Family structure and social vulnerability as risk factors for traumatic dental injuries in children and adolescents: a systematic review and meta-analysis.

OBJECTIVE: To investigate the associations between family structure and social vulnerability with TDIs in children and adolescents. METHODS: An electronic search was conducted in seven databases (PubMed, Scopus, LILACS, Embase, Web of Science, ProQuest, and Google Scholar) to retrieve observational studies that evaluated the prevalence of TDIs. The risk of bias was assessed using the JBI Critical Appraisal Tools. Meta-analyses were also conducted using odds ratios (ORs) and 95% confidence intervals (CIs). The certainty of evidence was evaluated using the GRADE approach. RESULTS: Out of 7,424 records, seventeen articles were included (n = 18,806 children and adolescents aged between 0 and 19 years). Only two studies had a low risk of bias. Children and adolescents from nonnuclear families were more likely to suffer from TDIs (OR: 1.39; 95% CI: 1.17; 1.66). On the other hand, the level of social vulnerability did not show a positive association with TDIs (OR - 1.21; 95% CI: 1.00; 1.47). The GRADE approach assessed the certainty of evidence as low. CONCLUSION: Despite the uncertainty of the evidence, children and adolescents from nonnuclear families are more likely to have TDIs than are those from nuclear families. On the other hand, social vulnerability does not seem to be associated with episodes of TDIs in children and adolescents. CLINICAL RELEVANCE: Through knowledge of the risk factors for TDIs, it is possible to develop public policies for their prevention.

In vivo method to evaluate volumetric changes in bioceramic repair materials.

This study aimed to evaluate the effect of in vitro immersion solutions or an in vivo method on volumetric change of bioceramic root repair materials: Bio-C Repair (BCR, Angelus, Londrina, PR, Brazil) and Biodentine (BIO, Septodont, Saint-Maur-des-Fossés, France) compared to IRM (Dentsply Sirona, York, Pennsylvania, USA) by using microcomputed tomography (µCT) assessment. Tubes of polyvinyl chloride (PVC, 4 mm of length x 1.3 mm of inside diameter, n = 7) were filled with the materials for volumetric analysis in µCT. Samples were scanned after materials setting and after immersion in distilled water, PBS, or in vivo tissue fluid of subcutaneous tissue of rats for 7 days. IRM showed higher volumetric change than BCR and BIO in all immersion solutions (P<0.05). BIO and BCR presented similar volumetric changes when immersed in PBS and distilled water (P>0.05). When the in vivo method was used, BIO and BCR showed lower volumetric change (P<0.05), including an increase in volume for BCR. The immersion solutions influenced the evaluation of the volumetric change of bioceramic repair materials. Bioceramic materials show greater volumetric stability when evaluated by the in vivo method. The in vivo method in the subcutaneous tissue of rats can be an alternative for analyzing the properties of bioceramic cement, showing similarity with the clinical application.

A novel simplified method for assessing crystal length and crystalline content in dental ceramics.

The purpose of this study was to introduce a novel and simple method of evaluating the crystal length and crystalline content of lithium disilicate dental ceramics using images obtained from scanning electron microscopy (SEM) and analyzed with ImageJ (NIH) processing software. Three evaluators with varying experience levels assessed the average crystal length and percentage of crystalline content in four commercial lithium disilicate reinforced glass ceramic materials: IPS e.max (Ivoclar Vivadent), Rosetta SM (Hass), T-Lithium (Talmax), and IRIS CAD (Tianjin). The specimens, prepared from partially crystallized CAD/CAM blocks (3.0 mm3), were fully crystallized and treated with 5% hydrofluoric acid for 20 s prior to SEM analysis. After acquiring the SEM images, ImageJ software was used to evaluate the average crystal length and crystalline content on the surface of the different ceramics. An inter-operator agreement was observed (ICC/p = 0.724), indicating that assessments by the various operators were similar across all ceramic materials tested (p < 0.001). When crystal length and crystalline content were compared, IRIS CAD exhibited significant differences compared to the other materials (p < 0.001), showing a less dense crystalline matrix based on the average length of crystals and the percentage of crystals per unit area. The use of this software facilitated the evaluation of crystalline content and average crystal lengths in dental ceramics using SEM images, and demonstrated very low variability among different operators. RESEARCH HIGHLIGHTS: The described method, using ImageJ open-source software, provides precise and reliable measurements of crystal length and crystalline content in lithium disilicate ceramics, with high inter-operator agreement. The proposed method identified higher crystalline content in IPS e.max CAD compared to Rosetta SM CAD and T-lithium CAD ceramics, while IRIS CAD exhibited significantly lower crystalline content and larger average crystal length. The novel, simplified method for assessing crystal length and crystalline content presented in this study may also be useful for evaluating other dental ceramics.

