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ABSTRACT Objective: To quantify H. pylori in the subgingival plaque of non-dyspeptic chronic periodontitis patients with halitosis and healthy controls. Material and Methods: Sixty participants, distributed into subjects with chronic periodontitis and halitosis who were systemically healthy (Group A, cases, n=30) and subjects with healthy gingiva (Group B, control, n=30) were included in the study. The clinical periodontal status was evaluated, and various clinical parameters, including the gingival index, gingival bleeding index, pocket probing depth, clinical attachment levels, and tongue coating scores. Quantitative Real-time PCR was performed with the subgingival plaque of both cases and control by using highly specific primers that amplify the ureA gene of Helicobacter pylori. Results: The H. pylori ureA gene was not identified in either the cases or the control group. The results strongly support the fact that H. pylori is a transient member of the oral microflora. Conclusion: The finding of the present study reveals a negative correlation of H. pylori with non-dyspeptic chronic periodontitis patients with halitosis.

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ABSTRACT Objective: To evaluate the cytotoxic and genotoxic effects of a phytotherapeutic ointment containing 2% L. ferrea L extract. Material and Methods: Libidibia ferrea L. barks were used as raw material. The extract was prepared by decoction under reflux in a hydroalcoholic solution. The extract concentration in the orabase formulation was determined based on the minimum inhibitory concentration. Biocompatibility was assessed by cell culture tests from MRC5 human fibroblasts. The Alamar Blue test evaluated cytotoxicity; the Trypan Blue Solution trial evaluated cell viability. The comet assay on alkaline and neutral pH assessed genotoxicity. Test results were tabulated and analyzed through descriptive and inferential statistics, with ANOVA Test (p≤ 0.05). Results: No cytotoxic activity or morphological induction of cell death for the test formulation. Regarding genotoxicity, the Juca formulation could not induce DNA damage in MRC-5 at 25 and 50 μg/mL concentrations through the comet assay at neutral or alkaline pH. Conclusion: The tested formulation is biocompatible, and no cytotoxic or genotoxic effects were observed under test conditions, demonstrating viability for future in vivo tests.

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ABSTRACT Objective: To investigate the antifungal properties and potential toxicity of Graptophyllum pictum leaves extract (GPLE) as a candidate for herbal biomaterial-based denture cleanser. Material and Methods: The research was conducted through an in silico study, phytochemical tests, antifungal activity tests, and brine shrimp lethality test (BSLT). An in silico study determined the grid score values of GPLE’s ligands and Candida albicans’ protein complexes. Antifungal activity was evaluated on Aquadest, Polident, and GPLE at 30%, 40%, 50%, 60%, and 70%. The BSLT test groups consisted of aquadest and groups of 1000, 500, 250, 100, 50, and 25 ppm of GPLE. Primary data analysis was performed using the Kruskal-Wallis test with a different significance value of p<0.05. A probit regression test was performed for BSLT results with a value of LC50 > 1000 μg/mL. Results: The in silico evaluation demonstrated GPLE’s antifungal efficacy, which is attributed to its high binding affinity to DHFR, hsp90, and NMT protein. Phytochemical analysis confirmed the presence of antifungal compounds such as flavonoids, saponins, alkaloids, tannins, terpenoids, and steroids. GPLE exhibits fungicidal properties at a concentration of ≥50%. Additionally, BSLT findings indicate an LC50 value of 4780.735 μg/ml with a 95% confidence interval, suggesting no acute toxicity potential. Conclusion: Graptophyllum pictum leaves extract has antifungal and nontoxic properties as a candidate for herbal biomaterial-based denture cleansers.

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ABSTRACT Objective: To analyze the availability of periodontal instruments, services, and specialized referrals in Primary Health Care and compare Brazilian geographical regions. Material and Methods: The historical time series analysis was carried out based on secondary data extracted from the 1st (2012), 2nd (2014), and 3rd (2018) cycles of the external evaluation of the Basic Care Access and Quality National Program. A comparison was carried out between the proportion (%) of Oral Health Teams (OHT) and dependent variables (Periodontal instruments, service offered, and specialized referral) and the independent variables of Brazilian geographical regions and years. Results: The number of OHT evaluated was 12,562 (2012), 18,333 (2014), and 21,817 (2018). Increase was observed in the availability of periodontal probe, periodontal curette, sharpening stones, and sodium bicarbonate jet for the Brazilian OHT, and in all regions of the country between 2014 and 2018 (p<0.001), and reduction in the availability of dental ultrasound in Brazil, mainly in the Southern (p<0.001), Southeastern (p<0.001), and Midwestern (p=0.008) regions. Supragingival Scaling and Root Planing were the most commonly performed periodontal procedures. At the same time, frenotomy/frenectomy was the least performed procedure by the OHT in Brazil and in all Brazilian regions, with a gradual increase according to the cycle (p<0.001). The offer of periodontal specialist referral increased from 54.6% (2012), 68.3% (2014), to 81.8% (2018) in Brazil and all Brazilian regions (p<0.001). Conclusion: Despite the increase in periodontal instruments, procedures, and specialist referrals in Brazil, regional differences were still observed.

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ABSTRACT Objective: To gather epidemiological data on AIDS in Brazil over more than four decades in the population aged 0 to 14 years. Material and Methods: This is a descriptive cross-sectional study. The population corresponded to individuals with AIDS aged 0 to 14 years, with data registered in the Notifiable Diseases Information System, collected through the DATASUS website, reported in Brazil from the first case in July 1982 to 2022. Using descriptive statistics based on the calculation, it was found that there was an association using the Chi-Square test. Furthermore, the Prais-Winsten linear analysis model was used for trend analysis. Results: A total of 28,007 cases were reported. An increase in HIV cases was observed until the beginning of the 2000s. Regarding races/skin color, the majority of affected individuals belonged to the white race (16.75%), second only to those who did not report this characteristic (64.5%). The highest incidence rate was found in the South region, with 475 new cases of AIDS per 100.000 live births. Conclusion: The annual variation rate showed a stationary trend, with a gradual decrease from 2000 to 2022. There was a significant percentage of notifications in which the race/color item was ignored. The most affected age group was 1 to 4 years old.

