Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

Abstract in English:

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

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

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

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

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

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

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ABSTRACT Objective: To preliminarily evaluate the endodontic treatments in primary teeth carried out by Brazilian dental practitioners. Materials and Methods: A preliminary nationwide cross-sectional e-survey was conducted. The data collection took place from December 2023 to January 2024. The sample consisted of 77 dental practitioners, based on their initial responses to a 32-item self-administered questionnaire that addressed the features of treatments provided in Portuguese. The instrument was made available online, and its link was distributed via messaging apps and social media campaigns. The significance level was set at 5% (α = 0.05), and Pearson's chi-squared test was used to assess associations. Results: Among the respondents, 61% carry out indirect pulp capping, 53.2% carry out direct pulp capping, 40.3% carry out pulpotomy, and 31.2% carry out pulpectomy in primary teeth. Respondents aged up to 35, working in public dental services, and self-assessing their knowledge as 'very good' or 'good' were more likely to provide some endodontic treatment in primary teeth (all p <0.05). Furthermore, 41.6% of the respondents did not rate their knowledge about endodontic treatments in primary teeth as 'very good' or 'good', and 49% of the providers reported referring children in need of endodontic treatments 'frequently' or 'occasionally'. Calcium hydroxide was the most commonly used material for direct or indirect pulp capping (78.7% and 68.1%, respectively) and pulpectomies (54.2%). In pulpotomies, Mineral Trioxide Aggregate (MTA) was the most frequently used material (45.2%), with its usage similar to that of calcium hydroxide (38.7%). Conclusion: There was notable variability in the characteristics of endodontic treatment providers for primary teeth among Brazilian dental practitioners.

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ABSTRACT Objective: To investigate the self-perception of dental surgeons regarding academic training for oral health care of people with disabilities (PWD). Material and Methods: This cross-sectional analytical study was conducted with a sample of 160 public and private dental surgeons from a Brazilian municipality. A semi-structured questionnaire with open and closed questions was administered to investigate the socioeconomic and demographic aspects, professional training, professional knowledge of the health rights of PWD, and relationships with PWD. Chi-square or Fisher's exact tests, along with a multiple logistic regression model, were used for data analysis at a significance level of 5%. Results: Almost 70% (n = 112) of professionals had training in the care of PWD. Professionals who had specific training during their undergraduate studies (AOR = 3.660; 95% CI = 1.169-11.467; p=0.026), who developed community activities in this period (AOR = 9.968; 95% C I= 1.887-52.639; p=0.007), who showed aptitude for providing oral health services (AOR = 4.155; 95% CI = 1.563-11.045; p=0.004), as well as for the behavioral management of these people (AOR = 2.808; 95% CI = 1.096-7.195; p=0.031) were more likely to have their self-perception regarding professional training being adequate for oral health care for PWD. Conclusion: Self-perception of academic training in caring for people with disabilities was associated with some variables related to training during undergraduate studies and work experience, but there are still gaps in knowledge of the rights of people with disabilities to oral health among Brazilian dentists.

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ABSTRACT Objective: To assess the impact of dental aesthetics and to identify the factors that contribute to overall well-being in the North Indian population. Material and Methods: The psychosocial impact of dental aesthetics was evaluated using the PIDAQ, a validated questionnaire. The content validity of the PIDAQ was established using the content validity index (CVI), and its reliability was assessed using Cronbach's alpha. The PIDAQ consists of four domains: Dental Self-Confidence (DSC), Social Impact (SI), Psychological Impact (PI), and Aesthetic Concern (AC). Descriptive statistics and chi-square tests were employed to analyse the relationship between age groups (18-35, 36-50, and 50+) and gender with the PIDAQ scores. Results: A total of 568 dental patients (60.4%% females and 39.6% males) participated in the study. The questionnaire showed good validity. The 18-35 age group reported higher dental self-confidence, while the 36-50 age group expressed higher concerns about social impact. The 18-35 age group reported lower psychosocial impact and aesthetic considerations. Females were more likely to express aesthetic concern. Conclusion: Younger individuals have more positive views of their teeth than older individuals. However, females are more concerned about aesthetic concerns, while males experience a higher psychological impact and are more dissatisfied. This shows the connection between dental health, society, and self-esteem.

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ABSTRACT Objective: To investigate the periodontal conditions and levels of inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6), in the gingival crevicular fluid (GCF) of individuals with and without diabetes. Material and Methods: Seventeen healthy participants and 14 individuals with diabetes were recruited. Various periodontal parameters, including plaque index, gingival index, and probing pocket depth, were assessed by a single, blinded investigator. GCF samples were analyzed for TNF-α, IL-1β, and IL-6 levels by using enzyme-linked immunosorbent assays. Results: The results showed significant differences between the control and diabetes groups in terms of mean probing depth, mean attachment level, plaque percentage, and percentage of bleeding on probing. The analysis of cytokine levels revealed that the mean ranks for TNF-α and IL-1β were significantly higher in the diabetes group than in the control group, indicating a pro-inflammatory state. However, no significant difference was observed in the levels of IL-6 between the two groups. Conclusion: Diabetes is associated with increased periodontal inflammation and elevated levels of specific inflammatory cytokines in the GCF. The study offers valuable insights into the interplay between diabetes and periodontal disease, emphasizing the importance of comprehensive dental care and the management of systemic health conditions for individuals with diabetes.

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ABSTRACT Objective: To assess the knowledge, attitude, and practice (KAP) of dental healthcare providers (DHCPs) in Guilan Province of Iran regarding COVID-19 and vaccination, and their level of fear before and after vaccination. Material and Methods: A questionnaire was designed, uploaded to Porsline, and administered to 617 DHCPs in Guilan Province via social media in 2022. The questionnaire included a demographic section, as well as questions to assess KAP regarding COVID-19 and vaccination, and the level of fear of COVID-19 before and after vaccination. Data were analyzed by independent t-test, ANOVA with Tukey's test (for pairwise comparisons), Kruskal-Wallis test with Mann-Whitney U test and Bonferroni adjustment (for pairwise comparisons), and Spearman’s correlation test (α=0.05). Results: A total of 345 DHCPs (55.9%) responded to the questionnaire, out of which 330 met the eligibility criteria. The mean scores of KAP regarding SARS-CoV-2 were 13.53±1.43 for knowledge, 3.91±0.98 for attitude, and 3.94±0.98 for the practice domain. The mean knowledge score about COVID-19 vaccination was 8.10±2.58. A significant reduction in fear of COVID-19 was observed after vaccination (p < 0.001). No correlation was found between KAP regarding SARS-CoV-2 and fear of COVID-19 before vaccination (p > 0.05). Conclusion: DHCPs in Guilan Province had a high level of KAP regarding SARS-CoV-2 and vaccination, and vaccination significantly decreased their fear of COVID-19.

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ABSTRACT Objective: To examine dentists' thresholds for restorative treatment for occlusal caries lesions in permanent molars, as a function of the patient's caries risk (PCR), and determine whether an "evidence-practice gap" (EPG) exists. Material and Methods: A convenience sample of dentists from a Brazilian community (n = 215) completed a questionnaire about their practice/patient characteristics, as well as a translated version of the "Assessment of Caries Diagnosis and Caries Treatment" Questionnaire. Dentists were presented with three clinical cases: Case 1, characterized by white discoloration in the outer enamel; Case 2, featuring brown discoloration in the inner enamel; and Case 3, presenting brown discoloration without cavitation in the outer third of the dentin. Two clinical scenarios were considered: low caries risk (LR) or increased caries risk. Results: An EPG was evident, as 57% of dentists would intervene operatively in the LR scenario, even when the lesion was still in the enamel. Dentists in private practice, those with a higher percentage of patients uninterested in individualized caries prevention, or those who graduated from a private dental school were more likely to perform operative treatment (p < 0.05). Conversely, dentists with an advanced degree or those who were female had a lower probability of performing operative treatment (p < 0.05). Conclusion: A substantial EPG was evident, the threshold for restorative treatment for occlusal caries progression was associated with dentists' professional context and educational background.

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ABSTRACT Objective: To describe digital intraoral scanning in five children with microcephaly caused by the Zika virus, detailing occlusal and dental characteristics using digital models. Material and Methods: An observational study assessed the dental occlusal profile of five 4-year-old children with Congenital Zika Virus Syndrome (CZS) using digital oral scanning. The children were treated at the Unichristus School of Dentistry Clinic. The Panda 2 intraoral scanner was utilized. A mouth opener made from wooden sticks, adhesive tape, and gauze was used individually for each patient, thereby minimizing the risk of trauma. The upper arches were scanned first, followed by the lower arches, and finally the arches in occlusion. Results: The 3D digital models revealed the relationship between the distal faces of the deciduous second molars, Baume's arch type, tooth eruption chronology, anterior open bite, posterior crossbite, overbite, overjet, and deviated midline. Conclusion: Intraoral scanning in children with congenital Zika virus microcephaly proved to be a viable alternative for producing reliable digital study models, offering more comfort and safety to these patients and replacing conventional molding techniques.

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ABSTRACT Objective: To compare the preferences of children and their parents regarding the characteristics of the dental operator and the clinical environment for dental care. Material and Methods: This cross-sectional study was conducted from August 2022 to July 2023. A questionnaire was developed in English and then translated into Spanish, before being subjected to a trial and a pilot study. After obtaining informed consent, 152 parents and their children, selected by convenience sampling, participated in the survey. Bivariate statistical analysis was performed using Fisher's exact and chi-square tests. Results: Statistically significant differences (p<0.05) were determined when comparing the preferences of children and parents for the variables gender, age, clothing, mask, floor, door, lighting, curtains, dental chair, play area, waiting area, and consulting room. Based on participants’ gender, it was determined that the highest percentage of boys (71.76%) and girls (86.57%) prefer to be seen by an operator of the same gender (p=0.001). Significant differences were identified among children regarding clothing preferences (p=0.001). Additionally, differences were observed in parents’ preferences for curtains and walls in the clinical scenario (p<0.05). Children showed varying preferences for the play area, waiting area, and office, whereas both parents and children had varying preferences for the reception area. Conclusion: Differences were observed when comparing the preferences of children and their parents concerning the dental operator and the clinical scenario.

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ABSTRACT Objective: To assess the oral health of children with autism and parental attitudes towards their oral care. Material and Methods: A cross-sectional study was conducted among 55 children with autism attending a daily care association in Pristina. Oral status was assessed using the decay, missing, and filled teeth (DMFT/dmft) index for primary and permanent teeth and the OHI-S index. All parents of children with autism completed a structured questionnaire regarding their sociodemographic data and knowledge of their children's oral health. Results: The mean of DMFT/dmft index was 1.79±1.560 and 4.04±2.641, whereas the OHI-S index was 1.67±0.477. Most parents had completed secondary school (63.6% and 56.4%), had a middle socioeconomic status (70.9%), and typically had a low monthly family income (50.9%). Moreover, fathers of these children were generally employed (98.2%), whereas mothers were not (78.2%). According to the results, most of the children consumed sweets, beverages, as well as fruits and vegetables several times a day (34.5%, 47.3%, and 43.6%), brushed their teeth at least once a day (50.9%), with fluoride paste (69.1%) mainly under the parent's supervision (41.8%), and visited the dentist only when necessary (83.6). Conclusion: Children with autism exhibited a high level of dental caries and poor oral hygiene. The data are indicative of poor oral health practices in autistic children. The development of educational and preventive oral health programs targeting these children and their parents is necessary.

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ABSTRACT Objective: To assess Turkish pediatricians' knowledge, perceptions, and educational levels regarding oral and dental health, particularly in light of the high prevalence of dental caries among children. Material and Methods: A cross-sectional study involved 323 practicing Turkish pediatricians utilizing Google Forms for data collection between December 2021 and November 2023. A structured questionnaire examined sociodemographic and clinical characteristics and employed scales to evaluate pediatricians' knowledge, attitudes, and self-perceptions concerning childhood oral health. Results: The study included 323 pediatrician participants, with a mean age of 37.15 ± 7.92 years, with a majority being female (65%). Academic staff demonstrated superior knowledge, positive attitudes, and higher self-perception scores than research assistants and specialists. Significant correlations were observed between age and years of service with attitudes and self-perceptions, while knowledge scores showed no such correlations. Pediatricians without formal dental education exhibited lower attitude and self-perception scores related to oral health. Conclusion: The study emphasizes the critical need for targeted education to enhance Turkish pediatricians' grasp of oral health. Strengthening their knowledge and attitudes is essential to advancing dental care, improving children's outcomes, and addressing dental caries effectively.

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ABSTRACT Objective: To investigate the impact of an educational intervention on the knowledge, attitude, and skills of dental students regarding smoking cessation. Material and Methods: The participants were dental students in their 7th (Intervention group) and 8th semester (Control group) between February and July 2022. The intervention group received an educational package consisting of a lecture, a podcast, a seminar, and role-playing on smoking cessation, while the control group only received a lecture. The students' knowledge, attitudes, and skills were assessed using a questionnaire. The questionnaire included statements regarding the importance of learning about smoking cessation, the level of students' knowledge of and attitudes towards treating tobacco addiction, and skills related to quitting smoking. Moreover, students' knowledge about the physiology of addiction, non-nicotine drugs for smoking cessation, and electronic cigarettes was evaluated. Results: In total, information from 55 students was used. In the intervention group, an increase was found in the willingness to advise patients from 56% to 92% (p=0.003), the mean score of knowledge regarding electronic cigarettes (3.11±1.65 to 4.19±1.33, p=0.001), agreement with "I can get information about the patient's smoking" from 22% to 90%, "I am able to advise for quitting smoking" from 38% to 81%, "I can provide recommendations for smoking cessation" from 22% to 58%, and "In my opinion, smoking addiction is a chronic disease" from 56% to 77%. Conclusion: Training dental students in smoking cessation counseling can enhance their understanding and motivation to assist patients in quitting smoking.

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ABSTRACT Objective: To determine the correlation of frontal sinus dimensions with maxillary and mandibular lengths in lateral head radiographs of Latin American individuals from Peru and Brazil. Material and Methods: This correlation study evaluated 200 lateral head radiographs from Peruvian (n=100) and Brazilian (n=100) individuals aged 15 to 20 years. Two investigators were trained and calibrated to perform all measurements. Digital measurement of frontal sinus height and width was performed using specialized software. Subsequently, the maxillary (condylion to A point) and mandibular (condylion to gnathion—point) effective lengths were measured. Pearson correlation tests were used to assess the strength of the association. A significant level of p<0.05 was used. Results: A significant correlation was found between frontal sinus height and effective maxillary and mandibular lengths (p= 0.013 and p= 0.014, respectively). Frontal sinus width was also significantly correlated with effective maxillary and mandibular length (p=0.001 and p<0.001, respectively). However, the correlations between frontal sinus height and width with maxillary and mandibular effective length were weak to moderate. Conclusion: The correlations between frontal sinus width and height and maxillary effective lengths are weak to moderate, indicating that, in most cases, as maxillary dimensions increase, frontal sinus lengths also increase but do not change by the same magnitude.

