Resumo em Inglês:

Abstract Guided bone regeneration (GBR) is a critical strategy for repairing large bone defects. This study aimed to assess the osteopromotive potential of a porcine cross-linked collagen membrane in critical calvaria-defects in rats. Seventy-two rats were divided into three groups: blood clot (CG - negative control), Bio-Gide® membrane (BG - positive control), and Ossix Plus® membrane (OSX - test). The defects were covered according to each group, and the experimental times were 7, 15, 30, and 60 days postoperatively. The collected samples were evaluated by histometric analysis, inflammatory profile, immunohistochemistry, and micro-computed tomography (micro-CT). At 7 days, no significant differences in bone neoformation were observed. At 15 days, the OSX group showed increased new bone formation compared to CG (p = 0.031). At 30 days, the BG group exhibited the most significant increase compared to both OSX (p < 0.001) and CG (p < 0.001). At 60 days, OSX demonstrated the highest osteopromotive potential, significantly outperforming CG (p < 0.001) and BG (p < 0.001). MicroCT analysis revealed that the OSX group had a bone volume (BV) of 17.33 ± 1.74 mm3, significantly higher than BG (8.06 ± 1.26 mm3, p < 0.05). The cross-linked collagen membrane was biologically more favorable for bone regeneration being a promising option for GBR procedures.

Resumo em Inglês:

Abstract The aim of the study was to explore female authorship in various aspects of randomized controlled trials (RCTs) in dentistry. A search was performed in PubMed for RCTs, in dentistry, indexed from 12/31/2016 to 12/31/2021. Only studies in English were considered. Data selection and extraction were performed by two authors and the following data collected: year of publication, journal, subject, number and names of authors, and country and gender (Genderize website) of the first 10 authors. Descriptive analyses, graphs, and maps were generated. Poisson regression assessed the influence of continent and year of publication on the presence of women as first or last authors. The results were presented as prevalence ratios (PR) and 95% confidence intervals (95%CI). A total of 844 RCTs and 4,305 authors (2,372 men and 1,662 women) were included. Gender disparity increases as the order of authorship advances. Among first authors, men represent 50.59% and women 44.08%, whereas among last authors, they account for 61.92% and 34.03%, respectively. Analyses showed no association between year of publication and the presence of women as authors. There were fewer women as first authors in Europe (PR: 0.82, 95%CI: 0.68–0.99) and as last authors in Europe and Asia (PR: 0.68, 95%CI: 0.53–0.87 and PR: 0.79, 95%CI: 0.63–0.99, respectively). The findings highlight a lower presence of female authors in all aspects analyzed in the RCTs, especially in last authorship. Also, there has been no indication of improvement in recent years. Female participation in RCTs is crucial not only for gender equity but also as a means to enhance the quality and relevance of clinical data for decision-making.

Resumo em Inglês:

Abstract This article describes a new multifunctional oral cavity simulator (MOCS) that allows, with little technical support and easy handling, the laboratory development of dental hard tissue lesions under clinically similar conditions. The MOCS consists of a heating unit containing three independent cylindrical chambers with three specimen holders inside. Liquids flow through the surfaces of specimens by inlets on the lid of the chamber, which is connected to a medium/artificial saliva source through a computer-controlled peristaltic pump. The design, operational principles, and clinical application of this simulator, such as microcosm-induced development of carious-like lesions, acidic-induced erosion-abrasion like-lesions, and testing the anticariogenic effect of restorative materials, are shown. The MOCS can mimic several aspects of the oral cavity, being a promising device for assessing dental hard tissue lesions.

Resumo em Inglês:

Abstracts The aim of the study was to compare the effect of salivary pellicle modification with polyphenol-rich solutions containing fluoride on enamel erosion and abrasion. Human enamel specimens (n = 14/group) were assigned to five pellicle-modifying groups: GSE+F (grape seed extract +500 ppm F-); CRA+F (cranberry extract +500 ppm F-); NaF (sodium fluoride solution -5 00ppm F-); Sn+F (commercial solution, SnCl2/NaF/AmF); and DW (deionized water, negative control). The specimens were submitted to 5 cycles, each one consisting of pellicle formation (120μl, 30 min, 37°C, no agitation), followed by pellicle modification with the experimental solutions (5 ml, 2 min, 25ºC, 70 rpm), and subsequent salivary pellicle formation (120 μl, 60 min, 37°C, no agitation). The specimens were then submitted to erosion (1% citric acid, 10 ml, 1 min, pH 3.6, 70 rpm, 25ºC). Subsequently, they were submitted to abrasion with a fluoride-based toothpaste slurry in a toothbrushing machine (50 strokes, 200 g load, 2 min exposed to slurry). The enamel surface was evaluated with an optical profilometer at baseline and after the 5 cycles to assess the surface loss. Data were submitted to Kruskal-Wallis followed by a multiple comparisons test (α = 0.05). Significant differences were found between the tested solutions (p <0.001). The highest surface loss was verified in the DW group (p < 0.001). The other tested solutions (GSE+F, CRA+F, Sn+F, NaF) promoted significant enamel protection against the erosive-abrasive challenges with no differences between them. In conclusion, the modification of salivary pellicle with both polyphenol-rich, commercial solution and fluoride solutions were able to protect the enamel surface from erosion and abrasion.

Resumo em Inglês:

Abstract This study aimed to evaluate the influence of a portable X-ray device on the diagnosis of proximal caries lesions. For that, radiographs of 40 human teeth with white spots or color changes in enamel and/or dentin were acquired using the Eagle X-ray portable device (Alliage, São Paulo, Brazil) set at 2.5 mA, 60 kVp and an exposure time of 0.5 s (1.25 mAs). Then, new radiographs of the teeth were acquired using the Focus X-ray wall-mounted device (Instrumentarium, Tuusula, Finland) set at 7 mA, 70 kVp, and exposure time of 0.16 s (1.12 mAs). Five oral and maxillofacial radiologists individually assessed the radiographs. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated from the responses of the five examiners and compared between the devices tested using Student’s t test. Significance level was set at 5% (α = 0.05). The weighted Kappa index evaluated the intra- and inter-examiner agreements for caries lesions diagnosis. The use of a portable X-ray device did not influence on AUC, sensitivity and specificity metrics for the diagnosis of caries lesions (p > 0.05). The intra- and inter-examiner agreements for the caries lesions diagnosis ranged from substantial to almost perfect (0.646–0.859) and moderate to substantial (0.491–0.617), respectively. The diagnostic accuracy for detecting proximal caries lesions is not impaired when using a portable X-ray device.

Resumo em Inglês:

Abstract This in vitro study evaluated the effect of proanthocyanidin, palm oil, and vitamin E against initial erosion. Bovine enamel blocks (n = 140) were divided into 14 groups: C+_SnCl2/NaF/Am-F-containing solution (positive control); C-_deionized water (negative control); O_palm oil; P6.5_6.5% proanthocyanidin; P2_2% proanthocyanidin; E_Vitamin E (97.8% oily tocopherol acetate); OP6.5_palm oil + 6.5% proanthocyanidin; P6.5O_6.5% proanthocyanidin + palm oil; OP2_palm oil + 2% proanthocyanidin; P2O_2% proanthocyanidin + palm oil; EP6.5_Vitamin E + 6.5% proanthocyanidin; P6.5E_6.5% proanthocyanidin + Vitamin E; EP2_Vitamin E + 2% proanthocyanidin; P2E_2% proanthocyanidin + Vitamin E. The acquired enamel pellicle (AEP) was previously formed in situ for 30 min. The specimens were treated in vitro with the solutions (500 µL, 30s). Then, the blocks were maintained for an additional hour in oral cavity to develop the modified AEP. The blocks were immersed in 0.5% citric acid (pH 2.5) during 30s. The response variable was the percentage of surface hardness loss (%SHL). Data were analyzed by one-way ANOVA and Fisher’s LSD test (p<0.05). P6.5E (12±7_%SHL) was the only group that promoted similar protection to C+ (11±8_%SHL). O (17±13_%SHL), P2 (20±10_%SHL), OP6.5 (19±12_%SHL), P2O (21±13_%SHL), P6.5E (12±7_%SHL), and P2E (19±9_%SHL) exhibited %SHL similar to both C+ and C- (25±10_%SHL) groups (p<0.05). P6.5 (23±11_%SHL), E (27±8_%SHL), P6.5O (24±13_%SHL), OP2 (27±12_%SHL), EP6.5 (24±11_%SHL), and EP2 (26±11_%SHL) were different to C+ and similar to C-. It was concluded that the combination of 6.5% proanthocyanidin and vitamin E (P6.5E) was the most effective strategy against enamel erosion, aligning closely with the positive control.

Resumo em Inglês:

Abstract Advancements in digital media have driven the study and use of photographic records as a diagnostic method for carious lesions, with smartphone images being widely utilized across various health fields. This study aimed to evaluate the diagnostic accuracy of smartphone photography for detecting active caries in orthodontic patients. The sample comprised 100 individuals of both sexes, aged 11 to 46 years, who were undergoing fixed orthodontic treatment. Following professional tooth cleaning and drying, patients underwent a visual-tactile clinical examination for caries detection, which served as the gold standard. Digital photographs were then taken using a smartphone camera in five views: frontal, right and left lateral, and upper and lower occlusal. The diagnostic parameters—sensitivity, specificity, accuracy, positive predictive value (PV+), and negative predictive value (PV-)—were calculated for the photographic method relative to the clinical examination. The prevalence of active caries in the sample was 74%. The smartphone photographs correctly identified 66 of the 74 individuals with active caries according to the gold standard. However, only 4 of the 26 sound patients were correctly identified. These findings correspond to the following diagnostic parameters: sensitivity, 89%; specificity, 15%; accuracy, 70%; PV+, 75%; and PV-, 33%. In conclusion, the photographic method demonstrated high sensitivity and satisfactory accuracy in detecting caries in patients undergoing fixed orthodontic therapy. However, the low specificity observed suggests a tendency to overdiagnose sound teeth.

Resumo em Inglês:

Abstract The aim of this study was to compare the esthetic, functional, and psychosocial impact of mandibular crowding and maxillary midline diastema in black adolescents. A cross-sectional study was conducted with 420 black (brown and black, distinguished according to Brazilian Institute of Geography and Statistics – IBGE) adolescents aged 12 with normal occlusal relationships. Esthetic (OASIS) and functional/psychosocial (OHIP-14) impact related to the need for orthodontic treatment in groups with mandibular crowding and maxillary midline diastema, and those without these conditions: G1, without crowding and diastema (n 113); G2, without crowding and with diastema (n 67); G3, with crowding and without diastema (n 202); and G4, diastema, and crowding (n 38) were evaluated. Generalized linear models were estimated for the effects of diastema, crowding, and the interaction between them, with a significance level of 5%. There was no significant influence of crowding and diastema on the OHIP-14 (p>0.05). However, the groups with diastema had higher OASIS scores, irrespective of crowding (p<0.05). The maxillary midline diastema influenced the esthetic perception of black adolescents.

Resumo em Inglês:

Abstract Teleconsulting consists of communication between professionals about clinical matters using information and communication technologies. Satisfaction is an important outcome in the evaluation of telehealth programs and an indicator of the effectiveness of the services offered. This cross-sectional study evaluated dentist satisfaction with asynchronous dental teleconsulting services offered by the Telehealth Brazil Networks Program and associated factors during 2020, using a secondary database: the Monitoring and Evaluation System of Telehealth Results. The outcome was the satisfaction of the dentist with the response of the teleconsulting session. The other variables collected were the dentist’s sex and specialty, the time at which the question and answer of the teleconsulting session were submitted, patient referral, and the dental specialty addressed in the teleconsulting session. The variables were analyzed descriptively using frequency, and binary logistic regression models were used to measure the association between satisfaction and factors related to the dentist and the teleconsulting service. A total of 1,719 dental teleconsulting sessions were conducted. A 26.7% satisfaction level was achieved. Satisfaction with teleconsulting was indicated by the association between professionals declaring that dental teleconsulting “avoided referrals” (OR =1.55, 95%CI: 1.17–2.04, p = 0.002) and the teleconsulting sessions in the field of oral medicine (OR = 0.61, 95%CI: 0.43–0.87, p = 0.006). Dentists’ satisfaction with asynchronous dental teleconsulting was low. Dentists reporting that teleconsulting avoided patient referrals to other care levels were more likely to be satisfied with the answer from the teleconsultant. Moreover, dentists who submitted oral medicine-related questions were significantly less satisfied with the teleconsulting feedback than those who submitted questions regarding other fields.

Resumo em Inglês:

Abstract Dentin hypersensitivity (DH) is a common and challenging clinical condition with limited long-lasting treatments. The objective of this study was to evaluate the effectiveness of 980 nm diode laser treatment, associated or not with fluoride varnish, in the treatment of DH. Sixty volunteers were selected and randomly assigned for treatment following three different protocols (1- treatment with 0.8W diode laser; 2- treatment with 0.8 W diode laser over fluoride varnish; or 3- fluoride varnish only). The 0.8 W diode laser was applied in contact with the exposed roots at 10 Hz, for 30 s, with 99.17J/cm2 energy density, using a zigzag pattern. DH assessment was performed using the visual analog scale (VAS), prior to treatment, immediately after treatment, and at 7, 30, and 180 days after treatment. The data obtained were subjected to two-way repeated-measures analysis of variance (ANOVA) (p <0.05). The varnish group showed a reduction in DH up to 30 days, whereas the laser and laser + varnish groups showed a reduction in DH up to 180 days ,with no difference between them. The laser and laser + varnish groups were superior to the varnish group after 30 days. The treatment of exposed roots with diode laser alone or associated with fluoride varnish, according to the parameters used in this study, was effective in reducing DH up to six months.

Resumo em Inglês:

Abstract In this cross-sectional study, carried out in 2012, we assessed factors associated with tooth loss among adolescents from Minas Gerais, Brazil, utilizing data from a secondary database. Individual and local-level variables were selected to represent health determinants. Individual covariates included sex, age, skin color, maternal education, household income, use of dental services, and self-perceived need for dental care. The contextual variables included illiteracy, unemployment, income, primary health care coverage, dental specialty centers, and oral health team coverage. Multilevel logistic regression models were used to examine the relationship between contextual and individual variables and the outcome (STATA version 16.0) – odds ratio (OR) and 95% confidence interval (CI). The prevalence of tooth loss was 12.4%. Female individuals were 40% more likely to experience the outcome (OR: 1.40; 95%CI: 1.01–1.98). Increased age was associated with greater tooth loss (OR: 1.16; 95%CI: 1.03-1.31). Low maternal education (OR: 1.72; 95%CI: 1.13–2.61), low household income (OR: 1.71; 95% CI 1.09-2.67), and self-perceived dental needs (OR: 2.94; 95% CI 1.97-4.39) were also associated with the outcome. Regular dental visits reduced the likelihood of tooth loss by 38% (OR: 0.62; 95 CI 0.44–0.87). Larger tooth loss was observed in municipalities with higher illiteracy rates (OR: 1.04; 95%CI: 1.01–1.08). Municipalities with larger dental specialty centers were associated with the outcome (OR: 0.58; 95%CI: 0.37–0.92). Contextual and individual factors influenced tooth loss in adolescents from Minas Gerais, Brazil, but socioeconomic status was the main determinant.

Resumo em Inglês:

Abstract This study investigated associations between sociodemographic and professional profiles, work-related factors, and the effectiveness of oral health promotion strategies implemented by dentists in the Family Health Strategy. A cross-sectional study was conducted with 211 dentists working in Oral Health Teams within the Family Health Strategy in the state of Paraíba, Brazil. Data were collected online using a validated instrument. A matrix encompassing the core values and pillars of health promotion was employed to evaluate the effectiveness of oral health promotion strategies. Data were analyzed using Poisson regression (p < 0.05), and all analyses were performed in Stata, version 14. Greater effectiveness of oral health promotion strategies was associated with mixed Oral Health Teams (urban and rural coverage) (PR = 1.54; 95%CI: 1.154–2.076; p = 0.003) and with dentists under temporary contracts (PR = 1.67; 95%CI: 1.240–2.250; p = 0.001). The effectiveness of oral health promotion strategies was associated with work-related factors. Evaluations of oral health promotion practices are essential to support improvements in oral health management. The findings highlight the need to strengthen these practices through professionals who, in addition to having a defined employment relationship and a structured work process, value oral health promotion as a key component of care.

Resumo em Inglês:

Abstract In this study, referrals for lingual frenotomy/frenectomy (F/F) were evaluated in children younger than 7 years the public dental services of Ribeirão Preto, São Paulo, Brazil, from 2017 to 2022. In this longitudinal observational retrospective study, the Hygiaweb System (Power BI) platform to access electronic medical records, and the following variables were collected: incidence of F/F, reports of symptoms associated with ankyloglossia, duration of exclusive breastfeeding (EBF), professional categories requesting the referral, and multiprofessional evaluation. Descriptive analyses, associations between variables, comparisons between groups and incidence ratios were performed. The significance level was set at 5%. During the study period, 242 procedures were performed, the majority of them in children younger than 1 year, with an increasing trend towards F/F (p = 0.028, S = 11). The estimated incidence was 40.6 F/F per 10,000 inhabitants. Among all children who underwent F/F, the majority were breastfed for up to 1 month (101, 41.7%), followed by 4 to 5 months (56, 23.1%). There was no significant association between exclusive breastfeeding for 6 months and lingual frenectomy before 6 months of age (p = 0.444). Confirmation of the need for lingual frenectomy was associated with multidisciplinary assessment at referral (p < 0.001; Cramér’s V = 0.268). It can be concluded that organization of the care process and the breastfeeding support movement may have had a positive influence on the management of cases and the upward trend towards F/F procedures. Multiprofessional assessment seemed to have an impact on the accuracy of referrals for cases requiring surgical intervention.

Resumo em Inglês:

Abstract This cross-sectional study aimed to evaluate the moderating role of social capital in the relationship between income and oral health-related quality of life (OHRQoL) among pregnant women. The study was conducted using a random sample of pregnant women registered with the public health system in southern Brazil. Women with sensory or cognitive impairments, non-Brazilian nationality, or high-risk pregnancies were excluded. The Oral Health Impact Profile (OHIP-14) was used to assess OHRQoL. Social capital was evaluated through “perceived social support” and “pregnancy group attendance.” The monthly household income was assessed in Brazilian Reais and categorized as either high (≥ 1,000 BRL) or low (< 1,000 BRL). The moderating role of social capital on the relationship between income and OHRQoL was tested using multilevel Poisson regression analysis. The results are presented as rate ratio (RR) with 95% confidence intervals (CI). A total of 520 pregnant women were assessed, with a response rate of 93%. Approximately 25.6% had low income. Both social capital variables demonstrated a moderating effect on the relationship between income and OHRQoL. Among pregnant women with a low household income, those without social support and those who did not attend pregnancy groups had 44% (RR = 1.44, 95%CI: 1.22–1.72) and 22% (RR = 1.22, 95%CI: 1.05–1.42) higher overall OHIP-14 scores, respectively, compared to their counterparts. This means that social support and group attendance substantially mitigate the negative effects of low income on OHRQoL. Our findings highlight the potential role of social capital promotion in this population.

Resumo em Inglês:

Abstract Although social capital can significantly impact oral health-related quality of life (OHRQoL), evidence of this association remains limited during pregnancy. We assessed the association between individual social capital and OHRQoL among pregnant women in public health services. This cross-sectional study assessed a representative sample of pregnant women grouped into 25 Brazilian public health units in 2022. Sociodemographic, individual social capital (social networks and social support), and health behaviour characteristics were collected through a questionnaire. Participants were also clinically examined for gingivitis and dental caries experience. The outcome OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14) questionnaire. Multilevel Poisson regression models with a hierarchical approach were used to assess the associations between social capital and overall OHIP-14 score. The results are presented as rate ratio (RR) and 95% confidence interval (95%CI). A total of 520 pregnant women were evaluated. Pregnant women with lower social support had higher overall OHIP-14 scores (RR: 1.21, 95%CI: 1.10–1.34). However, social networks were not associated with OHRQoL (p > 0.05). High number of children, lower household income and schooling factors, alcohol consumption before pregnancy, visiting a dentist for toothache, gingivitis, and dental caries experience were also associated with higher overall OHIP-14 scores (p < 0.05). Lower social support was associated with worse OHRQoL among pregnant women. These finding suggest that quality of personal resources was of greater relevance than social networks during pregnancy.