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ABSTRACT Objective: To evaluate the caries risk in adolescents, according to different protocols. Material and Methods: This is an observational, cross-sectional, quantitative, and analytical study, performed in 2024, in Araçatuba city, São Paulo, Brazil, with 15-year-old adolescents enrolled in an educational foundation that helps them find work. Sample size calculation was performed considering the prevalence of high risk of dental caries as the main outcome. Caries risk was evaluated according two protocols: 1) Technical Area of Oral Health of the State Department of Health of São Paulo, Brazil (TAOH); 2) American Dental Association (ADA). Data were collected by a single researcher through clinical examinations and interviews. Data were analyzed using descriptive statistics techniques and the binomial test was used to compare the proportions according to the caries risk. Results: 103 adolescents participated in the study. The proportion of low caries risk was higher (p=0.0113) in TAOH protocol compared to ADA protocol. Dental caries index (DMFT) was 3.56+3.39. The classification according to TAOH protocol was: 59.23% high risk; 25.24% moderate risk; and 15.53% low risk. The classification according to ADA protocol was: 62.14% high risk; 33.01% moderate risk; and 4.85% low risk. Conclusion: In both protocols, the caries risk of most adolescents was classified as high. The proportion of low caries risk was higher according to the TAOH protocol compared to ADA protocol.

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ABSTRACT Objective: To compare two protocols for adjunctive exercise prescription – before or after subgingival instrumentation (SI) – during periodontal therapy. Material and Methods: Twenty-four patients were randomly allocated into two groups and evaluated at 3-time points (T0 – Baseline, T1 – 45 days, T2 – 90 days). Group 1 (n=10) received SI at T0, re-evaluation and exercise at T1, and final re-evaluation at T2. Group 2 (n=14) started exercising at T0, received re-evaluation and SI at T1, and final re-evaluation at T2. Clinical parameters included probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BoP), and plaque index. Crevicular fluid was analyzed by multiplex immunoassay. The exercise lasted 7 minutes and was performed 3 times/week using an app. Results: Twenty-four patients completed the study. All clinical parameters improved at T2. Group 2, but not Group 1, significantly improved BoP and CAL at T1. There was no significant interaction or intergroup differences for any clinical parameter. For initial PD≥4mm sites, both groups showed significant reductions in PD and CAL at both time points. Only IL-1β and IFN-γ were significantly reduced for both groups at T2. Conclusion: Both exercise/SI protocols improved periodontal parameters after 90 days.

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ABSTRACT Objective: To identify the most common clefts in patients at a craniofacial deformity rehabilitation center, to evaluate the impact on oral health-related quality of life in different cleft types, and to compare it between children and adolescents with cleft lip and palate (CL/P) and a control group without clefts. Material and Methods: A quantitative cross-sectional design was used, involving 150 patients with CL/P from the center and 150 individuals in the control group from a public school, all aged between 8 and 18 years old. Data were collected using the Child Oral Health Impact Profile (COHIP) questionnaire and information on the orofacial cleft type. Bivariate analyses (Pearson's chi-squared test) examined the relationship between cleft types and COHIP domains and between the two groups, with a significance level of α=5%. Results: Cleft lip and palate were the most prevalent (61.3%). However, there was no significant difference in oral health-related quality of life between cleft types (p>0.05). General oral quality of life scores did not differ between the groups, but the control group showed higher scores in the 'functional well-being' and 'personal image' domains. Conclusion: There are no differences in the impact of oral health-related quality of life between children and young people with cleft lip and palate and the control group.

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ABSTRACT Objective: To evaluate methods for utilizing a validated educational comic to promote the safe use of fluoridated toothpaste among children. Material and Methods: This quasi-experimental study included 33 educators from four municipal preschools in Macapá, Brazil. Schools were randomly assigned to two groups: G1 (educators read the comic independently; n=19) and G2 (educators read the comic and later participated in a dentist-led discussion; n=14). Educators completed pre- and post-intervention questionnaires. Educators served as the unit of analysis, and statistical analyses were conducted at α=5%. Results: Knowledge improved in both groups. A significant reduction was observed in the amount of toothpaste applied to children's toothbrushes, along with increased awareness of the risks associated with toothpaste sitting on the brush before brushing began (p<0.05). G2 demonstrated a higher frequency of correct responses regarding toothpaste use and quantity. Furthermore, in G2, perceptions of fluorosis risk were significantly associated with key factors, including the age-appropriate amount of toothpaste (p=0.0277), children applying toothpaste independently (p=0.0251), adult supervision (p=0.0284), swallowing toothpaste (p=0.0425), and encouraging expectoration (p=0.0152). Conclusion: The comic effectively improved educators' knowledge of safe toothpaste use. The addition of a group discussion further enhanced this effect, underscoring the importance of integrating independent learning with interactive strategies to optimize oral health education.