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ABSTRACT Objective: To evaluate the antifungal effect of 25% Tea tree oil and compare it to 2% Chlorhexidine and Nystatin against Candida albicans at both the 4th day and 7th day of inoculation to explore potential alternative treatment options for fungal infections in endodontic therapy. Material and Methods: 82 single-canal human mandibular premolar teeth were cleaned, prepared, and inoculated with a C. albicans suspension. After incubating for 4 and 7 days, the teeth were randomly assigned to receive one of four treatments: Nystatin, Chlorhexidine (CHX), Tea tree oil (TTO), or Dimethyl Sulfoxide (DMSO). After treatment, samples were rinsed and dried. Dentine shavings were collected and incubated to observe the growth of C. albicans. The antifungal activity was measured by the number of Candida colony-forming units. Two-way ANOVA followed by post-hoc Tukey's test was applied to compare the CFU growth. Results: TTO exhibited comparable antifungal activity to CHX (p=0.976) and superior antifungal activity compared to Nystatin (p<0.001). Conclusion: 25% Tea tree oil shows antifungal efficacy against C. albicans, comparable to 2% Chlorhexidine, suggesting it could be a viable alternative for endodontic treatments. However, Nystatin demonstrated only limited antifungal effectiveness.

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ABSTRACT Objective: To analyze the oral biofilm and tracheal aspirate of children on invasive mechanical ventilation to observe similarities in the microbiota. Material and Methods: This study consisted of a retrospective descriptive analysis carried out in 35 children admitted to the Pediatric Intensive Care Unit of the University Hospital of the Federal University of Maranhão from March to December 2019. The lingual biofilm and tracheal aspirate were collected, and both samples were sent for culture examination. Results: In 34.3% of participants, the same bacteria were present in both the lingual biofilm and the tracheal aspirate, with Stenotrophomonas maltophilia and Acinetobacter baumannii being the most frequent. The frequency of detection of the same species at both sites was higher among patients who died compared to those discharged from the hospital (54.6% versus 25%, p = 0.087). There was a statistically higher frequency of deaths in patients aged up to 24 months (52.9% versus 11.1%, p = 0.01). Conclusion: There was a high similarity in the microorganisms found at the two sites studied in patients up to 24 months of age. Thus, it is noted that the oral cavity of hospitalized children on invasive mechanical ventilation serves as a reservoir for respiratory pathogens.

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ABSTRACT Objective: To develop and validate a predictive model for oral squamous cell carcinoma (OSCC) survival outcomes, assessing the impact of key risk factors on survival probability. Material and Methods: A retrospective analysis was performed using a Multilayer Feedforward Neural Network (MLFFNN) in R. The outcome variable was survival status (live or dead), while predictors included smoking status, age, betel quid use, alcohol consumption, and sex. Data were normalized and partitioned into training, testing, and validation sets using bootstrap resampling. The MLFFNN model was optimized with hidden layers and a logistic activation function to enhance predictive performance. Results: Smoking status was the most influential predictor of OSCC survival (24%), followed by age (16.91%), betel quid use (15.37%), sex (10.21%), and alcohol consumption (8.57%). Performance metrics included a Mean Absolute Error of 0.2628, Root Mean Squared Error of 0.3466, and validation accuracy of 73.715%. Conclusion: This study highlights the potential of neural network-based models in predicting OSCC survival outcomes. Smoking emerged as the dominant risk factor, providing critical insights for data-driven clinical management strategies.

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ABSTRACT Objective: To evaluate the knowledge and attitudes of final-year dental students in Southeast Iran regarding digital dentistry. Material and Methods: This cross-sectional descriptive study surveyed 81 final-year dental students from Kerman and Rafsanjan using a valid questionnaire that included demographic data and questions assessing their awareness and attitudes toward digital dentistry. Statistical analyses were performed using SPSS software. Results: 51.9% of participants were male, with mean knowledge and attitude scores of 24.56 ± 14.49 and 63.95 ± 23.11, respectively. Alarmingly, 80.2% exhibited weak knowledge, while only 38.3% had a positive attitude towards digital dentistry. No significant gender differences were found; however, students from Kerman showed higher knowledge levels, and those with greater knowledge tended to have more positive attitudes. Conclusion: Given the increasing importance of digital technology in dental treatment, educational curricula should incorporate more content related to digital dentistry to prepare future practitioners for better modern practices.

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ABSTRACT Objective: To evaluate the color stability, surface roughness, and microhardness of dental restorative materials in various pediatric liquid drugs (PLDs). Material and Methods: A total of 175 restorative material discs were prepared for the following groups (n=25): Filtek Ultimate (FU), ACTIVA BioACTIVE Restorative (AC), ADMIRA Fusion X-tra (AD), Beautifil II (BII), Equia Forte (EQ), Fujı II Lc (FII), Fuji IX (FIX). After the initial colour assessment was performed, surface roughness and microhardness values were measured. Specimens were divided into five subgroups (n = 5) for each test, including Aerius, Ferrosanol, Atarax, Keppra, and Ventolin. Measurements were repeated following a 4-week immersion cycle. The resulting data were analyzed statistically using the Shapiro-Wilk, Kruskal-Wallis, and Friedman tests. Results: The FII group showed the highest ΔE. However, there was no significant difference between the BII and EQ groups (p>0.05). The Ferrasanol B caused the most significant color change in materials (p < 0.05). The Ventolin significantly increased the surface roughness of the materials (p < 0.05). Following the PLD storage, the surface roughness of the BII and FIX groups increased, while the microhardness of the FU, BII, EQ, and FII groups decreased (p < 0.05). The Aerius, Atarax, Keppra, and Ventolin significantly disrupted the microhardness of the materials (p < 0.05). Conclusion: Pediatric liquid drugs may cause unfavorable effects on the color stability and surface properties of restorative materials.

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ABSTRACT Objective: To evaluate and compare the effects of 17% Ethylenediaminetetraacetic acid (EDTA) and 7% Maleic Acid (MA) on the push-out bond strength (POBS) and compressive strength (CS) of Biodentine and Bio-C Repair when used for furcal perforation repair. Material and Methods: Sixty extracted human mandibular molars were decoronated, and standardized furcal perforations were created. The teeth were mounted and randomly divided into two groups: Group I, Biodentine, and Group II, Bio-C Repair. Each group was irrigated with 2.5% Sodium Hypochlorite and then subdivided into three: Group A – 17% EDTA, Group B – 7% MA, and Group C – Distilled Water. For CS evaluation, eighteen cylindrical samples of each material were prepared, immersed in NaOCl, and similarly subdivided into three groups based on the irrigant used. All samples were tested using a universal testing machine. Results: Biodentine showed no significant difference in POBS among the irrigants (p=0.065). Bio-C Repair showed significantly higher POBS with MA and distilled water than with EDTA (p<0.001). Biodentine’s CS was significantly affected by the chelating agents (Control > EDTA > MA), whereas Bio-C Repair showed no significant difference; however, its CS remained lower than that of Biodentine. Conclusion: Chelating agents did not affect Biodentine's POBS, whereas MA improved Bio-C Repair's POBS over EDTA. Despite the reduction, Biodentine's CS remained higher than Bio-C Repair.

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ABSTRACT Objective: To evaluate the treatment decision-making of dental students from two dental schools for different stages of interproximal carious lesions in permanent and deciduous teeth. Material and Methods: This is a cross-sectional study, where a questionnaire with schematic diagrams and radiographs of deciduous and permanent teeth showing five stages of interproximal carious lesions (external third of enamel, internal third of enamel, enamel-dentin junction (EDJ), external third of dentin and internal third of dentin) were presented to dental students of one Public University and one Private University, to determine the need for invasive intervention. Results: For diagrams, significant differences were found between schools in dichotomized responses (external or internal to EDJ) for deciduous and permanent teeth (p=0.019 and p=0.015, respectively), with a higher frequency of responses for early intervention (external to EDJ) in the private school. For radiographs, a higher response frequency for early intervention was observed in permanent teeth; meanwhile, for deciduous teeth, a late intervention (internal to the EDJ) was preferred, without significant differences between schools. Conclusion: Students from both schools showed a high frequency of responses to early invasive intervention (external to EDJ) in interproximal caries lesions when diagrams and radiographs of permanent teeth were evaluated, with the private schools evaluating more frequently. Only in the deciduous teeth radiograph, the prevalence of late intervention (internal to the EDJ) was higher.

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ABSTRACT Objective: To assess stress, anxiety, and depression among preclinical and clinical dental students during online learning, as well as the factors that contributed to these conditions. Material and Methods: A cross-sectional study was conducted in late 2021 involving 580 dental students from Indonesian dental faculties. Data were collected via an online questionnaire distributed via social media, using a snowball sampling approach. The questionnaire included informed consent, sociodemographic data, behavioral factors, lecture activities, and the Depression Anxiety Stress Scale (DASS-21). Data analysis was performed using Chi-square and logistic regression. Results: The prevalence of anxiety, stress, and depression among the total 607 students enrolled was 70.8%, 63.1%, and 51.6%, respectively, with preclinical students showing higher levels. Regular exercise was associated with a 37% reduction in stress, while attending online shortly lowered the likelihood of anxiety by 56%. Conversely, having family or friends diagnosed with COVID-19 increased the risk of depression by 1.53 and 1.88 times, respectively. Conclusion: Stress was related to lack of exercise and insufficient sleep, anxiety to higher online learning frequency, and depression was reduced by extracurricular activities but worsened by COVID-19 cases among family or friends.

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ABSTRACT Objective: To evaluate the prevalence of dental anomalies (DA) in panoramic radiographs (PR) of Brazilian children and adolescents and to provide evidence to guide the appropriate timing of PR prescription. Material and Methods: This retrospective observational study analyzed 1,027 PR of patients aged 6 to 18 years, obtained from the electronic records of an Oral Radiology Service. DA in the primary and permanent dentitions were assessed by sex, age group, and tooth number. A trained professional with over 20 years of radiology experience performed radiographic evaluations. Data were evaluated using chi-square and Fisher's exact tests. Results: A total of 91.7% of patients presented at least one DA, with no correlation to sex or age. The anomaly rate per patient was higher in adolescents (>12 years) than in children (2.48 vs. 1.86). The mandible was more frequently affected in both dentitions. Adolescents exhibited significantly higher rates of microdontia, hypercementosis, agenesis, root dilaceration, taurodontism, retained deciduous teeth, and impaction. In contrast, tooth rotation was more frequent in children (p<0.05). Canines and third molars were the most affected permanent teeth; in primary teeth, canines and second molars were most involved. Conclusion: The high prevalence of dental anomalies highlights the importance of prescribing panoramic radiographs for early diagnosis. Timely detection enables preventive interventions and supports better clinical and developmental outcomes.

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ABSTRACT Objective: To explore how dental students at Kerman University of Medical Sciences perceive the implementation of ethical standards and principles of justice within their dental education curriculum. Material and Methods: This descriptive-analytical cross-sectional study investigated the views of 207 dental students (113 females and 94 males; mean age 22.94 ± 2.45 years, range 18-33) from the first to sixth year of the general dentistry program, with participants normally distributed across each academic year. Data were collected using two previously validated questionnaires with closed-ended questions that evaluate educational programs based on ethical (28 items) and justice (32 items) criteria. Data were analyzed using one-sample t-tests, one-way ANOVA, and Pearson's correlation with SPSS software version 22 (p < 0.05). Results: Students' perspectives on adherence to justice were moderate, while their views on ethical adherence were significantly above average in the dental education curriculum (p < 0.05). No significant differences were found by gender or age; however, basic sciences students had significantly different views on justice than clinical students (p = 0.04). A significant positive correlation was found between justice and ethics scores (p = 0.01). Conclusion: Dental students perceived moderate adherence to justice and above-average adherence to ethics in their curriculum. Higher justice scores were associated with higher ethics scores.

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ABSTRACT Objective: To evaluate the effect of dentifrices labeled as vegan on the mass and surface roughness of a nanoparticulate composite resin subjected to simulated toothbrushing, and to analyze the labeling of these products. Material and Methods: Sixty composite resin specimens were divided into six groups (n=10): one control group using a conventional dentifrice (CG) and five test groups using dentifrices labeled as vegan (TG1, TG2, TG3, TG4, and TG5). Mass and surface roughness were measured before and after simulated brushing equivalent to six months (25,000 cycles) and twelve months (50,000 cycles) of use. The labeling analysis assessed the composition of the dentifrices and their compliance with Brazilian Health Regulatory Agency regulations. Results: Mass analysis showed no significant differences between groups at either time point. Regarding surface roughness, the control group showed no significant change (p>0.05) after 6 and 12 months of brushing. However, the test groups exhibited variable responses. After twelve months, TG4 exhibited significantly greater roughness compared to CG, TG1, and TG2 (p<0.05), while TG5 showed greater roughness than CG and TG1 (p<0.05). Visual indicators of veganism were present on the packaging of the test dentifrices, although no certification seals were found. Conclusion: The labeling analysis revealed that vegan dentifrices are not currently regulated by national or international agencies, raising concerns about their reliability and safety, as well as the absence of agents with proven anticaries efficacy. Additionally, while brushing with vegan-labeled dentifrices did not significantly increase the roughness or reduce the mass of the composite resin, their effects after twelve months of simulated brushing were comparable to those of conventional dentifrices.

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ABSTRACT Objective: To investigate the radiographic periapical healing after root canal treatment using a novel 1-Hydroxyethylidene-1,1-Diphosphonic acid (Dual Rinse HEDP) irrigant in necrotic teeth with an apical periodontitis. Material and Methods: In this clinical study, 65 patients with necrotic molars, premolars, and anterior teeth requiring root canal treatment were enrolled. Before the commencement of the study, all study participants signed informed consent forms individually. Teeth were mechanically prepared with E3 Azure rotary files, irrigated with Dual Rinse HEDP irrigant, and then obturated with a single-cone technique and bio-ceramic sealer. After one year, 50 patients (15 dropped out) were evaluated radiographically for periapical healing using the Periapical Index (PAI) scores. Fisher's Exact test and Friedman's test were used. The significance level was set at 5%. Results: After one year, the PAI scores of all patients decreased significantly (p < 0.001). Regarding pain, there was a statistically significant decrease in the prevalence of pain after one year of follow-up amongst the different groups of teeth (anteriors, premolars, molars) (p < 0.001). Conclusion: Dual Rinse HEDP, in conjunction with sodium hypochlorite, can be used as an effective irrigant to promote periapical healing.