Resumo em Inglês:

Abstract The objective of this study was to evaluate the occlusion potential of in-office desensitizing agents, and characterize the human dentin elements after acid exposure. Twelve human dentin discs were sectioned into four specimens each, and randomized into treatments (n = 20): no treatment (negative control); no treatment and 6% citric acid exposure (positive control); application of Gluma desensitizer (Heraeus Kulzer) or PRG Barrier Coat (Shofu), followed by 6% citric acid exposure. Occlusion and dentin surface characteristics were determined by scanning electron microscopy (SEM, n = 10), and elemental composition (at%), by energy-dispersive X-ray spectroscopy (EDS, n = 10). Three calibrated, blinded evaluators used SEM to categorize the occlusion potential: 1 = occluded, 2 = partially unoccluded, 3 = equally occluded/unoccluded, 4 = partially occluded, 5 = unoccluded. Data were analyzed by weighted kappa, Friedman, and Nemenyi tests (α = 0.05). For SEM, mean occlusion scores were higher for the PRG Barrier Coat than the positive control (p = 0.0235). Most specimens in the controls scored 4 or 5. The most frequent scores for PRG Barrier Coat were 1(60%) and 2(20%), while 30% of Gluma specimens scored 1 and 2. Gluma showed intratubular precipitation, while PRG Barrier Coat covered dentinal tubules totally or partially. For EDS, the K% was lower for Gluma than the negative control (p = 0.0046), with Si peaks in dentin treated with PRG Barrier Coat. The bioactive in-office desensitizing agent with S-PRG filler (PRG Barrier Coat) promoted dentin tubule occlusion, and persisted after exposure to acid.

Resumo em Inglês:

Abstract The study objective was to analyze dimensional change, flexural strength, surface hardness, wear profile, and conversion degree of different additive splint materials under various post-polymerization conditions of time and artificial aging. Two additive manufacturing systems (Cara Print 4.0, Dima Print Ortho, Kulzer; SprintRay Pro, SprintRay Splint, SprintRay), and a thermally activated resin control (Clássico) were evaluated in artificial aging (deionized water or saliva; 28 or 84 days at 37°C), with recommended or doubled post-polymerization cycles. Dimensional change (surface metrology), flexural strength (ISO 20795-1:2013), fractography (SEM), Knoop hardness, two-body wear profilometry (150,000 cycles; 3mmØ; 20N; 2.1Hz), and conversion degree (FTIR spectroscopy) were assessed. Two-way ANOVA and post-hoc Tukey tests were used for parametric data, and Kruskal-Wallis and post-hoc Dunn tests, for non-parametric data (α = 0.05). Results indicated no statistically significant differences in dimensional change or flexural strength among the materials. Recommended post-polymerization cycles resulted in lower hardness for additive resins than the thermally activated control. Doubling post-polymerization time significantly increased flexural strength and hardness of Dima Print Ortho, but decreased flexural strength of SprintRay Splint, and did not affect wear resistance. Dima Print Ortho demonstrated the highest wear resistance. Artificial aging did not affect flexural strength, surface wear, or dimensional change, but negatively impacted the hardness of all materials except Dima Print Ortho. The conversion degree was unaffected by post-polymerization time, and no significant differences were found among the materials. Overall, additive materials exhibited mechanical and dimensional properties comparable to thermally activated resin, with doubling post-polymerization time positively influencing the properties.

Resumo em Inglês:

Abstract This study analyzed the properties of three-dimensional (3D)-printed resins designed for interim restorations and subjected to different printing and post-curing protocols. Specimens were manufactured with two 3D-printed resins for interim restorations at varying exposure times per layer, in accordance with the manufacturer’s recommendations (Tm) or using a calibrator (Tc). Subsequently, the specimens were post-cured for 5, 10, or 15 min. Trueness, surface roughness, and color analyses were performed. For biological characterization, the specimens were incubated for up to 72 h in a culture medium, and the extracts were applied at 24-h intervals to keratinocyte cells (NOK-Si). Cellular metabolism was evaluated after 1 and 3 days. Leaching of residual monomers from the extracts was evaluated. Data were analyzed using two-way analysis of variance (ANOVA) and Tukey’s honestly significant difference (HSD) test (α = 5%). The exposure time beyond Tc resulted in specimens with increased trueness and smoother surfaces. Color stability was also influenced by the type of resin and post-curing time; the longer the time, the greater the color change, allowing for brighter and clearer specimens. The resins were cytocompatible with NOK-Si, regardless of the printing and post-curing parameters, although residual monomer leaching was affected by the parameters tested. The evaluated resins were cytocompatible; however, variations in the exposure times per layer and post-curing duration affected their roughness, leaching, trueness, and color stability.

Resumo em Inglês:

Abstract In this study, citations, altmetric scores, and field-normalized impact of articles investigating resin-based adhesives, luting agents, or restorative composites were investigated. Articles published in 2019 on resin-based dental materials indexed in Scopus were searched and assessed by independent investigators. Data collected in 2023 included several article variables and, as outcomes, citation in Scopus and Google Scholar, Altmetric Attention Scores (AAS), and Field-Weighted Citation Impact (FWCI). Data were analyzed using stepwise backward quasi-Poisson regression models (p < 0.05). A total of 707 articles were included, which evaluated restorative composites (58.3%), adhesives (27.2%), and luting agents (19.5%). The majority of corresponding authors were from Asia/Oceania (42.2%), with publications mainly subscription-based (54%) and lacking international collaboration (68.5%). Only 1.4% reported conflicts of interest, and 47.7% did not disclose sponsorship. Median citations were 7 in Scopus and 13 in Google Scholar, whereas the median FWCI was 1. The majority of articles had an AAS of zero. Multivariate analysis showed study sponsorship type and journal CiteScore influenced citations, while COI and the author’s continent impacted AAS and FWCI, respectively. Articles on luting agents were less likely to receive citations. The report of conflict of interest was associated with approximately 18 times higher AAS values. This study emphasizes the significance of the type of resin-based material, journal CiteScore, authors’ continent, and type of sponsorship in affecting citations, visibility, and impact of scientific articles. Research on luting agents may need better dissemination strategies for increased visibility. The substantial effect of COI presence underscores the importance of transparency.

Resumo em Inglês:

Abstract The present in vitro study evaluated the effect of titanium dioxide nanotubes (nTiO2) incorporated into glass ionomer cement (GIC) on the growth and viability of Lactobacillus acidophilus (L. acidophilus). GIC (Ketac Molar EasyMix® = KM) was added to concentrations of 0%, 3%, 5%, 7% by weight of nTiO2 (20 nm in size). L. acidophilus strains (1x108 CFU/mL) were cultivated on GIC discs with or without the addition of nTiO2 for 1, 3 and 7 days, and the following parameters were evaluated: inhibition zone (mm) (n = 6); cell viability (Live/Dead) (n = 6); cell morphology (SEM) (15 KV, 2000X, n = 3). The data were submitted to ANOVA and the Tukey and Dunnett tests (α = 0.05). Regarding the agar diffusion test, there was no difference between GIC and the groups containing nTiO2 (p > 0.05). As for bacterial viability, the percentage of viable bacteria was lower for GIC+7% nTiO2 (p ≤ 0.05). There was no difference in the percentage of non-viable bacteria (p > 0.05). In addition, the morphology of L. acidophilus did not change in the presence of nTiO2. It can be concluded that the incorporation of titanium dioxide nanotubes into GIC, particularly at 5%, reduced L. acidophilus viability, and might hence interfere negatively with the initial colonization process of the bacterial biofilm.

Resumo em Inglês:

Abstract Radicals from tooth whitening products can reduce bond strength, posing challenges for dentists when a bonding procedure must be performed in teeth immediately after whitening. This study aimed to evaluate the antioxidant activity (AA) of Terminalia catappa Linn (TCL) leaf extract as a potential agent to mitigate the negative impact of high-concentration whitening agents on immediate bonding performance. The AA of green and ripe leaf extracts was measured using the 2,2-di-phenyl-1-picrylhydrazyl radical scavenging capacity assay (DPPH). To determine the TCL influence on bond strength, six groups of bovine enamel blocks (n=10) were created. Group 1 was the positive control (unbleached enamel), while Group 2 was the negative control (no antioxidant treatment). Groups 3 to 6 were bleached and treated with 10% sodium ascorbate (SA) or 0.1%, 0.2%, and 0.3% TCL gels. Adhesion was conducted using a two-step conventional system and dental composite resin. Microtensile testing was performed after 24 hours, and data were analyzed by one-way ANOVA with Tukey’s post hoc test (p > 0.05). From the DPPH assay, results with IC50 < 50 µg/mL indicate high AA for all tested extracts. This method established a difference of around 12 times more AA for the TCL-hydroalcoholic extract of green leaf to the aqueous extract of ripe leaves. There were no significant differences in bond strength among groups treated with TCL-hydroalcoholic extract of green leaf gels (p > 0.05) and unbleached enamel. Tropical almond-derived antioxidant gels emerge as a promising strategy to enhance immediate bond strength on enamel after high-concentration in-office whitening treatments.

Resumo em Inglês:

Abstract This study aims to evaluate in vitro the whitening effects of gels containing hydrogen peroxide at acidic and basic pH using internal and external techniques. Forty artificially darkened bovine incisors were split into four groups: bleaching on the buccal surface with HPE (HP Blue 35%, FGM), at basic pH; PBE (Potenza Bianco 38%, PHS), at acidic pH; bleaching in the pulp chamber with HPI at basic pH; and with PBI at acidic pH. CIELab color parameters, microhardness, roughness, enamel demineralization (FT-Raman), and surface topography (SEM) were evaluated in enamel/dentin blocks after bleaching (T0) and seven days after immersion in saliva (T7). Bleaching agent diffusion was evaluated after 30 minutes, while pH was measured throughout the application period. Physicochemical analysis showed a reduction in the mineral-matrix ratio in both groups after bleaching and at 7 days. Roughness increased over time in the PBE and HPE groups. Porosity increased, but decreased after 7 days of immersion in saliva. Bleaching gels were different at T0 and T7, with acidic pH gel promoting greater whitening (T7) and enamel roughness. Raman scanning demonstrated that the bleaches propagated across the enamel layer with increased concentration at the dentin-enamel-junction and decreasing diffusion gradient along the dentin. The gel with acidic pH promoted a greater increase in enamel roughness and the 7-day immersion in saliva was not enough to restore initial roughness in either gel. The gel with basic pH showed a higher pH decay and a greater diffusion capacity in the dentin.

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Abstract This study assessed the effect of saliva exposure on roughness (Ra) and Vickers hardness (VHN) of two direct restorative materials, enamel, and dentin adjacent to the restorations. Enamel and dentin cavities in molars (n = 10) were restored with a) bulk-fill resin composite (Tetric N-Flow Bulk Fill, BF) with the application of a universal adhesive (Tetric N-Bond Universal) and b) alkasite restorative material (Cention N, CN) with and without the application of a universal adhesive. After 24 h (baseline), surface roughness and hardness of the restorative material and dental tissues were assessed at 100 μm from the tooth/restoration interface. The specimens were subjected to degradation in whole saliva for 7 days (combined with the application of 20% sucrose 10x/day). Ra and VHN were then reassessed. The data were analyzed by ANOVA and Tukey’s test (α = 5%). BF exhibited a significantly lower Ra than CN. Ra increased significantly after degradation in saliva when compared to baseline values. Enamel hardness was higher for BF restorations. No differences in enamel hardness were observed for alkasite restorations with and without adhesive application. For dentin hardness, significantly lower values were found in alkasite restorations with previous application of an adhesive system. It can be concluded that BF had a smoother surface than CN before and after degradation. Immersion in saliva reduced the hardness of both restorative materials, enamel, and dentin adjacent to the restoration.

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Abstract This study evaluated the cytotoxicity, biocompatibility, and bioactivity potential of bioglass solutions (F18 and F18 with cobalt; F18-Co) compared to Ca(OH)2 solution, to determine their suitability for use in vital pulp therapy. F18 bioglass was prepared, with a part being doped with cobalt. The solutions were prepared at a 1:10 powder-to-water ratio. L929 fibroblasts viability was assessed (MTT assay; 24 and 48-h). Tubes containing fibrin sponges embedded with either the solutions or saline (control) were prepared (16 tubes/group) and immediately implanted into 16 rats (4 tubes/rat). At 7 and 30 days, the euthanized rat specimens were analyzed for inflammation and bioactivity. The ANOVA with Tukey’s test, or Kruskal-Wallis with Dunn’s test was performed (p < 0.05). Undiluted, 1:2, and 1:4 diluted solutions reduced cell viability at 24-h (p < 0.05). The 1:8 and 1:16 dilutions of F18 and F18-Co exhibited cell viability similar to that of the control (p > 0.05), whereas Ca(OH)2 was cytotoxic (p < 0.05). At 48-h, F18 dilutions (undiluted, 1:2, and 1:4) exhibited similar results to the control (p > 0.05). F18-Co at 1:8 and 1:16 dilutions increased cell viability compared to Ca(OH)2 (p < 0.05) and were similar to the control (p > 0.05). On day 7, moderate-to-severe inflammation (p > 0.05) and thick fibrous capsule were observed. On day 30, mild inflammation was observed in the control and F18-Co groups, moderate inflammation in F18 (p < 0.05), and mild inflammation in Ca(OH)2 (p > 0.05). The fibrous capsule was thin. None of the materials exhibited positive structure in von Kossa and polarized light analysis. The F18 and F18-Co solutions are cyto- and biocompatible; however, no bioactivity was observed.

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Abstract The objective of this study was to develop a bioabsorbable membrane composed of poly(butylene adipate-co-terephthalate) (PBAT) with alkyl trimethyl ammonium bromide (ATAB) to provide antimicrobial properties. Membranes were manufactured via the solvent casting technique using chloroform solutions containing PBAT and varying concentrations of ATAB (1, 2.5, and 5% wt), with ATAB-free membranes as a control. The characterization of the membranes included assessments of contact angle, surface free energy, and degradation in distilled water over periods of one week, one month, and three months. Mechanical properties were evaluated via tensile strength, and changes in water pH were monitored from 24 hours to three months post-immersion. Cytotoxicity was assessed using gingival fibroblasts and pre-osteoblasts via the SRB assay. Antimicrobial activity was tested against Staphylococcus aureus. ATAB inclusion reduced water contact angle and increased surface free energy compared to controls (p < 0.001). The addition of 5% wt ATAB decreased the tensile strength of PBAT membranes. At one month, a reduced mass was observed for the 2.5% wt ATAB membrane. The specimens’ mass was reduced for all groups after three months of immersion in water in comparison to the initial measurement, while a reduction in thickness was found in all time points, without the influence of ATAB. ATAB incorporation reduced cell viability. Antimicrobial efficacy, resulting in a > 3 log10 bacterial reduction, was observed for S. aureus at the 5% wt concentration. The addition of 2.5% wt ATAB to PBAT membranes may be a suitable strategy to generate barrier membranes with an antibacterial effect while maintaining acceptable mechanical and surface properties.

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Abstract The aim of this study was to assess the effect of a chlorhexidine digluconate solution (CHX) applied as an antiproteolytic agent for controlling erosive tooth wear or as part of the adhesive treatment on long-term bond strength to eroded dentin. Dentin specimens were abraded with a 600-grit silicon carbide (SiC) paper for 1 min (sound dentin - S), subsequently treated with 2% CHX for 1 min (with excess removed, followed by a 6-hour rest), and eroded by exposure to Coca-Cola for 5 min, three times a day, for 5 days (CHX-treated and eroded dentin - CHXE), or only eroded (eroded dentin - E). The specimens were acid-etched (15 s), rinsed (30 s), dried (15 s), and rehydrated with 1.5 μL of distilled water for 1 min, with excess removed (control - S.C/CHXE.C/E.C) or 2% CHX (S.CHX/CHXE.CHX/E.CHX). Adper Single Bond 2 was scrubbed twice on the surface for 15 s each and then light-cured for 10 s, and resin composite cores were built up. Specimens were sectioned into beams and microtensile bond strength was tested (μTBS; 0.5 mm/min) immediately or after 18-month aging. Failure modes were analyzed using a digital microscope. Data (μTBS/MPa) were analyzed by three-way ANOVA, followed by Tukey’s test (α = 0.05). μTBS to E and CHXE, irrespective of the rehydration solution and aging period, were equivalent to each other and lower than that to S. CHX as the rehydration solution reduced immediate and long-term µTBS to S. Aging reduced μTBS. By controlling tooth wear or interface aging, CHX could not influence long-term bonding to eroded dentin.

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Abstract The emergence of toothpastes containing different abrasive and whitening substances has been a constant concern among dental professionals. The aim of the present study was to perform an in vitro assessment of the surface topography of nanoparticle composite resins subjected to simulated brushing with dentifrices. Test samples were prepared with Filtek Universal (3M ESPE), Filtek Bulkfill (3M ESPE) and Z350 (3M ESPE), with 24 samples per resin. A testing machine was used to simulate brushing with the dentifrices Colgate Total 12, Oral B 100% and Oral B Gengiva Detox Gentle Whitening (8 samples per group). The constant speed of the machine was 250 cycles per minute, and 20.000 cycles were carried out, which corresponds to 24 months (1 hour and 20 minutes). Roughness features and qualitative surface topography were investigated. Statistical analysis involved the Kruskal–Wallis, Wilcoxon and Mann–Whitney tests. A significant increase in surface roughness was found for all the resins (p < 0.05). However, no significant difference was found among the resins in terms of final roughness values (p = 0.690). In contrast, a significant difference among dentifrices was found with respect to roughness measurements (p < 0.001). The qualitative analysis revealed an increase in surface roughness in all the samples and differences in the abrasive potential of the dentifrices. In conclusion, brushing with dentifrices increases the surface roughness parameters of composite resin restorations. Moreover, the differences in the abrasive effects of the dentifrices indicate a need for further studies to establish efficacy and safety criteria.

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Abstract This study evaluated the microtensile bond strength (μTBS) and fracture pattern of direct composite resin reinforced with polyethylene fiber (Ribbond®) on dentin substrate after thermomechanical cycling (TMC). Dentin blocks (dentin thickness=2 mm) were obtained from forty human third molars and randomly divided into four groups (n=10) according to type of restoration (composite resin with or without Ribbond®) and to whether they were or were not subjected to TMC (100,000 cycles of 50 N / 2 Hz / 1-minute baths of 5 and 55ºC). The 1-mm-thick square-shaped specimens were submitted to μTBS testing in a universal testing machine at 0.5 mm/min. The fracture patterns were assessed by stereoscopic magnifying glass (30X magnification). The μTBS (in MPa) and failure pattern data were subjected to the generalized linear model and G tests (a=0.05). Neither the polyethylene fiber nor TMC had any statistically significant effect (p=0.196 and p=0.136, respectively) on the μTBS of the composite resin to dentin. Adhesive failures were more prevalent in the composite resin group compared with the Ribbond-containing group when subjected to TMC. Additionally, the composite resin containing Ribbond® showed a higher proportion of cohesive failures in composite resin than the resin groups not containing this fiber, irrespective of TMC. It was concluded that reinforcing the direct layer of composite resin with Ribbond® polyethylene fiber did not influence the adhesive resistance to dentin, even when subjected to TMC. However, its incorporation did result in a higher frequency of cohesive failures in resin after TMC.