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ABSTRACT Objective: To observe the impact of military training on the oral health of Brazilian Air Force (FAB) recruits in the first phase and to assess the efficacy of ozonated sunflower oil (Oleozon) in improving the periodontal indices of FAB recruits in the second phase. Material and Methods: In the observational phase, PPD (periodontal probing depth), CAL (clinical attachment level), PI (plaque index), GI (gingival index), and DMFT (decayed, missed, and filled teeth) values were compared before and at the end of military training. In the interventional phase, a randomized, double-anonymized, placebo-controlled study was conducted to evaluate whether the daily use of oleozon added to toothpaste would improve periodontal indices. Results: At the end of their military training, recruits exhibited a significant worsening in periodontal disease indicators, resulting in increased dental costs for FAB and increased duty absence. In the second phase, a substantial reduction in PPD and GI (p<0.004 and p<0.001) was observed in the oleozon group. Conclusion: Oleozon, in association with toothpaste brushing, was superior to brushing alone in improving the periodontal health. Despite the need for further studies, it is proposed that oleozon should be included in the oral hygiene protocol for Brazilian Air Force recruits, thereby reducing periodontal risk and dental costs.

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ABSTRACT Objective: To investigate the association between dental caries, sociodemographic factors, oral health literacy (OHL), and periodontal conditions in pregnant women. Material and Methods: A cross-sectional study was conducted with 256 pregnant women in southern Brazil. Demographic and socioeconomic characteristics were collected using a semi-structured questionnaire. The OHL was assessed using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Dental caries were evaluated using the Decayed, Lost, or Filled Teeth (DMF-T) index, and the periodontal conditions were assessed using the Visible Plaque Index (VPI) and the Gingival Bleeding Index (GBI). Data analysis was performed using adjusted logistic regression. The results are presented as Odds Ratio (OR) and its respective 95% confidence intervals (CI). Results: The results showed that pregnant women with a high level of OHL were 46% less likely to have caries experience (OR 0.54; 95% CI: 0.30-0.99). Pregnant women under 24 years of age were 3 times more likely to have caries experience (OR 3.15; 95% CI: 1.78-5.47). Regarding untreated caries, pregnant women who had less than 8 years of formal education were two times more likely to have untreated dental caries (OR 2.39; 95% CI: 1.16-4.91). Furthermore, pregnant women with severe marginal bleeding were three times more likely to have untreated dental (OR 3.64; 95% CI: 1.59-8.34). Conclusion: Our findings demonstrated that OHL, age, education, and gingival bleeding among pregnant women were associated with dental caries.

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ABSTRACT Objective: To investigate ChatGPT®’s knowledge of Brazilian dental ethics and legislation. Material and Methods: A cross-sectional study analyzed ChatGPT® 3.5’s responses to 281 dichotomous questions (“yes” or “no”) based on Federal Council of Dentistry (CFO) Resolution 118/2012 – Code of Dental Ethics (CEO) and Brazilian Law No. 5,081/1966 (L5081). The answer was “yes” in all cases, and when not provided, the question “What is the source of this information?” was asked. Answers were classified as “Correct,” “Partially correct,” and “Incorrect.” Errors were then reassessed with a reverse question: “What is described in Art. X of L5081?”. The same approach was applied to errors in the CEO, with classifications of “Correction,” “Same error,” and “New error.” Data were analyzed descriptively and using the Kruskal-Wallis test (α=5%). Results: Among answers, 134 (47.7%) were “Correct,” 127 (45.2%) were “Partially correct,” and 20 (7.1%) were “Incorrect.” Excluding the CEO’s initial and final provisions, Chapter XVII had the highest percentage of correct answers (n=7, 77.8%), while Chapter X had the highest rate of “Incorrect” answers (n=1, 25.0%). Of the 147 errors, 98.6% (n=145) generated a “New error.” No statistically significant difference was found among CEO chapters (p=0.058), but there was one between CEO and L5081 (p=0.005). Conclusion: ChatGPT®’s knowledge of Brazilian dental ethics and legislation may contain inaccuracies, and its use without source verification is not recommended.

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ABSTRACT Objective: To present the TL Sharps Bin, a newly developed device designed to enhance safety and functionality in healthcare settings, and to evaluate its performance and usability among healthcare professionals. Material and Methods: A total of 82 participants, comprising 40 dental surgeons and 42 medical doctors, were selected using random sampling. Following a demonstration and hands-on session on the proper use of the TL Sharps Bin, participants completed a structured questionnaire consisting of 19 items. The questionnaire assessed the bin’s performance across two key domains: visibility and accommodation. To analyze the relationship between categorical variables, chi-square tests were applied, allowing for the assessment of associations between participant characteristics and their responses to the questionnaire. Results: The TL Sharps Bin was rated highly in all three dimensions, with safety receiving a mean score of 4.6, usability 4.5, and efficiency 4.7 on a 5-point Likert scale. Participants highlighted the bin’s superior puncture resistance, ease of use, and accessibility in busy clinical settings. Statistical analysis confirmed that the TL Sharps Bin significantly outperformed traditional containers in terms of both user satisfaction and adherence to safety protocols (p<0.05). Conclusion: The TL Sharps Bin demonstrated exceptional performance in clinical settings, meeting and exceeding the safety guidelines set by the World Health Organization and the Occupational Safety and Health Administration. Its adoption is strongly recommended to improve sharps disposal practices and enhance occupational safety for healthcare workers. Further studies could explore its long-term impact on reducing the incidence of sharps-related injuries and infections.

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ABSTRACT Objective: To evaluate the influence of two antioxidants on the fracture resistance of bleached enamel. It also assessed their impact on color change and surface microhardness. Material and Methods: Forty-eight bovine enamel samples underwent three bleaching sessions and were randomly divided into three groups (n=16): Control – No antioxidant application; Sodium Ascorbate – Application of sodium ascorbate for 30 min; DL-alpha-lipoic Acid – Similar to Sodium Ascorbate, but the antioxidant used was DL-alpha-lipoic Acid. Then, color was evaluated with a spectrophotometer, and microhardness was measured using the Knoop test, before the start of the bleaching treatment and immediately after the final application of the bleaching agent and the antioxidant. Afterward, the specimens were restored with composite resin. After seven days, the fracture resistance test was performed using an electromechanical testing machine. Fracture resistance and color evaluation data were subjected to one-way ANOVA, followed by Tukey’s post-hoc test. Microhardness was assessed using Kruskal-Wallis and Dunn tests (p<0.05). Results: Sodium ascorbate provided the highest fracture resistance compared to DL-alpha-lipoic acid and the control group after bleaching (p<0.05). The antioxidant agents did not interfere with the whitening effect of 35% hydrogen peroxide (p>0.05). Conclusion: Using sodium ascorbate reduced the deleterious effects on enamel microhardness and fracture resistance.