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ABSTRACT Objective: To evaluate the correlation between salivary Proline Rich Proteins (PRPs) levels, salivary pH, and the caries index in children aged 10-12 years from coastal and plateau areas of Jember, East Java, Indonesia. Material and Methods: A cross-sectional design was used, involving 136 students from the district of Puger and Jelbuk, Jember regency. Caries index was assessed using DMF-T examinations, salivary pH measurements, and PRP quantification by ELISA; data were analyzed using the Spearman correlation test. Results: The average DMF-T index in the coastal area was 1.8, with an average salivary pH of 8.25 and PRP level of 8.076 ng/ml. The plateau area had an average DMF-T index of 1.7, a salivary pH of 6.51, and a PRP level of 0.338 µg/ml. In both regions, a significant inverse correlation was found between salivary pH and DMF-T (p < 0.05). No significant correlation was observed between PRP levels and DMF-T or between salivary pH and PRP levels. Conclusion: The higher caries index is due to low PRP levels and a low salivary pH. Conversely, the lower the caries index, the higher the levels of PRPs and salivary pH.

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ABSTRACT Objective: To investigate the profile of people with disabilities, factors related to referral for general anesthesia (GA), dental procedures performed under hospital care, and return to specialized outpatient follow-up in Curitiba, Brazil. Material and Methods: This retrospective study analyzed electronic records from individuals treated through the Amigo Especial Program between 2009 and 2019. Variables included age, gender, baseline diagnosis, use and type of protective stabilization, reasons for GA referral, hospital dental procedures, and return to outpatient care. Descriptive statistics, Chi-Square tests, and binomial logistic regression were performed. Results: A total of 657 records were reviewed, and 119 patients (18%) were referred for GA. The most frequent age group was 22-40 years, predominantly male, and without a recorded baseline diagnosis. Protective stabilization was used in 44% (n=286) of the total sample and had previously been used in 71% (n=84) of those referred for GA. The main reason for referral was the risk of injury to patients and professionals. Tooth extraction was the most frequent procedure. Among those treated under GA, 74% (n=88) returned for outpatient follow-up. Additionally, 55 individuals required a new referral due to failure to complete treatment in the outpatient setting. Conclusion: The patient profile consisted mainly of adult males without a diagnosis. Protective stabilization was common before GA. Surgical procedures were frequent, and most patients returned for follow-up.

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ABSTRACT Objective: To characterize the microscopic structure and surface properties of commercially available 3D-printed resin composites using Scanning Electron Microscopy (SEM) to assess their clinical applicability and durability. Material and Methods: Four different 3D-printed resin composites were analyzed. Specimens were fabricated under controlled conditions, followed by standardized cleaning, post-curing, and polishing procedures. SEM imaging was performed at various magnifications to evaluate filler distribution, particle morphology, and surface integrity. Results: The analysis revealed significant differences among the tested resins. Varseo Smile Crown Plus (Bego) exhibited the most homogeneous microstructure, with a high filler content, nanoscale particles, and strong polymer-filler integration, suggesting superior mechanical properties. Biocrown and Nanolabs resins showed intermediate levels of filler content and particle distribution. At the same time, Printax AA Temp had the lowest inorganic content and the highest incidence of structural defects, including layer discontinuities and cracks. Conclusion: The structural and surface characteristics of 3D-printed resin composites vary significantly among different commercial brands. Varseo Smile Crown Plus demonstrated the most promising properties for clinical applications, while other materials showed limitations related to filler distribution and structural integrity. Further studies on mechanical performance and long-term stability are needed to optimize the application of these materials in definitive restorations.

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ABSTRACT Objective: To compare the adequate time, canal transportation, remaining resin quantity, and volume after instrumentation with different manual and mechanized files. Material and Methods: Eighty root canals from prototyped deciduous molars were divided into four groups according to instrumentation: WOG - reciprocating file; SMF - nickel-titanium manual file; K - manual stainless steel file; SBF - rotary file for deciduous teeth. Micro-CT scans were taken before and after instrumentation, and data were collected and statistically analyzed. Two-way ANOVA and Tukey's test were used for parametric results, and Kruskal-Wallis and Dunn's test for nonparametric results. Results: Mechanized groups showed shorter times than manual groups (p≤0.05). In canal transportation, the WOG group showed greater deviation than the other groups (p=0.002). The SBF group showed the highest remaining resin quantity (p=0.008). All groups showed statistically significant differences between apical and cervical thirds (p=0.008), although no differences in volume were observed among groups (p≥0.05). Conclusion: NiTi files (SMF) are a viable alternative for pulpectomy in deciduous teeth, preserving original canal anatomy without excessively altering root canal volume, providing efficient treatment in reduced time, whether used manually (SMF) or mechanized nickel-titanium files (WOG and SBF).

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ABSTRACT Objective: To assess the color stability of resin-modified glass ionomer cement and composite-based restorative materials exposed to Ayurvedic-based iron supplements for pediatric patients. Material and Methods: Twenty disk-shaped samples were fabricated from composite and resin-modified glass ionomer cement (RMGIC). The baseline color values of both materials were measured via the CIE l*a*b* system. The samples were divided into groups A (RMGIC) and B (composites), which were exposed to 2 iron supplements, Tonoferon and Lohasava (n=40), over a 40-day test period. The colors of all the samples were measured again. The data were analyzed using one-way ANOVA with Tukey's post hoc test and an independent sample t-test (p<0.05). Results: Dental restorative materials based on composites and RMGIC are susceptible to color changes when exposed to pediatric iron supplements. A significant color change was observed in RMGIC discs immersed in Lohasava, followed by composite discs immersed in Lohasava when subjected to immersion in composite discs immersed in standard pediatric iron syrup (Tonoferon). Conclusion: Compared with conventional iron supplements, Ayurvedic iron supplements cause more discolouration in composites and resin-modified glass ionomer cement.

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ABSTRACT Objective: To evaluate the impact of possible sleep bruxism on oral health-related quality of life (OHRQoL) in adolescents. Material and Methods: This is a cross-sectional study nested within a cohort study initiated in 2010 with a sample of preschool children from Santa Maria, Brazil. Subsequently, individuals were re-evaluated in 2020, totaling 10 years of follow-up. The sample used in this study is a follow-up sample, comprising 429 adolescents aged 11 to 15 years. OHRQoL was assessed using the CPQ11-14. Possible sleep bruxism was assessed by self-report using the question "Do you grind your teeth while sleeping?" Demographic, socioeconomic, and clinical variables were also taken into account. An adjusted multilevel Poisson regression analysis was conducted to evaluate the association between sleep bruxism and OHRQoL. Results: The mean age of the individuals followed was 12.6 years (standard deviation [SD] 1.6). The mean CPQ11-14 scores were 10.6 (SD 8.4), and the prevalence of sleep bruxism was 14.4%. Adolescents who presented possible sleep bruxism had scores 30% higher on the CPQ11-14, indicating a greater impact on OHRQoL. Conclusion: Individuals with sleep bruxism experience a lower OHRQoL compared to those without sleep bruxism.

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ABSTRACT Objective: To evaluate the fluoride release from Colgate Zero Kids® dentifrice compared to two children’s dentifrices, Tandy® and Sorriso Kids®. Material and Methods: All products, from the same manufacturer, had identical fluoride formulations (NaF/silica; 1,100 ppm F) but differed in rheological properties. A 4-g sample of each dentifrice (4.4 mg F) was agitated in ultrapure water and centrifuged; the supernatant was collected for fluoride analysis using a fluoride ion-selective electrode, calibrated with standards (0.25-16.0 µg F/mL) in 50% TISAB II. Fluoride release was expressed as a percentage of total fluoride, and data (n=6) were statistically analyzed using ANOVA and Tukey’s test (α = 5%). Results: Mean fluoride release was: Tandy® (71.4 ± 3.2%), Sorriso Kids® (70.3 ± 2.1%), and Colgate Zero Kids® (37.7 ± 9.7%), with Colgate differing significantly (p < 0.05). To investigate the lower fluoride release from Colgate Zero Kids®, the flow and viscosity curves of the toothpastes were obtained using a Brookfield R/S Plus rheometer. Colgate Zero Kids® showed significantly higher thixotropy compared to the other dentifrices. Conclusion: The results suggest that the reduced fluoride availability in Colgate Zero Kids® may be attributed to its higher viscosity, potentially limiting fluoride ion diffusion. These findings highlight the importance of considering not only fluoride content but also physicochemical properties such as viscosity in dentifrice formulations for effective fluoride bioavailability.

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ABSTRACT Objective: To compare optical, morphological, and physicochemical characteristics of whitening and conventional toothpaste. Material and Methods: The following groups were established: G1: Colgate Máxima Proteção; G2: Closeup White Now; G3: Sorriso Xtreme White 4D; G4: Colgate Luminous White; G5: Closeup Extra Whitening; G6: Oral-B Complete; G7: Oral-B 3D White; G8: Sensodyne Whitening. Scanning Electron Microscopy (SEM) with an X-Ray Energy-Dispersive Spectrometer (EDS) was used to characterize the morphology of the abrasive particles. Images were adjusted by spectral-domain Optical Coherence tomography (OCT) from each toothpaste to characterize the different phases present in the samples. Images of different toothpastes were also compared using an optical microscope (OM). Physical-chemical analysis was performed using Fourier Transform Infrared Spectroscopy (FTIR) to characterize the main components in each toothpaste analyzed. Results: The FTIR analysis showed a high content of silica and calcium carbonate as abrasive agents in toothpastes, especially silica in whitening toothpastes. OCT demonstrated the presence of reflective particles in G2, G4, and G7. SEM with EDS confirmed the high content of large silica (abrasive) particles in all whitening toothpastes except G5. Conclusion: All analyses revealed the absence of whitening agents in the composition of the whitening toothpastes and a significant amount of abrasives, such as silica and reflective particles, which are mainly responsible for the apparent whitening effect on the tooth structure.

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ABSTRACT Objective: To investigate the antifungal and antibiofilm action of hydroethanolic extract of Spondias monbim L. and the tannin, flavonoid, and phenolic acid fractions against fungi of the Candida genus, being of clinical importance. Material and Methods: the minimum inhibitory concentration was determined using disks and the broth microdilution technique, determination of the fungal death curve, and antibiofilm activity of the fractions against C. albicans, C. tropicalis, C. Krusei, and C. Glabrata fungi using Nystatin (100,000 IU) in triplicate as a positive control. Results: Both the hydroethanolic extract of Spondias mombin L. and its fractions exhibited antifungal and antibiofilm activities. However, Spondias mombin L. demonstrated superior activity at higher concentrations (500 μg/mL and 250 μg/mL) compared to its fractions. Compared with the control group (Nystatin 100,000 IU), the tested substances showed inferior results against the evaluated fungi. Conclusion: The Spondias monbim L. extract displayed antifungal activity against all tested microorganisms, except Candida krusei, and exhibited antibiofilm activity against at least one Candida species. Despite its efficacy, the results were inferior to those obtained with the control group.

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ABSTRACT Objective: To determine the attitudes towards blind and deaf persons and experience-related factors in a sample of Chilean dental students. Material and Methods: This cross-sectional study involved dental students from one Chilean university. Data were collected through a survey, including sex, course, acquaintance with disabilities, training on disability, and healthcare delivery to people with disabilities (PwD), and attitudes were measured using the Chilean validated Multidimensional Attitudes Scale (MAS). Data analysis involved descriptive statistics, internal consistency, and comparative analyses. Results: 311 dental students completed the survey. The Cronbach's alpha coefficients indicated good internal consistency (>0.7) for the MAS scales and their dimensions. Attitudes towards deaf and blind individuals were generally positive (<2.5 points), except for the calm dimension, which showed a tendency towards negative attitudes (>3.5 points) across most groups. Students with cognitive disability connections scored higher (>0.5 points) than those with sensory disabilities. Conclusion: Chilean dental students' attitudes towards blind and deaf individuals showed an overall positive inclination, except in the calm dimension.

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ABSTRACT Objective: To investigate changes in the quality of life of patients undergoing hemodialysis. Material and Methods: A longitudinal cohort study was conducted with 226 patients undergoing hemodialysis at two hospitals in Campina Grande, Paraíba, Brazil. Patients were clinically examined for dental caries experience (number of decayed, missing, and filled teeth - DMFT) and asked to complete a socioeconomic and demographic questionnaire. The Short Form Health Survey (SF-36) and Oral Health Impact Profile-14 (OHIP-14) questionnaires were used to assess general health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL), respectively. After 3 years, patients were contacted again to participate in the research. The Wilcoxon test was used to compare OHIP-14 and SF-36 scores between the initial and final assessments. Results: The comparison of the SF-36 and OHIP-14 scores obtained at the beginning and end of the study revealed statistically significant differences in all dimensions of both questionnaires. Conclusion: The OHRQoL of patients undergoing hemodialysis worsened after 3 years of follow-up; HRQoL improved regarding pain, vitality, limitations by social aspects, limitations by emotional aspects, and worsened regarding functional capacity and limitations by physical aspects.

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ABSTRACT Objective: To analyze the number of dental implants performed at dental specialty centers of the Unified Health System (SUS) between 2010 and 2020, in the Brazilian macro-regions. Material and Methods: A retrospective, quantitative, longitudinal study was conducted using publicly available data from the DATASUS/TABNET platform. The total number of annual dental implants was calculated by macro-region. The Kruskal-Wallis and Mann-Whitney nonparametric tests were applied, with 95% confidence intervals and a significance level of 5%. Results: A total of 146,875 dental implant procedures were performed from 2010 to 2020. When comparing regions, the South performed 88,034 (59.94%) procedures, while the North performed 1,173 (0.80%; p < 0.0001). The South region showed statistical significance compared with Central-West (p = 0.0019), Northeast (p = 0.041), and Southeast regions (p = 0.0006). Annual comparisons of total procedures between regions indicated a statistical significance (p < 0.05) for dental implants. Also, statistical significances were observed between 2010 vs. 2016 (p = 0.0476), 2010 vs. 2017 and 2010 vs. 2018 (p = 0.0079), 2010 vs. 2019 and 2010 vs. 2020 (p = 0.0476), 2011 vs. 2017 (p = 0.0159), and 2012 vs. 2017 and 2017 vs. 2020 (p = 0.0317). Conclusion: Therefore, differences in the number of dental implants across regions may be associated with barriers to access or the unavailability of services.