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Abstract This study aimed to histomorphometrically evaluate the effect of guided bone regeneration (GBR) and two implant surfaces on the thickness and height of newly formed bone in dehiscence defects around titanium implants. Three premolars and the first bilateral molar were extracted from ten adult mongrel dogs, and 40 buccal bone dehiscences measuring 5 mm in height and 4 mm in width were created using a University of North Carolina (UNC) periodontal probe to confirm the dimensions. Forty implants were randomly assigned to one of four groups: oxidized implant surfaces (OIS, n = 10), turned/machined implant surfaces (TIS, n = 10), OIS + GBR (n = 10), and TIS + GBR (n = 10). After 3 months, the dogs were euthanized, and the blocks containing the implants and adjacent bone were processed for non-decalcified histological analysis. Statistical analysis was performed using two-way ANOVA and the Pearson correlation (p = 0.05). The results showed that GBR significantly influenced both the vertical (height) and horizontal (thickness) dimensions of the newly formed bone (p < 0.001). Strong positive correlations were observed between the thickness and height of newly formed bone at the base of the defect, as well as between the thickness of the bone at the base of the defect and the thickness of newly formed bone in the central region of the defect. No significant correlations were found between implant surface type and bone formation. Bone regeneration occurred in both the vertical and horizontal directions, with greater bone growth in GBR-treated groups, irrespective of implant surface type (oxidized or turned).

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Abstract Marginal adaptation failure in noncarious cervical restorations (NCCRS) significantly compromises restoration longevity and adversely impacts patient outcomes. early identification of high-risk restorations is therefore of clinical importance. This study aimed to develop and evaluate a supervised machine learning (ML) model capable of predicting the risk of marginal adaptation failure in NCCRS within 18 months following treatment. A total of 262 restorations were analyzed, incorporating multiple clinical variables, including adhesive system used, cavity geometry, degree of dentin sclerosis, incisogingival height, tooth characteristics, and patient age. Seven supervised ml algorithms were trained and assessed: decision tree, support vector machine (SVM), gradient boosting, k-nearest neighbors (KNN), logistic regression, multilayer perceptron, and random forest. model performance was evaluated using fivefold cross-validation and standard metrics, including the area under the receiver operating characteristic curve (AUC), accuracy, recall, precision, and F1 score. Key predictive features identified were incisogingival height, patient age, and type of adhesive system. the auc values ranged from 0.72 (95% confidence interval [95%CI]: 0.57–0.88) to 0.52 (95%CI: 0.51–0.83), and recall values ranged from 0.77 (95%CI: 0.66–0.89) to 0.53 (95%CI: 0.40–0.66). Among the tested algorithms, SVM, gradient boosting, and KNN demonstrated superior predictive performance. these findings suggest that ml models can serve as effective tools for predicting restoration failure and may assist clinicians in optimizing post-treatment monitoring and follow-up strategies for patients with NCCRS.

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Abstract: Cone beam computed tomography (CBCT) is an imaging exam used increasingly in various fields of dentistry, and a greater number of endodontists are progressively gaining access to this technology. This study focused on applying an artifact suppression algorithm featured in CBCT software, and designed specifically to address artifacts related to root canal filling materials. Method The sample consisted of eighty-four mandibular molars, with mesial root canals endodontically treated by using the lateral condensation technique. Four root canal sealers were applied: G1 – Sealapex®, G2 – AH Plus®, G3 – Endofill®, and G4 – Bio-C Sealer. CBCT scans were taken using PreXion 3D Elite®. Initially, the diameter of the root canal filling (in the mesiodistal and buccolingual directions) was measured using a digital micrometer (control). Next, these diameters were reevaluated in the CBCT images using the blooming artifact reduction (BAR) tool of the e-Vol DX software. The Van der Waerden nonparametric analysis of variance was performed, followed by applying the Tukey test to the normalized data. The significance level was set at α = 5%. Results There were no statistically significant differences (p>0.05) in the measurement of original root canal filling materials obtained by the micrometer versus the e-Vol DX software in the mesiodistal and buccolingual directions. Conclusions The tested software algorithm effectively suppressed artifacts resulting from obturation materials.

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Abstract This study aimed to compare the effects of intracanal medication pastes Bio-C Temp® (BC), UltraCal XS® (UC), and Pure Calcium Hydroxide (CH) on crown color change, pH, and antimicrobial activity. Color change was assessed using the CIEL*a*b* color space system parameter. pH values were measured at 3, 24, 72, and 168 hours. Antimicrobial activity was evaluated using agar diffusion and direct exposure tests. Statistical analyses were conducted using ANOVA, Kruskal-Wallis, and Friedman tests (α = 0.05). After 15 days, BC exhibited significantly greater color variation than the control, and higher L* values at 60 days compared to baseline (p < 0.05). BC demonstrated lower pH values than UC and CH at 3 and 72 hours (p < 0.05). In the agar diffusion test, BC produced a smaller microbial inhibition halo than UC and CH. In the direct exposure test, CH completely inhibited microbial growth, whereas BC showed microbial growth at all evaluated time points. In conclusion, BC resulted in greater crown color change, lower pH, and reduced antimicrobial activity compared to UC and CH.

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Abstract The iVAC system combines ultrasonic activation with negative-pressure irrigation, highlighting the importance of determining its vibration characteristics. This study aimed to evaluate the oscillation characteristics of the iVAC system using laser Doppler vibrometry and to compare them with those of metallic inserts used for ultrasonic irrigation. Four ultrasonic inserts—Irrisonic, Nitisonic, Ultra X Blue, and iVAC—were attached to an ultrasonic unit, secured in a holder, and operated at a power setting of 15%. A laser scanning vibrometer was used to scan the first four millimeters of each insert. Each measurement, lasting approximately 20 seconds, was repeated ten times per insert and performed at millimeter intervals. Displacement amplitude and frequency data were recorded for each insert. Furthermore, scanning electron microscopy was employed to evaluate the surface finish of the inserts, and their elemental compositions were analyzed using energy-dispersive X-ray spectroscopy (EDS). Analysis of variance and Tukey’s test were conducted to compare the performance of the inserts. The displacement amplitudes showed significant differences between inserts and among the scanned points (p < 0.05). All inserts demonstrated ultrasonic vibration frequencies exceeding 20 kHz. EDS analysis revealed that the elemental composition of the E1-Irrisonic tips was consistent with stainless steel. In contrast, the Nitisonic insert displayed a chemical composition characteristic of an equiatomic nickel–titanium (NiTi) alloy, whereas the Ultra X Blue insert contained additional elements beyond NiTi. The characteristics and composition of ultrasonic inserts significantly influence their displacement amplitude and vibration frequency. At the tested activation power, the iVAC insert, made of the organic thermoplastic polymer polyether ether ketone (PEEK), demonstrated an ultrasonic vibration pattern but exhibited the lowest oscillation amplitude among the inserts.

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Abstract Ultrasonic activation of the endodontic sealer makes it difficult to remove the material during endodontic reintervention. Therefore, supplementary removal protocols should be tested to optimize the removal of the remaining filling material. This study assessed the effectiveness of supplementary protocols for filling material removal after sealer ultrasonic activation (UA). Sixty teeth were prepared and distributed into two groups: UA and No UA of the sealer before obturation. Teeth were re-instrumented and two supplementary removal protocols were tested, resulting in six groups (n = 10): NoUA; NoUA+XP (XP-endo Finisher); NoUA+CS (Clearsonic-R1); UA; UA+XP; and UA+CS. Root canals were analyzed under stereomicroscopy and scanning electron microscopy for quantification of the remaining filling material. Considering the total root canal area, the NoUA+CS group had the lowest remaining filling material compared to NoUA+XP, UA+XP and UA+CS groups (p < 0.05). When the root thirds were compared, there was no statistical difference among groups (p > 0.05). The XP-endo Finisher instrument demonstrated the lowest effectiveness when used as a supplementary step. In contrast, the Clearsonic-R1 insert exhibited the highest performance.

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Abstract

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Abstract The aim of this ex vivo study was to evaluate the efficacy of the Reciproc, Hyflex CM, and ProDesign Duo Hybrid in the retreatment of mesial root canals with Vertucci Type 4 of mandibular molars with curvatures between 10 and 20 degrees. Forty-five mesial roots of mandibular molars were prepared up to size 25.06 Nickel-Titanium (NiTi) file and filled by the single cone technique. The roots were then divided into 3 groups according to retreatment procedures: Reciproc R25 followed by R40; Hyflex 25.04 followed by 40.04; ProDesign Duo Hybrid 25.06 followed by 40.05. The canals were irrigated with 1 mL 1% sodium hypochlorite, and a final rinse was performed with 5 mL 17% EDTA for 3 minutes. Microcomputed tomography scans were performed in each step of the procedure to evaluate root canal transportation at distances of 2, 4, 6, 8 and 10 mm from the apex and volume of endodontic filling remaining at segments of 1–3, 3–5, and 5–7 mm from the apex. The filling material that was not removed during retreatment was evaluated by confocal laser scanning and the percentage after each procedure was expressed in terms of percentage of the initial root-filling material volume. The time taken to remove the material and re-instrumentation was measured in seconds with a digital chronometer. Statistical analysis was performed with t-paired, ANOVA, Kruskal-Wallis and Friedman tests (p < 0.05). In all groups, sections at 4, 6, 8, and 10 mm from the apex were transported to the danger zone, towards the furcation. However, the section at 2 mm from the apex was transported in opposite direction to the furcation, but no statistically significant differences (p > 0.05) in canal transportation and filling material removal were found between the 3 groups. Filling removal and re-instrumentation took significantly (p < 0.05) less time in the Reciproc group. None of the retreatment techniques completely removed the root fillings. The results suggest that no difference exists between the groups in apical transportation of curved canals. The Reciproc system took less time for filling removal and re-instrumentation and the combination of reciprocating and rotary files in the retreatment of curved canals was as efficient as rotary and reciprocating motion.

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Abstract This study investigated the influence of ethylenediaminetetraacetic acid (EDTA) irrigation on cementum-like tissue formation and TGF-β1, FGF-2, and VEGF immunolabeling during regenerative endodontic procedures (REPs) in immature rat molars. The lower first molars of 12 four-week-old male rats (80 g) underwent pulpectomy in the mesial canal and were randomly categorized into two experimental groups (n = 6): sodium hypochlorite (NaOCl) – irrigated for 5 min with 2.5% NaOCl; and NaOCl-EDTA – irrigated with 2.5% NaOCl, followed by 5 min of 17% EDTA. After inducing bleeding with a size 10 K-file, the cavities were sealed. Untreated molars served as control-15d (n = 3) and immediate control (n = 3). Either immediately or after 15 days, the animals were euthanized, and the teeth were collected for histomorphometric and immunohistochemical (TGF-β1, FGF-2, and VEGF) analysis. The results were analyzed by the Mann-Whitney U-test (p < 0.05). Histomorphometric analysis revealed increased cementum-like tissue formation in the NaOCl-EDTA group compared with that in the NaOCl group (p < 0.05). Regarding growth factor immunolabeling, the NaOCl-EDTA group exhibited enhanced TGF-β1 and VEGF immunolabeling in the root tip area and the center region of the apical third of the pulp tissue, compared with that in the NaOCl group (p < 0.05); however, no significant difference was observed in FGF-2 (p > 0.05). In conclusion, the use of EDTA in REPs positively affected the formation of cementum-like tissue and TGF-β1 and VEGF in the apical region but did not influence FGF-2.

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Abstract NeoSealer Flo (NSF) is a novel ready-to-use endodontic bioceramic sealer, and NeoMTA2 (NMTA2) is a powder-gel bioceramic used as a repair or filling material. Setting time (ST), pH, solubility, radiopacity, and flow were evaluated in accordance with the ISO 6876:2012 standards for NSF and NMTA2, in comparison with Bio-C Sealer (BCS) and AH Plus Jet (AHP). Bond strength was assessed using the push-out test. Antibiofilm activity was evaluated by a modified direct contact test on Enterococcus faecalis biofilm with fresh sealer eluate and material after setting. Data were analyzed using the t-test, ANOVA, and Tukey post-hoc tests (α = 0.05). AHP exhibited the highest ST value, followed by NMTA2 (p < 0.05). NSF and BCS showed solubility above 3%, while NMTA2 exhibited values lower than 3% (p < 0.05). All materials demonstrated radiopacity above 3 mm Al (p > 0.05). NMTA2 demonstrated flow below ISO-recommendation (p < 0.05). NSF showed the highest bond strength values (p < 0.05). The bioceramic sealers induced higher pH compared with AHP (p < 0.05). NMTA2 exhibited more significant antibiofilm activity after the sealer set (p < 0.05). For fresh sealer eluate, NSF, BCS, and AHP demonstrated higher levels of antibiofilm activity compared with NMTA2 (p < 0.05). NSF and NMTA2 demonstrated the required physicochemical and mechanical properties, as well as antibiofilm activity against E. faecalis. However, NSF and BCS presented higher solubility. NMTA2 presented adequate solubility, however lower flow rates than those recommended by ISO standards.

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Abstract This study aimed to evaluate the impact of the blooming artifact reduction (BAR) algorithm on the measurement of various sealing materials (Biodentine, MTA ProRoot, MTAFlow, and amalgam) for furcal perforation repair using cone-beam computed tomography (CBCT). A total of 105 extracted human mandibular first and second molars were prepared and root-filled. Furcal perforations were created, and the specimens were randomly organized into five groups based on the sealing material used: (1) Biodentine, (2) MTA ProRoot, (3) MTAFlow, (4) Amalgam, and (5) Control (no sealing material). After setting, the specimens were embedded in wax, and the crowns were sectioned to measure the diameter of the sealing materials using a digital micrometer. CBCT scans were acquired using the Prexion 3D Elite® CT scanner. The dimensional measurements of sealing materials on the CBCT images was measured using DICOM files and the e-Vol DX software measurement tool, configured to thousandths of a millimeter. BAR algorithms were applied as follows: BAR 3 for the control group, Biodentine, and MTAFlow; BAR 2 for MTA ProRoot; and BAR 1 for amalgam. Statistical analysis was performed using ANOVA and Tukey’s test with a significance level of 5%. No significant differences were observed between the diameters of sealing materials measured using the micrometer and those obtained from CBCT images processed with BAR algorithms (Biodentine, MTA ProRoot, MTAFlow, and amalgam). The BAR algorithm in the e-Vol DX software preserved the dimensional accuracy of CBCT images for the tested sealing materials.

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Abstract The aim of this study was to assess the impact of the apical patency technique on apical transportation and centering ability of a controlled memory (CM) instrument in the apical region using cone-beam computed tomography (CBCT). Sixty distobuccal canals of extracted maxillary molars were assigned to three groups (n = 20) based on the patency length achieved using the Easy ProDesign Logic (EPL) 25.01 file: Group A — 1 mm beyond the apical foramen; Group B — at the apical foramen; and Group C — 1 mm short of the apical foramen (no patency). Each group was then subdivided into two subgroups (n = 10) according to the working length used for root canal preparation with the EPL 25.05 file: A1, B1, C1-I, and C1-II — 1 mm short of the apical foramen and A2, B2 — at the apical foramen. CBCT images were acquired at three time points: pre-patency, post-patency, and post-instrumentation. The scanned images were analyzed using the E-VOL DX software. No statistically significant difference in apical transportation was found between the groups after patency or after instrumentation (p < 0.05), irrespective of the measurement levels (0.5, 1, and 2 mm short of the apical foramen). A significant difference in the centering ability of the patency instrument was observed only at 2 mm short of the foramen (p < 0.05). The B2 group exhibited a higher centering ability, with a statistically significant difference compared to the A2 group (p < 0.05), observed only at 0.5 mm short of the foramen. In conclusion, maintenance of apical patency using the EPL instrument had no influence on apical transportation; however, it may slightly affect the centering ability of the root canal.

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Abstract To evaluate the pH, solubility and intratubular disinfection of the bioceramic intracanal drug Bio-C® Temp (BCT), calcium hydroxide-based paste Calen® (CAL) and their associations in different proportions: BCT 75% + CAL 25%; BCT 50% + CAL 50%; BCT 25% + CAL 75%. Polyethylene tubes containing the medication, were used. The pH was evaluated after 1, 3, 7, 14 and 21 days and solubility after 14 days. Bovine dentin tubes were contaminated with Enterococcus faecalis to assess intratubular disinfection by using confocal laser scanning microscopy and use of Live/Dead BacLight Bacterial stain. Data were submitted to statistical tests of normality, then ANOVA and Tukey (α = 0.05). BCT showed a lower pH after 3 and 14 days (p < 0.05). CAL had the highest pH at all time intervals (p > 0.05). CAL and associations with BCT showed greater weight loss (p < 0.05). BCT showed intratubular disinfection similar to that of BCT/CAL 25% (p > 0.05). CAL and BCT/CAL at 50% and 75% were similar and had the highest intratubular disinfection values (p > 0.05). Combinations of Bio-C® Temp with 50% or more calcium hydroxide paste provide higher alkalinization, solubility and intratubular disinfection values of the bioceramic medication, favoring its potential for clinical application.

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Abstract The objective of this study was to assess the impact of root canal treatment (RCT) in single-rooted teeth with asymptomatic apical periodontitis on oral health-related quality of life (OHRQoL). As a secondary objective, the impact of factors such as age, gender, ethnicity, tooth groups, arch position, crown destruction, postoperative pain, edema, and use of analgesics after procedure were also noted. A prospective cohort study was designed and enrolled in a sample of 105 patients who needed root canal treatment in single-rooted maxillary or mandibular teeth with asymptomatic apical periodontitis, without preoperative symptoms. RCT was performed in one session. The impact of the OHRQoL was recorded using the Oral Health Impact Profile (OHIP-14) at baseline and after seven and 30 days. Predictor variables were also collected: age, gender, ethnicity, tooth groups, arch position, destruction of the crown, postoperative pain, edema, and the use of analgesics. Data were tabulated and analyzed in SPSS software, with alpha value set at 0.05. All domains of the OHIP-14 questionnaire revealed a statistically significant difference between the times evaluated (p < 0.001), showing the positive impact of the RCT on OHRQoL, with moderate and large effects. There was a significant difference in the total score for gender (p = 0.001), ethnicity (p = 0.010), and crown destruction (p = 0.002). RCT improved OHRQoL scores in all domains assessed by OHIP-14, with moderate and large effects. Factors such as female gender, mixed race and afrodescendant participants, and extensive crown destruction negatively influenced the OHRQoL of patients pre-RCT.

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Abstract This study aimed to evaluate the longitudinal effect of dentition status on the perceived mobility limitation of community-dwelling Brazilian older adults. This cohort study used data from individuals who participated in the second (2006), third (2010), and fourth (2015) waves of the Health Well-being and Aging Study, conducted in the urban region of the city of São Paulo, Brazil, with adults aged 60 years and older. Mobility limitation was assessed in all waves according to reports of difficulty in performing seven activities, with higher scores representing a higher number of limitations. The independent variables of interest were number of teeth, use of dental prostheses, impact of oral health on functionality, and presence of periodontal pockets. Oral health measures were assessed by dentists, in all waves, during a clinical oral examination. The generalized linear mixed model with a Poisson distribution was used to assess longitudinal associations. All the variables were treated as time-varying in the analysis. Older adults with 20 or more teeth had a lower risk of mobility limitation than edentulous individuals, while the impact of oral health on functionality was associated with an increased risk. Similar findings were observed among dentate individuals. Periodontal disease was not associated with the outcome in dentate individuals. The associations were constant over time. The number of teeth and the impact of oral health on functionality are risk factors for mobility limitation, underscoring the importance of maintaining functional dentition for healthy aging.

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Abstract Poor oral health can negatively impact overall health and quality of life. Understanding how oral health predicts weakness in older adults is critical, since weakness increases the risk of health outcomes. However, the predictive role of oral health indicators in weakness among older adults remains unclear. This study assessed the ability of oral health indicators to predict weakness using data from Brazil’s EpiFloripa Aging cohort study. Predictive validity was evaluated in a sample of older adults participating in the cohort’s second (n = 440) and third (n = 347) waves. Self-reported sociodemographic, general health, and oral health variables were analyzed, with weakness diagnosed using cut-off points for handgrip strength. Predictive models incorporating sociodemographic, general health, and oral health variables were tested. Receiver operating characteristic curves, sensitivity and specificity, and positive and negative predictive values were calculated. Approximately 45.9% of the participants had two to three compromised oral health indicators during the second wave, and the five-year incidence of weakness was 31.9%. Oral health indicators and the oral frailty score did not enhance the prediction of weakness compared to models based solely on demographic, socioeconomic, and general health variables. However, models including oral health indicators demonstrated predictive accuracy comparable to those with demographic, socioeconomic, and general health variables. Sensitivity values were low (3.70-6.48%), while specificity values were high (>99%), with accuracy ranging from 0.64 to 0.71. These findings suggest that oral health indicators offer comparable predictive validity for weakness as sociodemographic and general health models, potentially serving as useful tools for health teams in screening older adults for weakness.