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ABSTRACT Objective: To explore the proliferative and wound-healing potential of Periostin and Emdogain® on periodontal fibroblasts. Material and Methods: Human PDL (hPDL) fibroblasts were cultured and treated with two biological agents, Emdogain® and Periostin. The Dulbecco's Modified Eagle Medium (DMEM) served as the control. The cytotoxic effects of Emdogain® and Periostin were analyzed using the Clonogenic assay. Cell viability was estimated using the CCK-8 assay. Further, the migratory potential of the hPDL fibroblasts was assessed using the scratch migration assay. Results: The results showed that 1/1000 dilution of Emdogain® and 1/10 dilution of Periostin had the highest cell survival fraction (p<0.05). In the CCK-8 assay, Emdogain® displayed maximum cell viability compared to Periostin (p=0.000) and control (p=0.006). The PDL fibroblasts' migratory rate corresponded to the experimental agents' wound-healing potential. Emdogain® presented with earlier wound closure compared to Periostin (p=0.002) and control (p=0.000). Conclusion: Thus, based on the results of this study, Periostin may be a viable biologic agent for promoting periodontal regeneration.

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ABSTRACT Objective: To compare the percentage of collagen in the coronary dentin of human teeth across sexes, ethnicities, and age groups, and to correlate this percentage with the microtensile bond strength (μTBS) of an adhesive system. Material and Methods: Fifty-one sound extracted molars were selected from patients of different sexes and ethnicities with age variation between 16 and 51 years. The crown was separated from the root. The dentin of the coronal part was restored with a hybrid composite resin block. After 24 hours of storage in distilled water at 37 °C, each specimen was sectioned perpendicular to the bonding interface area to obtain beams with a cross-sectional area of approximately 0.9 mm². The beams were submitted to μTBS test until failure. The μTBS was expressed in MPa. The root portion containing 1.0 mm of the crown was processed histologically to assess the percentage of collagen. The following statistical tests were used: Kolmogorov-Smirnov, Mann-Whitney, Student's "t" test, Kruskal-Wallis, ANOVA, and the Pearson and Spearman correlation tests. Results: No-white and female individuals had the highest percentage of collagen when compared to white and male individuals (p<0.0001). The age group between 44 and 51 years had the highest percentage of collagen (p=0.0013). There were no significant differences in relation to µTBS regarding ethnicity, sex, and percentage of collagen. Conclusion: The percentage of collagen in coronal dentin is higher in the group between 44 and 51 years, in females, and in non-white individuals, and is not related to the microtensile bond strength.

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ABSTRACT Objective: To analyze the agreement between responses generated by AI tools regarding dental trauma, as derived from a validated questionnaire for laypeople, based on the latest International Association of Dental Traumatology (IADT) guideline recommendations. Materials and Methods: Eleven questions were entered into the AI tools ChatGPT-3.5, Microsoft Bing-Copilot, and Google Gemini on the same date and in sequence. The answers were collected and coded as "correct" (1 point) or "incorrect" (0 point). The difference between correct responses among the AI tools analyzed was evaluated using Fisher's exact test (p<0.05). The agreement between the AI tools and IADT was assessed using the Kappa test. Results: None of the AI tools answered all the questions correctly, and there were no significant differences between the three AI tools (p>0.05). Regarding the accordance with IADT recommendations, ChatGPT-3.5 demonstrated weak agreement (k = 0.46; p = 1.122), Google Gemini showed moderate agreement (k = 0.63; p = 0.036), and Microsoft Bing-Copilot exhibited strong agreement (k = 0.81; p = 0.006). The frequency of correct answers among ChatGPT-3.5, Google Gemini, and Microsoft Bing-Copilot was 73%, 82%, and 91%, respectively. Conclusion: Although there were no differences regarding the number of correct answers, the level of agreement with IADT recommendations varied among the AI tools, and their use by the public should be cautiously approached.

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ABSTRACT Objective: To evaluate the risk of percutaneous injuries (PCIs) that novice predoctoral operators undergo due to non-compliance with biosafety standards in the Endodontics clinic. Material and Methods: This is a prospective longitudinal observational study, developed for two years, which included 120 dental students from the Endodontic Clinic of Dentistry course. The following circumstances were analyzed: burs left in the handpiece after use; bare needles lying on the instrument tray or being recapped with two hands; cannulas left in the suction; Gates-Glidden drills left in the micromotor; and biosafety violations involving endodontic files. Descriptive and inferential statistical analysis was performed using Chi-square test (α=5%). Results: The sample consisted of 75% women (90). Ninety-nine students (82.50%) were involved in situations that could cause percutaneous injuries. Despite the risk, no accidents occurred during the study period. In total, 364 situations involving risk of percutaneous injuries were observed. In this study, 209 (57.4%) cases of burs left in the handpiece after use were observed, 60 (16.5%) cases of aspiration cannulas left in the suction, 52 (14.3%) cases of bare needles on the instrument tray or being recapped with two hands, 26 (7.1%) cases of Gates-Glidden drills left in the micromotor socket and 17 (4.7%) cases of biosafety violations involving endodontic files. A significant difference (p<0.05) was observed between the 5 types of risk situations. Conclusion: There was a high percentage of the risk of percutaneous injuries in novice predoctoral operators. Burs left in the handpiece after use were the most encountered risk situation, and most novice predoctoral operators in the Endodontic Clinic disrespected biosafety standards.