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ABSTRACT Objective: To identify the factors associated with the resolution of endodontic treatments in Brazilian municipalities with Brazilian Dental Specialty Centers (CEO). Material and Methods: Ecological study with 684 municipalities participating in the second cycle of the National Program for Improving Access and Quality of Specialty Dental Centers (PMAQ‑CEO) in 2018. Data were obtained from the health information systems of the Brazilian Unified Health System (SUS), the PMAQ-CEO, and additional sources. The dependent variable, resolution, was the ratio of completed endodontic treatments to endodontic access procedures. For the bivariate analysis, Pearson's chi-square test was applied, considering contextual and health system-related municipal factors as independent variables. These included the Municipal Human Development Index (MHDI), resident population size, national macro-region, dental insurance coverage, oral health team coverage, number of dentists affiliated with the SUS, coverage of initial dental consultations, existence of an Urgent Care Center, number of CEO, and PMAQ-CEO certification. Multivariate analysis was performed using ordinal logistic regression, adopting a two-level hierarchical model. Results: The median of the dependent variable was 0.33; that is, for every 10 teeth opened for pain relief due to deep dental caries, approximately 3 teeth had completed endodontic treatment. The adjusted analysis showed greater chance of resolution in municipalities with the following characteristics: Northeastern region (OR=1.9; 1.1-3.4); medium population size (OR=2.0; 104-2.9); second HDI-M quartile (OR=2.5; 1.6-4.0); lower dental plan coverage (OR=2.4; 1.5-4.0); classified as good, very good or excellent in the PMAQ-CEO certification (OR=1.4; 1.1-1.9). Conclusion: There was low resolution in endodontic treatments performed in SUS. Municipalities of both small and large sizes demonstrate greater fragility in care continuity, as reflected in a low proportion of completed endodontic treatments within the SUS.

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ABSTRACT Objective: To determine the percentage of families who have had multiple children receive dental treatment under dental general anesthesia (DGA), as well as the factors associated with repeated DGA within families. Material and Methods: A cross-sectional study was conducted among 264 patients who visited for treatment under GA at the King Abdullah Specialized Children's Hospital in Riyadh, Saudi Arabia. A self-administered questionnaire was used to collect data on the research question. Descriptive analysis was performed to assess the prevalence of recurrent dental GA, and linear logistic regression was used to identify the demographic factors associated with the higher prevalence. Results: Most participants (94.7%) lived in a two-parent household. Around 32.95% of families had at least three children, and 9.9% had seven or more. A prevalence of 24.6% was observed among the siblings for dental treatment under general anesthesia. The number of children in a family was statistically significant with a negative association (OR=0.084; p=0.001). Conclusion: A substantial number of parents reported seeking dental care only during emergencies, indicating limited awareness of routine preventive practices. These findings highlight the need for family-centered oral health education to reduce the risk of recurrent dental general anesthesia (DGA) among siblings.

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ABSTRACT Objective: To evaluate the effect of different prophylaxis systems on the surface of sound enamel and in induced white spot lesions using confocal microscopy analysis. Material and Methods: 40 specimens were obtained from sound premolars, and the buccal surface was divided into two parts: sound enamel and with an induced white spot lesion. The specimens were randomly divided into 4 groups (n=10/group): Group I: ClinproTM Prophy Paste (Perlite Particles); Group II: Extra-thin Pumice Stone; Group III: ClinproTM Prophy Powder (Glycine Amino Acid Powder); and Group IV: Sodium Bicarbonate Jet Powder. The specimens were analyzed by a confocal laser scanning microscope for surface roughness, preand post-prophylaxis. Data were analyzed by T-test and ANOVA (α= 0,05%). Results: Confocal microscopy analysis showed that ClinproTM Prophy Paste and ClinproTM Prophy Powder did not cause an increase in the surface roughness (p > 0.05). On the other hand, the Sodium Bicarbonate Jet Powder caused a significant increase in the surface roughness only in the induced white spot lesion (p = 0.015). Conclusion: Professional prophylaxis with Sodium Bicarbonate Jet Powder should be avoided in case of white spot lesions, and the ClinproTM Prophy Paste and ClinproTM Prophy Powder seem to be a good option for professional dental prophylaxis, especially in these cases.

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ABSTRACT Objective: To compare the colour variation of the composite resins Forma, Z350XT, and Vittra APS at different exposure times in tea and chicha de jora solutions, and with different polishing techniques. Material and Methods: In this in vitro experimental study, the sample consisted of 90 resin discs, 30 of the Forma brand [15 with CP and 15 with CPG, divided into 3 subgroups of 5 each: Tea subgroup, Chicha de Jora subgroup, and Control group (saline solution)], 30 of the Filtek Z350 XT (15 with CP and 15 with CPG), and 30 of the Vittra APS brand (15 with CP and 15 with CPG), similarly divided into 3 subgroups. Results: A significant colour variation was found in the Forma, Z350 XT, and Vittra APS resins with the polishing techniques, pigmenting solutions, and at different times: 7 days (p<0.05), 14 days (p<0.05), 21 days (p<0.05), and 28 days (p<0.05). Conclusion: All resins showed colour changes due to the pigments, with Z350 XT showing the least variation in tea and chicha de jora with the Sof-Lex disc technique plus glycerine at 7, 14, 21, and 28 days.

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ABSTRACT Objective: To assess the relationship between salivary pH variation - measured before and after toothbrushing - and the presence of dental caries in children aged 0-12 years with and without cleft lip and palate (CL/P) in Lima, Peru. Material and Methods: This analytical and longitudinal study included 104 children, of whom 65 had CL/P and 39 did not. Salivary pH was measured using MQuant® pH-indicator strips, before and after oral hygiene with a fluoridated toothbrush and toothpaste Dentito®. Additionally, the Decayed, Missing, and Filled Permanent (DMFT) Teeth/decayed, extracted, and filled primary teeth index (dmft) was determined through an odontogram. Results: Significant differences in preand post-brushing salivary pH were observed in both groups (p < 0.001), with greater variation among children with CL/P. However, no significant relationship was found between salivary pH variation and the presence of dental caries in either the CL/P group (p=0.718) or the non-CL/P group (p=0.726). Conclusion: Children with cleft lip and palate exhibited a significantly greater variation in salivary pH before and after toothbrushing compared with children without cleft lip and palate; this variation was not found to be associated with the presence of dental caries.

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ABSTRACT Objective: To investigate factors influencing the occurrence of linear gingival erythema (LGE) in people living with HIV (PLHIV). Material and Methods: A cross-sectional study was conducted at the Dental Hospital of Sultan Agung, Central Java, Indonesia. PLHIV who provided informed consent underwent oral clinical examination and history taking. Inclusion criteria included the presence of well-demarcated, band-like erythema along the gingival margin. Blood samples were collected to assess CD4 cell counts, while mucosal swabs were cultured on Sabouraud Dextrose agar to identify Candida spp. Multivariate analysis was performed using logistic regression with a 95% confidence interval. Results: A total of 91 participants were examined, and LGE was identified in 35.2% of cases. Mycological analysis revealed that 33% tested positive for Candida spp. Multivariate analysis showed prevalence ratios for gender (PR = 1.44, p=0.423), smoking (PR = 0.432, p=0.314), alcohol (PR = 0.000, p=1.000), ARV duration (PR = 0.962, p=0.49), CD4 count (PR = 0.999, p=0.587), CFU Candida spp. (PR = 1.000, p=0.528), Candida spp. presence (PR = 0.638, p=0.182), and fungal burden (PR = 0.713, p=0.232). Conclusion: The presence of linear gingival erythema in people living with HIV was not significantly associated with gender, lifestyle factors, antiretroviral therapy duration, CD4 count, or Candida spp. colonization.

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ABSTRACT Objective: To classify samples based on caries lesions, restorations, and structural anomalies to facilitate research sample selection and analyze potential oral health patterns. Material and Methods: Two undergraduate researchers conducted a visual inspection to evaluate teeth by predetermined characteristics. Teeth were classified by anatomical position for caries lesions, resin restorations, and structural anomalies using binary classification (present/absent). Data were analysed using Excel formulas to calculate prevalence rates by dental category. Results: Among 9,536 teeth analysed, caries lesions were reported most frequently in upper first molars (46.4%) and lower second molars (70.6%). Restoration prevalence was highest among upper central incisors (40.8%). Analysis indicated that 22.8% of the included sample exhibited caries lesions, 15.7% had restorations, and 3.7% presented structural anomalies. Multiple surface analyses revealed higher caries lesions and restorations in anterior teeth. Anomalies classification showed a predominance of size and morphology, such as microdontia and root dilacerations, compared to structural defects like hypercementosis and hypomineralization. Conclusion: A significant prevalence of dental caries and restorations in the upper and lower anterior teeth and canines, with first molar teeth showing higher caries and anomalies than second molars. Findings emphasize the need for enhanced public oral health strategies focused on caries prevention through educational initiatives.

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ABSTRACT Objective: To evaluate the effect of mouth breathing on sleep quality and oxygen saturation in pediatric patients aged 6-12 years. Material and Methods: A cross-sectional observational study was done on 120 children recruited from the pediatric outpatient department. Based on clinical evaluation and parental history, participants were separated into 2 groups: mouth breathers (n=60) and nasal breathers (control group, n=60). Sleep quality was assessed using a validated Pediatric Sleep Questionnaire (PSQ), and overnight oxygen saturation was recorded with pulse oximetry. Data were analyzed using SPSS version 24.0, applying independent t-tests and Pearson’s correlation coefficient, with significance set at p<0.05. Results: Children in the mouth-breathing group exhibited significantly poorer sleep quality, with mean PSQ scores of 6.8 ± 1.1 compared to 2.3 ± 0.9 in the nasal-breathing group (p<0.01). Mean overnight oxygen saturation was 93.6% ± 2.4 in mouth breathers versus 96.8% ± 1.8 in controls (p<0.01). A moderate positive correlation was observed between reduced oxygen saturation and deteriorated sleep quality (r = 0.64, p<0.01). Conclusion: Mouth breathing in children is significantly associated with decreased sleep quality and reduced oxygen saturation during sleep. These findings highlight the importance of early identification and management of mouth breathing habits to mitigate their adverse effects on pediatric sleep and respiratory health.

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ABSTRACT Objective: To evaluate the pattern of traumatic dental injuries (TDI) among Nigerian children. Material and Methods: This was a cross-sectional prospective study in which data were collected from 66 children aged 1 to 16 years who presented at the two tertiary dental centres. Data on age, sex, cause and place of trauma, time of presentation and reason for delay in presentation to the dental clinic, involved tooth, and radiographic findings were collected from July 2021 to May 2023 using a questionnaire. Garcia-Godoy’s classification was used to record the type of TDI. Chi-square test was conducted and factors associated with immediate presentation were considered significant when p < 0.05. Results: More males (57.6%) than females (42.4%) had TDI. Many children (62.1%) sustained TDI at home and falls (77.3%) were the major cause. Only nine (13.6%) children presented within 24 hours following the trauma. There was a significant association between age (p=0.03) and immediate dental visit. Conclusion: Traumatic dental injuries occurred more in boys and at home. Fall was the commonest cause, and few presented within 24 hours following the trauma. Age was a predictor of immediate presentation to the dental clinic.

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ABSTRACT Objective: To describe the effect of myofunctional speech therapy performed after lingual frenectomy in infants. Material and Methods: It is an observational and analytical case series study involving infants aged 0 to 4 months, exclusively breastfed, diagnosed with ankyloglossia, and referred for frenectomy. Seventy-two hours after surgery, the infants received orofacial myofunctional therapy on the tongue, without manipulation of the surgical wound, for four weeks. The caregivers received training to perform the exercises at home three times daily. Thirty days after the last session, the infants underwent a reassessment using the same protocol as the initial assessment. Those with unsatisfactory healing or functional impact were referred for further surgical intervention. Results: Sixty-five of the 114 evaluated infants were diagnosed with ankyloglossia and referred for frenectomy. Twenty infants were selected, but only 12 met all the inclusion criteria for analysis. The initial assessment using the lingual frenulum evaluation protocol for infants showed a median of 13.5 (q1 = 13, q3 = 14.75), which decreased to 8 (q1 = 7.25, q3 = 9.75) after the intervention (p = 0.002). Fibrosis or re-adhesion cases did not occur, and no infant scored above 10 during reassessment. The findings demonstrated a significant improvement in breastfeeding complaints. Conclusion: The orofacial myofunctional therapy was effective in oromyofacial rehabilitation after frenectomy, improving tongue mobility and strength while optimizing functions such as sucking and swallowing, thereby benefiting breastfeeding. The findings suggest that orofacial myofunctional therapy supports the recovery of stomatognathic functions and promotes adequate healing.

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ABSTRACT Objective: To evaluate the knowledge of Iranian dentists regarding bisphosphonate-related osteonecrosis of the jaw (BRONJ) etiology, risk assessment, and clinical management, aiming to identify gaps in knowledge and inform targeted educational interventions. Material and Methods: This analytical cross-sectional study was performed on 2000 dentists whose list was obtained from the Medical Council Organization. A questionnaire, whose validity and reliability were ensured, containing demographic questions (age, sex, etc.), general questions, and questions about bisphosphonate use, was provided to individuals. The data were analyzed using the t-test, Mann-Whitney test, and Chi-Square test. The level of significance was p < 0.05. Results: Of the participants, 56% were male, and the mean age was 32.5±5.6 and and 51.5% had less than 5 years of professional experience. Approximately 27.5% of dentists were familiar with the term MRONJ. The mean knowledge score was 10.4 ± 2.1, indicating poor dentists' knowledge. There was no significant difference between knowledge score, age, sex, working hours, and work experience. Conclusion: Dentists' knowledge of BRONJ is inadequate. A patient with bisphosphonate-related osteonecrosis can be a significant challenge for the dentist, and sufficient understanding of the signs, treatments, and management of these patients is necessary for any dentist.

