface texture (CI=1.09 [0.97,1.23]; I2=19%; p=0.14) and retention (CI=1.00 [1.91,1.10]; I2=0%; p=1.00). The certainty of the evidence was very low. Conclusion: No evidence supports using sonic energy for direct composite resin restorations, regardless of the technique and the restored tooth. More robust and well-conducted studies should be performed.

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ABSTRACT Objective: To guide professionals about the criteria for replacing amalgam restorations and inform them about the new guidelines regarding the use/indication of this (amalgam) material after the Minamata Convention - COP-4. Material and Methods: The articles were selected from the databases (PubMed, Scielo, Bireme), and relevant articles on the subject between the years 2003-2021 were selected. Recently, social media have been flooded with dental treatments that aim to perform restorations only with composite resins or other types of esthetic material and completely replace all dental amalgam restorations, irrespective of their time in place, size, and functionality. Results: Although improperly, it has been noted that this information reaches patients, and they are led to believe in the inaccurate data that is passed on, such as, for example, (that amalgam leads to) permanent contamination by mercury, causing systemic problems and the loss of the tooth. Conclusion: The "phase down" of amalgam in research and teaching has previously been observed in several countries worldwide; however, its use is still necessary given particular circumstances, which, theoretically, make it a material with exact indication.

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ABSTRACT Objective: To analyse pharmacological overlap in patients with autism spectrum disorder (ASD) under conscious sedation in a dental office environment, identifying any potential risks and complications. Material and Methods: A critical review was conducted by selecting articles from online databases (Pubmed and Lilacs), using a search algorithm and eligibility criteria. The Medscape® platform was used to verify interactions between drugs commonly used by patients with ASD and medications used for sedation in paediatric dentistry. Results: Due to their polydrug use, children with ASD are at risk of complications, namely Serotonin Syndrome (SS), Neuroleptic Malignant Syndrome (NMS), increase or decrease of the QT interval (QTi) and Torsade de Pointes (TdP), due to pre-existence of metabolic syndrome, deepening the sedation level or even leading to a decrease in the sedative capacity of the drugs used. Conclusion: It is essential to assess better drug interaction in ASD patients submitted to sedation. The severity of the disorder and the need for sedation for dental treatment are directly proportional. However, increases in sedative doses tend to increase risks and complications in children with ASD.

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ABSTRACT Objective: To map, through a scoping review, the characteristics of scientific dental production directed at LGBTQIA+ people. Material and Methods: Text searches were carried out (September 2022) in three databases: PubMed (MEDLINE), Virtual Health Library (BVS/BIREME), and SciELO (Scientific Electronic Library Online). Data extraction was carried out through the content of the abstracts and full texts. Results: A total of 1,524 studies were found, of which 186 were considered eligible. The results point to the stigmatizing nature of HIV-AIDS among the LGBTQIA+ population, a highlight of the scientific production that is linked to serophobic outcomes. Studies were also found that addressed the precariousness of oral health and inaccessibility to dental services, anatomical specificities, and the risks of contracting and preventing sexually transmitted infections. However, a substantial gap became evident: questions and directions aimed at providing dental care for the LGBTQIA+ population. Conclusion: There is a need to expand the number and scope of research aimed at this population in an attempt to provide evidence for the construction of an effective model of dental care, therefore, integral, collective, and contextualized to the specificities, needs, and demands of the multiple LGBTQIA+ identities.