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ABSTRACT Objective: To evaluate the mechanical properties of dentin under the effect of grape seed extract (GSE) as intracanal medication (ICM). Material and Methods: Ninety-six single-rooted bovine teeth were divided into groups, as follows: control group (Ctrl), without any dentin treatment; groups treated with Ca(OH)2 (Ca7, Ca15 and Ca30); and GSE (GSE7, GSE15 and GSE30), with direct contact between dentin and ICM for different durations of 7, 15 and 30 days. The samples underwent tests of maximum fracture load (FL), flexural strength (σf), cohesive strength (σc), and elastic modulus (E) of the remaining root. For statistical analysis, one-way ANOVA was used, followed by Dunnett's test to verify whether ICMs interfere with dentin properties. Two-way ANOVA (ICM and application time) and Tukey's test were also used, considering the groups treated with different ICM at different intervals. All analyses were performed at p ≤ 0.050. Results: GSE had a less pronounced effect on dentin's mechanical properties compared to Ca(OH)2. GSE showed less interference with FL (p=0.000), σf (p=0.002), and σc (p=0.000). It was observed that the duration of exposure to ICM had a negative impact on FL (p=0.002) and σc (p=0.031). ICM (p=0.080) and the application time (p=0.985) did not significantly affect E. Moreover, the application time of ICM did not have a significant impact on σf (p=0.169). Conclusion: Grape seed extract did not affect the mechanical properties of bovine dentin when used as intracanal medication.

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ABSTRACT Objective: To carry out an epidemiological survey of oral and maxillofacial lesions at the Integrated Center for Pathological Anatomy of the Oswaldo Cruz University Hospital, Brazil. Material and Methods: Between the years 2013 and 2023, the histopathological reports and clinical forwarding sheets were analyzed. Among the 909 units obtained, 118 patients were excluded because they had lesions on their skin or had inconclusive histopathological diagnoses. The data were presented using descriptive statistics. Results: 791 different reports and 88 different histopathological variants were obtained. The distribution by race or skin color showed that most patients were non-black (33.1%). The most prevalent sex was female (51.9%), and the mean age was 42 years (1 to 100). Most biopsies were excisional (68.5%), of a benign nature (87.1%), and located in the jaws (51.6%). The group of epithelial pathologies (18.8%), odontogenic cysts (17%), and bone pathology (14%) were the most common ones. Regarding diagnoses, oral squamous cell carcinoma (8.98%) was the most frequently reported, followed by fibrous hyperplasia (8.09%) and ameloblastoma (7.33%). Conclusion: The profile of patients with oral and maxillofacial lesions assisted at the service corresponds to individuals who need high-complexity medical and dental treatment.

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ABSTRACT Objective: To investigate the effect of 0.26mol/L Clodronate Disodium Tetrahydrate, 9% Etidronic acid (HEDP), and 17% Ethylenediaminetetraacetic acid (EDTA) on the dislodgement resistance of Biodentine. Material and Methods: 80 human single-rooted premolar teeth were selected. For bond strength analysis, samples were treated (n=15) according to the irrigation protocol employed: EDTA Group - 2.5% sodium hypochlorite (NaOCl) + 17% EDTA; HEDP Group - 9% Etidronic acid + 2.5% NaOCl; Clodronate Group- 0.26mol/L Clodronate + 2.5% NaOCl; and Control Group- 2.5% NaOCl + Distilled Water. Root canals were condensed with Biodentine, and 1.5 mm thick dentine discs were produced, and push-out bond strength was analysed. For FTIR analysis, dentine samples (n=5) were prepared (1cm × 1cm). Pre and post-irrigation scans were performed to compare compositional changes in the Amide III, Phosphate, and Carbonate infrared bands. One-way analysis of variance with post-hoc Tukey’s test was employed to analyze the results. Results: The highest bond strength value was obtained with 0.26mol/L Clodronate, followed by 9% HEDP and 17% EDTA (p<0.001). Amide III: Phosphate levels decreased with EDTA and HEDP, whereas the opposite was observed with Carbonate: Phosphate. No difference was observed with 0.26 mol/L Clodronate. Fractographic analysis revealed 20% adhesive failure, 48% mixed failure, and 32% adhesive failure, respectively. Conclusion: 0.26 mol/L Clodronate produced the most favourable outcome in terms of bond strength of Biodentine.

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ABSTRACT Objective: To evaluate the perception of Brazilian pediatric dentists (PD) regarding the behavior of child patients and their dental care management during the COVID-19 pandemic. Material and Methods: A self-administered online questionnaire was answered. Professionals who assisted children and/or adolescents, who had a postgraduate degree in Pediatric Dentistry, and worked in public and/or private services, were considered eligible for the study. Demographic information, perception of behavior changes of children and adolescents during appointments and the use of behavioral management techniques (Remained the same; Reduced/suspended or Increased employment) were collected. Fisher's exact test was used (p<0.05) to assess the association between the use of behavior management techniques and the perception of the child’s behavior in the consultation during the pandemic. Results: A total of 231 PD participated, of which 45.6% noticed a worsening in the behavior of children and adolescents during the pandemic. Regarding the management of child behavior, appropriate/physical contact was the technique that had the greatest reduction/suspension of use (77.6%), followed by the distraction technique using toys and books (55.9%). A higher prevalence of protective stabilization use (p<0.001) and positive reinforcement (p=0.002) was identified among PD who noticed a worsening of the behavior. Conclusion: The COVID-19 pandemic interfered with the dynamics of pediatric dental appointments regarding the use of some behavioral management techniques, as well as the perception of child behavior.