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Abstract The aim of this in-vitro study was to verify which field of view (FOV) in cone-beam computed tomography (CBCT) yields greater accuracy in the detection of internal root resorption (IRR) volume, in comparison to the gold standard of micro-computed tomography (micro-CT) and to a physical method. Twenty-five extractedsingle-rooted teeth were scanned by CBCT with two different FOV parameters (6x6-FOV and 10x10-FOV) and via micro-CT. The volume of dental hard tissue was measured on these images. A simulated IRR was produced by a demineralization protocol. After the simulated IRR, the volumes of the dental hard tissue and the simulated IRR were measured with the same scanning parameters. In addition, the volume of the simulated IRR was measured via a physical method. The simulated IRR volumes obtained by CBCT, micro-CT, and the physical method were statistically compared using one-way ANOVA. Before the simulated IRR, the mean volume of dental hard tissue obtained by 6x6-FOV, 10x10-FOV, and micro-CT were 266.64 ± 11.56, 284.78 ± 14.99, and 233.07 ± 19.91, respectively. The simulated IRR mean volumes obtained by 6x6-FOV, 10x10-FOV, micro-CT, and the physical method were 19.35 ± 5.92, 17.43 ± 5.20, 23.85 ± 6.63, and 13.51 ± 3.11, respectively. The mean volume of the simulated IRR obtained by micro-CT was similar to that of the 6x6-FOV and was significantly different from that of the 10x10-FOV and physical method. The mean volume value of simulated IRR obtained by the physical method was significantly different from those of the micro-CT and 6x6-FOV groups. In conclusion, the 6x6-FOV was better than the 10x10-FOV for the detection of IRR volume by CBCT under clinical conditions.

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Abstract This study aimed to assess the biomechanical behavior of reinforcement materials [cobalt chromium alloy (CoCr) and carbon fiber-reinforced polyether ether ketone (CFR-PEEK)] and their extensions (short: 15 mm and long: 25 mm) of single implant-retained mandibular overdentures (MO-1) by 3D finite element analysis (FEA), comparing them with MO-1 without a framework. Five models (CoCr-Short, CFR-PEEK-Short, CoCr-Long, CFR-PEEK-Long, and no framework) were created using the McNeel Rhinoceros 3D software, version 7.0. Stress distribution analysis by FEA was performed using the Optstruct solver, and a 30° oblique load (100 N) was applied in the anterior region (50 N on each central incisor). Biomechanical behavior was analyzed by overdenture displacement, maximum (MaxP) and minimum principal (MinP) stress, and von Mises stress. The MO-1 model ‘without a framework’ produced the largest dislocation, MinP stress on the mucosa, and MaxP stress in the cortical bone. Regardless of the extension of the framework, CFR-PEEK had minor MinP stress in the mucosa and lower overdenture displacement. The ‘CoCr-Long’ and ‘CFR-PEEK-Long’ models had higher von Mises stress on the implant housing, and MaxP stress on the O’ring nylon conventional implant and overdenture. The ‘CoCr-Short’ and ‘ CFR-PEEK-Short’ models showed a greater tendency for tension concentration solely in the framework. The incorporation of a framework into MO-1 decreased stress concentration on the overdenture, resulting in lower stress on the attachment, mucosa, implant, and peri-implant bone, irrespective of the material used. The short framework, however, performed better biomechanically in MO-1, and it is therefore the most recommended option. CFR-PEEK showed favorable biomechanical outcomes, and is suggested for reinforcement of MO-1.

Resumo em Inglês:

Abstract Pterygoid implants have been demonstrated to have a high success rate. Nevertheless, there are few biomechanical tests to evaluate the tensile forces induced by force dissipation in peri-implant tissues. This study employed photoelasticity and extensometry to demonstrate and compare the biomechanical behavior of non-axial implants in a pterygoid model and a conventional model of oral rehabilitation, thus allowing for qualitative and quantitative analysis. Two models received an implant measuring 3.75 x 13 mm in the canine pillar at a 90 ° angle to the Frankfurt plane. In the control group, an implant with a diameter of 3.75 mm and a length of 11 mm was placed in the maxillary tuberosity parallel the medial implant. In the study group, an implant with a diameter of 3.75 mm and a length of 11 mm was installed with an angulation of 45 degrees in the antero-posterior direction and 15 degrees in the buccal-palatal direction, with apical anchorage in the pterygoid process of the sphenoid bone. In the extensometric analysis, the models were subjected to five cycles of repeated axial tensile loading (100 N) at a rate of 0.5 mm/min. A computer was connected to the amplifier in order to record the output signal of the polyurethane surface, and the acquisition system software was employed to record the data. The data were analyzed in accordance with data distribution, as determined by the Shapiro-Wilk test and equality of variance. Subsequently, the data were classified according to the variables. The Student’s t-test was employed when normal distribution of variances was identified, whereas the Mann-Whitney U test was utilized for data with non-normal distribution. A 5% significance level was employed. In the photoelastic analysis, replicas of both configurations were produced using photoelastic resin. The models were subjected to a single axial loading cycle, with a load of 100 N applied at a rate of 0.5 mm/min, and the resulting stress was observed under a circular polariscope. Photographs were taken at two time points: before and after loading. These images were then processed by the same operator using a computer graphics program, allowing for a more straightforward analysis of stress distribution. This was achieved by the formation of isochromatic fringes. The results of the strain gauge analysis revealed no statistically significant differences between the two groups (p = 0.37) or between the anterior (p = 0.08) and posterior (p = 0.74) implants. The photoelasticity analysis revealed the presence of high-intensity isochromatic fringes at the apex of the axial implant in the control model, as well as in the cervical-distal and apical regions of the pterygoid implant, where a high concentration was also observed. Although no statistically significant results were obtained from the quantitative analysis, our findings suggest that the favorable outcomes observed in the clinical studies are due to the high force dissipation observed in the pterygoid plate, which is composed of dense cortical bone.

Resumo em Inglês:

Abstract This study evaluated the influence of a customized healing abutment (CHA) placed on immediate implants. It also assessed bone ridge volume, keratinized mucosal collar, and postoperative pain. Thirty-one patients needing tooth extraction and immediate implant were selected. Gingival papilla height, bone ridge volume, and keratinized mucosal collar thickness were measured using a millimeter periodontal probe and a dry-point caliper. A visual analog scale (VAS) was applied to determine postoperative pain. Study participants were randomly assigned to a control group (n = 15, with extraction, immediate implant placement, alveolar gap filling with a bovine bone graft, PTFE barrier, and suture) and an experimental group (n = 16, with extraction, immediate implant placement, gap filling with a bovine bone graft, and CHA). The healing abutments were prepared before surgery and customized during the procedure. The data were tabulated and statistically analyzed using the Mann-Whitney test (α = 0.05). The “changes in the papilla” outcome presented a statistical difference, and the control group showed higher values than those of the experimental group (p = 0.04). The remaining characteristics demonstrated no statistical differences between the groups (p > 0.05). CHA and the barriers exhibited similar behavior in maintaining bone ridge and keratinized mucosal thickness. CHA proved more effective than the conventional barrier in preserving the gingival papilla, with the distance measured three months post-surgery averaging 17% greater than the pre-surgical measurement.

Resumo em Inglês:

Abstract The contamination of dental curing light tips was evaluated before and after treatment and after their use and disinfection. The influence of a plastic protective barrier over the flexural strength and the modulus of elasticity of resin composites were also analyzed. Microbiological sampling was conducted at initial contamination (T0), in Log 10 CFU/4 mL; after dental treatment (T1); and after disinfection with 70% ethanol (v/v) (T2). The results were analyzed by descriptive statistics and analysis of variance. The flexural strength and the modulus of elasticity analyses were performed using bar-shaped test specimens of three commercial resin composites with and without barriers, and the tests were subjected to a statistical normality test. Turbidity was observed in the media in 60.7% of the tubes at T0, 100.0% at T1, and 57.1% at T2. The microbial contamination was similar at T0 and T2, but a significant increase was observed at T1. The recovered microbial load differed significantly between T1 and T2 (p < 0.05). The results of the flexural strength and modulus of elasticity analyses showed no significant differences with or without a barrier for any of the different colors of resin, polymerization time, or the three resins. Under the present experimental conditions, 70% ethanol significantly reduced the levels of microbial contamination, but it did not guarantee the inactivation of all microbial cells. The use of plastic protective barriers did not alter the flexural strength or the modulus of elasticity of any of the tested resin composites, indicating that they are a safe and viable measure to prevent cross-contamination when using a dental curing light.

Resumo em Inglês:

Abstract This study aimed to establish the frequency of oral mucosal conditions and xerostomia, identify a possible association between them, and verify their associated factors from a sample of the population of Três Corações, Brazil. A cross-sectional study was conducted with volunteers without age restriction. To evaluate the presence of oral mucosal conditions, an intra-oral examination was performed and a clinical diagnosis was established based on the official classifications of oral diseases. The report of xerostomia was identified by a validated questionnaire completed during anamnesis. Descriptive and association statistics were performed using a significance level of 5%. A total of 1,052 volunteers were evaluated. Oral mucosal lesions were observed in 42.11%, variations of normal structures in 38.50%, and xerostomia in 60.64%. Women were more affected than men, particularly women aged 20-49. Xerostomia was not found to be associated to oral mucosal conditions in general (p > 0.05); however, inflammatory fibrous hyperplasia (27.99%) and oral candidiasis (24.38%), the most prevalent lesions in the study, were associated with xerostomia (p < 0.001 and p = 0.006, respectively) and denture use (p = 0.025 and p < 0.001, respectively). Use of tobacco and alcohol intake were not associated with the presence of oral lesions (p = 0.319 and p = 0.739, respectively). The findings of this study are important for determining the prevalence of oral conditions and xerostomia in the general population, serving as a baseline for further investigations into the association between xerostomia, inflammatory fibrous hyperplasia, and oral candidiasis.

Resumo em Inglês:

Abstract Oral squamous cell carcinoma (OSCC) remains the most prevalent neoplasm of the head and neck. In recent decades, the incidence and prevalence of OSCC have not significantly changed, highlighting the critical need to develop and implement new risk assessment measures. The present study aimed to define argyrophilic proteins of the nucleolar organizer region (AgNOR) cut-off risk points by oral exfoliative cytological smears comparing specialized humans with a convolutional neural network (CNN) system AgNOR Slide-Image Examiner. This study included four experimental groups: control, exposure to carcinogens (alcohol and tobacco), oral potentially malignant disorders, and OSCC. In the first phase, 50 cells were used for AgNOR quantification. In the second phase, AgNOR quantification was established in an automated manner using an AgNOR System – Slide Examiner (captured – bounding-boxed – CNN analysis). In phase 1, the cut-off point for considering a smear as suspicious was established at 3.69 AgNORs/nucleus with sensitivity of 86%, specificity of 93%, and accuracy of 90%. In phase 2, the analysis of the intraclass correlation coefficient of AgNORs attributed to the system and human was 0.896 (95% confidence interval = 0.875–0.915; p < 0.0001), and this quantification with the CNN was 20 min compared to 67 h, considering human analysis. The AgNOR Slide-Image Examiner successfully differentiated the nuclei and accurately quantified the number of NORs in oral cytological smears. The cut-off risk point of 3.69 AgNOR/nucleus indicates a suspicious sample may contribute to improvements in oral cancer screening.

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Abstract This study aimed to assess the clinicopathological characteristics of medication-related osteonecrosis of the jaw (MRONJ), addressing histopathological features and bone structure. Twenty-two MRONJ patients were retrospectively evaluated for osteonecrosis, osteomyelitis, bacterial colonization, bone resorption, reactive bone, osteon-like structure, lamellar bone, and basophilic lines. Specific staining and fluorescence and polarized light microscopy assessments were also performed. The mandible was significantly more affected by MRONJ. There was a predominance of African-Brazilian women aged sixty and older. Osteomyelitis was present in 82% of patients. Actinomycosis was observed in 36.4% of MRONJ patients. Osteoclasts were absent in MRONJ but bone resorption was often seen. Basophilic lines were observed in more than 80% of the patients. The MRONJ patients exhibited lamellar bone with osteon-like structures. This study provided important insight into MRONJ, demonstrating a diverse histopathological spectrum and infection with Actinomyces and fungi. The condition was characterized by a necrotized lamellar bone structure and more frequently affected the mandible of older women.

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Abstract This cross-sectional study aims to investigate the prevalence of oral manifestations in a sample of the Brazilian population with COVID-19. Adults diagnosed with COVID-19 through real-time PCR/serological tests were invited to participate. The online questionnaires were distributed at different times to analyze and compare SARS-CoV-2 variants considering the period of prevalence of these variants in Brazil. A total of 846 participants were included, of whom 539 were diagnosed before the Omicron variant. In total, 47.28% were vaccinated with at least two doses. The prevalence of oral manifestations was 52.6% (95%CI: 49.23–55.95), and the most common manifestations included taste disorder (38.06%; 95%CI: 34.85–41.38), xerostomia (17.61%; 95%CI: 15.19–20.32), and halitosis (11.58%; 95%CI: 9.59–13.92). The prevalence of persistent symptoms in post-COVID-19 was 12.1% (95%CI: 10.0–14.4) for taste disorder and 5.4% (95%CI: 4.1–7.1) for xerostomia. A significant association was found between females and persistent taste disorder (p = 0.0084) and oral manifestation and depression/anxiety (OR = 1.855, 95%CI: 1.267–2.717, p = 0.002), worse oral hygiene (OR = 1.729, 95%CI: 1.189–2.516, p = 0.004), and medication use (OR = 1.630, 95%CI: 1.123–2.367, p = 0.010) (p < 0.0001). In the Alpha, Beta, Gamma, and Delta variants, compared with the Omicron variant, taste disorder and xerostomia were less present when toothbrushing habits remained unchanged or improved (p < 0.0001). Oral manifestations in patients with COVID-19 were associated with depression/anxiety, worse oral hygiene, and medication, all of which reinforce its multifactorial etiopathogenesis.

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Abstract The etiological intersection between orofacial clefts and oral cancer may involve environmental factors modulating gene expression in shared biological pathways. This study aimed to investigate the association between orofacial clefts and oral potentially malignant disorders or oral squamous cell carcinoma, focusing on genetic variants and environmental risk factors. A case-control design was employed, comprising 48 histologically confirmed cases of oral potentially malignant disorders or oral squamous cell carcinoma and 96 age- and sex-matched controls. Information on family history of orofacial cleft, and biological and environmental risk factors, was collected through interviews. Genomic DNA was extracted from saliva samples and genotyped for rs1533767 (WNT11), rs9879992 (GSK3B), and rs3923087 and rs11867417 (AXIN2). Unadjusted and adjusted odds ratios (OR) for the associations between family history of orofacial cleft and oral potentially malignant disorders/oral cancer, and between environmental risk factors and oral potentially malignant disorders/oral cancer were calculated using STATA software. Genotype and allele frequency comparisons between groups were conducted using PLINK Software. Statistical significance was defined as p<0.05 and 95% confidence interval (95%CI). No statistically significant association was found between family history and orofacial clefts (p = 0.52). However, place of residence (adjusted OR:5.46, p < 0.001, 95%CI: 3.76–63.543), and three genetic variants—rs1533767 (OR: 1.94, p = 0.042, 95%CI: 1.018–3.694), rs3923087 (OR: 0.58, p = 0.038, 95%CI: 0.344–0.974), rs11867417 (OR: 0.51, p = 0.010, 95%CI: 0.304–0.857)—were associated with oral potentially malignant disorders and oral squamous cell carcinoma. These findings suggest that specific environmental risk factors and genetic variants may be associated with increased susceptibility to oral potentially malignant disorders and oral cancer.

Resumo em Inglês:

Abstract A cross-sectional study was carried out among patients with ulcerative colitis (UC) and Crohn’s disease (CD) in order to determine the frequency of oral mucosal lesions or conditions (OL), as well as to analyze its relationship with some clinical and laboratory parameters. Epidemiologic, clinical, and laboratory data were considered. Statistics included univariate and multivariate analyses. Ninety patients [46 (51.1%) males] were included [median age: 43 years (range 18–79 years)]. UC was diagnosed in 65 (72.2%) patients; CD in 25 (27.8%) patients; and inactive CD was detected in 78 (86.6%) patients. All patients (100%) had OL; fissured tongue was the most frequent finding [68 (75.6%)]. Furred tongue was more common in UC than in CD patients [45 (69.2%) vs. 11(44.0%); p = 0.03]; lower levels of hemoglobin were more often detected in mucosal pallor [(median (Md) =12.1 vs. 14.4g/dL); p = 0.02] than in other OLs. Higher frequency of melanosis was observed when oral rinses were used [37 (71.2%) vs. 15 (28.8%)]; p = 0.03], compared to those who did not use them. A higher risk of varix [OR: = 37.6 (95%CI: 4.7–298.9), p < 0.001], leukoedema [OR: 5.8 (95%CI: 1.4–24.2); p = 0.004], candidosis [OR: 3.9 (95%CI: 1.4–10.6); p = 0.05], fissured tongue [OR: 3.8 (95%CI: 1.2–11.5); p = 0.01], and all infectious processes analyzed collectively [OR: 3.6 (95%CI: 1.3–9.8); p = 0.03], was found in patients older than 45 years than in younger ones. Also, patients with fissured tongue presented a higher risk of having candidosis than those without this condition [OR: 6.1 (95%CI: 2.1–17.5); p = 0.007]. OLs were highly frequently observed in UC and CD patients. Age (> 45 years), low levels of hemoglobin, use of mouthwashes, among other variables, were predictive factors of OL in these patients; thus, their assessment and detection in inflammatory bowel disease should be emphasized.

Resumo em Inglês:

Abstract Oral squamous cell carcinoma (OSCC) is the most common malignancy of the head and neck. Studies on the inflammatory pathways that have evolved during the development of the disease remain controversial. We assessed the expression of inflammatory markers, such as COX (cyclooxygenase)-2, CD68, CD4, and tumor necrosis factor (TNF)-α, based on prognostic variables and disease-specific survival in patients with OSCC. Immunohistochemical analysis of COX-2, TNF-α, CD4, and CD68 was conducted in 72 patients treated surgically. Neural invasion was evaluated based on S100 expression. Disease-specific survival was assessed using Cox regression analysis. Most participants were male, with a mean age of 61 years. A total of 77.5% of patients presented with clinical stages III–IV, and 70% underwent surgery combined with radiotherapy or chemotherapy. The expression of CD68, CD4, and TNF-α was not associated with clinical variables or tumor differentiation. COX-2 expression correlated with tumor size (p = 0.01), whereas high TNF-α expression was noted in moderately/poorly differentiated OSCC. The absence of nodal involvement (hazard ratio [HR]: 0.47, confidence interval [CI]: 0.25–0.87, p = 0.001) was linked to lower death risk, whereas surgery without adjuvant radiotherapy or chemotherapy was associated with a higher risk of death (HR: 2.09, 95%CI: 1.02–4.27, p = 0.043). Multivariate analysis revealed that high COX-2 expression predicted a shorter disease-specific survival. Altogether, high TNF-α expression is prevalent in moderately/poorly differentiated OSCC, and elevated COX-2 expression correlates with larger tumor size and poorer survival in OSCC.

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Abstract This study aim was to evaluate the need for orthodontic treatment of mixed to permanent dentition using the Dental Aesthetic Index (DAI) in a 4-year follow-up. A longitudinal study was conducted with 353 children in the stages from mixed (T1) to permanent (T2) dentition. The need for orthodontic treatment was assessed using the DAI categorized into: DAI 1 (absence of malocclusion and orthodontic treatment need; DAI ≤ 25); DAI 2 (malocclusion is defined and elective orthodontic treatment is needed; DAI = 26 to 30); DAI 3 (severe malocclusion and a desirable orthodontic treatment need; DAI = 31 to 35) and DAI 4 (severe malocclusion and a mandatory orthodontic treatment need; DAI ≥ 36). The Bowker symmetry test was used to determine agreement in the categorization of DAI at T1 and T2, with a significance level of 5%. The results showed a significant disagreement in the need for orthodontic treatment between T1 and T2 (p<0.05). In 34.6% of children evaluated in T1, the same need for orthodontic treatment was maintained in T2. According to the DAI, in 60.8% of the children, the need decreased, and in 39.2% their need for orthodontic treatment increased. This preliminary longitudinal study using DAI, showed a decrease in malocclusion and need for orthodontic treatment as the dentition transitioned from mixed to permanent occurred. This finding has valuable implications for epidemiological data in orthodontics.