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ABSTRACT Objective: To evaluate the changes in the color of dental filling materials after being immersed in pediatric syrups for a period of time. Material and Methods: This study had a quasi-experimental design. Three restorative materials were employed: a conventional self-curing ionomer cement, a light-curing ionomer cement, and a light-curing composite resin. Forty disc-shaped samples of each material were prepared and randomly assigned to 6 subgroups (n=20). The samples were immersed in 2 pediatric drugs: paracetamol and ferrous sulfate, for 2 min once a day for 28 days. Color stability evaluations were performed at 7, 14, 21 and 28 days. The color variation of the materials was evaluated using a digital colorimeter. The Kruskal-Wallis test was used for intraand inter-group comparisons. Results: In all subgroups, the total color difference values increased significantly from the first evaluation to day 28 (p < 0.05). Conclusion: Long-term use of pediatric syrups may affect the color stability of restorative materials. Among pediatric syrups, the composite resin showed the least color variation when immersed in paracetamol and ferrous sulfate compared to the ionomer materials.

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ABSTRACT Objective: To assess trabecular bone structural complexity in children with different sunlight exposure levels using panoramic radiographs (PR). Fractal dimension (FD) and pixel intensity (PI) were evaluated. Material and Methods: Panoramic radiographs of 120 children aged 6 to 9 years were analyzed, divided equally into groups with more (n=60) and less (n=60) sunlight exposure. Three regions of interest (ROI) on each radiograph were analyzed using ImageJ software. FD was calculated by the box-counting method, and PI values were measured. Data were compared between exposure groups and genders using Kruskal-Wallis and t-tests (p<0.05). Results: Children with less sunlight exposure showed significantly higher FD values (3.60 ± 0.29) than those with more exposure (3.31 ± 0.29) (p<0.001), notably in ROI2 and ROI3. Overall, PI values did not differ between exposure groups (p=0.735) or genders (p=0.553). Conclusion: Lower sunlight exposure in children was associated with increased trabecular bone structural complexity, indicated by higher fractal dimension values. Routine panoramic radiographs analyzed using fractal dimension and pixel-intensity measurements may help dentists detect early trabecular bone changes in children.

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ABSTRACT Objective: To assess dentists' knowledge of sustainable dental practices, focusing on environmental regulations, dental waste management, and proper disposal. It also to examine the relationship between dentists' sociodemographic characteristics and their knowledge of environmental laws in Brazil. Material and Methods: A cross-sectional study was conducted with 90 dentists, achieving a 76.9% response rate. Participants completed a structured online questionnaire. The study employed a non-probabilistic snowball sampling strategy, which may limit generalizability. Descriptive statistics were performed, followed by chi-squared and Fisher’s exact tests. Logistic regression analysis explored associations between knowledge and demographic variables. Results: Most participants were female, without a dental specialty, and trained in southern Brazil. Approximately half demonstrated knowledge of environmental legislation and waste management. Male dentists showed lower odds of regarding environmental regulations, suggesting a potential gender-related knowledge disparity (OR = 0.26, 95% CI: 0.10-0.69, p = 0.007). Conclusion: Although the findings indicate some level of awareness, significant gaps in knowledge and training persist - particularly among male dentists. These results reinforce the importance of integrating environmental sustainability into both undergraduate curricula and continuing dental education. Curricular reforms and professional development initiatives are essential to promote eco-conscious practices in dentistry.

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ABSTRACT Objective: To evaluate the clinical changes and primary caregivers' perceptions regarding the habitual posture of the lips and tongue in children with Trisomy 21 (T21) after using the Palatal Memory Plate (PMP). Material and Methods: The sample consisted of children diagnosed with T21 and their respective caregivers. Data collection included demographic and clinical questionnaires, extra and intraoral physical examinations, questionnaires assessing primary caregivers' perceptions of habitual lip and tongue posture, video recordings evaluating habitual lip and tongue posture, scanning, and PMP fabrication. After four months of PMP use, the questionnaires and video were repeated. Results: Fifteen children were evaluated, aged 8-43 months. Initially, 60% of caregivers observed an "open lips" posture, which decreased to 40% showing a "semi-open lips" posture. Tongue posture also improved, with "between the teeth" decreasing from 40% to 27%, and "mouth floor " becoming prevalent in 73%. The median time for the "open lips" category decreased from 92 seconds to 53 seconds, while "mouth floor " increased from 62 seconds to 86 seconds. Conclusion: The palatal memory plate effectively improves habitual lip and tongue posture in children with Trisomy 21. Both caregivers and professionals observed the benefits of the palatal memory plate.

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ABSTRACT Objective: To map and analyze scientific research on pain in endodontics through bibliometric and altmetric analysis. Material and Methods: An electronic search was conducted in the Web of Science database in August 2024. Two researchers selected studies and extracted key data, including authors, year, study design, journal, institution, country/continent, research topic, keywords, and citation count/density. Bibliometric graphical networks were generated using VOSviewer software, and altmetric analysis was performed using Dimensions. Results: A total of 706 studies published between 1963 and 2024 were analyzed. The most-cited article received 442 citations. Most studies were published in 2021 (n=90). The USA contributed the most studies (n=162). Al Reader was identified as the most prolific author (n=30). Clinical trials were the most common study design (n=464), with a predominance of investigations related to the use of systemic medications for pain control (n=122). Graphical network analysis revealed substantial collaboration among authors, while Dimensions highlighted notable interest in this topic on social media platforms, particularly Mendeley and X. Conclusion: The findings highlight a strong research focus on pain in endodontics, primarily on investigating systemic medications for pain control. However, studies addressing specific topics, such as pain in regenerative endodontic procedures, remain scarce. Clinical trials, which offer higher levels of evidence, currently have the greatest influence in this field.

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ABSTRACT Objective: To investigate the antimicrobial activity, surface roughness, and biocompatibility of conventional glass ionomer cement (GIC) modified with 1% graphene oxide (GO). Material and Methods: GIC samples (8 mm x 1 mm discs) were prepared with and without 1% GO incorporated into the powder via mechanical agitation. The samples were exposed to Streptococcus mutans UA 159 suspensions (OD600: 1.6 ± 0.05, diluted 1:500 in BHI + 1% glucose medium) for 24 hours to evaluate their antimicrobial activity. Surface roughness was measured before and after biofilm formation. Biocompatibility was investigated by inoculating polyethylene tube implants with GIC or GIC+GO on the backs of Wistar rats. Results: Scanning Electron Microscopy (SEM) and Energy Dispersive Spectroscopy (EDS) confirmed the presence of GO in the GIC. The materials did not alter biofilm formation or the acidification profiles of the supernatant. However, GIC+GO exhibited significantly lower surface roughness and greater resistance to biofilm-induced wear compared to unmodified GIC. Histological analysis revealed increased fibroblast and blood capillary proliferation in the GIC+GO group. Conclusion: The incorporation of 1% graphene oxide improved the surface stability and biocompatibility of glass ionomer cement under the tested conditions. These findings suggest potential benefits for restorative applications. Nonetheless, further studies involving multispecies biofilms and long-term evaluations are needed to confirm these effects and support clinical translation.

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ABSTRACT Objective: To evaluate the effectiveness of high-volume irrigation and irrigant activation as methods to remove obturation material during endodontic retreatment in mesial canals of mandibular molars with isthmuses. Material and Methods: After micro-CT scanning, 30 mandibular molars were accessed, prepared and obturated (AH Plus/Gutta-percha). After 60 days, the samples were retreated using Reciproc R25/R40 instruments with a 2.5% sodium hypochlorite (NaOCl). Samples were scanned with micro-CT for quantification of residual obturation material (ROM) and divided into three groups based on final irrigation protocols (n=10): conventional irrigation (CI), passive ultrasonic irrigation (PUI) and continuous ultrasonic irrigation (CUI). 60 mL of NaOCl was used for each canal, divided into aliquots of 20 mL in the PUI/CUI groups according to the activation cycles. The samples were re-scanned with micro-CT, allowing for a new quantification of ROM. Normality testing revealed a non-parametric distribution for ROM values before/after the protocols. The Wilcoxon test indicated significant intragroup differences for ROM reduction in all three groups (p<0.05). Results: Regarding the percentage reduction by the protocols, median values of 35.44% (CUI), 32.37% (PUI), and 26.03% (CI) were found; the Kruskal-Wallis test showed no significant differences between the groups (p>0.05). Conclusion: The three proposed protocols were effective in removing ROM during retreatment; however, ultrasonic agitation did not affect this removal.

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ABSTRACT Objective: To assess whether the restorative treatment decisions and knowledge of dentists and dental students in a state in northeastern Brazil agree with the International Caries Consensus Collaboration (ICCC) recommendations. Material and Methods: This is a descriptive cross-sectional study where an online questionnaire was administered to dentists and dental undergraduate students. The questionnaire consisted of four clinical cases to assess the restorative clinical decision and four statements regarding the restorative clinical decision to assess agreement with the ICCC. Statistical tests were carried out using Jamovi software to compare the data of the participants, such as profile, training institution, training time, participation in Operative Dentistry projects, and specialization, with a 5% significance level. Results: A total of 119 dentists and 183 students were assessed. Most dentists and students showed conservative clinical decisions, but those from public teaching institutions were more conservative (p<0.05). Students were more in agreement with the ICCC, while dentists with longer training times were less in agreement with the consensus (p<0.001). Conclusion: Dentists and students adopted a conservative approach to the management of dental caries lesions, especially those from public institutions. Students and dentists with shorter training times are more in agreement with the ICCC.

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ABSTRACT Objective: To analyze pregnant women's perception regarding prenatal dental care in Primary Care within a health territory in the municipality of Vitória, Brazil. Material and Methods: This is a qualitative research conducted at the Basic Health Unit. Semi-structured interviews and secondary data from medical records of the Rede Bem Estar were used. Data analysis followed Bardin's content analysis approach. Results: Seven interviews were conducted with pregnant women; three received prenatal dental care. During this period, the municipality's coverage was 36%, below the target of 60%. Although pregnant women recognized the importance of oral health during pregnancy, factors such as limited appointment availability and insufficient information contributed to low service uptake. Among those who received prenatal dental care, all reported being satisfied with the care provided by the healthcare team. Conclusion: Despite four pregnant women not having undergone prenatal dental consultations, all demonstrated understanding of the importance of this care during pregnancy, especially for the baby's health. Additionally, all positively evaluated the care provided by the healthcare team.

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ABSTRACT Objective: To use digital radiographs for the morphometric evaluation of the mandibular ramus in gender identification. Material and Methods: For the current cross-sectional investigation, 100 randomly selected panoramic images of patients were included. The sample selection was based on purposive sampling. At two-day intervals, a trained dental radiologist evaluated the mandibular ramus morphometrically (minimum and maximum ramus breadths, projective height of the ramus, condylar height, coronoid height, gonial angle, and bigonial width). The mean of the two measurements was used. The data were analyzed using discriminant function analysis and an independent t-test, with p<0.05 as the significance level. Results: Among participants, 46% were men and 54% were women. Males were discovered to have a significantly greater mean maximum ramus height and projected maximum ramus height, whereas females were noted to have a slightly higher maximum ramus breadth. The overall accuracy of using the mandibular ramus to determine sex was 76%; however, the accuracy for identifying males and females was 78.1% and 74.1%, respectively. Conclusion: The mandibular ramus is resistant to injury and disintegration processes; it can be used as a useful tool in gender assessment.

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ABSTRACT Objective: To investigate the prevalence of early childhood caries (ECC) and its association with demographic, socioeconomic, behavioral, and psychosocial factors in preschool children aged 0-5 years old in Brazil. Material and Methods: This cross-sectional study was conducted in 2019 in Santa Maria, a Southern city in Brazil. 545 children aged 0-5 years old were evaluated for ECC through the decayed, missing, and filled deciduous teeth dmft index in 15 health centres. Demographic, socioeconomic, behavioural, and psychosocial characteristics were measured through a questionnaire applied to parents. Poisson regression models with a hierarchical approach, accounting for sample weights, were used to estimate the association between children's dental caries and predictor variables. Results: 545 of the 653 children invited to participate in the study were evaluated (response rate of 83.5%). The prevalence of ECC was 19.4% (dmft ≥ 1). Living only with the father or another family member, having gone to the dentist before or after the first year of life, having routine exams as the reason for the last dental attendance, and the lack of paternal perception regarding the child's need for dental treatment showed a significant association with ECC (p<0.05). Conclusion: The prevalence of ECC remains significantly high among children from an emerging country. Demographic, socioeconomic, behavioral, and psychosocial factors continue to influence the development and establishment of the disease.

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ABSTRACT Objective: To assess the outcomes of mouth protector use in preventing further tooth injuries. Material and Methods: Participants were selected from those referred for care at the School of Dentistry, Federal University of Juiz de Fora, Brazil. The children were evaluated by dentists who provided necessary treatment after dental trauma incidents, including clinical examinations, radiographs, treatment of affected teeth, and impressions, fitting, and periodic adjustments of the mouth protector. To fabricate, patients first underwent an intraoral scan, which created a three-dimensional image of the dental arches. Based on this scan, the mouthguards were made from silicone with a thickness of 5 mm and delivered to the patients within one week. After adjustments were made using Maxicut and Minicut burs to ensure optimal fit. Results: Four children with varying histories of tooth injuries were followed. In three cases, no new trauma was reported after the introduction of a mouth protector. In the fourth case, a new trauma occurred when the mouth protector was not being used at the time of the incident. Despite initial adaptation challenges, most patients reported good acceptance and consistent use during sports activities. Conclusion: These cases reinforce the importance of mouth protectors as a preventive tool for children at high risk of tooth injuries and highlight the need for ongoing awareness to ensure regular use.

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ABSTRACT Objective: To assess the reproducibility of two clinical approaches based on visual criteria for evaluation of carious lesions around the restorations in primary teeth and the impact on treatment decisions. Material and Methods: Twenty-five photographs of resin composite restorations on primary teeth, including all scores of the two criteria, were selected. Restorations’ evaluations were performed by five specialists in Pediatric Dentistry. All examiners underwent training to use both criteria. First, the evaluations were performed based on FDI criteria, and 1 month later, with CARS criteria. The consensus of two benchmark examiners was considered to be the reference standard. Kappa statistics were used to determine inter-examiner reliability, considering the scores of both criteria. The Wilcoxon test was used to compare the treatment decision with two criteria. The chi-square test was used to compare the frequencies of true positives, true negatives, false positives, and false negatives across two criteria. The significance level was set at 5%. Results: Inter-examiner reliability ranged from 0.53 to 0.63 and 0.54 to 0.71 when using FDI and CARS systems, respectively. A higher frequency of false negative results was observed when using the FDI criteria, while the CARS system leads to more true positive results. Conclusion: The CARS and FDI criteria present moderate to good inter-examiner reproducibility in the photographic evaluation of resin composite restorations in primary teeth. However, the use of the CARS system results in more assertive decision-making.