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ABSTRACT Objective: To analyze beliefs about oral health in pregnant women and their association with the average number of decayed teeth in these women. Material and Methods: This is a cross-sectional study nested in a prospective cohort involving 202 pregnant women from a Hospital in Northeast Brazil. Information on oral health beliefs during pregnancy was collected through face-to-face interviews. The number of decayed teeth was assessed by clinical examination (ICDAS-II). Mann-Whitney test was used to estimate the association between beliefs and dental caries (α=5%). Results: The mean age of pregnant women was 25.6 (±6.0) years. The mean number of decayed teeth was 5.9 (±4.0) and for active decay was 3.5 (±3.6). More than 50% of women believe that pregnant women cannot have teeth extracted (76.82%), receive dental anesthesia (75.56%), or undergo X-rays (64.83%). They also believe pregnant women have caries (70.3%) or gum problems (61.4%) regardless of care, and that babies absorb calcium from mothers’ teeth and bones (50.79%). Pregnant women had an average of 5.9 decayed teeth. Healthy tooth surfaces were predominant (22.8±4.7), while early and advanced carious lesions were infrequent. Although there were no significant differences, the average number of decayed teeth differed most in beliefs like “Pregnant women cannot undergo dental treatment” (3.3±0.6 caries for those who agree vs. 6.8±5.4 for those who disagree; p=0.299), “Pregnant women cannot undergo X-rays” (6.7±4.4 vs. 3.8±2.9; p=0.177), and “It is normal to develop cavities during pregnancy” (4.5±4.9 vs. 6.6±5.4; p=0.157). For all other beliefs, the average number of caries was also similar. Conclusion: Unfounded beliefs about oral health and dental care during pregnancy persist among pregnant women. The experience of decay during pregnancy proved to be high, regardless of beliefs.

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ABSTRACT Objective: To investigate the prevalence of erosion in permanent teeth and associated factors. Material and Methods: A cross-sectional study was conducted with 208 children aged 8 to 11 years old, from public schools and dental clinics (both private and public). Data collection included a demographic and socioeconomic questionnaire, and questions related to dental erosion, as well as an oral clinical examination. Dental erosion (DE) in permanent teeth was assessed using the Tooth Wear Evaluation System (TWES). Chi-square test, and univariate and hierarchical multivariate Poisson regression were performed. Results: The overall prevalence of DE was 26%, being more prevalent in children from dental clinics (61.1%; p=0.003), those who consumed soft drinks (62%; p=0.016), and with attrition (51.9%; p=0.049). The sample of children from dental clinics, soft drink consumption, and the frequency of consuming acidic foods and beverages 2 to 3 times a day were suggestive factors for explaining DE (PRadjust=1.864; CI95% =1.072-3.242; PRadjust=2.027; CI95%=1.040-3.951; PRadjust=1.803; CI95%=1.171-2.775). The age of 11 years was revealed as a protective factor against DE (PRadjust=0.420; CI95%=0.196-0.899). Conclusion: Dental erosion was associated with dental clinic samples, consumption of soft drinks, and the frequency of consuming acidic foods and beverages.

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ABSTRACT Objective: To assess maternal knowledge about ECC prevention in breastfed versus bottle-fed children, exploring how breastfeeding practices and socio-demographic factors like education and income influence this understanding. Material and Methods: This cross-sectional study involved 340 mothers from the dental clinics at Qassim University. Mothers, aged 20-49 and currently breastfeeding or bottle-feeding, completed questionnaires covering socio-demographic background, birth-related information, and knowledge about the dental health of toddlers. The questionnaires were adapted from previous studies and translated into Arabic. Data analysis was conducted using SPSS, focusing on descriptive statistics and Chi-square tests. Results: The majority of participating mothers fell within the 30-39 age range, were employees, and predominantly practiced mixed feeding. While many showed acceptable to high knowledge about child dental prevention and awareness of dental caries due to lactation, significant gaps were noted in areas like the timing of the first dental visit and understanding of the impact of nocturnal breastfeeding on caries development. Variations in knowledge were also observed across different income groups and lactation types. Conclusion: The study highlights the need for targeted educational interventions to bridge knowledge gaps among mothers, particularly regarding the timing of dental appointments and the implications of feeding practices on dental health. It underscores the importance of educational and socio-economic factors in shaping maternal knowledge about ECC prevention.

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ABSTRACT Objective: To assess the effects of physical exercise on salivary pH, amylase, mucin, and total protein concentration. Material and Methods: Saliva samples were collected from 34 participants (21 males, 13 females) at four time points: rest (control), moderate-intensity exercise, high-intensity exercise, and recovery (post-30 min rest). Salivary pH was measured using a pH meter, while amylase, mucin, and total protein concentrations were analyzed using ELISA. Results: Salivary pH remained stable throughout. Amylase levels significantly increased (p<0.05) post-moderate (males: 85.66 ± 2.79 units/mL; females: 85.46 ± 2.36 units/mL) and high-intensity exercise (males: 104.42 ± 1.91 units/mL; females: 103.69 ± 2.05 units/mL), declining during recovery. Mucin levels also rose significantly (p<0.05) post-moderate (males: 3.99 ± 0.79 mg/mL; females: 3.95 ± 0.73 mg/mL) and high-intensity exercise (males: 4.57 ± 0.68 mg/mL; females: 4.52 ± 1.07 mg/mL), then decreased in recovery. Total protein concentration followed a similar trend, increasing post-moderate (males: 2.80 ± 0.62 mg/mL; females: 3.95 ± 0.73 mg/mL) and high-intensity exercise (males: 3.94 ± 1.04 mg/mL; females: 3.63 ± 0.59 mg/mL), then declining during recovery. Conclusion: Moderate and high-intensity exercise significantly increased salivary amylase, mucin, and total protein levels, while salivary pH remained unaffected.