Identification of oxidative stress biomarkers in apical periodontitis: A scoping review with bibliometric analysis.

Oxidative stress (OS) is a ubiquitous process for protecting against microorganisms' challenges. This review maps the most used methods for obtaining samples and analysing reactive oxygen species levels in apical periodontitis, following the PRISMA Extension for Scoping Reviews and is registered in Open Science Framework ([https://doi.org/10.17605/OSF.IO/D5U76]). A systematic search was conducted in electronic databases MEDLINE (PubMed), Embase, Scopus, Web of Science, LILACS, SciElo, OATD and DANS up to 17 July 2023. A total of 18 studies were included, with periapical tissue being the most common sample. Twenty-eight different oxidative stress markers were identified, with inducible nitric oxide synthase being the most prevalent. The use of diverse biomarkers for oxidative stress assessment lacks specificity in identifying particular OS species for evaluating apical periodontitis and potential systemic effects. Studies are necessary to compare results obtained from less invasive methods (such as saliva and crevicular fluid) with those from periapical lesion samples.

Evaluation of Cytotoxicity, Cell Attachment, and Elemental Characterization of Three Calcium Silicate-Based Sealers.

We investigated three calcium silicate-based sealers with respect to their chemical characterization, cytotoxicity, and attachment to RAW264.7 cells. BioRoot RCS (BR), Bio-C Sealer (BC), and Sealer Plus BC (SPBC) were assessed using Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence spectroscopy (XRF), and energy-dispersive X-ray spectroscopy (EDX) (n = 4) for elemental characterization, and using scanning electron microscopy (SEM) to evaluate cell morphology and adhesion. Cytotoxicity was determined at different dilutions (1:1, 1:2, and 1:5) using the succinate dehydrogenase activity (MTT assay). Statistical analysis was performed for normal distribution using the Shapiro-Wilk test and for homoscedasticity using Levene's test, and one-way ANOVA, Tukey's/Dunnett's post hoc tests for cell viability and XRF (α = 0.05). Calcium silicate hydrate and calcium hydroxide were detected by FTIR in all groups. EDX detected a higher calcium content for BR and SPBC and aluminum only in the premixed sealers. XRF detected the highest calcium release in BR (p < 0.05). The surface morphology showed irregular precipitates for all the sealers. SPBC at a 1:2 dilution resulted in the lowest cell viability compared to BR (p < 0.05) and BC (p < 0.05). The calcium silicate-based sealers produced a statistically significant reduction in cellular viability at a 1:1 dilution compared to the control group (p < 0.0001). All the sealers maintained viability above 70%.

Physicochemical properties and osteoclastogenesis for three premixed calcium silicate-based sealers post set.

Solubility, pH, ion release, cytotoxicity, and osteoclastogenesis inhibition in bone marrow-derived monocyte macrophages (BMMs) were evaluated in EndoSequence BC Sealer (END), Bio-C Sealer (BC), and Sealer Plus BC (SPBC). pH was determined after immersion of the sealers in deionized water (DW) and Minimum Essential Medium Alpha (α-MEM). Solubility was obtained by mass loss. Ion release was measured by using X-ray fluorescence spectroscopy (XRF). Cytotoxicity was evaluated by MTT assay. Inhibition of osteoclastogenesis was evaluated by tartrate-resistant acid phosphatase (TRAP). Data were analyzed using the t-test, ANOVA and Tukey/Dunnett's post-hoc tests (α = 0.05). END had the highest pH in DW (p < 0.05), and BC, in α-MEM (p < 0.05). Solubility in DW was the lowest for SPBC (p < 0.005). The highest calcium release was observed for BC in DW at 12 h (p < 0.05), and in α-MEM at 12 and 24 h (p < 0.05). The lowest toxicity was detected for END (p < 0.05). BC had the highest inhibitory effect on osteoclasts (p < 0.05). Overall, the highest solubility and pH values were found in DW. However, the calcium silicate-based sealer showed higher solubility than the ISO standards. Calcium release was the highest for BC. END showed the highest cell viability, and BC, the highest osteoclast inhibition.