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ABSTRACT Objective: To assess the prevalence of oral health problems and associated factors among Brazilian homeless. Material and Methods: This cross-sectional study included 133 participants aged 18 years or older, both sexes, from a medium-sized city in the Northeastern region of Brazil. Sociodemographic and behavioral data were obtained using a structured questionnaire administered through interviews. The DMFT index was used to diagnose dental caries; the PUFA index was used to assess the consequences of untreated caries; and the Community Periodontal Index and the Periodontal Attachment Loss Index were used to assess periodontal alterations. Possible associations between dental caries, its consequences, and periodontal disease, and the independent variables were verified using Pearson's Chi-square and Fisher's exact tests, with a significance level of 5%. Results: Regarding dental services, 75.9% reported having no access. All participants reported experiencing dental caries and periodontal changes. The prevalence of dental caries and the consequences of untreated caries were 87.2% and 83.9%, respectively. Dental calculus was the most prevalent among the identified periodontal conditions (91.0%), followed by bleeding on probing (60.9%). Dental caries was associated with self-perception need for treatment (p=0.028) and the presence of fractured teeth (p<0.001). Sex, age group, skin color, oral hygiene, and self-perception of gingival bleeding/edema and tooth mobility were associated with distinct periodontal alterations. Conclusion: A high prevalence of oral health problems was identified, with dental caries and periodontal diseases being the most prominent. Additionally, demographic, behavioral, and self-perception factors related to oral health were associated with these outcomes.

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ABSTRACT Objective: To compare the amount of debris extruded apically between various root canal instrumentation techniques. Material and Methods: 60 extracted human premolars were randomly divided into 4 groups (n= 15). The first group was instrumented with manual stainless steel instrumentation (ISO Manual Files). The second group was instrumented with Pro-Taper Manual Files. The third group was instrumented with Pro-Taper Power-driven Files "UDG". The Fourth Group was instrumented with Pro-Taper Power-driven Files "Fanta". Eppendorf tubes were numbered and used for each root to collect apically extruded debris during root canal instrumentation. The Eppendorf tubes were weighed 3 times before and 3 times after instrumentation to calculate the average amount of apically extruded debris and to compare results between the 4 groups. Results: There was a significant difference in the amount of apical extrusion of debris (g) between all groups (p<0.05). The amount of apically extruded debris in root canals instrumented by power-driven instrumentation techniques was significantly less than in root canals instrumented by manual instrumentation techniques. Conclusion: There was a significant difference in the amount of apical debris extrusion between various root canal instrumentation techniques.

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ABSTRACT Objective: To measure the linear dimensions of the Sella Turcica (ST) and assess its morphological characteristics across different age groups, genders, and skeletal malocclusion classes within a Cambodian population sample. Material and Methods: A total of 150 archived cephalometric radiographs comprising 50 each from skeletal Class I, Class II, and Class III malocclusion groups were retrospectively selected from patient records at the UP Dental Hospital and traced to measure the ANB angle (A point-Nasion-B point), ST length, depth, anteroposterior diameter, and Cp-Ca distance in millimeters. Results: Age showed a significant positive relationship with the ANB angle (r = 0.415, p < 0.001), AP diameter (r = 0.314, p < 0.001), and Cp-Ca (r = 0.269, p = 0.001). Females had a higher mean ANB angle and depth compared to males, whereas males had a higher mean length, AP diameter, and Cp-Ca compared to females. Class III exhibited significantly lower mean length, AP diameter, and Cp-Ca than Class I and Class II. At the same time, Class II demonstrated a significantly greater mean depth than Class I. Conclusion: This study highlights significant variations in the linear dimensions of the ST across different skeletal malocclusion classes in a Cambodian population. Class III individuals exhibited smaller ST dimensions compared to Class I and II, while Class II showed greater ST depth.

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ABSTRACT Objective: To synthesise and evaluate Vitex negundo-conjugated hydroxyapatite (VN-HAp) as a bioactive material for bone regeneration, particularly in oral squamous cell carcinoma-infiltrated bone, by assessing its physicochemical properties, biomineralization potential, and cytocompatibility. Material and Methods: A VN-HAP solution was prepared, and the in vitro biomineralization of VH-HAP in simulated body fluid solution (SBF) was evaluated in normal and carcinoma-infiltrated bone at 7 and 14-day immersion periods. Comparative surface characterizations and an MTT assay were performed. Results: The SEM and FT-IR spectra confirmed the successful incorporation of Vitex negundo extract into hydroxyapatite (VH-HAP), resulting in a porous structure that enhances in vitro biomineralization. After 7 and 14 days of immersion in SBF, both normal and tumor bone showed increased mineral deposition, confirmed by EDX and SEM analysis. FT-IR spectra highlighted phosphate nucleation. The MTT assay demonstrated 90% and 80% cell viability in normal and tumor bone, respectively, and confocal microscopy showed osteoblast recruitment, suggesting VH-HAP's potential to promote bone regeneration. Conclusion: Vitex negundo-conjugated hydroxyapatite exhibited excellent biomineralization ability and cytocompatibility, demonstrating its potential as a novel herbal-bioceramic composite for bone regeneration, particularly in post-cancer reconstructive applications.

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ABSTRACT Objective: To develop a self-help resource based on Cognitive Behavioral Therapy, investigate the approval of the material by participants, and evaluate its feasibility for clinical use. Material and Methods: The resource was developed through a person-centered qualitative approach and applied in a test with adolescents aged 10 to 16 who presented dental anxiety identified through the Dental Question Anxiety (DAQ). The level of anxiety was measured before and after the end of the treatment, using the Modified Child Dental Anxiety Scale - Faces. Oral health teams answered structured questionnaires about the resource, while the parents' assessment was carried out based on the interpretation of the dialogue with the dentist. Results: In total, 10 adolescent/parent dyads and 13 oral health teams participated. The average score for initial anxiety was 23.0 and 19.33 for follow-up assessments. A reduction in dental anxiety was observed, in addition to good acceptance of the material. Conclusion: The results demonstrate the effectiveness and acceptability of the resource and reinforce the need for a Randomized Clinical Trial.

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ABSTRACT Objective: To assess the association between parental reports of dental caries in preschool children and socioeconomic status, brushing habits, and early introduction of sugary foods. Material and Methods: In this cross-sectional study, parents and guardians of children (n=86) aged less than 5 years completed a questionnaire on sociodemographic, eating, and brushing habits. Results were compared between children with (n=19) and without early childhood caries (n=67) based on parental self-report, between children with or without early introduction of sugar, and in a multiple regression model between dental caries and independent variables with significance in univariate analyses. The significance level was 0.05. Results: Children with reported caries by parents had younger mothers (p=0.049), lower education levels (p=0.02), and lower family incomes (p=0.048). Children with reported caries had earlier introduction (p=0.049) and a higher frequency of sugar consumption (p=0.032). Children who have early introduction of sugar live in families with lower incomes (p=0.0047). The frequency of sugar consumption was associated with reported caries (Coef = 0.3375, p = 0.0001). Conclusion: Preschool children with reported caries were more likely to have worse socioeconomic status, early introduction, and higher frequency of sugar. Preschool children who had an early introduction to sugar were more frequently from families with lower incomes. Children who frequently consume sugar have a 40% higher likelihood of presenting dental caries.

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ABSTRACT Objective: To explore the correlation between dental fluorosis (DF) and intelligence quotient (IQ) in 1063 schoolchildren from two districts in Arequipa, Peru, one located near a mining center. Sociodemographic and contextual variables were also analyzed. Material and Methods: DF was assessed using Dean's index, and IQ was measured with the Toni-2 Test. Maternal education, age, sex, and district of residence were recorded. Fluoride levels in water were determined using ion-selective potentiometry. Statistical analysis included chi-square, Kruskal-Wallis, Spearman's correlation, and multiple linear regression models at a 5% significance level. Results: Most children without or with mild DF exhibited very superior IQ levels, while those with moderate to severe DF had average IQs. In the district near the mining center, higher fluoride levels coincided with average IQ scores and cases of low IQ. In contrast, the district with lower fluoride levels showed a predominance of very superior IQs and no low IQ cases. A weak negative correlation was observed between DF severity and IQ (ρ = -0.131). However, multivariate analysis revealed that maternal education and district of residence had stronger associations with IQ than fluorosis severity. Conclusion: While a slight inverse pattern between DF severity and IQ was observed, the adjusted analysis highlights the greater influence of contextual and sociodemographic factors, suggesting the need for more comprehensive evaluations in future studies.

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ABSTRACT Objective: To evaluate how parental previous dental experiences influence their children's oral health care and dental visits, as well as their expectations regarding sedation methods in pediatric dentistry. Material and Methods: A descriptive cross-sectional study was conducted using an electronic questionnaire that collected personal and socioeconomic data, childhood dental memories, and parental expectations regarding sedation methods. The chi-square and Fisher's exact tests were used for statistical analysis. Results: A total of 347 parents participated in the study. Among them, 88.8% reported having visited the dentist during childhood, and 27.4% experienced trauma during dental care. However, this was not associated with their children's fear of the dentist. Additionally, 34.9% of parents believed their past experiences influenced their children’s dental visits. Furthermore, 47.7% reported that they would allow the dentist to choose the type of sedative. Inhalation sedation with nitrous oxide and oxygen was the least accepted. Conclusion: Parental dental experiences were not linked to the frequency with which they take their children to the dentist. However, their limited knowledge about sedation techniques may impact their acceptance of these methods in behavior management.

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ABSTRACT Objective: To analyze the impact on quality of life related to endodontic treatment by applying the OHIP-14 questionnaire before and after completion of treatment. Material and Methods: This is a longitudinal, prospective, non-controlled "before and after" intervention study that analyzed an initial sample of 312 participants and a final sample of 148 participants. Two questionnaires were used for data collection, one to define the sociodemographic profile of the participants and the Oral Health Impact Profile (OHIP-14) to measure quality of life. The impact at the second stage of the study was compared with that at the first using the nonparametric Wilcoxon test. Results: The impact on quality of life before endodontic treatment was declared by 130 people (87.8%), and the most reported domains were psychological discomfort (75.7%), physical pain (66.9%), and psychological disability (52%). However, after endodontic treatment, only 10 people (6.8%) reported an impact, with the same dimensions being the most prevalent. Comparing impact frequencies, we observed improvements in the indices for all domains of the OHIP-14 instrument and in the overall score. Conclusion: There was a significant reduction in the impact across all OHIP-14 domains analyzed, with a 92.3% reduction in overall impact before and after endodontic treatment, thus confirming the ability of endodontic treatment to improve quality of life.

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ABSTRACT Objective: To evaluate and compare the accuracy of Working Length (WL) determination using two different systems in simulated open apex teeth, employing two irrigants and file sizes. Material and Methods: Twenty-five mandibular premolars were decoronated and apices enlarged to 1.5 mm to simulate open apices. Samples were grouped by file size and irrigant. Group A: Root ZX mini: A1a & A1b- 3% NaOCl + 25K file & 40K file respectively; A1c & A1d: 2% Chlorhexidine + 25K file & 40K file respectively. Group B: Canal Pro CL2i-B1a & B1b: 3% NaOCl+ 25K file & 40K file respectively; B1c & B1d: 2% Chlorhexidine + 25K file & 40K file respectively. The working length was determined, and the mean WL values were statistically analyzed using SPSS 26.0. Independent t-test and the Wilcoxon signed-rank test were used in the study, with p>0.05. Results: No significant difference was found between the subgroups in intragroup and intergroup comparison (p>0.05). Conclusion: Both integrated and electronic apex locators effectively determined working length using different file sizes and irrigants in open apex conditions.

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ABSTRACT Objective: To evaluate the correlation between tongue posture and the Needs Ratio in untreated adults aged 18-25 years with varying sagittal (Class I, II, III) and vertical (hyperdivergent, normodivergent, hypodivergent) skeletal malocclusions, using cone-beam computed tomography (CBCT). Material and Methods: A total of 98 untreated adults aged 18-25 years were classified into skeletal Class I, II, or III malocclusions and further categorized into hyperdivergent, normodivergent, or hypodivergent growth patterns. Tongue posture was assessed at seven angular sectors using CBCT. The Needs Ratio was calculated as the ratio of pharyngeal depth to velar length. Mean values were compared across different skeletal classifications, and correlations between tongue-to-palate distance and the Needs Ratio were analyzed. Results: Class III hyperdivergent individuals demonstrated the highest Needs Ratio (mean: 0.87) and the greatest tongue-to-palate distance in all sectors, especially in posterior regions. In contrast, Class I normodivergent individuals showed the lowest Needs Ratio (mean: 0.71) and the most elevated tongue posture. A moderate positive correlation was identified between increased tongue-to-palate distance and elevated Needs Ratio. Conclusion: Tongue posture is significantly influenced by both sagittal and vertical skeletal morphology. Lower tongue posture increases pharyngeal depth relative to velar length, potentially compromising velopharyngeal closure. Elevated tongue-palate separation may serve as an anatomical indicator of velopharyngeal insufficiency risk, particularly in Class III hyperdivergent individuals.

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ABSTRACT Objective: To report the prevalence of caries and its associated factors in children aged 4 to 6 years isolated on two islands in the state of Pará. Material and Methods: This is a cross-sectional study, involving 170 children from five schools, with clinical examinations based on WHO standards (DMFT and dmft indices) and sociodemographic questionnaires adapted from national surveys, such as SB Brazil. Caries prevalence was calculated as the proportion of children with dmft > 0, expressed as percentages with 95% confidence intervals (95% CI). Bivariate associations between caries prevalence and independent variables were assessed using the chi-square or Fisher's exact tests. Logistic regression was conducted to identify factors associated with toothache. Results: A prevalence of 58.82% for caries was found, with frequent dental pain; associated factors include low income (54.12% with 1-2 minimum wages) and dependence on river transport (74.12%). Logistic regression identified low income (OR = 2.34) and reliance on river transport (OR = 1.89) as significant risk factors. Conclusion: The need for specific interventions, professional training, and recognition of limitations in generalizing to other contexts is highlighted, with the potential to stimulate reflection in similar realities.