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ABSTRACT Objective: To evaluate the in vitro antimicrobial activity of zinc oxide cement formulated with eugenol and oregano essential oil (OEO) against Streptococcus mutans. OEO was chosen for its established activity against oral bacteria, although its incorporation into dental materials has not been previously reported. Materials and Methods: Eugenol and an eugenol-OEO mixture were introduced into perforated wells on agar plates inoculated with S. mutans. Disk-shaped zinc oxide cement specimens formulated with either eugenol alone or the eugenol-OEO mixture were placed on the agar surface, and stick-shaped specimens were inserted into the agar. After incubation, the inhibition zones were measured. Statistical analysis included one-way ANOVA followed by Tukey's post hoc test for comparing inhibition zones from the oils. An unpaired t-test was used to compare the inhibition zones from the cement specimens. Statistical significance was set at p<0.05. Results: OEO exhibited significantly greater antibacterial activity than other agents (p<0.001), including the positive control (0.12% chlorhexidine digluconate). Cement specimens (diskand stick-shaped) containing the eugenol-OEO mixture produced larger inhibition zones compared to those formulated with eugenol alone (p<0.05). Conclusion: Zinc oxide cement formulated with eugenol and OEO demonstrated superior antimicrobial activity against S. mutans compared to the conventional formulation.

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ABSTRACT Objective: To test the validity and reliability of the Brazilian Portuguese version of the Children's Experiences of Dental Anxiety Measure (CEDAM). Material and Methods: The sample consisted of 80 pairs of parents and 9 to 12-year-old students at a public school in Ubá, Brazil. Children self-applied the CEDAM, Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and Child Perceptions Questionnaire (CPQ8-10/CPQ11-14), and were clinically evaluated at school. Parents were interviewed about the child's dental history, the Corah's Dental Anxiety Scale, and the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Criterion validity was assessed using the Mann-Whitney/Spearman's correlation; construct discriminant validity was evaluated using the Mann-Whitney/Kruskal-Wallis test; construct convergent validity was examined using Spearman's correlation; and predictive validity was assessed using multiple logistic regression. The reliability was calculated by Cronbach's alpha and McDonald's omega coefficients. Results: About 80% had already been to the dentist. Overall, highly fearful children had higher CEDAM mean scores than those who were less afraid, demonstrating criterion validity. In CPQ8-10 global ratings, those reporting "regular" oral health had the highest CEDAM scores compared to those reporting "very good", showing discriminant validity. For convergent validity, the CEDAM score was positively correlated with the CPQ8-10 emotional well-being domain. Moreover, significant positive correlations were observed between CEDAM scores and P-CPQ total scores and P-CPQ emotional well-being domain scores. The predictive validity was indicated by the greater chance that younger children with previous experience of dental visits, who had avoided and cried during dental treatment, presented higher CEDAM scores. Cronbach's alpha of 0.93 indicated almost perfect internal consistency of the CEDAM. Conclusion: The Brazilian Portuguese version of CEDAM proved to be valid and reliable for application in 9 to 12-year-old children. Dental anxiety is more likely to be observed in younger children who have visited the dentist, avoided, and cried during dental treatment.

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ABSTRACT Objective: To study cases of neonates diagnosed with ankyloglossia in a maternity hospital, submitted to frenotomies with the aid of a high-power laser. Material and Methods: 18 newborns in a maternity hospital between 2021 and 2022, with difficulties in breastfeeding due to ankyloglossia, participated in this cohort study. Neonates submitted to frenotomy with high-power laser were evaluated pre, trans, and postoperatively. Data were obtained from the patient's medical records and assessment form, questionnaire Bristol Tongue Assessment Tool (BTAT), Martinelli´s Protocol, Neonatal Infant Pain Scale (NIPS), and questions answered by mothers and by the performing professional. Results: There was a significant difference in the benefits of surgical removal of the lingual frenulum on tongue movements. Neonatal pain scores significantly decreased in the immediate postoperative period after frenotomy. The mother's perception of the improvement in the quality of breastfeeding in the postoperative period was positive (p<0.001). Conclusion: Lingual frenotomy in neonates, performed with the aid of a high-power surgical laser, didn't bring discomfort, bleeding, or infections during the trans and postoperative period, and made breastfeeding possible, bringing benefits to the mother-baby dyad.

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ABSTRACT Objective: To summarize data on the prevalence of Molar Incisor Hypomineralization (MIH) in Brazilian children and adolescents and to evaluate its frequency and geographic distribution. Material and Methods: A systematic review was conducted using the following databases: PubMed, Scopus, Latin American Literature in Health Sciences (LILACS), EMBASE, Scientific Electronic Library Online (SciELO), Virtual Health Library (BIREME), Cochrane Library, and Web of Science, covering studies published from 2000 to 2023. The inclusion criteria were studies assessing the prevalence of MIH in Brazilian children and adolescents, published in English, Portuguese, or Spanish, with samples of Brazilians aged 5 to 15 years. Two reviewers conducted the study selection under the PRISMA and MOOSE guidelines. The risk of bias was assessed using the JBI Critical Appraisal Tool for Analytical Cross-Sectional Studies. A total of 12 studies met the inclusion criteria, with a combined sample of 8,312 participants. A meta-analysis was performed to determine the pooled prevalence of MIH using random-effects models. Results: The pooled prevalence of MIH in the Brazilian population is 15.9% (95% CI: 11.3-20.5). The Southeast region has the highest prevalence, at 20.2%, followed by the Northeast at 16.7%, the South at 13%, and the Midwest at 11.5%. Conclusion: These findings suggest that the prevalence of MIH in Brazil is comparable to the global estimate, albeit with regional variations.

