Globe-shaped central incisors in a patient with otodental syndrome.

Hearing impairments and dental anomalies are found in many genetic syndromes. Otodental syndrome is a rare combination of hearing loss and the presence of a pathognomonic dental phenotype known as globodontia, in which the tooth exhibits an abnormal globe shape. There is no histologic evidence of structural anomalies in the enamel, dentin, or pulp. This report describes the case of a 12-year-old boy who had hearing loss and 2 supernumerary globe-shaped teeth in the sites of the permanent maxillary central incisors. The diagnosis of otodental syndrome was established based on the clinical, radiographic, and histologic features, but other conditions, including dens evaginatus, talon cusp, dens invaginatus, and compound odontoma, should be included in the differential diagnosis. Dental treatment consisted of the extraction of both anomalous teeth, allowing spontaneous eruption of the impacted permanent central incisors. Early diagnosis of otodental syndrome permits a multidisciplinary approach to prevent other pathologic conditions, reduce functional damage, and avoid social problems.

Photodynamic therapy adjuvant to non-surgical periodontal therapy: Systematic review of randomized clinical trials.

OBJECTIVES: To systematically evaluate randomised controlled trials (RCTs) on whether adjuvant application of antimicrobial photodynamic therapy (aPDT) through the technique of irradiation in the external region of the periodontal pocket with optic-fibre tip offers benefits to scaling and root planning (SRP). METHODS: Five databases were searched by two independent reviewers according to pre-specified eligibility criteria up to April 2023. No restrictions regarding date of publication, language and minimum follow-up period were imposed. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and Grading of Recommendations, Assessment, Development and Evaluation for assessing the certainty of evidence. RESULTS: A total of 1388 publications were identified and reviewed for eligibility. Four of them fulfilled the inclusion criteria. The sample consisted of a total of 83 patients with periodontitis. In these, 330 periodontal sites were evaluated. The clinical findings of the majority of the included studies demonstrated that patients who received the association of aPDT + RAR with the protocol evaluated here, obtained clinical results similar to patients who received only the SRP alone. In none of the evaluated RCTs, clinical advantages were observed that would categorise this aPDT protocol as superior to conventional treatment. CONCLUSION: Applying aPDT after SRP with external irradiation of the periodontal pocket does not seem to result in any clinical benefit compared to the use of SRP alone in patients with periodontitis.

Computed tomography assessment of maxillary sinus hypoplasia and associated anatomical variations: a systematic review and meta-analysis of global evidence.

OBJECTIVE: To summarize the scientific evidence on the prevalence of maxillary sinus hypoplasia (MSH) and associated anatomical variations as assessed by computed tomography scans. STUDY DESIGN: This PROSPERO-registered systematic review followed the recommendations of the PRISMA guidelines. Search algorithms were constructed for each of the six databases and gray literature. After screening the references (Rayyan®), the extracted data were meta-analyzed according to a random-effects model. The joanna briggs critical appraisal tool assessed the methodological quality of the included studies. The GRADE approach was used to estimate the certainty of the evidence. RESULTS: From a total of 2781 studies screened, 22 were considered for four meta-analysis. The prevalence of MSH in 7358 patients was 5.65% (CI95% = 4.07-7.47%) with significant heterogeneity between studies (p < 0.001, I2 = 89.30%). MSH was identified in 295 patients, of whom 82.38% (CI95% = 75.82-88.09%) had unilateral hypoplasia and 17.62% (CI95% = 11.91-24.18%) bilateral hypoplasia with moderate heterogeneity between studies (p < 0.0503, I2 = 42.87%). The prevalence of MSH in 9998 maxillary sinuses was 3.77% (95% CI = 2.44-5.38%), with significant heterogeneity between studies (p < 0.001, I2 = 92.84%). Hypoplastic/aplastic uncinate process, concha bullosa and paradoxical concha were the most reported anatomical variations. The studies presented a low-moderate methodological quality. The certainty of the evidence was very low to moderate. CONCLUSION: The prevalence of maxillary sinus hypoplasia observed was 5.65%, with most cases being unilateral.