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ABSTRACT Objective: To identify characteristics of the work processes of oral health teams (eSB) associated with users’ access to oral health services within primary health care (PHC) in Brazil and its geographic regions, based on data from the 3rd cycle of Brazilian National Program for Improving Primary Care Access and Quality (Programa para Melhoria do Acesso e da Qualidade da Atenção Básica, PMAQ-AB). Material and Methods: This cross-sectional study used data from Module III, which collected users' responses on oral health care, and Module VI, which collected data on the work processes of eSBs. The analysis focused on variables related to "Territorialization and Assigned Population," "Support Matrix," and "Schedule Management and Service Delivery by the Team." Descriptive and inferential analyses were performed using logistic regression (α = 0.05). Results: In Brazil, 40.9% of PHC users reported having access to dental care. Among the regions, the Northeast had the highest proportion of users able to schedule dental appointments (48.4%), while the Southeast had the lowest (33.9%). Several characteristics of eSB work processes were found to influence access to oral health services positively. These include: the eSB being assigned to a single Family Health Team (eFS); the eSB not relying on the Dental Specialty Center for managing complex cases; integration of eSB actions with other services in the territory; assessment of users' health needs and provision of clinical care during the initial encounter; risk/vulnerability-based prioritization of users over first-come, first-served approaches; eSB professionals trained to assess and classify risk and vulnerability; initial dental appointments scheduled at the primary care reception desk; and follow-up appointments scheduled at the end of current consultation. Conclusion: Some aspects of the eSB workflow hinder user access to oral health care, underscoring the need to reorganize processes and fully implement national guidelines to ensure effective service delivery within the PHC framework.

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ABSTRACT Objective: To evaluate the pulp canal obliteration (PCO) frequency in permanent traumatized teeth and the association of PCO with various types of dental trauma and demographic data. Material and Methods: This was an observational study with 287 teeth. The data were obtained from the retrospective analysis of existing clinical records and radiographs to assess the existence of an open or closed apex, the teeth involved, and PCO frequency. Results: The average follow-up period was 35 months. The upper central incisors were the most frequently affected teeth (63.4%), especially in males (59.9%), and the most common traumatic dental injuries (TDIs) involved lateral luxation and avulsion. Females have PCO more frequently (32.4%) and experience mild to moderate TDI at an older age (mean 26 years) than males (mean = 21 years) (p<0.05). An open apex was associated with PCO onset, and injuries to periodontal tissues were 2.5 times more likely to occur and develop into pulp necrosis than trauma to the hard dental tissues (OR=2.56, CI 95%: 1.16-5.65; p=0.02). Conclusion: Pulp canal obliteration is more frequent in 26-year-old female patients, and most likely to occur after mild to moderate traumatic dental injury. The study cohort was composed mainly of teeth with open apices.

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ABSTRACT Objective: To compare the penetration and adaptation of a silver nanocrystal-incorporated pit and fissure sealant with a conventional resin-based sealant using stereomicroscopy and scanning electron microscopy (SEM) analysis. Material and Methods: In this in vitro comparative study, 28 non-carious premolars and molars were divided into two groups (n=14). One group received a conventional sealant and the other a silver nanocrystal-incorporated sealant. All the teeth were sectioned buccolingually, following which one half of each sectioned tooth was used to assess sealant penetration and adaptation using stereomicroscopy, and among the remaining other halves, seven randomly selected samples from each group were evaluated qualitatively under SEM. Results: A statistically significant difference (p=0.002) was observed in the number of resin tags at the fissure base, with the conventional sealant showing superior penetration. SEM images also revealed more resin tag formation in the conventional group. Conclusion: While both sealants showed comparable overall performance, the conventional sealant demonstrated better penetration into fissure bases. However, further research is needed to optimize the physical properties of silver nanocrystal-based sealants.

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ABSTRACT Objective: To evaluate parents' knowledge about emergency management of avulsed teeth. Material and Methods: This cross-sectional study was conducted in Turkey between March and June 2022. A total of 1328 parents aged 18 or older (35.38 ± 8.41 years) with at least one child aged 0-13 years participated. Data were collected using a self-administered questionnaire, including sociodemographic characteristics, knowledge of tooth avulsion, and awareness. Knowledge was scored with responses assigned 0:incorrect, 1:correct, 2:ideal, for a total score (range 0 - 27). The data were analyzed with a significance level of 0.05% using the Kolmogorov-Smirnov, Mann-Whitney U, Kruskal-Wallis tests, and multiple linear regression analysis. Results: Parents' knowledge score showed that 56.6% were in the 0 - 9 range, 41.3% in the 10 - 18 range, and 2% in the 19 - 27 range. The mean correct score was 8.85 ± 4.39 (median [min - max]: 9 [1 - 24]). 94.8% of parents recognized the importance of dental trauma information, only 67.4% were willing to participate in training, with seminars (42.1%) and short films (38.2%) being the most preferred methods. Conclusion: It is imperative that nationwide training be increased and maintained so that parents can manage the emergency treatment of an avulsed tooth correctly without panicking in the event of an accident.

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ABSTRACT Objective: To normatively evaluate the Dental Specialty Centers (CEO) and investigate the relationship with service and context aspects. Material and Methods: This was an evaluative, normative, quantitative, descriptive, and analytical study based on data from the External Evaluation of the 2nd cycle of the Program for Improving Access and Quality of CEOs. A total of 1026 CEOs were evaluated using a Logical Model with evaluative dimensions (Structural, Organizational, Production), subdivided into evaluative sub-dimensions (Human Resources, Structural Resources, Developed Activities, Accessibility, Referral and Counter-referral, Productivity) and indicators classified as poor/regular/good. Classifications were calculated, and a multivariate analysis was performed using Generalized Linear Models and Poisson Regression with robust variance to assess the set of variables related to service (CEO type; Manager presence; Manager tenure; Manager additional training; Planning execution) and context (Geographical region; Population size; HDI; Oral Health Coverage) that are explanatory predictors for the classification of subdimensions. A significance level of p<0.05 was adopted. Results: The majority of the CEOs were classified as regular (41.1%). The best-evaluated dimension was structure, with 86.5% of the CEOs classified as good. The best-evaluated sub-dimension was Structural resources, with 86.9% of the CEOs classified as good. Statistically significant associations were found between all sub-dimensions and the considered variables. Conclusion: Service-related variables, especially CEO type, Manager additional training and time of Manager presence, and Planning execution, are determinants for the evaluation. In parallel, contextual factors such as region, Population size, HDI, and Oral Health Coverage also reveal inequalities that affect the CEOs` results. It is concluded that service and contextual factors influence CEOs' classification results.

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ABSTRACT Objective: To evaluate the level of pharmacology knowledge among dental students enrolled in different undergraduate terms at two dental schools in a city in the Brazilian Amazon. Material and Methods: This cross-sectional, descriptive survey included 128 dental students enrolled in either the sixth term, having recently completed the pharmacotherapy or equivalent course, or in the tenth term. Participants anonymously completed a previously validated multiple-choice questionnaire consisting of four questions on drug-prescription regulations and ten questions based on clinical pharmacology cases. The students’ knowledge levels were categorized as poor, fair, good, or excellent, and the frequencies of correct answers were compared using chi-square tests. Results: The percentages of correct answers from students in different undergraduate terms within the same dental school were not significantly different (p = 0.938). In both institutions, most students demonstrated poor or fair knowledge levels. Overall, students from the private dental school achieved a significantly higher percentage of correct answers than those from the public dental school (p = 0.025). Questions related to drug prescription for medical emergencies and appropriate fluoride concentrations showed the lowest mean percentages of correct responses (7.8% and 13.3%, respectively). Conclusion: The students assessed demonstrated insufficient levels of knowledge in pharmacotherapy and drug prescription, with marked deficiencies in prescribing fluorides and managing medical emergencies.

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ABSTRACT Objective: To evaluate the health literacy (HL) levels in a sample of Brazilian adults and their associations with self-perceived oral health (SPOH) and tooth extraction due to dental caries (TE). Material and Methods: A cross-sectional study was conducted with 667 adults, aged 40.6 ± 14.1 years, users of public dental services in a medium-sized city located in the state of São Paulo, Brazil. Participants answered a sociodemographic and health outcomes questionnaire. HL was measured using the HLS-EU-Q47 instrument, short-short form (HLS-EU-Q6). Logistic regression models were used to analyze the associations between predictor variables and the studied outcomes. Results: Most participants had inadequate HL levels (n=575; 86.2%) per the HLS-EU-Q6. Regarding SPOH, participants with long-term oral health problems, who had already undergone TE and brushed their teeth up to twice per day, were, respectively, 1.85 (95% CI: 1.26-2.72), 3.88 (95% CI: 2.71-5.54) and 1.97 (95% CI: 1.39-2.80) times more likely to rate SROH as bad (p<0.05). As for TE, female participants and those with low motivation to take care of their oral health were, respectively, 1.56 (95% CI: 1.12-2.16) and 1.79 (95% CI: 1.27-2.54) times more likely to undergo TE (p<0.05). HL levels showed no association with the oral outcomes evaluated. Conclusion: Most participants had inadequate health literacy levels, as indicated by HLS-EU-Q6 scores, and this variable was not associated with the oral health outcomes evaluated.

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ABSTRACT Objective: To analyze the impact on quality of life before and after rehabilitation with implant-supported prostheses. Material and Methods: Prospective longitudinal study, non-controlled intervention, of the “before and after” type, with an initial sample of 319 participants, and a final sample of 160 patients, who underwent treatment with implants, from November 2021 to March 2023, in postgraduate schools in implantology, in a metropolitan region of the Southeast region of Brazil. A sociodemographic questionnaire, the Oral Health Impact Profile (OHIP-14) instrument for measuring quality of life, and data collected from the patients' medical records were used. The Wilcoxon test was used to compare the impact at the second stage of the study in relation to the first. The IBM SPSS 20 statistical program was used for this analysis, with a significance level of 5%. Results: The impact of partial or total edentulism on quality of life before implant treatment was declared by 216 (67.7%) patients, with the domains with the greatest impact being psychological discomfort (45.8%) and psychological disability (46.7%). Only 6 patients (3.8%) reported an impact on their quality of life after treatment. In the functional limitation, physical pain, social incapacity, and disability domains, 0.6% of patients reported an impact; the psychological discomfort domain had the highest number of patients with an impact (2.5%). Conclusion: Patients undergoing rehabilitation with prostheses on implants showed a significant improvement in quality of life across all dimensions of the OHIP-14.

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ABSTRACT Objective: To evaluate the occlusal characteristics of the primary dentition and their association with dental caries and oral habits in children aged 3 - 6 years in Prishtina, Kosovo, aiming to provide epidemiological data to support early intervention and preventive strategies for malocclusion. Material and Methods: This cross-sectional study included 655 children with complete primary dentition and no history of previous orthodontic treatment, recruited from both public and private kindergartens in Prishtina. Occlusal parameters were clinically assessed across three spatial planes, evaluating the terminal plane relationship of the second deciduous molars, the primary canine relationship, overjet, overbite, crossbites, and the presence of spacing or crowding. Dental caries was recorded using the defs index (decayed, extracted, and filled surfaces) according to the WHO Child Oral Health Assessment form, by tooth surface. In addition, parents completed structured questionnaires regarding their children’s oral habits and hygiene practices, followed by intraoral clinical examinations. Results: The flush terminal plane (FTP) was observed in 57.7% of children, the distal step (DS) in 27.8%, and the mesial step (MS) in 2.0%. Regarding primary canine relationships, Class I was the most prevalent (62.9%), followed by Class II (30.7%) and Class III (2.1%). Most children (84.7%) exhibited a normal overjet, while 35.7% presented with a deep bite. Common oral habits included object or toy sucking (13.3%), nail biting (12.2%), and pacifier use (12.1%), with significant correlations identified between certain oral habits and occlusal characteristics. The defs index was significantly associated with pacifier use (p = 0.031) and mouth breathing (p = 0.014). No significant association was observed between dental caries and malocclusion. Conclusion: Most preschool children in Prishtina exhibited favorable occlusal patterns. However, parafunctional oral habits, such as pacifier use and mouth breathing, were associated with occlusal anomalies and an increased risk of dental caries, while inadequate oral hygiene habits correlated with higher defs index scores. These findings highlight the need for early screening to promote healthy occlusion and minimize future orthodontic needs.

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ABSTRACT Objective: To compare digital impression with the traditional method in 6-year-old children, evaluating preference, comfort, and the time required for each technique. Material and Methods: A randomized, controlled, single-center crossover trial was conducted with 32 six-year-old children. Digital impressions were taken with a scanner, and conventional impressions were taken with alginate, with a 1-week interval between procedures. During each procedure, impression time data were recorded, and upon completion, data on comfort and method preference were collected. For statistical analysis, Pearson's chi-square test was used, followed by a paired Student's t-test or the nonparametric Wilcoxon test, with α=0.05. Results: Intraoral scanners offer a more pleasant experience for pediatric patients, with a significant reduction in discomfort, such as gag reflex and fear. 96.9% of the children preferred digital impressions, while only 3.1% preferred conventional impressions (p = 0.000). The average time for digital impressions was 128.2 ± 12.4 seconds, compared to 202.1 ± 10.8 seconds for conventional impressions, a highly significant statistical difference (p = 0.000). Conclusion: Digital impressions obtained with an intraoral scanner are an effective and promising alternative to conventional methods, especially in pediatric patients.

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ABSTRACT Objective: To analyze Brazilian Instagram posts related to Biomimetic Restorative Dentistry (BRD) and identify their characteristics, communicative intent, and level of technical foundation. Material and Methods: In this exploratory study, 1,000 posts associated with eight specific BRD-related hashtags were manually collected between December 26 and 28, 2024. After applying the inclusion and exclusion criteria, 84 posts from Brazilian accounts were classified into eight thematic categories. Inferential analyses were performed to assess associations between categorical variables. Results: Visual content centered on clinical procedures was predominant, with limited technical contextualization. The most frequent category was Clinical Sequence (43%); nevertheless, 38.9% of these posts lacked any technical explanation, only 5.6% included references, and none showed clinical follow-up. Categories with an educational focus (Education for Dentists: 14%; Information for Patients: 13%) were underrepresented and rarely included explicit citations to supporting sources. No statistically significant associations were observed between the assessed categorical variables. Conclusion: Content related to BRD on Instagram displays a predominantly visual, promotional character focused on clinical practice, with limited technical information, scarce citation of references, and complete absence of clinical follow-up. Although some posts demonstrate educational potential, their impact remains limited. These findings highlight the need to promote more critical, structured, and evidence-based digital communication, especially on platforms with broad professional and social reach, such as Instagram.