Resumo em Inglês:

Abstract The aim of this study was to assess the impact of orthodontic treatment with orthodontic aligners (OAs) and fixed appliances (FAs) on oral health-related quality of life (OHRQoL). This parallel randomized clinical trial included 40 male and female patients aged 13 to 35 years diagnosed with Angle’s Class I malocclusion. Participants were assigned to two groups: OA (n = 20) and FA (n = 20). OHRQoL was assessed using the Brazilian OHIP-14, which was administered before treatment (T0), at 1 month (T1), 6 months (T2), and 12 months (T3) after treatment initiation. Data were analyzed using the independent t test, the chi-square test, the Mann-Whitney test, and Friedman test (p < 0.05). FAs had a significantly (p < 0.05) higher impact on OHRQoL at T1 in terms of functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, and overall score. Within-group comparison showed higher scores for the FA group in comparison to the OA group. Functional limitation scores were higher at T1 than at T0 (p = 0.034), while physical pain scores were higher at T1 compared to T0 (p = 0.034) and T2 (p = 0.010). Psychological discomfort scores were higher at T1 than at T2 (p = 0.015). Physical disability scores were higher at T1 compared to T0 (p = 0.008). Overall scores were higher at T1 than at T2 (p = 0.003). No significant changes were observed in the OA within-group comparison. Patients treated with OAs had less impact on OHRQoL compared to those treated with FAs in the first month. There was no difference between the groups at the 6-month follow-up.

Resumo em Inglês:

Abstract The aim of this study was to assess the biosafety practices adopted during the COVID-19 pandemic that persisted in post-pandemic orthodontic clinical routines. In this cross-sectional study, 722 Brazilian orthodontists who were in the early phase of the pandemic, and 203 from the later phase, respectively, answered a 45-item questionnaire addressing basic personal information, use of personal protective equipment, biosafety protocols, and COVID-19 incidence. Descriptive statistics and chi-square tests were used to analyze the data. Most participants were infected with the coronavirus (from 10.1% to 65%). While 52.4% perceived providing care as very risky during the pandemic, this perception shifted to decreased to a moderate level of risk in the late phase of the pandemic (40.4%). The use of protective face masks/face shields decreased from 51.7% to 25.1%, as well as the use of disposable coats (from 77.1% to 45.8%). Many orthodontists discontinued the use of PFF2/N95 masks and reverted to wearing surgical masks again. Most orthodontists disinfected orthodontic bands, and photographic retractors through manual washing and autoclaving. Most participants preferred to clean their orthodontic pliers with 70% alcohol. A decline in orthodontists’ concern about biosafety during clinical appointments was observed in the late phase of the pandemic. Moreover, the need for greater specific care still persists, especially regarding the proper use of disposable coats, face shields, and surgical masks.

Resumo em Inglês:

Abstract The aim of this cross-sectional study was to perform a three-dimensional (3D) assessment of the cranial base of patients with unilateral cleft lip and palate (UCLP). Cone-beam computed tomography (CBCT) scans of 52 UCLP patients (21 females and 31 males; mean age, 10.0 ± 2.12 years) were compared with the scans of 72 individuals (24 females and 48 males; mean age, 11.0 ± 2.11 years) without CLP, matched by gender and age (control group, CG). The 3D Euclidean distances of anterior cranial base (N-S), posterior cranial base (S-Ba), total cranial base (N-Ba) lengths, cranial base width (Po-Po), as well as the cranial base flexure (NSBa), were measured using open-source software ITK-SNAP and 3D Slicer. Statistical analyses were carried out with the Student’s t-test at a significance level of 5%. UCLP demonstrated shorter 3D distances than CG in the N-S, S-Ba, and N-Ba cranial base lengths (p < 0.001). In comparison with female CG, female UCLP had a smaller cranial base flexure (NSBa; p = 0.020). No statistically significant differences between UCLP and CG were found for the cranial base width (Po-Po). UCLP patients presented distinct morphological cranial base characteristics in comparison with CG. These results indicate that morphological and positioning changes in the maxillary bones are not solely attributable to the cleft and/or surgical procedures.

Resumo em Inglês:

Abstract The objective of this study was to analyze the directions by which school jet lag is associated with traumatic dental injury in children, evaluating direct and indirect effects of socioeconomic factors and sleep. A representative, population-based, cross-sectional study was conducted with 739 schoolchildren eight to ten years of age. Parents/guardians answered a sociodemographic questionnaire, the Sleep Disturbance Scale for Children and the Circadian Energy Scale. Four examiners underwent training and calibration exercises for the diagnosis of traumatic dental injury (K > 0.80) using the criteria proposed by Andreasen (2007). Descriptive analysis was followed by structural equation modeling to determine direct and indirect associations between the variables incorporated into the theoretical model. School jet lag [standardized coefficient (SC): -0.238, 95%CI: -0.390–0.087], income (SC: -0.151, 95%CI: 0.0010–0.292), and number of residents in the home (SC: -0.109, 95%CI: -0.212–0.007) were directly associated with traumatic dental injury, whereas sleep disturbances and schooling of the parents/guardians exerted an indirect effect. Sociodemographic factors and school jet lag were associated with traumatic dental injury in children eight to ten years of age.

Resumo em Inglês:

Abstract An association between bruxism and musculoskeletal disorders, such as neck pain, has been established. This study investigated the association of possible sleep bruxism (PSB) activities, including grinding, bracing, and thrusting, with smartphone use, smartphone-induced neck pain, and sleep features. This cross-sectional study involved 403 Brazilian adolescents aged 11 to 19 years. A self-administered questionnaire was used to assess the severity of PSB, smartphone use, smartphone-induced neck pain, and sleep features (sleep duration and quality and history of nightmares). Sociodemographic factors, as well as snoring and drooling on the pillow, were considered potential confounders and were assessed based on reports from parents/caregivers. Participants were selected using multiple-stage sampling. Descriptive analysis and multinomial regression were performed (p ≤ 0.05). Adolescents reporting nightmares at least once a month (OR = 3.402; 95%CI: 1.315–8.802) and sometimes experiencing smartphone-induced neck pain (OR: 3.697, 95%CI: 1.103–12.388) were more likely to report moderate/severe grinding. Drooling on the pillow (OR = 3.105, 95%CI: 1.316–7.329), poor/fairly good sleep quality (OR = 2.717, 95%CI: 1.279–5.770), and smartphone-induced neck pain (OR = 3.227, 95%CI: 1.121–9.285) were associated with mild bracing. Adolescents experiencing nightmares once a week (OR = 3.209, 95% CI: 1.202– 8.565) had a higher prevalence of mild thrusting. Self-reported smartphone-induced neck pain, nightmares, poor/fairly good sleep quality, and drooling on the pillow were associated with a higher prevalence of PSB activities among Brazilian adolescents. Clinicians and researchers are encouraged to include assessments of smartphone use and sleep features in anamnesis, promoting a comprehensive approach to PSB, from diagnosis to treatment.

Resumo em Inglês:

Abstract The aim of this study was to explore the association between oral health literacy (OHL) and dental caries in children, evaluating the direct and indirect effects of brushing frequency, obesity, and socioeconomic factors. A cross-sectional study was conducted with 739 schoolchildren aged eight to ten years and their parents/caregivers who answered a questionnaire addressing sociodemographic characteristics and oral hygiene habits as well as the OHL – Adult Questionnaire. Cavitated dental caries in the schoolchildren was evaluated using International Caries Detection and Assessment System criteria. Descriptive analysis was performed, followed by structural equation modeling into the theoretical model (95% CI). Goodness-of-fit indices were considered satisfactory (root mean square error of approximation < 0.06; comparative fit index > 0.90–0.95; standardized root mean square residual < 0.10 and Tucker-Lewis Index > 0.90–0.95). Mother’s age (standardized coefficient [SC]: -0.08; p < 0.01), caregiver’s schooling (SC: -0.22; p < 0.01), obesity (SC: 0.13; p < 0.01), and brushing frequency (SC: -0.09; p < 0.01) had a direct effect on dental caries, whereas OHL had an indirect influence on the outcome. Mother’s age, caregiver’s schooling, brushing frequency, and obesity directly affected the occurrence of cavitated carious lesions in children in the mixed dentition phase, whereas OHL had an indirect effect on this clinical outcome.

Resumo em Inglês:

Abstract The aim of this study was to evaluate, in vitro, the effects of radiation therapy on the morphology and chemical composition of root dentin and cementum of primary teeth. Roots of human primary teeth were exposed to varying doses of irradiation using a linear accelerator: Group 1 = irradiation dose of up to 30 Gy (n= 6); Group 2 = irradiation dose of up to 42 Gy (n= 6); and Group 3 = irradiation dose of up to 54 Gy (n= 6). Non-irradiated human deciduous teeth were used as controls (n= 3). Energy-dispersive X-ray spectroscopy (EDX) data were analyzed using the chi-square test (alpha = 5%). The morphological evaluation was performed using scanning electron microscopy (SEM). In the cementum, radiation increased inorganic composition and decreased oxygen levels. However, no morphological changes were observed. In the root dentin, obliterated dentinal tubules were observed in specimens irradiated with 54 Gy, with no changes in composition. Thus, radiation therapy significantly altered the morphology and composition of important tooth structures such as dentin and cementum, in primary teeth.

Resumo em Inglês:

Abstract Tooth avulsion is an emergency dentoalveolar trauma, and knowledge of this condition can improve the prognosis of trauma. This study aimed to assess and improve elementary school teachers’ knowledge of tooth avulsion using two educational intervention methods. Data were obtained through a parallel, blinded educational intervention study involving 116 teachers from public and private schools. They participated and completed a structured questionnaire regarding the immediate measures required for dentoalveolar trauma to permanent teeth, storage methods, and the ideal time for the dental element to remain outside the socket. After randomly assigning teachers to the leaflet and video groups, they were provided guidance on dentoalveolar trauma and completed the questionnaire again. Comparison tests, namely chi-square and logistic regression, were performed to assess the post-intervention responses and compare the differences between the groups. The results were interpreted with a significance level of 5% and a 95% confidence interval. Most responses showed a statistically significant difference (p < 0.05), indicating that the interventions improved teachers’ knowledge, except for questions on time and immediate management after dentoalveolar trauma (p > 0.05). There was no statistical difference between the intervention methods, demonstrating that both the leaflets and videos improved teachers’ knowledge (p > 0.05). The results revealed that teachers’ knowledge of tooth avulsion improved regardless of the format of the educational intervention.

Resumo em Inglês:

Abstract The aim was to evaluate the association between dental development (dental maturity) and genetic polymorphisms in PTH and genes involved in vitamin D synthesis in a cohort of Brazilian children. This retrospective cross-sectional study was performed on children receiving orthodontic treatment. Patients who had already undergone orthodontic treatment previously, those with syndromes, congenital anomalies, craniofacial deformities, and those with a previous history of dental trauma and bilateral agenesis/missing tooth/teeth were excluded. Panoramic radiographs were used for dental age evaluation according to the method proposed by Demirjian, Goldstein, and Tanner (1976). A delta [dental age minus chronological age (DA-CA)] was calculated to determine whether the patient's dental age was normal, delayed (negative values), or advanced (positive values). DNA isolated from buccal cells was used for genotyping genetic polymorphisms in PTH (rs694, rs307247, and rs6256), VDR (rs7975232), CYP27B1 (rs464653), and CYP24A1 (rs927650). A statistical analysis was performed and p<0.05 indicated statistical difference. A total of 79 orthodontic patients were included (44 (55.70%) girls and 35 (44.30%) boys). Demirjian, Goldstein, and Tanner's method (1976) overestimated the age of patients by 0.75 years. None of the genetic polymorphisms were associated with dental age (p>0.05). In conclusion, there is no association between genetic polymorphisms in PTH and genes involved in vitamin D synthesis and dental maturity.

Resumo em Inglês:

Abstract Preventive maintenance in pediatric dentistry is essential for monitoring oral health and promoting healthy habits. This study aimed to evaluate how the frequency of follow-up appointments, as well as sex- and age-related differences, impact the probability of referral for curative treatment among pediatric dentistry patients at a Brazilian dental school. This retrospective longitudinal study included dental records of patients who had their first appointment between the second half of 2013 and the second half of 2019, completed treatment, and returned for at least one check-up visit. Descriptive and survival analyses were performed. A total of 296 dental records were evaluated, comprising 47.6% female and 52.4% male patients. The likelihood of referral to curative treatment increased with longer follow-up intervals, reaching 18.9% at six months and 82.7% at 48 months. Patients aged 9 years or younger were 2.07 times more likely to be referred to curative treatment than those aged 10 years or older. No significant difference was observed in referral probability between boys and girls. Longer intervals between check-up visits increased the likelihood of referral to curative treatment, which was higher among older children. Establishing personalized follow-up intervals based on individual patient needs is crucial for maintaining oral health.

Resumo em Inglês:

Abstract This study evaluated the influence of socioeconomic factors, caregiver characteristics, and early feeding practices on sugar consumption frequency (FSC) during early childhood. Data were collected from dental records of children aged 1 to 5 years old, who were attended at CliBin®, including sex, age, skin color, income level, mother’s age and years of education, primary caregiver, prior instructions on caries prevention, type of early feeding practices (breastfeeding/formula/mixed), exclusive breastfeeding (EB) up to 6 months, children’s dental care and their consumption of sugar-sweetened beverages (SSB) and cookies/sugar (CS), with frequency classified as: never (2 points), ≤ 3 times/day (1 point) and > 3 times/day (0 points). The lower the median score the higher the FSC. Descriptive analysis, Kruskal-Wallis test, and ANOVA were applied considering p < 0.05. A total of 123 records were included. The children were predominantly male (56.1%), and brown (46.5%), with an average age of 2.1 (± 0.9) years. The mother was the primary caregiver (86.1%), with ≤ 30 years of age (52.0%), < 12 years of education (75.2%), and previously instructed on caries prevention (58.2%). Most children were breastfed (45.5%) for 23.2 (±9.7) months on average, received EB (87.1%), consumed SSB (87.6%) and CS (90.9%) 3 times/day. The total FSC mean score was 1.6 ± 0.9 (95%CI: 1.4–1.7). Children of younger mothers (≤ 30 years) had the lowest FSC scores (1.4 ± 0.9; 95%CI: 1.0–1.6; p=0.01). It was observed that among the factors studied, only mothers in the younger age range influenced high sugar consumption during early childhood.

Resumo em Inglês:

Abstract Environmental and systemic factors play a role in the development of hypomineralization characterized by demarcated opacities. This study aimed to investigate the prevalence, distribution, severity, and etiologic factors associated with hypomineralization in all primary teeth, hypomineralized second primary molars (HSPM) and evaluate its association with Molar Incisor Hypomineralization (MIH). A sample of 2,102 male and female Brazilian children aged 3 to 10 years exhibiting good general health was examined by 30 calibrated dentists using WHO probes and clinical mirrors, using the index proposed by Ghanim et al. Data were collected through clinical examinations and a questionnaire answered by mothers, addressing sociodemographic and prenatal, perinatal, and postnatal factors. Prevalence was assessed by calculating frequency, whereas etiologic factors were evaluated using univariate and multivariate Poisson logistic regression with robust adjustment. In addition, multivariate analysis was conducted using nonparametric resampling with Jacknife adjustment. The overall prevalence of hypomineralization in primary teeth was 18.5%, with second molars affected in 17% and canines in 6.7% of the cases, while other teeth were affected at lower rates. Exclusive breastfeeding for six months showed a protective effect against hypomineralization (p = 0.40). Children with HSPM were five times more likely to develop MIH, regardless of sex (OR: 4.92). Furthermore, lower family income increased the likelihood of MIH. In conclusion, hypomineralization in primary teeth is prevalent, exclusive breastfeeding for six months is associated with a lower prevalence of enamel defects, and children with primary dentition defects are at greater risk for similar conditions in their permanent teeth.

Resumo em Inglês:

Abstract This study aimed to explore the prevalence of developmental defects of enamel (DDE) and dental caries in children with and without Down syndrome (DS) and evaluate potential associations between these conditions. This was a cross-sectional, exploratory, census-based study with children of both sexes aged 6 to 11 years. The sample consisted of 10 children diagnosed with DS and 61 without DS. Standardized forms and records of dmft/DMFT and modified developmental defects of enamel (mDDE) were used. Inter- and intraexaminer agreement was assessed, with an intraclass correlation coefficient (ICC) of 0.93 for DDE and 0.81 for caries. The data were tabulated using SPSS 20.0. Categorical variables were subjected to Pearson’s chi-square test to identify significant associations (p = 0.05). The Kolmogorov–Smirnov test revealed a nonnormal distribution pattern of the data (p <0.001). Therefore, numerical variables were subjected to the Mann–Whitney test to verify statistically significant differences (p = 0.05). Among the 71 study participants, 43 (60.6%) were male, and 28 (39.4%) were female. Among them, 10 (14.1%) had DS, 42 (59.2%) had caries, and 19 (26.8%) had DDE, with demarcated opacity as the most common type of DDE. A significant association was identified between having DS and not having dental caries (p = 0.007) and between having DS and having DDE (p <0.001). Individuals with DS were found to have 9.8 times greater odds of having DDE (p = 0.018). Compared with normotypic children, children with DS had a greater prevalence of DDE and a lower prevalence of dental caries. Additionally, children without DS were more likely to have caries in the presence of DDE.

Resumo em Inglês:

Abstract Understanding recurrent injuries in the deciduous dentition and possible associated factors could help in the control and prevention of such episodes in children. The aim of the present study was to investigate the frequency of recurrent injuries in the deciduous dentition and associated factors. A retrospective cross-sectional study was conducted involving 517 children aged between six months and six years treated at the Clinic for Traumatic Dental Injuries in the Deciduous Dentition of the School of Dentistry of the Universidade Federal de Minas Gerais. Data were collected from dental records with information on sociodemographic and clinical characteristics. Data analysis involved descriptive statistics, chi-square test, and bivariate and multivariate Poisson regression analyses (p < 0.05; 95%CI). The prevalence of recurrent tooth injuries in the deciduous dentition was 17.2% (n = 89). Children aged between four and six years (PR = 1.917; 95%CI: 1.055–3.484; p = 0.033), those with inadequate lip protection (PR = 1.790; 95%CI: 1.085–2.953; p = 0.023), those with uncomplicated crown and crown-root fractures (PR = 1.856; 95%CI: 1.224–2.816; p = 0.004), and those with complicated crown and crown-root fractures (PR = 1.818; 95%CI: 1.021–3.239; p = 0.042) had a greater frequency of repeated tooth injuries compared to children without these characteristics. In the present study, older age, inadequate lip coverage, and the occurrence of complicated and uncomplicated crown and crown-root fractures were associated with repeated injuries in the deciduous teeth.

Resumo em Inglês:

Abstract Specific measures for assessing dental anxiety and fear are crucial in pediatric dentistry for their management. This cross-sectional study aimed to test the validity and reliability of the Brazilian Portuguese version of the Modified Child Dental Anxiety Scale – Faces (MCDASf). A total of 189 children enrolled in public schools in Pelotas, Southern Brazil, and their parents were included. The children completed an interview that included the MCDASf, Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), Dental Anxiety Question (DAQ), and self-reported oral health-related outcomes. The parents provided sociodemographic data and information on dental visits and pain. Descriptive statistics, comparison and correlation tests, and psychometric analyses were conducted. The MCDASf scores were positively correlated with the CFSS-DS scores (rho = 0.60; p < 0.001). Children reporting dental anxiety (DAQ) had higher MCDASf scores. Exploratory factor analysis (EFA) was conducted on MCDASf items. The factor model was supported by Bartlett’s test of sphericity (p < 0.001) and the Kaiser-Meyer-Olkin (KMO) measure (0.782). The loadings indicated that the two factors explained 18.9% and 13.9% of the variance. Factor 1 included items 1–3, 5, 7, and 8, whereas Factor 2 included items 4 and 6. The MCDASf showed satisfactory internal consistency: Cronbach’s α = 0.73 and McDonald’s ω = 0.82 for the total scale, with α and ω > 0.66 for both factors. Coefficients ≥ 0.70 are considered acceptable. This study provided psychometric evidence supporting the Brazilian MCDASf (B-MCDASf) as a reliable self-report tool for assessing dental anxiety in children in both clinical and research settings.