Effect of irrigation protocols on root canal wall after post preparation: a micro-CT and microhardness study.

The aim of this study was to investigate the effects of different post space irrigation protocols for removing residual filling material from dentin walls, by using microcomputed tomography (micro-CT), and the influence of these protocols on dentin microhardness. Bovine incisors (n = 35) were filled with the single-cone technique and MTA Fillapex (Angelus, Londrina, PR, Brazil). Post space preparation (PSP) was performed 7 days after filling, using the Odous Touch electrical system (Odous De Deus Ind. e Com., Belo Horizonte, MG, Brazil), followed by post space irrigation using manual irrigation, passive ultrasonic irrigation, or Easy Clean, together with 2.5% sodium hypochlorite (NaOCl), or with 2.5% NaOCl and 17% EDTA (NaOCl/EDTA). Micro-CT scans were performed at three time points. The residual filling material was evaluated at three levels: cervical, middle and apical. The Knoop test was measured with four indentations around the canal lumen at three dentin depths: X (100 µm), Y (200 µm) and Z (400 µm). Statistical analysis was performed using ANOVA (p < 0.05). The effects of the activation method (p < 0.001), and the root level (p = 0.013), as well as the interaction between the irrigant and the activation method (p = 0.041), led to different percentages of residual filling material. Lower amounts of residual filling material were observed at the cervical versus the middle and apical levels (p < 0.05). No significant differences were observed in dentin microhardness (p > 0.05). The best removal of the residual filling material was performed using the Easy Clean tip and NaOCl/EDTA, regardless of the activation methods.

Apical Displacement and Residual Root Canal Filling with Single-Cone After Post Space Preparation: A Micro-CT Analysis.

The purpose of this study was to evaluate the presence of residues after post space preparation (PSP) and establish whether the apical displacement of the gutta-percha was affected by the moments and methods of PSP in teeth filled by the single-cone technique. The root canals of 20 bovine incisor teeth were instrumented with Reciproc and filled with single-cone and AH Plus. The specimens were divided into 4 groups according to the moment and method of PSP (n=5): immediate with drill, immediate with thermoplasticizer, delayed with drill and delayed with thermoplasticizer. Micro-CT scans were performed before and after the PSP for residues of the root canal filling (1) and analysis of apical displacement (2). Data were analyzed by using 2-way repeated measurement ANOVA (1) and 2-way ANOVA (2) followed by the Tukey's test (a=0.05). Significance effect on the residues percentage remaining for methods (p=0.044), for moments (p=0.006), for thirds repetition (p<0.001), and for interaction between methods and thirds (p<0.001), and moments and thirds (p=0.044). Significance effect on the apical displacement of root canal filing was detected for methods (p=0.008), however no difference was found between moments (p=0.617). In general, PSP using drill resulted in more homogeneous root canal preparation, mainly when made immediately. For all other combinations between methods and moments for PSP, the middle and apical thirds presented significant higher residues remaining. Thermo method performed in both moments and the drill method performed immediately had displacement in the apical direction, representing extrusion of the root filling material.

Physicochemical properties and osteoclastogenesis for three premixed calcium silicate-based sealers post set

Abstract: Solubility, pH, ion release, cytotoxicity, and osteoclastogenesis inhibition in bone marrow-derived monocyte macrophages (BMMs) were evaluated in EndoSequence BC Sealer (END), Bio-C Sealer (BC), and Sealer Plus BC (SPBC). pH was determined after immersion of the sealers in deionized water (DW) and Minimum Essential Medium Alpha (α-MEM). Solubility was obtained by mass loss. Ion release was measured by using X-ray fluorescence spectroscopy (XRF). Cytotoxicity was evaluated by MTT assay. Inhibition of osteoclastogenesis was evaluated by tartrate-resistant acid phosphatase (TRAP). Data were analyzed using the t-test, ANOVA and Tukey/Dunnett's post-hoc tests (α = 0.05). END had the highest pH in DW (p < 0.05), and BC, in α-MEM (p < 0.05). Solubility in DW was the lowest for SPBC (p < 0.005). The highest calcium release was observed for BC in DW at 12 h (p < 0.05), and in α-MEM at 12 and 24 h (p < 0.05). The lowest toxicity was detected for END (p < 0.05). BC had the highest inhibitory effect on osteoclasts (p < 0.05). Overall, the highest solubility and pH values were found in DW. However, the calcium silicate-based sealer showed higher solubility than the ISO standards. Calcium release was the highest for BC. END showed the highest cell viability, and BC, the highest osteoclast inhibition.