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ABSTRACT Objective: To evaluate the lavender essential oil effects on pain and anxiety in dental patients. Material and Methods: Forty patients, aged 18-60 years, undergoing dental procedures were randomly assigned to lavender essential oil (experimental group; n=20) or negative control (n = 20). In the essential oil group, participants inhaled pure lavender essential oil under supervision 5 times, 15 minutes before the dental procedure, directly from the bottle held at a distance of 15 cm. In the negative control group, participants inhaled five times, under supervision, a hydroalcoholic solution directly from the bottle held at a distance of 15 cm, 15 minutes before the dental procedure. Pain was assessed with the Visual Analog Scale (VAS) and anxiety with the Dental Anxiety Scale (DAS). Results: Baseline anxiety ranged from mild (6-10) to moderate (11-15), with no spontaneous pain (score 0). Both groups reported mild treatment-related pain (VAS: 1.2 experimental vs 1.7 control; p > 0.05). The experimental group showed significantly greater anxiety reduction post-treatment (p < 0.05). Conclusion: Lavender inhalation positively modulates pain perception and significantly reduces anxiety, suggesting a cost-effective adjunct in routine dental practice.

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ABSTRACT Objective: To compare the use of visual cues and video modeling as tools for developing toothbrushing skills in children with Autism Spectrum Disorders (ASD). Material and Methods: Descriptive and exploratory study, with a quantitative approach. Nine children with ASD aged between six and nine years old, diagnosed with ASD level 1 (mild), and their parents, were randomly divided into Group 1 (visual cues) and Group 2 (video modeling). Parents were asked to send four video recordings of their child brushing their own teeth, one per week (one baseline, three brushing with the instruments). Results: Despite improvements in the frequency of tooth-brushing behaviors, there was no statistical difference in behavior frequency across videos for both groups (p>0.05). Spontaneous parental intervention was more frequent in the visual cues group, suggesting that this method may require greater caregiver involvement for effective implementation. Conclusion: The methods employed improved tooth-brushing skills, especially for the group that used video modeling. The increased parental mediation in the visual cues group highlights the importance of caregiver involvement.

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ABSTRACT Objective: To evaluate the effects of simulated brushing on Candida albicans biofilm formation, surface roughness, hardness, mass loss, and color stability of denture base resins fabricated using different materials. Material and Methods: The study included three groups of resins: heat-cured PMMA (Vipicril Plus), CAD-CAM milled PMMA (Ivotion Base), and 3D-printed resin (Cosmos Denture), with 10 samples per group. Surface roughness, Vickers hardness, mass loss, color change (∆E00), and Candida albicans biofilm formation were measured before and after brushing. Statistical analyses were conducted using ANOVA and Tukey's post-hoc tests at a significance level of 5%. Results: Heat-cured resin exhibited lower hardness values compared to milled resin (p < 0.05), while the hardness of the 3D-printed resin showed more significant variability (p > 0.05). The 3D-printed resin had the lowest surface roughness values before and after brushing (p < 0.05). In contrast, heat-cured resin demonstrated minimal color change and mass loss (p < 0.05). Candida albicans biofilm formation was lower on 3D-printed resin before brushing, although no significant difference was noted post-brushing. Conclusion: Simulated brushing significantly altered the optical and mechanical properties of all resins. Heat-cured resin showed superior color stability and resistance to mass loss, while 3D-printed resin demonstrated the lowest surface roughness but higher biofilm formation after brushing.

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ABSTRACT Objective: To evaluate facial soft tissue thickness in different orthodontic malocclusions. Material and Methods: This was an observational study utilizing pre-existing cephalometric images of 540 subjects (270 females and 270 males). Cephalometric images were then classified sagittally based on the Wits appraisal analysis into skeletal Classes. One-way ANOVA was used to compare the means of facial soft tissue thickness between the skeletal groups, followed by Tukey's post hoc test for individual comparison. The significance level was set at p≤0.05. Results: A statistically significant difference in both sagittal and vertical groups was observed (p≤0.05). Tukey's post hoc analysis showed that the skeletal Class III group has increased soft tissue thickness in the subnasal and upper lip compared to Class I and Class II subjects. Moreover, the hypodivergent group showed greater soft-tissue thickness at the pogonion landmarks compared with the other groups. Conclusion: Vertical skeletal pattern exerts a more consistent and significant influence on facial soft tissue thickness (FSTT) than sagittal skeletal classification across different malocclusion classes. Specifically, hyperdivergent individuals consistently exhibited thinner soft-tissue measurements, particularly in the chin and perioral regions, whereas hypodivergent subjects showed thicker soft tissue. These findings highlight the importance of considering vertical skeletal patterns when evaluating facial soft tissue thickness, which may improve orthodontic diagnosis and treatment planning.

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ABSTRACT Objective: To describe a technique used to measure wear on the surface of occlusal splints using dental Computer-Aided Design (CAD) software. Material and Methods: The technique employs intuitive CAD software (Exocad), which features innovative tools capable of providing qualitative analysis and quantitative data regarding wear and structural modifications of occlusal splints in patients with sleep bruxism. The workflow for file acquisition and wear evaluation is described as follows: Digitization of occlusal splints; Importation of STL files; Initial mesh alignment; Automated superimposition of STL files; Assessment of mesh agreement degree. Results: The technique enabled the quantitative analysis of the wear on the occlusal surface of the splints. After the superimposition of the standard tessellation language (STL) files of the splints with and without wear, the CAD software displayed the chromatic deviations that indicated areas of thickness reduction. The highest degrees of wear were observed in the anterior guidance and posterior contact areas. This wear pattern provided evidence of the different muscle activity behaviors associated with the bruxism, including predominantly eccentric movements in the anterior region and centric forces in the posterior region. Conclusion: Dental CAD software can be utilized as a viable complementary tool to identify the thickness of occlusal splints after adjustments and, consequently, diagnose the severity level of sleep bruxism, providing predictable treatment and effective patient management during clinical follow-up visits.

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

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

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

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

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ABSTRACT Objective: To identify and discuss the impact of the application of chitosan gels on the dental and periodontal health of patients. Material and Methods: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and its protocol was registered in the International Prospective Register of Systematic Reviews. Searches were performed in the Embase, MEDLINE/PubMed, Elsevier/Scopus, and Web of Science databases using the descriptors "dentistry", "chitosan", "gels", "hydrogels", "oral health", "tooth", "gingiva", and "periodontics" combined with the Boolean operators "AND" and "OR". The risk of bias was assessed using the Cochrane Risk of Bias 2 tool for randomized controlled trials. Results: A total of 30 studies were retrieved; after reviewing titles, abstracts, and full articles and applying the inclusion and exclusion criteria, only three were included. Subsequently, two studies were manually added through reference searches, bringing the total to 5. In the overall risk-of-bias analysis, only one study was classified as having a low risk of bias, three as having some concern, and one as having a high risk of bias. Conclusion: Gels containing chitosan appear to have a promising positive impact on patients' dental and periodontal health. However, these results should be evaluated with caution due to the risk of bias identified in the studies.

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ABSTRACT Objective: To investigate whether there is an association between low exposure to sunlight and the presence of bone alterations in individuals. Material and Methods: Searches were conducted in seven electronic databases and grey literature, with no language or publication date restrictions. Studies comparing humans with low sunlight exposure to those with higher exposure were evaluated for possible differences in bone structure. Methodological quality and the certainty of evidence were assessed using the Joanna Briggs Institute criteria and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, respectively. Results: Out of 276 studies retrieved, 4 were included. Among these, 3 studies, one with a high risk of bias and 2 with low risk, demonstrated positive associations between low sunlight exposure and bone alterations in individuals, such as low levels of bone mineral density. Of the total studies, 2 were classified as high risk of bias and the other 2 as low risk, resulting in very low certainty of the evidence. Conclusion: There is low certainty of evidence regarding the association between bone alterations in healthy humans and low exposure to sunlight, indicating the need for further studies with more sophisticated designs.

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ABSTRACT Objective: To compare the osseointegration of surface-coated and uncoated titanium dental implants. Material and Methods: PubMed, Cochrane Library, SCOPUS, Web of Science, Google Scholar, and trial registries with no language or date of publication restrictions were searched on electronic databases. The risk of bias was assessed using the Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB-2) and the Risk of Bias in Non-randomized Studies - of Interventions (ROBINS - I) tool. Data were pooled for bone-implant contact percentage (BIC%) of the included studies and forest plots were produced accordingly. A funnel plot was generated to detect the publication bias and GRADEpro was used to assess the certainty of evidence. Results: Four studies with full reports satisfying the eligibility criteria were included. Three studies had a moderate risk and one study had a high risk. The BIC% at 6 months after implant placement was high in surface-coated titanium dental implants with a mean difference of 16.66% (p=0.0005) and a 95% confidence interval (CI) of 7.28% to 26.03% and heterogeneity of I2 of 0% compared to uncoated titanium dental implants. Conclusion: With moderate methodological risk of bias, certainty of evidence, and low heterogeneity, we suggest that surface-coated titanium dental implants can be used to increase osseointegration and implant survival rate.

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ABSTRACT Objective: To systematically review and compare postoperative pain levels following NSET using calcium silicate-based sealers versus traditional sealers. Material and Methods: This systematic review adhered to PRISMA 2020 guidelines and was registered with PROSPERO (CRD42024607698). A comprehensive search of the PubMed, Scopus, and Web of Science databases was conducted to identify clinical trials comparing postoperative pain following obturation with calcium silicate-based versus traditional sealers. Studies including patients with symptomatic irreversible pulpitis or retreatment cases were selected. Pain outcomes were assessed using visual analog scales (VAS) or numeric rating scales (NRS) at 24 hours to 7 days postoperatively. Risk of bias was evaluated using RoB-2 for randomized trials and ROBINS-I for non-randomized trials. Meta-analysis was conducted where appropriate. Results: Five studies met the inclusion criteria. Meta-analysis indicated that calcium silicate-based sealers significantly reduced postoperative pain at 24 hours (SMD: -0.34; 95% CI: -0.63 to -0.04; p=0.02) but not at 48 hours (SMD: -0.26; 95% CI: -0.62 to 0.11; p=0.17). Overall, calcium silicate-based sealers demonstrated lower postoperative pain, especially within the first 24-72 hours. However, variability among study designs, patient conditions, and obturation techniques influenced outcomes. Conclusion: Calcium silicate-based sealers may offer short-term advantages in reducing postoperative pain after NSET. Nevertheless, findings were inconsistent across studies, and further high-quality randomized controlled trials are needed to confirm these results and establish long-term clinical relevance.

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ABSTRACT Objective: To systematically review the clinical longevity of direct resin composite (RC) restorations on teeth affected by Molar-Incisor Hypomineralisation (MIH). Material and Methods: This review followed the PRISMA guidelines. Electronic databases (Cochrane Library, EMBASE, Medline/Pubmed, SCOPUS, Web of Science) and gray literature sources (Google Scholar, OpenGrey, ProQuest) were searched. Randomized clinical trials (RCTs) and cohort studies evaluating the longevity of direct RC restorations in MIH-affected molars in participants aged 6 years or older were included. Search covered database inception to November 2023 and was updated in November 2025. Risk of bias was assessed with the ROB-2 tool (RCTs) and the Newcastle-Ottawa Scale (cohort), and certainty of evidence was evaluated using GRADE. Results: Nine studies (four RCTs and five cohort studies) were included, totaling 487 restorations in individuals aged 6 to 18 years. Overall longevity rates ranged from 49.2% at 24 months to 100% at 48 months, indicating substantial clinical and methodological heterogeneity. In cohort studies, the longevity ranged from 49.2% to 100%, whereas in RCTs, it ranged from 54% to 89.2%. Risk of bias was rated as uncertain, low, and moderate, and effect estimates as very low and moderate. Conclusion: Longevity of direct RC restorations in MIH-affected teeth varies widely, ranging from 49.2% to 100%. Failures were mainly associated with loss of retention, marginal adaptation, secondary caries, and esthetic shortcomings.

Abstract in English:

ABSTRACT Objective: To evaluate factors associated with the clinical outcomes of individuals with pharyngeal teratoma/epignathus. Material and Methods: An integrative and systematic literature review was conducted using the PubMed, Scopus, Web of Science, and BVS databases, with the descriptors "Pharynx" and "Teratoma" or "Epignathus," selecting case reports and series published in English between 2014 and 2024. The search was performed in May 2024. Inclusion criteria followed the WHO (2022) recommendations, selecting cases of tumors with pharyngeal implantation that histologically presented the three embryonic germ layers. Statistical analysis was performed descriptively. Results: 41 studies were selected, comprising 42 cases of epignathus. Cases were categorized based on clinical outcomes as survival (25 cases) or death (17 cases). The mean maternal age was 28.47 ± 6.30 years, with polyhydramnios being the most reported gestational complication (40.7%). There was a slight predominance of female cases (1.5:1). The oral portion of the pharynx was the most common anatomical site of tumor implantation (73.8%). The EXIT procedure was employed to prevent respiratory distress and improve neonatal survival (23.8%). Partial surgical excision of the tumors was directly associated with lesion recurrence (26.2%). Conclusion: Identification of the lesion at ≤20 weeks of gestation, rapid tumor growth, predominance of immature tissues, intracranial involvement, and the presence of severe developmental abnormalities in the nervous and cardiocirculatory systems negatively impact the outcomes of epignathus cases.

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ABSTRACT Objective: To investigate the current research on digital health literacy (DHL) in dentistry to better understand its associations with dental outcomes and gaps in the literature. Material and Methods: The methodology followed the PRISMA-ScR checklist. A critical review was conducted by selecting articles from the online databases PubMed, Web of Science and Latin American and Caribbean Literature on Health Sciences Database (LILACS) and searches were also carried out in Google Scholar to identify articles in the gray literature published until February 2025. Studies on DHL in dentistry were analysed and only full-text, peer-reviewed articles were selected for analysis. Results: The bibliographical search identified 1855 articles, of which 15 were selected for qualitative synthesis. All of the included studies had a cross-sectional design, the majorityof the studies was carried out in Brazil and most of them used the eHealth Literacy Scale (eHEALS) to measure DHL levels. The research gaps identified concerning DHL in dentistry point to the need for further research in diverse sociodemographic groups and settings to better understand the impact of DHL in this area of knowledge. Conclusion: This review has shown that few articles published to date have focused on digital health literacy in dentistry, indicating that the relationships between digital literacy, oral health, and health literacy needs to be further explored.

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

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