Resumo em Inglês:

Abstract This cross-sectional study aimed to evaluate the association between the degree of depression, anxiety, and stress and oral health-related quality of life (OHRQoL) of adolescents aged 11 to 19 years from Santa Maria, Brazil. The Child Perception Questionnaire (CPQ 11-14) was used to evaluate OHRQoL. The degree of anxiety, depression, and stress was assessed using the Depression, Anxiety and Stress Scale – Short Form (DASS-21). Additionally, sociodemographic, clinical, and psychosocial variables were considered. Adjusted Poisson regression models were applied to examine the associations between predictive variables and overall CPQ11-14 scores. Results are reported as rate ratio (RR) and 95% confidence intervals (95% CI). A total of 164 adolescents were evaluated. The mean DASS-21 scores for depression, anxiety, and stress were 6.9 (standard deviation [SD] 9.0), 8.7 (SD 8.9), and 11.9 (SD 9.7), respectively. The mean CPQ 11-14 score was 12.2 (SD 10.3). Adolescents with high levels of depression (RR = 1.03; 95%CI: 1.02–1.05) and stress (RR = 1.02; 95%CI: 1.01–1.04) presented higher CPQ 11-14 scores, indicating a significant impact of those symptoms on OHRQoL. In conclusion, adolescents with high depression and stress scores experienced poorer OHRQoL, highlighting the need for integrated mental health and oral health interventions to improve their overall well-being.

Resumo em Inglês:

Abstract The aim of this study was to translate and validate the 14-item Oral Health Impact Profile (OHIP-14) into the Collao variant of the Quechua language for the population of southern Peru. A cross-sectional instrumental study was carried out with 288 participants of both sexes aged between 18 and 65 years (M = 37.53 years; SD = 10.38) who were residents of the department of Cusco, Peru. A convenience sampling method was used. The cultural adaptation process included initial translation, back-translation, review by a committee, focus group evaluation for comprehension and clarity of the items, and a pilot test to ensure the cultural adequacy of the questionnaire. Content validity was evaluated by three evaluators using Aiken’s V coefficient. The internal structure was assessed through confirmatory factor analysis (CFA), which tests a three-factor model. The fit indices demonstrated an acceptable model fit, with χ2 = 156.25 (df = 74), RMSEA = 0.062 (90%CI: 0.049–0.076), CFI = 0.999, and TLI = 0.999. The standardized factor loadings exceeded 0.70 for all the items. The corrected item–total correlations indicated strong internal consistency. Reliability was assessed with Cronbach’s alpha, which is a high value across all dimensions. The evaluators’ assessment demonstrated a high level of agreement for all the items, with Aiken’s V coefficient above 0.70. This finding demonstrates that the OHIP-14 is a valid and reliable instrument for the Quechua-speaking population of the Collao variant in Cusco. The study received approval from an ethics committee and adhered to the ethical principles of the Declaration of Helsinki.

Resumo em Inglês:

Abstract This study compared the outcomes of two endodontic instrumentation protocols (rotary or reciprocating files), using artificial primary teeth and micro-computed tomography. Twenty-four artificial primary molars were equally distributed into two groups of 12, according to the type of instrumentation – rotary files (Sequence Baby NiTi Files©) or reciprocating files (X1-Blue File NiTi files©). The following parameters were evaluated: root canal and dentin volumes, canal transportation and centering ability, risk of root perforation, and time of instrumentation. Statistically significant differences between the two instrumentation protocols considering root canal transportation and centering ability were identified. There was no difference in dentin thickness, fractures, and cracks comparing preoperative and postoperative time points for both endodontic files. Although the time of instrumentation was shorter for reciprocating files, rotary files promoted smaller root canal enlargement. Instrumentation with reciprocating and rotary files proved generally safe for pulpectomy in primary molars, promoting a negligible reduction in dentin volume, canal transportation, and centering ability, thereby preserving dentin thickness and lowering the risk of fractures.

Resumo em Inglês:

Abstract This study aimed to identify factors associated with dental pain among schoolchildren in Diamantina, Minas Gerais, Brazil. A total of 627 children aged 8–11 years were assessed through questionnaires and clinical examinations in both public and private schools. We employed a complex, probabilistic, two-stage cluster sampling method involving schools and classes. The sample size was calculated assuming a 50% prevalence of events or diseases, a 95% confidence level, a 5.0% margin of error, a design effect (deff) of 1.5, and a 15% non-response rate. The dependent variable, dental pain, was assessed by asking: “Have you ever had a toothache in your life?” with possible responses of “No” or “Yes.” The independent variables included sociodemographic factors and dental history. Binary logistic regression was used to estimate the odds ratio (OR). Approximately 70.6% of the children reported having experienced dental pain at least once in their lives. In the final model, the likelihood of having experienced dental pain was higher among children who had either deciduous or permanent teeth restored (OR = 1.99; 95%IC: 1.19–3.29), who had a normative need for dental treatment (OR = 3.00; 95%IC: 1.96–4.58), and whose guardians perceived their oral health negatively (OR = 1.81; 95%IC: 1.19–2.75). Dental pain is a significant oral health issue among children. This pain was associated with both unfavorable normative assessments and subjective perceptions of oral health, underscoring the importance of preventive and promotive strategies for children’s oral health.

Resumo em Inglês:

Abstract Oral health literacy (OHL) may play a crucial role for managing traumatic dental injuries. In this pre-post study, the effect of the different dimensions of OHL on the efficacy of using an information leaflet (IL for managing permanent tooth avulsion ) was assessed in elementary schoolteachers. Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), while interactive OHL was assessed with the Oral Health Literacy Adult Questionnaire (BOHL-AQ). Knowledge scores (KS) on avulsion management were collected at three intervals: before reading the IL (baseline), immediately post-intervention (Phase I), and 60 days post-intervention (Phase II). The effect on OHL was assessed by comparing KS means between Phase I/Baseline (acquisition) and Phases II/I (retention). Participants with high OHL/BOHL had a greater difference in mean KS values between Phase I/baseline, while those with high OHL/BREALD-30 showed a smaller difference between phases II/I. Different dimensions of OHL impacted the effectiveness of an educational intervention on managing permanent tooth avulsion with use of a leaflet.

Resumo em Inglês:

Abstract Assess the association between dental caries clinical stage, lesion location, and oral health-related quality of life (OHRQoL) in preschool children. A cross-sectional study was conducted with a representative sample of 643 caregiver–child dyads aged 0–5 years. Children underwent oral examinations using the International Caries Detection and Assessment System (ICDAS) and the International Caries Classification and Management System (ICCMS™) criteria to classify caries stage and lesion location. Traumatic dental injuries (TDI) were assessed using Andreasen’s classification. Caregivers completed the Early Childhood Oral Health Impact Scale (ECOHIS). Weighted Kappa coefficients assessed intra- and inter-examiner reliability. Negative binomial regression models, adjusted for sociodemographic variables and clinical factors, estimated the association between caries stage/location and ECOHIS scores. The prevalence of dental caries (all stages) was 72.6%, with 27.3% of children caries-free. Overall, 48.2% of caregivers reported at least one oral health impact in their child’s life (ECOHIS ≥ 1). Children with extensive lesions (stage C) had significantly worse total and domain ECOHIS scores than caries-free children (p < 0.001), regardless of lesion location. Moderate lesions (stage B) affected OHRQoL only when present in both anterior and posterior teeth (RR = 1.54; p = 0.045). Older age, public school attendance, and household crowding were also associated with poorer OHRQoL. The presence of TDI was independently associated with poorer OHRQoL (RR = 1.63; p < 0.001). These findings highlight the need for targeted, patient-centred interventions to address caries burden effectively.

Resumo em Inglês:

Abstract Although it is recognized that periodontal disease negatively impacts quality of life, there is no validated instrument to assess this impact in Brazil. This study aimed to translate, cross-culturally adapt, and validate the OHIP 14 PD (Oral Health Impact Profile Applied to Periodontal Diseases) for application among Brazilian patients. The original instrument was translated and validated into Brazilian Portuguese in a cross-sectional study with 110 participants recruited from a Dental School clinic. The sample was divided into two groups: 55 with periodontal disease and 55 without periodontal disease. The instrument was self-administered twice within an interval of 7 to 10 days for patients with periodontal disease. The psychometric properties of the Brazilian version were verified using internal consistency (Cronbach’s α) and the reliability through the test-retest method (ICC, intraclass correlation coefficient), convergent validity (Spearman correlation), and discriminant validity (Mann-Whitney test), with p <0.05. Most of the sample consisted of women (n=69; ±40.65 years). The OHIP 14 DP - Br showed excellent internal consistency (α=0.997) and outstanding reliability using the test-retest method (ICC=0.945, p<0.001). There was a significant correlation between the scores obtained in all seven domains between this questionnaire and self-perceived gingival health (p=0.023). This study provides psychometric evidence supporting the cross-cultural validity of the OHIP 14 DP - Br version for use in Brazil.

Resumo em Inglês:

Abstract The use of aromatase inhibitors (AIs) leads to an imbalance in bone remodeling and can cause osteoporosis. This study aimed to identify clinical, periodontal, nutritional, and biochemical determinants of bone mineral density (BMD) changes in patients using AIs. The sample consisted of 40 women using AIs and 32 controls. BMD was assessed by dual X-ray absorptiometry (DXA). Data on nutritional, anthropometric, oral and periodontal status, and oral health-related quality of life (OHRQoL) were collected. Cytokines and adipokines were quantified in saliva and serum. Thirty-nine of the 72 women had low BMD, with a similar distribution in the control and AIs groups. BMD was lower in older women using AIs (p = 0.009) and in smokers (p = 0.034). Anthropometric assessment demonstrated that women with low BMD who used AIs had lower weight (p = 0.028). Although the frequency of periodontitis was similar in all groups, higher IL-6 (p = 0.004), IL-1β (p = 0.002), and IL-33 (p = 0.006) levels were associated with poor periodontal status. Women who used AIs were 1.18 times more likely to report better OHRQoL than controls. While advanced age, smoking, and lower weight are factors associated with low BMD, the use of antiresorptive agents was a protective factor for maintaining BMD in women using AIs.

Resumo em Inglês:

Abstract Angiotensin II (Ang II) releases inflammatory mediators from several cell types. The objective of this study was to investigate the potential of Ang II to induce mRNA expression of inflammatory mediators in primary cultured fibroblast-like cells isolated from gingival and periodontal ligament tissues. A synergistic effect of co-treatment with Ang II and Interleukin-1β (IL1β) on the mRNA expression of inflammatory mediators was explored. Immunophenotyping of STRO-1, Ang II type 1 receptor (AT1R), and Ang II type 2 receptor (AT2R) was performed using flow cytometry. Cell cultures were challenged with Ang II (1 µM) for 3, 6, and 24 h with or without co-treatment with IL1β (0.1 ng/mL) for 24 h. mRNA expression of inflammatory mediators was determined using qPCR. We present, for the first time, precise quantification of AT1R and AT2R in human gingival and periodontal fibroblast-like cell types; the percentage of positive immunostaining compared to the total cell population varied from 3.35% to 5.29% for AT1R and 2.97% to 4.57% for AT2R. Ang II slightly upregulated IL6 and CCL2/MCP1 mRNA expression in gingival cells and IL8 and PTGS2/COX2 in periodontal ligament cells. IL1β upregulated IL8, IL6, CCL2/MCP1, PTGS2/COX2, and IL1β mRNA in both cell types. Co-treatment with Ang II and IL1β did not show a synergistic effect. Ang II showed a low potential to induce mRNA of inflammatory mediators, most likely owing to the low percentage of Ang II receptors in such cells and no synergistic effect with the co-treatment with IL1β.

Resumo em Inglês:

Abstract In this randomized controlled clinical study, the effectiveness of two different modes of extending oral hygiene - either gargling or using an oral spray - on the self-reported incidence of upper respiratory symptoms were evaluated, to help with the prevention of respiratory symptoms. The study was conducted in Porto Alegre, Brazil. A total of 205 individuals were enrolled and assigned to one of three groups: Control Group: brushed twice daily for two minutes with a commercially available fluoride toothpaste; Gargling Group: brushed twice daily for two minutes with a commercially available fluoride toothpaste and then gargled with a mouthwash containing 0.075% CPC (cetylpiridinium chloride); and Oral Spray Group: brushed twice daily for two minutes with a commercially available fluoride toothpaste and instructed to use an oral spray containing 0.075% CPC (3 pumps of spray applied directly into their mouth) twice daily. All subjects were asked to complete the WURSS-21 Daily Symptom Report via a diary for the 3 months duration of the study. Based on analysis of the diaries, the use of regular oral hygiene with brushing, in addition to a type that extended to the entire oral cavity, reduced the incidence and severity of upper respiratory symptoms throughout the duration of the study. Data were statistically analyzed using ANOVA (α = 0.05). Individuals using either mouthwash or spray reported approximately 20% fewer days with respiratory symptoms compared with the control group. Regular oral hygiene that extended to the whole oral cavity with either a mouthwash or an oral spray may help to reduce the incidence of upper respiratory symptoms.

Resumo em Inglês:

Abstract Orofacial pain impairs quality of life, and current therapies, limited in efficacy and associated with adverse effects, drive the search for new treatments. Thiophene derivatives exhibit remarkable therapeutic properties, including antinociceptive and anti-inflammatory activities, with recent studies demonstrating superior activity compared to commercial drugs, highlighting their relevance in the design of novel agents. This study investigated the antinociceptive effect of the thiophene derivative 2-[(4-diethylamino-benzylidene)-amino]-5,6,7,8-tetrahydro-4H-cyclohepta[b]thiophene-3-carbonitrile (7CN03) and its possible mechanisms of action. In vivo tests were performed on male mice (n = 6 per group), and nociception was induced by formalin, capsaicin, and glutamate 1 h after treatment. Facial rubbing was used as a parameter to measure nociceptive behavior. 7CN03 exhibited significant action during the neurogenic phase of the formalin test at different doses (1 mg/kg, 0.1 mg/kg, and 0.01 mg/kg), reducing nociceptive behavior by up to 56%. During the inflammatory phase, the 1 mg/kg dose exerted an antinociceptive effect, reducing nociceptive behavior by 32% (p < 0.05). In the glutamate test, 7CN03 blocked nociception by up to 90% (p < 0.001), and in the capsaicin test, it reduced nociceptive behavior by up to 74%. Molecular docking studies predicted higher binding affinity of 7CN03 for µ-opioid (-97.00 Kcal/mol), TRPV1 (-87.79 Kcal/mol), and NMDA (-104.86 Kcal/mol) receptors when compared with cocrystallized ligands. The findings suggest that the evaluated thiophene derivative exhibits an orofacial antinociceptive effect, with a mechanism of action likely mediated by opioid, transient receptor potential vanilloid, and glutamatergic receptors.

Resumo em Inglês:

Abstract This study aims to evaluate the mechanical properties of 3D printing resins for occlusal splints (OS) under different preservation conditions based on sleep duration. The study factors (n = 10) included material types: PriZma 3D Bio Splint (PZ), Cosmos Splint (CS), NightGuard Firm (NGF), and self-polymerizing acrylic resin (control group - CG); preservation: artificial saliva (S), natural water (W), 0.12% chlorhexidine (C), and Corega tabs (CTs); and evaluation times: T0 (24 h after fabrication) and 30 d after exposure. Further, the surface roughness (Ra), Knoop microhardness (KH), three-point flexural strength (FS), and flexural modulus (FM) were analyzed. In terms of the time and material, Tukey’s test revealed no significant differences in Ra between the groups at 24 h. After 30 d, PZ showed significantly lower values than the other groups (p < 0.05). For the KH, NGF was significantly higher than that in all groups at 24 h (p < 0.05); after 30 d, the NGF decreased in W and C (p < 0.05), and the NGF and PZ exhibited elevated values in S and CT, respectively. The Kruskal–Wallis test and multiple comparisons showed that the PZ had a higher value at 24 h (p < 0.05). Post 30 d, all 3D-printing resins increased values in CT and S (p < 0.05), and the PZ decreased in the C and W (P < 0.05). Finally, the FM increased under all conditions. The preservation of S and CT partially enhanced the mechanical properties of the OS.

Resumo em Inglês:

Abstract This in vitro study evaluated the effects of citric acid (CA) on surface properties, biofilm removal, and electrochemical performance of Co-Cr alloys compared to common denture cleansers. Co-Cr discs were divided into five groups based on the decontamination solution: NaCl 0.9% (control), Corega Tabs®, Periogard®, and 10% CA. The surface was characterized at baseline in terms of morphology, topography, and chemical and phase composition. Surface properties, including microhardness, wettability, and roughness, were assessed before and after exposure to each solution. Microbial viability, metabolic activity, and morphology of the polymicrobial biofilm were assessed after treatment to evaluate the efficacy of the decontamination solutions. Electrochemical and morphological evaluations were performed to assess the impact of each solution on the alloy’s corrosion process. No significant changes in microhardness were observed (p > 0.05). Decontamination solutions significantly increased surface hydrophilicity (p < 0.05) and roughness, though Ra values remained below the threshold for bacterial colonization. All denture cleansers significantly reduced biofilm viability compared to NaCl (p < 0.05), with no viable colonies post-treatment. The CA group showed a significant reduction in bacterial metabolic activity compared to NaCl and Periogard® (p < 0.05), indicating superior biofilm disruption. Electrochemical tests demonstrated that CA maintained a stable Cr-oxide passive layer, evidenced by nobler OCP values and lower icorr and corrosion rates compared to Periogard® (p < 0.05). SEM images revealed pitting corrosion in all groups, except CA. These findings suggest that CA is a promising and safer alternative for denture care, offering effective antimicrobial action while preserving the electrochemical integrity of Co-Cr alloys.

Resumo em Inglês:

Abstract This study aimed to evaluate the adaptation of CAD/CAM crowns and the impact of resin cement polymerization contraction on crown deformation under different cementation configurations. Thirty human molars were randomly divided into three groups (n = 10) to manufacture ceramic crowns with three different cementation space configurations: LD40 (40 μm), LD80 (80 μm), and LD160 (160 μm). The samples were subjected to computerized microtomography scanning for measuring internal and marginal adaptation, and internal fit was analyzed at occlusal, axial, axiogingival points. Five light-curing protocols were used to verify the wavelength spectrum peak of the curing device and the irradiance delivered using two situations: with 0 mm sensor distance and through a ceramic of differing thickness, and an external crown deformation (ECD) test. The highest statistically significant vertical fit was obtained for group LD40, independent of region. LD160 yielded the highest ECD values, independent of positioning of the buccal and distal strain gauge. The highest internal fit was observed at occlusal and axial points of the LD160 group (P<0.001), and LD80 yielded the lowest values at the axiogingival point (p = 0.003, p = 0.006). The irradiance delivered was reduced significantly upon interposition of the ceramic block to the sensor. The peak wavelength for curing was similar among the LD groups. The luting space configurations significantly influenced vertical fit and the ECD results for the CAD/CAM ceramics owing to polymerization shrinkage. Finally, variations in ceramic thickness at different sites affected both the irradiance by the curing device and ECD results.