Effect of irrigation protocols on root canal wall after post preparation: a micro-CT and microhardness study

Abstract: The aim of this study was to investigate the effects of different post space irrigation protocols for removing residual filling material from dentin walls, by using microcomputed tomography (micro-CT), and the influence of these protocols on dentin microhardness. Bovine incisors (n = 35) were filled with the single-cone technique and MTA Fillapex (Angelus, Londrina, PR, Brazil). Post space preparation (PSP) was performed 7 days after filling, using the Odous Touch electrical system (Odous De Deus Ind. e Com., Belo Horizonte, MG, Brazil), followed by post space irrigation using manual irrigation, passive ultrasonic irrigation, or Easy Clean, together with 2.5% sodium hypochlorite (NaOCl), or with 2.5% NaOCl and 17% EDTA (NaOCl/EDTA). Micro-CT scans were performed at three time points. The residual filling material was evaluated at three levels: cervical, middle and apical. The Knoop test was measured with four indentations around the canal lumen at three dentin depths: X (100 μm), Y (200 μm) and Z (400 μm). Statistical analysis was performed using ANOVA (p < 0.05). The effects of the activation method (p < 0.001), and the root level (p = 0.013), as well as the interaction between the irrigant and the activation method (p = 0.041), led to different percentages of residual filling material. Lower amounts of residual filling material were observed at the cervical versus the middle and apical levels (p < 0.05). No significant differences were observed in dentin microhardness (p > 0.05). The best removal of the residual filling material was performed using the Easy Clean tip and NaOCl/EDTA, regardless of the activation methods.

Dental behavior management of a patient with osteogenesis imperfecta type V: case report / Abordagem odontológica de paciente com osteogênese imperfeita tipo V: relato de caso

Aim: the aim of this study is to report a case of a four-year-old male patient diagnosed with Osteogenesis Imperfecta (OI) type V and the dental care performed. Material and method: the patient has been monitored by a multidisciplinary team composed by Pediatric Dentistry, Nurse and Nutritionist at a Special Patients Center in Dentistry Hospital on the Federal University of Uberlândia since one month of life. It was reported that a child had already suffered several bone fractures and currently he has been using calcium carbonate, D vitamin and pamidronate. Results: the proposed intervention was dental preventive strategies by parental education, caries risk assessment and controlling the dental biofilm with professional prophylaxis. But, due to the uncooperative behavior, it was used the active protective stabilization technique and mouth opener. Conclusion: it was concluded that due to the bone fragility and the risk of fractures, it is important a careful placement of the patient on the dental chair. Also, the correct use of basic auxiliary devices and advanced techniques of behavior management were relevant.

Objetivo: relatar caso de paciente do sexo masculino, com quatro anos de idade, diagnosticado com Osteogênese Imperfeita (OI) tipo V e os cuidados odontológicos realizados. Material e método: O paciente foi acompanhado por equipe multidisciplinar composta por Odontopediatra, Enfermeira e Nutricionista de um Centro Especial de Pacientes do Hospital Odontológico da Universidade Federal de Uberlândia desde um mês de vida. Foi relatado que a criança já havia sofrido várias fraturas ósseas e atualmente está usando carbonato de cálcio, vitamina D e pamidronato. Resultado: a intervenção proposta foi de estratégias preventivas odontológicas por educação dos pais, avaliação do risco de cárie e controle do biofilme dental com profilaxia profissional. Porém, devido ao comportamento não cooperativo, utilizou-se a técnica de estabilização protetora ativa e o abridor de boca. Conclusão: concluiu-se que, devido à fragilidade óssea e ao risco de fraturas, é importante uma colocação cuidadosa do paciente na cadeira odontológica. Além disso, o uso correto de dispositivos auxiliares básicos e técnicas avançadas de gerenciamento de comportamento foram relevantes.