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ABSTRACT Objective: To assess the quality and effect of xylitol-containing chewing gums on oral microflora. Material and Methods: A systematic review was conducted utilizing a database from 2016 to 2023. The PICO question implemented through this research was “Does xylitol-containing chewing gums show any effect on oral microflora?”. A total of 372 articles were found, and after eliminating duplicates, 48 articles were retrieved. By applying inclusion and exclusion criteria, a total of 10 RCTs were identified. Quality assessment was done using the CONSORT checklist, and the Risk of Bias was assessed using the RoB 2 tool (A revised Cochrane risk-of-bias tool for randomized trials). Meta-analysis was performed using the Comprehensive Meta-analysis version 4 software for 4 RCTs. Results: A total of 1003 subjects who are aged between 3 and 63 years were included in the randomized trials with a follow-up period ranging from 2 days to 2 years. All the included studies have shown reduced mutans streptococci count after using xylitol chewing gums. On performing Meta-analysis, a significant difference was found between the experimental (xylitol) and control (Polyol) groups with a Standard Mean Difference (SMD) of -0.559, 95% Confidence Interval (CI): -0.860 to -0.258 (p=0.001). Conclusion: Regular use of xylitol chewing gum will reduce the count of mutans streptococci.

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ABSTRACT Objective: To investigate the clinical and radiographic success of pulpotomy in primary teeth with sodium hypochlorite (NaOCl) compared with other materials such as formocresol, ferric sulfate, MTA, saline solution, and diode laser. Material and Methods: Clinical trials and cohort studies were included. Seven electronic databases and gray literature were searched by November 2023 without restrictions of language, year of publication, or sample size. For quality assessment, Rob-2, ROBINS-I, and Newcastle-Ottawa Scale were used. Network meta-analyses were conducted. Direct-comparison heterogeneity was assessed with I2. Indirect-comparison heterogeneity was also evaluated. The certainty of the evidence was evaluated using the GRADE approach. Results: Sixteen studies were eligible and 13 studies were included in the network meta-analyses. There was no significant difference between pulpotomy with NaOCl and pulpotomy with formocresol, ferric sulfate, MTA, saline solution, and diode laser in clinical and radiographic outcomes at 6, 12, and 18 months. For most direct comparisons, I2 = 0%. Indirect-comparison heterogeneity ranged from low to considerable. Most clinical trials had moderate or high risk of bias. Cohort studies had low risk of bias. The certainty of the evidence was very low. Conclusion: There is no difference between NaOCl and other materials. The certainty of evidence is very low.

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ABSTRACT Objective: To estimate the prevalence of facial paralysis in patients with malignant parotid tumors who underwent parotidectomy. Material and Methods: The method employed was a systematic review, with a search conducted in the following databases: PubMed, Embase, Scopus, Web of Science, and LILACS. Grey literature from Google Scholar and ProQuest Dissertations and Theses was also used. The included studies were observational, performed with patients with malignant parotid tumors, diagnosed from the histopathological examination of the gland, with permanent or transient facial paralysis, verified by clinical examination, as a result of surgical treatment for the neoplasm. Results: Among the 2156 studies identified, 16 were selected for this systematic review. The prevalence of facial paralysis after parotidectomy due to malignancy varied according to the type of facial paralysis, the size of the tumor, the kind of parotidectomy performed, the presence of preoperative facial paralysis, and the need for adjuvant radiotherapy. Conclusion: The prevalence of facial paralysis after parotidectomy due to malignancy ranged from 9.09% to 100% among the studies.

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ABSTRACT Objective: To assess the effects of cannabis and its synthetically derived products on temporomandibular disorders (TMD) treatment and explore the potential mechanisms underlying these effects in various TMD nociception models. Material and Methods: Electronic searches in five databases were conducted for publications up to August 2024. Clinical and animal studies about the use of cannabinoids for TMD-related pain control were included. Letters to the editor, conference proceedings, protocol articles, historical reviews, in vitro studies, and unpublished articles were excluded. Results: A total of 2,708 unique citations were found. Following the screening, 31 studies were evaluated as full-text copies, and 13 (nine pre-clinical, two observational, and two interventional studies) were included. The pre-clinical studies demonstrated that cannabinoid compounds effectively reduce nociceptive behavior in the temporomandibular joints (TMJ) and masseter muscle using different animal models. Moreover, all the included studies using formalin-induced TMJ nociception reported that cannabinoid agonist-induced antinociception in the TMJ region was mediated by the central activation of CB1 but not CB2 receptors. The observational and interventional studies reported pain reduction, improvement in function, and better health quality with cannabis use. Furthermore, the use of cannabis for chronic pain appears to be an effective alternative to the use of opioids and other pain control drugs associated with unwanted side effects. Conclusion: The use of cannabis and its synthetically derived products seems to be effective in reducing nociceptive behavior in TMJ and masseter muscle. However, further clinical and mechanistic studies are necessary to thoroughly investigate the therapeutic potential of cannabinoid compounds in TMD.

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ABSTRACT Objective: To investigate clinical studies that evaluated the relationship between endodontic alterations and transplanted patients or those in need of liver or kidney transplantation compared to patients not in need of transplantation. Material and Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Two independent authors conducted an electronic search of the main databases until January 2025. Clinical studies evaluating endodontic changes in transplant patients were included in this study. There was no restriction on the date of publication. Results: Among the 332 studies retrieved, 11 studies were included. Two cross-sectional studies assessed the interrelationship between patients undergoing liver transplantation and endodontic changes. Nine studies evaluated the relationship between kidney transplantation and endodontic changes; two studies found no relationship between pulp calcification and these patients; however, another three studies found a relationship between the chronicity of the actual disease and pulp chamber narrowing. Conclusion: Few clinical studies have evaluated the interrelationship between patients of liver transplantation and endodontic changes; studies that have evaluated the interrelationship between patients of kidney transplantation have found a relationship mainly with pulp chamber narrowing, but no relationship with pulp calcifications.