Resumo em Inglês:

Abstract Tumor necrosis factor-alpha (TNF-α) is a cytokine involved in the immune-inflammatory response. It can induce an odontoblastic phenotype and enhance biomineralization in dental pulp mesenchymal stem cells but does not have the same effect on osteoblasts. The reasons for this differential response, despite the shared lineage of these cell types, are not yet clear. This study examined the effects of TNF-α on immortalized mouse dental pulp stem cells (OD-21) and pre-osteoblastic cells (MC3T3-E1). Cells were treated with recombinant TNF-α at concentrations of 1, 10, and 100 ng/mL. Cell viability, proliferation, and migration were assessed using the MTT, CyQUANT, and wound healing assays, respectively. Gene expression was assessed via real-time RT-PCR, and biomineralization was evaluated using alizarin red staining. Statistical analysis was conducted using one-way ANOVA followed by Tukey’s post-hoc test (α = 0.05). TNF-α did not affect cell viability at any concentration (p > 0.05). Proliferation and migration increased after 12 h, with near-complete wound closure by 24 h. TNF-α promoted proliferation and migration in both cell types. OD-21 cells exhibited high levels of Tnfr1 and Runx2 expression and showed biomineralization. In contrast, MC3T3-E1 cells showed high Tnfr2 levels, suppressed Runx2, and inhibited biomineralization. These results highlight how TNF-α influences different cell types from the same lineage in distinct ways.

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Abstract Social networks consist of a group of individuals connected by family, work, or other interests and facilitated by an online structure or platform. They are also a relatively recent and widely used marketing phenomenon that is constantly evolving. The healthcare field includes professions such as social work, biology, biomedicine, physical education, nursing, pharmacy, physiotherapy, speech therapy, medicine, veterinary medicine, nutrition, dentistry, psychology, and occupational therapy. The present study aimed to analyze the influence of social networks in the process of finding and selecting healthcare professionals. The methodology was a survey using a structured questionnaire created on Google Forms. Descriptive research was carried out with non-probabilistic convenience and snowball sampling, followed by quantitative data analysis. A total of 268 participants who signed the informed consent were included in the study. The findings revealed that the most common way to find healthcare professionals is through recommendations from friends/relatives and other professionals, followed by the use of social networks. The majority of participants used social networks to search for healthcare professionals, with Instagram being the most widely used platform. Sponsored advertisements can be an effective way to reach potential new patients. The most valued characteristics in healthcare content creators were reliability, expertise, and the ability to convey messages, with health-related explanations in an easily understandable manner being the preferred type of content. Therefore, this study revealed that social networks can influence the search for and selection of healthcare professionals.

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Abstract Although caries is a preventable disease, it is still a health burden in all countries in all age categories. This study aimed to identify the determinants associated with caries risk factors in Indonesian adults. This secondary analysis used 2018 National Health Survey data, which included 37,057 respondents aged ≥ 15 years. The sampling design was based on census blocks selected using linear systematic sampling with probability proportional to size (PPS). The survey included an interview to collect data on sociodemographic characteristics, oral health practice, and health behavior. An oral examination was conducted to measure the DMFT (decayed, missing, filled- teeth) index. Multivariable models were generated to estimate the odds ratio (OR) and confidence intervals (95% CI) using caries as the dependent variable. The highest average DMFT index was seen in those respondents aged over 45 years, those from rural areas, individuals with low formal education, those who consumed sweets and sugary beverages at least once a day, those who did not brush their teeth regularly, and those who smoked. The multivariable analysis showed the potential risk of caries: risk of 19.51 times for older adults, 74% for male, 94% for those living in rural areas, 1.62 times for those with lower formal education, 78% for those with no dental visits, 1.18 times for those who eat sweets often, 1.37 times for those who drink sugary beverages often, 1.48 times for those who do not brush their teeth regularly, and 1.3 times for those who smoke. The multifaceted nature of caries in the Indonesian adult population highlights the influence of various factors, ranging from lifestyle habits and oral hygiene practices to access to dental services, age, and educational level.

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Abstract Data were collected by trained interviewers at primary healthcare units and hospitals during pregnancy and childbirth, and by trained dentists when the children were 4 years old. A total of 3,644 mothers and 3,645 babies were included in the study, which evaluated the association between systemic diseases, maternal physical activity, weight gain during pregnancy, and the oral health of four-year-old children enrolled in the 2015 Pelotas Birth Cohort (Brazil). Exposure variables included systemic diseases, maternal physical activity, and gestational weight gain. Outcome variables were dental caries and caries experience in four-year-old children, assessed using the ICDAS index. Statistical analyses were performed using the Stata 15 software, and they included Pearson’s chi-square test and Poisson regression to estimate prevalence ratios and their respective 95% confidence intervals. Excessive weight gain during pregnancy was associated with a higher risk of dental caries in children (PR: 1.12; 95%CI: 1.01–1.23). Maternal physical activity before or during pregnancy was considered a protective effect against dental caries in the unadjusted analysis ([RP: 0.82; 95%CI: 0.71–0.93] [RP: 0.60; 95%CI 0.44–0.81]), respectively, but this association was no longer significant after adjusting for confounding factors. The presence of maternal systemic diseases during pregnancy was not associated with childhood caries. In conclusion, maternal systemic diseases during pregnancy were not associated with dental caries in children. On the other hand, an excessive increase in maternal weight during pregnancy was associated with poorer oral health among children.

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Abstract The aim of this study was to evaluate the association of body image perception and self-assessment of oral health with other associated factors in a sample of Brazilian adolescents. This cross-sectional study involved a total of 281 adolescents aged 14 to 19 years enrolled in 29 public schools from May 2021 to December 2023 in the urban area of Juiz de Fora, state of Minas Gerais, Brazil. The total enrollment of 9,502 participants in the first stage of the study () was considered for sample size calculation. The prevalence of negative self-assessment of oral health in the adolescent population was estimated at 18%, with a standard error of 1%, a 95% confidence interval, and a 20% loss to follow-up. Participants completed a questionnaire via the Google Forms platform, which gathered information on their socioeconomic status, self-perception of body image, self-assessment of oral health, and self-esteem. Bivariate analysis and logistic regression models were used to evaluate the associations between variables. Variables with p < 0.10 in the bivariate analysis were included in the logistic regression model. Variables with p < 0.05 were retained in the final model. The final logistic regression model revealed that adolescents with a higher socioeconomic status rated their oral health as excellent or good. Additionally, those who reported not living with their parents and had a low level of self-esteem had a poor oral health self-assessment. Adolescents’ perception of their body image was not associated with oral health self-assessment. On the other hand, socioeconomic factors, family structure, and self-esteem influenced adolescents’ oral health self-assessment.

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Abstract This study aimed to analyze the factors associated with the perception among Brazilian dentists of the preventive or therapeutic use of sealants on permanent molars. A cross-sectional web-based survey was conducted with Brazilian dentists between July and October 2021 to examine their use of social media and gather data regarding sealant-related practices. A structured questionnaire was developed and applied to collect information on participants’ professional profiles, clinical indications, materials, techniques, and perceptions of pit and fissure sealants. The study outcomes were the positive perception of sealant use as: (a) a preventive measure, or (b) a therapeutic approach to carious lesions. Responses were dichotomized into positive perception (“strongly agree” or “agree”) and negative perception (“neither agree nor disagree,” “disagree” or “strongly disagree”). Independent variables included sociodemographic, educational, professional, and technical characteristics. Multiple logistic regression models were used to analyze associations (p < 0.05). A total of 2,394 dentists participated in the study, 82.5% of whom had a positive perception of sealants for prevention, and 83.1%, for therapeutic purposes. A greater likelihood of positive perception of preventive sealant use was observed among educators, those employed in public health services, dentists who “always” performed sealant application, and those who used resin sealant, glass ionomer cement, or flowable resin. Conversely, professionals working in capital cities had a lower likelihood of a positive perception. Professionals from cities with populations exceeding 500,000 inhabitants, interior areas, or metropolitan regions were less likely to have a positive perception of therapeutic sealant use. However, those who used resin sealants, glass ionomer cement, or flowable resin were more likely to perceive sealants positively. In conclusion, the positive perception of sealant use for prevention was associated with educational, professional, and technical factors, whereas the positive perception of therapeutic use was associated with professional and technical factors.

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Abstract The objective was to compare physical accessibility indicators for people with motor disabilities (PwMD) at dental specialty centers (acronym in Portuguese - CEO) across Brazil during the two evaluation cycles of the Access and Quality Improvement Program (acronym in Portuguese - PMAQ) for CEOs. This ecological study utilized secondary data from the external evaluation of PMAQ-CEO in Cycle I (C1), conducted in 2014, and Cycle II (C2), conducted in 2018, including all CEOs that participated in both cycles (n = 889). The structural items analyzed included corridors and doors adapted for wheelchairs, functional wheelchairs, access ramps with handrails, and bathrooms adapted for PwMD. Latent class transition analysis was applied to identify patterns in physical accessibility among CEOs, selecting the latent status (LS) model based on conceptual interpretability and goodness of fit. The final model identified five LS, labeled as follows: LS1 (most accessible); LS2 (inappropriate doors and bathrooms); LS3 (inappropriate ramps and bathrooms); LS4 (wheelchair unavailability); and LS5 (least accessible). In C1, 33.9% of the CEOs were highly accessible, while 17% were minimally accessible. In C2, these proportions shifted to 69.7% for highly accessible and 6% for minimally accessible. When analyzing the two PMAQ-CEO cycles, improvements in physical accessibility indicators were observed across Brazilian CEOs: corridors (9.7% increase) and doors (4.9%) adapted for wheelchairs; functional wheelchairs (15.7%); access ramps with handrails (38.7%); and bathrooms adapted for PwMD (19.6%). It may be concluded that physical barriers to PwMD in Brazilian CEOs were significantly reduced between 2014 and 2018, improving physical accessibility.

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Abstract This study aimed to determine the prevalence and provide an overview of Down syndrome and child- and mother-associated factors in Brazil from 2010 to 2020. This was a cross-sectional study including epidemiological characteristics related to live births of individuals with and without Down syndrome using the Brazilian government website. The average prevalence of Down syndrome in Brazil was approximately 30.4 children per 100,000 live births during the 10-year period, corresponding to 1 case in every 3,289.47 newborns. The occurrence of Down syndrome was increased in White children, preterm births, and low birth weight infants compared to the no-Down syndrome group; however, it was decreased in males. The prevalence of Down syndrome was low among mothers without a spouse, insufficient prenatal care, and vaginal delivery. Conversely, the prevalence was high among mothers aged 35 years and older and mothers considered White. There was no evidence of a time correlation in the prevalence among the regions of Brazil during this 10-year period. It is imperative to strengthen national monitoring of the prevalence of children with Down syndrome and provide better support to mothers and public services for this group.

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Abstract The aim of this study was to elucidate, unclear points of the “Oral Health Survey: basic methods”, of the World Health Organization (WHO), relative to reproducibility (encompassed reliability and agreement) issues during examiners’ calibration. Thus, Kappa statistics and percent agreement were calculated for a sample of 10 12-year-old schoolchildren examined by 1 gold standard examiner and 5 dentists from Nova Friburgo, RJ, Brazil, in 2018, under the WHO and SB Brasil 2010 Project settings. Weighted Kappa was used to measure reliability between 2 examiners, and Fleiss’ Kappa for 5 examiners. Tooth-to-tooth reliability was also assessed. The results showed that, although the choice of different settings invariably produced different reliability and agreement values, this approach was feasible, coherent and even desirable depending on the purpose of an epidemiological survey conducted. Kappa values were slightly lower in the SB Brasil 2010 Project setting. The results for tooth-to-tooth reliability, in turn, allowed identification of teeth (in this sample, teeth 17, 23, 27, 34, 37, 44, 45, and 47) for which additional examiner calibrations would be necessary. It is concluded that providing additional information for inclusion in the WHO manual, such as the possibility of varying the setting, adopting the tooth-by-tooth unit, and selecting the correct type of Kappa statistic depending on the number of examiners, within a multilevel calibration proposal, may result in more reliable results during the calibration stage.

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Abstract In the state of Roraima, Brazil, indigenous populations have distinct cultural habits and ethnic characteristics compared to those of the nonindigenous population. Changes in the oral health of indigenous people are critical areas of investigation for generating oral health indicators, which significantly influence the overall health of this population, given their fundamental role in the development of public health policies. Our objective was to compare the oral conditions of indigenous people of the Yanomamis (YANs) and Macuxis (MACs) ethnicities in the state of Roraima. A total of 148 indigenous people were evaluated: 83 (53.50%) YANs and 65 (46.50%) MACs. All indigenous participants were assessed at the Indigenous Health House (CASAI), in the municipality of Boa Vista/RR, and data regarding oral condition, DMFT index, periodontal indices, basic erosive wear examination (BEWE) index, and eating habits were obtained. Significant differences were found in the DMFT index, which was higher for MAC individuals than for YAN individuals (P<0.05). Periodontal evaluation revealed a significantly larger probing depth in YAN individuals aged over 35 years. Plaque index was higher for YAN individuals, with a significant difference noted in all compared groups. As for the BEWE index, no statistically significant difference was observed between YAN and MAC individuals. With respect to eating habits, YAN individuals consumed significantly more native foods, whereas MAC individuals consumed predominantly processed foods. Periodontal indices are affected by poor oral hygiene, and oral hygiene instruction and guidance are necessary and could help reduce the incidence of dental caries and periodontal disease.

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Abstract This study analyzed the influence of sociodemographic, occupational, and accident-related factors on adherence to post-exposure prophylaxis (PEP) among dental professionals. A cross-sectional study was conducted using secondary data from the Brazilian Notifiable Diseases Information System, covering incidents of biological material exposure from 2018 to 2023 across all federal units. PEP adherence was the outcome analyzed, and related factors included sociodemographic, occupational, and accident characteristics. Descriptive, bivariate, and multivariate logistic regression analyses were performed (α = 5%). A total of 15,650 notifications involving dental professionals were analyzed, representing 3.91% of all cases of occupational exposure, with a PEP adherence rate of 91.0%. The exposed professionals had a mean age of 32.5 years (SD = 10.4), were predominantly women (76.6%), of White race/ethnicity (65.4%), and had higher education (79.7%). The mean work experience was 3.6 years (SD = 6.8). In the adjusted model, adherence was associated with lower educational attainment (OR = 0.71; 95%CI: 0.58–0.88), younger age (OR = 0.99; 95%CI: 0.98-0.99), and longer work experience (OR = 1.02; 95%CI: 1.01-1.03). Percutaneous exposure (OR = 1.39; 95%CI: 1.16–1.67), contact with blood (OR = 1.47; 95%CI: 1.18–1.82), and dental procedure-related accidents (OR = 1.35; 95%CI: 1.07–1.70) increased the likelihood of adherence. Hepatitis B vaccination (OR = 1.96; 95%CI: 1.62–2.36) was associated with increased adherence to PEP. Adherence to PEP was influenced by multiple factors, highlighting the need for effective strategies to improve adherence and occupational safety among these professionals.

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Abstract The aim of this study was to assess the oral condition of individuals diagnosed with COVID-19 and its impact on their quality of life. The cross-sectional study participants were patients with or without a diagnosis of COVID-19, on room air, and conscious, admitted to the ICUs and wards of Public Hospital Units in São Luís, Maranhão, Brazil. The data collected included: demographic information, length of stay, comorbidities, and type of diet, obtained from medical records; Oral Health-Related Quality of Life (OHRQoL) [Oral Health Impact Profile (OHIP-14)]questions patients were asked; oral health (measured by the Bedside Oral Exam Scale); oral hygiene status (assessed by the Oral Hygiene Index - Simplified and lingual: degree of lingual coating); and salivary flow. The prevalence of COVID-19 was associated with gender (p = 0.038), with a higher incidence observed in male patients (61.9%). Moreover, there was a correlation between the hospitalization sector (p = 0.037) and the frequency of ICU admissions (53.7%). The prevalence of comorbidities was comparable between the two groups. Relative to oral health, 53% of individuals with confirmed COVID-19 had moderate oral health, while 9% exhibited poor oral health. The prevalence of hyposalivation was higher in the group with a confirmed diagnosis of COVID-19. The quality of life of individuals with confirmed COVID-19 was most significantly impacted by moderate to severe oral health concerns. The most significant alteration in oral health was a reduction in salivary flow, negatively impacting the quality of life of individuals hospitalized for COVID-19 complications.

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Abstract The aim of this study was to evaluate the main oral adverse effects and their relationship with dental care before radiotherapy (RT) and combined RT and chemotherapy (RT+CT). Additionally, we assessed the association of other risk factors with the development of these adverse effects. This paper is a retrospective cross-sectional analytical study of data from medical records of patients with head and neck cancer (HNC) who underwent RT or RT+CT attended at the stomatology unit in a southern Brazil hospital. The records of 78 patients with HNC were accessed. Demographic data, tumor characteristics, cancer treatment, follow-up data, adverse effects, and dental treatment prior to RT were evaluated individually for descriptive analysis. Kaplan-Meier survival curves were plotted. Risk factors were assessed using chi-square or Mann-Whitney test. The results showed that most patients were male (88.3%) in their 6th decade of life. Tumors were mostly located in the oral cavity (52.6%) and squamous cell carcinoma was the main diagnosis (94.8%). Most cases were diagnosed in advanced stages (67.9%). RT was of 2D or 3D types in 93.6% of patients. Oral adverse effects were observed in 94.7% of patients treated with RT or RT+CT. Osteoradionecrosis (ORN), oral mucositis (OM), candidiasis, and xerostomia were the main complications. Patients who received 2D RT had higher risk of developing ORN and xerostomia compared to those who received 3D RT. The risk of developing ORN was higher in smokers compared to non-smokers and in patients who had not previously consulted a dentist. This study showed that patients who underwent RT for HNC have a high occurrence of oral complications. Dentists play a key role in the management of these oral side effects.

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Abstract The objective of this study was to estimate the prevalence of comorbidities among people living with HIV/AIDS (PLWHIV) attending a dental outpatient clinic and discuss the impact of these comorbidities on dental management. A cross-sectional observational study evaluated 238 PLWHIV attending a specialized dental outpatient clinic in Brazil. We collected sociodemographic data, self-reported and physician-diagnosed comorbidities, hemogram results, CD4+ T cell count, viral load, use of combined antiretroviral therapy (cART), and information on harmful habits. The most prevalent comorbidities were sexually transmitted infections (STIs) (116/238; 48.7%), psychiatric disorders (105/238; 44.1%), and lipodystrophy (97/238; 40.8%). Men were more likely to have STIs (OR 4.0) and tuberculosis (OR: 2.5) (p < 0.05). Age ≥ 50 years increased the risk of diabetes mellitus by 2.6 times (p < 0.05). The risk of lipodystrophy (OR: 2.99, 95%CI 1.44–6.19) and psychiatric disorders (OR: 2.13, 95%CI 1.01–4.47) was greater in those who had been diagnosed with HIV for more than 20 years. In summary, psychiatric disorders and severe hematological alterations, such as anemia and neutropenia, are significant comorbidities that may limit dental treatment of HIV-positive patients. These findings underscore the need for integrated medical and dental care to address the complex health needs of PLWHIV.

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Abstract The aim of this study was to verify the role of Brazilian researchers in publications related to photobiomodulation (PBM) in the field of oral medicine. We examined ten years from 2012 to 2022 across 16 journals. Our analysis included scientific publications with a Brazilian author either in the first or last position and publications from international collaborations. The search yielded 43,525 publications. After examining titles and abstracts, 269 studies were categorized as having a specific emphasis on PBM in oral medicine, of which 147 (54.6%) were undertaken by research groups based in Brazil. The citations ranged from 1 to 149 (an average of 31 per manuscript). The male-to-female ratio of first and last author was 1:2 and 1:1.4, respectively. Brazilian involvement in the field of PBM was significant, with a marked focus on basic research, clinical applications, and technological advances. Our results also underscore the remarkable participation of female researchers in pivotal roles. Brazilian publications positively impacted healthcare worldwide using PBM in oral medicine, as evidenced by the substantial number of articles published and the citations of these articles received.

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Abstract Head and neck radiotherapy quantitatively and qualitatively compromises salivary flow, and salivary substitutes have the potential to alleviate the symptoms. This study aims to assess the effectiveness of two salivary substitutes in relieving symptoms of radiotherapy-induced xerostomia through a double-blind randomized controlled trial. Twenty-four patients were selected from a dental oncology clinic and randomly assigned to the over-the-counter or compounded mouthwash group. Each patient was instructed to rinse their oral cavity with the assigned solution three times a day for 30 days. Both participants and researchers were blinded to the product used during the trial. The impact of xerostomia was assessed using a numerical rating scale and validated questionnaires on oral health-related quality of life and xerostomia, administered before and after the intervention and subsequently compared. Both groups exhibited a statistically significant reduction in xerostomia symptoms. The studied salivary substitutes produced transient beneficial effects on complaints of radiotherapy-induced xerostomia.

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Abstract The aim of this study was to investigate the profile of the Brazilian population exposed to risk factors for oral cancer, as well as the profile of patients in the high-risk group for this disease in Brazil. This study relied on a cross-sectional design, utilizing secondary data from the 2020 National Health Survey (PNS). The database used contained information on 90,846 individuals aged 18 and older. The dependent variable was “High-risk group for oral cancer development” and the independent variables were grouped into biological characteristics, educational level, access to health services, and self-care practices. In the multivariate analysis, odds ratios of outcomes were assessed using a logistic regression model. Individuals of white ethnicity, with low levels of education, residing in rural areas, not registered in the Family Health Strategy program, who have rarely or never seen a dentist, self-assessing their general health as poor, and lacking regular physical exercise were more likely to be in the high-risk group for the development of oral cancer. The data from the 2020 National Health Survey (PNS) demonstrate that a large portion of the Brazilian population is exposed to risk factors for oral cancer. This highlights the disparities in access to medical and dental health services, as well as in the educational and preventive interventions by healthcare professionals regarding risk factors for oral cancer.

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Abstract Temporomandibular joint disorder (TMD) has a multifactorial etiology involving psychological and genetic aspects. This condition commonly begins in adolescence, which is a period of emotional, physical, and psychological maturation. The aim of the present study was to investigate associations between temporomandibular joint (TMJ) disorder and happiness as well as polymorphisms in the COMT, HTR2A, and FKBP5 genes in Brazilian adolescents. A cross-sectional study was conducted with 90 adolescents aged 13 to 18 years. TMD was diagnosed using the RDC/TMD. The Subjective Happiness Scale (SHS) was used to assess happiness. Saliva samples were collected for the analysis of genomic DNA and genotyping of single nucleotide polymorphisms in the COMT (rs165656, rs174675), HTR2A (rs6313, rs4941573), and FKBP5 (rs1360780, rs3800373) genes using real-time PCR (Taqman method). Bivariate, unadjusted, and adjusted binary logistic regression analyses were performed (p < 0.05). Happiness was associated with TMD in the adolescents (OR=1.37; 95%CI: 1.02–1.85; p = 0.037). The rs174675 polymorphism in the COMT gene was significantly associated with TMD (OR = 0.18; 95%CI: 0.04–0.74; p = 0.018). No associations were found between TMD and polymorphisms in HTR2A and FKBP5 genes (p > 0.05). TMD was associated with happiness, as adolescents who considered themselves less happy were more likely to have this disorder. The diagnosis of TMD was also associated with the rs174675 polymorphism in the COMT gene, as the prevalence of the disorder was higher among homozygous C Brazilian adolescents than in heterozygous CT individuals.

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Abstract The aim of this study was to assess the prevalence of temporomandibular disorder (TMD) and associated factors in an adult population in southern Brazil. The population-based sample (n = 4.65) included participants from Passo Fundo, a town in southern Brazil. The Fonseca Anamnestic Index was used to establish the prevalence of TMD. Sociodemographic and pathophysiologic factors and those that could cause tissue injury (trauma) were investigated. Data were analyzed using the chi-square or Fisher’s exact test and Poisson regression model (p < 0.05; 95%CI). The prevalence of TMD was 13.4%, and the most prevalent symptoms were pain in the neck and/or shoulders (30.1%), headache (26.0%), and presence of popping or clicking sounds (17.0%). None of the sociodemographic factors (sex, age, marital status, occupation, and education) were associated with the prevalence of TMD (p > 0.05). Among pathophysiologic factors, those associated with the prevalence of TMD were insomnia (PR: 1.83; 95%CI: 1.07–3.12), osteoporosis (PR: 2.50; 95%CI: 1.22–5.12), rheumatoid arthritis (PR: 1.99; 95%CI: 1.07–3.68), and xerostomia (PR: 1.36; 95%CI: 1.07–1.73). The factors that could cause tissue trauma/injury associated with TMD were sleep bruxism (PR: 2.16; 95%CI: 1.01–4.62), awake bruxism (PR: 2.44; 95%CI: 1.16–5.11), tongue pressure against the teeth (PR: 4.11; 95%CI: 1.95–8.65), and neck support of objects during work (PR: 2.94; 95%CI: 0.88–9.73). The prevalence of TMD was 13.44%, and it was associated with pathophysiologic factors and those that cause tissue trauma/injury, but not with sociodemographic factors.

Resumo em Inglês:

Abstract The aim of this study was to analyze the trends and main characteristics of articles on resin infiltration (RI) in dentistry. The search was carried out in August 2023 on Web of Science. Two researchers selected the articles and excluded conference articles. The following data were extracted from the selected articles: citations, year and journal of publication, study design and theme, authorship and institutions, keywords, country and continent. Collaborative networks were generated using the software Vosviewer. Dimensions were consulted to measure altmetric data. Correlation between data was determined by the Sperman’s test. A total of 351 articles were included. The number of citations ranged from 0 to 230. The articles were published between 2007 and 2023. The most prominent journal was Journal of Dentistry (n = 36). The majority were laboratory studies (n = 171) evaluating the performance of RI to mask white spot lesions (n = 248), mainly due to caries (n = 256). The country with the most articles was Brazil (n = 51), however the biggest highlight was Europe (n = 141). The most prominent author was Meyer-Luckel H (n = 33). Vosviewer indicated strong collaborations between authors. According to Dimensions, most citations were from Mendeley followed by X users. This study identified an emerging trend in research on RI in dentistry. Based on this review, most research interest in RI was from Europe, addressing the use of RI to arrest and mask white spot lesions. It is concluded that more intervention studies are needed and that Africa and Oceania have a low publication rate.

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Abstract This study carried out a critical review of the principles of radioprotection, including the ALARA, ALADA, and ALADAIP principles. The Google Scholar and PubMed databases were the search resources, and the following keywords were searched: Linear No-Threshold (LNT); Biologic Effects of Ionizing Radiation (BEIR VII); As Low As Reasonably Achievable (ALARA); As Low As Diagnostically Acceptable (ALADA); As Low As Diagnostically Acceptable, being Indication-oriented and Patient-specific (ALADAIP). This critical review included studies with historical references, reviews, position papers, and clinical and experimental studies. Regarding data extraction, only original articles were selected after the screening process. Much of the current evolution of X-ray machines and radioprotection protocols has stemmed from legitimate concerns about this topic. This development has grown out of the relevant work of organizations like ICRP, UNSCEAR, and other renowned international organizations. Low doses of radiation, such as those used for diagnosis, also occur naturally and are present in everyday life. Although there is no agreement on the actual risk involving low doses, the recommendations of ALARA, ALADA, and ALADAIP prevail, in line with the trend to uphold principles that balance the importance of X-ray diagnostic imaging with the intention of keeping the doses as low as possible. The benefits of X-ray exams, when justified, tend to outweigh the low risks attributed to them.

Resumo em Inglês:

Abstract Objectively evaluating an individual’s capacity for food fragmentation (masticatory performance) is crucial for understanding oral physiology and dental rehabilitation processes. Our aim was to conduct a bibliometric analysis of the literature focusing on masticatory performance. We conducted a survey in Web of Science up to August 31, 2024, applying specific category filters. Two calibrated reviewers manually tabulated the data, extracting information on title, authorship, keywords, institutions, countries, number of citations, year of publication, journal title, study design, masticatory test, population, and dentition status. VosViewer software generated collaborative network maps, while JAMOVI was used to perform ANOVA and Poisson regression analyses. The selection process resulted in 814 articles published between 1950 and 2024, with a recent increase to at least 50 articles per year. The average impact factor was 3.16, with around 30 citations per article. Citations were significantly influenced by the masticatory performance technique, publication year, and journal impact factor. The comminution test was the most prevalent (n = 411). Most studies focused on adults (n = 420) and older adults (n = 361), in which natural dentition (n = 404) and complete dentures (n = 214) were the most widely assessed parameters. The most frequent study designs were cross-sectional (n=489) and prospective (n = 145). The leading countries were Japan (n=202), Brazil (n=134), and the Netherlands (n = 69), and the Journal of Oral Rehabilitation was the most recurrent journal (n = 162). This study highlights the growing interest in evaluating masticatory performance, with a significant increase in publications over the years. This study highlights the need for further research involving children and longitudinal study designs, as well as studies evaluating rehabilitations with removable partial denture and implant-supported prostheses.

Resumo em Inglês:

Abstract Metrics derived from online social platforms indicate current interest in a specific topic. This study aimed to analyze the characteristics and social interest in scientific publications on bruxism using an altmetric analysis. A search was conducted in August 2024 in the Dimensions database. The following data were extracted: altmetric attention score (AAS), citations, year, language, access type, study design, topic (general objective and age group), journal, country, institution, and authors. VOSviewer was used to generate collaborative networks, whereas Google Trends was consulted to assess public interest in bruxism-related research. A Spearman correlation analysis was performed to establish the relationship between AAS and citations. A total of 196 studies published between 1992 and 2024 were included. The most widely accessed study had an AAS of 393. Significant interest in bruxism was observed among Mendeley, news outlets, and X users. Most studies were observational (n = 99), addressing the etiologic factors of bruxism (n = 75) and focusing primarily on the adult population (n = 148). The Journal of Oral Rehabilitation stood out as the most relevant journal (n = 36). Most articles were published in Brazil (n = 40), and Lobbezoo was the most frequent author (n = 27). VOSviewer revealed significant collaborations among authors. Most studies were not openly accessible (n = 105). A very weak positive correlation (r = 0.042) was observed between AAS and the number of citations. This study highlighted a social interest in scientific publications on bruxism, particularly those addressing etiologic factors.

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Abstract The aim of this systematic review was to synthesize the available literature on pretreatment factors, from a patient-centered perspective, that predict successful orthodontic treatment. Systematic and unrestricted searches were conducted across the electronic MEDLINE, Embase, Web-of-Science, Scopus, Cochrane Library, and LILACS/Bireme databases. Grey literature was also searched to identify potential studies. Qualitative assessments of the role of patient-centered pretreatment factors in orthodontic treatment success (adherence, satisfaction, and discontinuation rates) were evaluated and synthesized. Study selection and data extraction were performed independently by two reviewers. A total of sixteen studies were included. Three main domains related to the patient emerged as positive predictors of orthodontic treatment success: previous patterns of social behavior, attitudes of parents/caregivers, and reasonable motivation. Certain personality traits were associated with both positive and negative levels of adherence and treatment satisfaction. The evidence did not support the notion that the impact of malocclusion on aesthetic self-perception could serve as an indicator of cooperation, satisfaction, or discontinuation rates related to orthodontic treatment. Positive social behavior patterns and parental/caregiver attitudes, along with realistic prior motivation toward treatment goals, were found to be reliable predictors of orthodontic treatment success. Additionally, some personality traits were found to be associated with successful treatment outcomes. However, the evidence did not support the impact of malocclusion on self-perceived aesthetics as an indicator of compliance and satisfaction levels with orthodontic treatment.

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Abstract This study aimed to investigate oral conditions and their impact on salivary biochemical parameters in institutionalized individuals with and without substance use disorder. This was an epidemiological, cross-sectional, and clinical study. It included two groups, institutionalized individuals with substance use disorder (SUD group) and without substance use disorder (control group), each consisting of 60 participants. Salivary samples were analyzed for various parameters, while oral conditions were assessed using the DMFT index, community periodontal index, clinical attachment loss index, and need for prosthesis. Statistical analysis included the Mann-Whitney U test, t-tests, and correlation analysis (p ≤ 0.050). The SUD group showed a higher need for dental prostheses (p < 0.001) and more pronounced dental erosion (p < 0.001). This group also exhibited elevated DMFT indices, with significant associations in sextants with calculus (p = 0.010), periodontal pockets (p < 0.001), and attachment loss of 12 mm or more (p = 0.036). Regarding salivary parameters, the SUD group had high cortisol levels and significant correlations between uric acid and bleeding sextants (p = 0.024), salivary amylase and decayed teeth (p = 0.002), cortisol and the DMFT index (p = 0.045), and cortisol and the absence of DMFT (p = 0.042). In conclusion, individuals in the SUD group exhibited worse oral conditions than did those in the control group, suggesting a relationship between drug addiction and increased cortisol, uric acid, and salivary amylase levels.

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Abstract The prevalence of early childhood caries (ECC) tends to increase in the first 5 years of life as children grow, and those affected by ECC are likely to experience caries throughout their lives. ECC negatively impacts the oral health-related quality of life of both children and their families. Although controlling sugar intake and the use of fluoride are well-known methods for managing dental caries, preventive and therapeutic interventions alone have not been sufficient to prevent the development of new caries lesions. This review aims to explore why ECC continues to occur despite the oral health team having the necessary knowledge to prevent it. Based on current scientific evidence, this article highlights the need for the oral health team to consider additional factors, such as implementing oral health prevention programs in the first 450 days of life, enhancing caregivers’ oral health literacy, creating a supportive environment, and engaging in upstream actions (teledentistry, implementation science, health policies development etc.) to effectively manage and prevent dental caries. Otherwise we would be educating and treating children and sending them back to the conditions that made them sick. By addressing these factors, it might be possible to improve long-term oral health outcomes for children and reduce the burden of ECC on children and their families.

Resumo em Inglês:

Abstract The principal objective of this studywas to produce and characterize a machinable glass ceramic containing muscovite-mica as the main crystalline phase to be used as a dental restorative material. The secondary objective was to evaluate the use of muscovite-mica to improve machinability and generate a toughening mechanism in the experimental glass ceramic. After fine milling of a feldspathic glass frit was milled and then mixed with muscovite-mica, die-pressed, and sintered under vacuum at 850 to 1,150 °C. The resulting sintered composite was characterized by X-ray diffraction, scanning electron microscopy, and had its fracture toughness evaluated by micro-indentation. The results were as follows: (a) improved thermal stability of muscovite-mica crystals in the composite; (b) improved leucite crystallization in the feldspathic glass matrix by increasing sintering temperature in the studied range ; (c) the composites consisting of glass + 10% muscovite and glass + 20% muscovite sintered at 1,050°C presented fracture toughness values of 9.0 ± 1.2 and 8.4 ± 0.6 MPa.m1/2, respectively, which are higher than those found in the literature for glass ceramics. Feldspar frit blocks with addition of muscovite-mica (up to 20%) can be densified at temperatures between 1,050 and 1,150°C. This material was stable at a temperature substantially higher than the stability limit of pure muscovite and also showed indentation fracture toughness values greater than those reported in the literature for other glass ceramics.

Resumo em Inglês:

Abstract The purpose of our review was to group the evidence and attempt to provide a consensus on the behavior of salivary flow rate in patients with Down syndrome. Observational studies evaluating salivary flow rate in children and teenagers with Down syndrome compared with non-syndrome individuals were selected. Ten sources of information were researched. The risk of bias was assessed by using the Newcastle Ottawa Scale tool . Inverse Variance was ty the SMD (95% Confidence Interval). The certainty of the evidence was determined according to the GRADE approach. Fourteen studies were evaluated. The results showed, with a very low certainty of evidence, that children and teenagers with Down syndrome present a lower salivary flow rate compared with non-syndrome controls (SMD: -1.71, 95%IC: -2.81; -0.60, p < 0.05), with significant differences in the saliva collection methods (p < 0.05) (Unstimulated saliva, SMD -5.07, 95%CI: -7.96; -2.18, p < 0.01; Stimulated saliva, SMD -0.80, 95%IC: -1.78; 0.17, p = 0.11). The behavior of the salivary flow rate is not significantly different between the age groups (p = 0.60) (up to 5 years old, SMD -1.85, 95%CI: -2.90; -0.81, p < 0.01; 2 to 18 years old, SMD -1.51, 95%CI: -2.24; -0.78, p < 0.01), and the sex (p = 0.70) (Male, SMD -1.77, 95%CI: -2.39; -1.16, p < 0.01; Female, SMD -1.53, 95%CI: -2.58; -0.48, p < 0.01). Children and teenagers with Down syndrome present a lower salivary flow rate with an unstimulated saliva collection method compared to non-syndrome.

Resumo em Inglês:

Abstract This study aimed to evaluate the influence of pacifier use, bottle feeding, and finger/thumb sucking on the occurrence of otitis media in children. Searches were conducted in grey literature and six databases: Web of Science, Cochrane Library, LILACS, Scopus, MEDLINE/PubMed, and EMBASE, from inception through May 2025. Observational studies investigating the association between harmful sucking habits and otitis media in newborns, infants, preschoolers, and older children were included. Risk of bias was assessed using the Joanna Briggs Institute tool. Meta-analysis results were reported as odds ratios (ORs) with 95% confidence intervals (CIs), and the certainty of evidence was also evaluated. A total of 36 studies were included, most of which were cohort studies (n = 14), with sample sizes ranging from 46 to 35,613. Eleven studies were incorporated into meta-analyses. Children who used a pacifier were 1.17 times more likely to develop otitis media (95%CI: 1.00–1.33) and 1.54 times more likely to develop acute otitis media (95%CI: 1.01–2.36) compared to those who did not use a pacifier. No significant association was found between bottle feeding and otitis media (OR = 0.83; 95%CI: 0.59–1.17). Most studies did not report a significant association between finger or thumb sucking and otitis media. The certainty of evidence was rated as very low. These findings suggest that pacifier use may increase the likelihood of developing otitis media, particularly acute otitis media, with potentially relevant implications.

Resumo em Inglês:

Abstract This prospective, double-blind, randomized clinical trial aimed to evaluate the effect of an additional instrument following the single-file instrumentation approach on postoperative pain. Fifty-six mandibular molars with asymptomatic apical periodontitis were randomly assigned to two groups: G1 – instrumentation using a single reciprocating file; G2 – additional enlargement. The frequency and intensity of postoperative pain were assessed at 24 h, 48 h, and 7 days after endodontic treatment using the numerical pain assessment scale (NPAS) (Mann-Whitney U test). Analgesic intake was also recorded and analyzed using chi-square or Fisher’s exact tests. The incidence of root canal filling extrusion was also evaluated (chi-square). Statistical significance was set at p < 0.05. At 24 h, the incidence of postoperative pain was higher when additional enlargement was performed (p = 0.019). The incidence of pain was similar between groups after 48 h (p = 0.121) and 7 days (p = 1.000). The intensity of pain was also higher at 24 h in Group 2 (p = 0.019), while it was similar between groups after 48 h (p = 0.177) and 7 days (p = 1.000). The frequency of analgesic intake was higher in Group 2 after 24 h (p = 0.019). The incidence of root canal filling material extrusion was similar in both groups (p = 0.181). In conclusion, additional enlargement following single-file root canal preparation resulted in a higher incidence and intensity of postoperative pain immediately after treatment (24 h), with no significant impact at 48 h and 7 days.

Resumo em Inglês:

Abstract The aim of this systematic literature review and meta-analysis was to answer the following research question: “Is sugar consumption associated with early childhood caries among children under 6 years of age in cohort studies?”. The following electronic databases were accessed from December 2020 to May 2025 to identify the existing literature: Bireme, Pubmed/Medline, Scielo, Scopus, and Web of Science. Studies considered eligible for this systematic review were those that investigated sugar consumption as the main exposure and early childhood caries (ECC) as the outcome. Study selection and data extraction were performed independently by two reviewers. Study quality was assessed using the Joanna Briggs Institute (JBI) checklist for cohort studies scale. The search strategy retrieved 718 studies. After title and abstract screening, 59 were selected for full-text review, leading to the inclusion of 17 original studies in this systematic review. Finally, nine studies provided sufficient data for a meta-analysis. The association between sugar consumption and ECC was consistent across most of the cohort studies included in this review, which reported that higher sugar consumption was associated with higher prevalence of dental caries. The pooled effect estimate from the meta-analysis yielded an OR of 1.59 and a 95% CI (1.50-1.68), indicating that children who consumed sugar in early childhood were 59% more likely to develop caries compared to those who did not consume sugar. The included studies had a low risk of bias. Our systematic review and meta-analysis confirmed the association between sugar consumption and ECC in longitudinal cohort studies.