Effects of Laser Photobiomodulation on the Regeneration of Bone Defects Grafted with BioOss® Xenograft: a Systematic Review of Animal Models / Efeitos da Fotobiomodulação a Laser na Regeneração de Defeitos Ósseos Enxertados com Xenograft Bio-Oss®: uma Revisão Sistemática de Modelos Animais

Photobiomodulation with low-power laser has stood out for its effects on metabolism, bone regeneration and its notable osteogenic potential. This study aimed to review the literature regarding the effectiveness of photobiomodulation with low-level laser therapy (LLLT) in inducing bone regeneration in sites grafted with Bio-Oss®, through experimental animal studies. It was a systematic review, based on a search performed in PubMed/Medline, Google Scholar, Capes Journals, SciELO and BIREME databases. Descriptors were selected from DeCS/MeSH and the PICOS strategy was applied. Experimental studies published from 2012 to 2023 were included, according to the PRISMA parameters, registered in the PROSPERO platform. The SYRCLE risk of bias tool was used. Using the search strategy, 1352 articles were identified, and five were included in this qualitative synthesis. Despite the divergence observed in the laser dosimetry protocols adopted by the studies, it was evident that laser photobiomodulation associated with the use of Bio-Oss® promotes bone density gains and a considerable increase in the amount of mineralized tissue in bone defects induced in animals. In addition, the use of laser alone has contributed to an improvement in bone formation in non-grafted sites. The data presented show a potential for improvement in the bone reconstruction process by associating photobiomodulation with low-level laser with the application of the Bio-Oss® inorganic bovine bone xenograft. (AU)

A fotobiomodulação com laser de baixa potência tem se destacado pelos seus efeitos no metabolismo, na regeneração óssea e por seu notável potencial osteogênico. Este estudo teve como objetivo revisar a literatura sobre a eficácia da fotobiomodulação com laserterapia de baixa potência (LLLT) na indução da regeneração óssea em locais enxertados com Bio-Oss®, por meio de estudos experimentais em animais. Trata-se de uma revisão sistemática, baseada em busca realizada nas bases de dados PubMed/Medline, Google Acadêmico, Periódicos Capes, SciELO e Bireme. Os descritores foram selecionados no DeCS/MeSH e aplicada a estratégia PICOS. Foram incluídos estudos experimentais publicados de 2012 a 2023, segundo parâmetros PRISMA, cadastrados na plataforma PROSPERO. Foi utilizada a ferramenta de risco de viés SYRCLE. Utilizando a estratégia de busca, foram identificados 1.352 artigos, e cinco foram incluídos nesta síntese qualitativa. Apesar da divergência observada nos protocolos de dosimetria do laser adotados pelos estudos, ficou evidente que a fotobiomodulação laser associada ao uso do Bio-Oss® promove ganhos de densidade óssea e aumento considerável na quantidade de tecido mineralizado em defeitos ósseos induzidos em animais. Além disso, o uso isolado do laser contribuiu para uma melhora na formação óssea em locais não enxertados. Os dados apresentados mostram potencial de melhoria no processo de reconstrução óssea através da associação da fotobiomodulação com laser de baixa intensidade com a aplicação do xenoenxerto ósseo bovino inorgânico Bio-Oss®. (AU)

Effect of Different Cone Beam Computed Tomography Devices and Protocols on Image Quality for the Evaluation of Periodontal Structures / Efeito de Diferentes Dispositivos e Protocolos de Tomografia Computadorizada deFeixe Cônico na Qualidade de Imagem para Avaliação de Estruturas Periodontais

The quality of Cone Beam Computed Tomography (CBCT) images is directly influenced by scanning and visualization protocols. Evaluate the subjective quality of the Cone Beam Computed Tomography (CBCT) image of different devices and protocols for diagnosing periodontal structures and correlate the findings with the contrast-to-noise ratio (CNR). One dry dentate mandible was scanned by six CBCT devices: Accuitomo 3D 170, CS 9000, CS 9300, Eagle 3D, i-CAT Classic, and Orthophos XG 3D. All CBCT devices were adjusted to provide a spatial resolution closest to 0.2 mm, and a FOV height limited to less than 100 mm. Cross-sectional images were evaluated randomly. The buccal bone coverage, the periodontal ligament space and the amount of image noise were assessed. The statistics were calculated based on a logistic regression model with the significance level set at 5%. Protocols with large FOVs demonstrated significantly lower image quality. No statistical differences were found regarding buccal bone coverage between the CBCT devices. The CNR showed the highest value for the Accuitomo 60mm x 60mm HiFi 180°, followed by the Accuitomo 60mm x 60mm HiFi 360°, and lower values for the i-Cat Classic and Orthophos XG 3D devices. Most protocols studied presented good image quality in evaluating the buccal bone coverage and periodontal ligament space. However, the exam with the lowest FOV of the Accuitomo 60mm x 60mm HiFi 180° device showed superiority concerning the others.(AU)

A qualidade das imagens de tomografia computadorizada de feixe cônico (CBCT) é diretamente influenciada pelos protocolos de digitalização e visualização. Avaliar a qualidade subjetiva da imagem da Tomografia Computadorizada de Feixe Cone (CBCT) de diferentes aparelhos e protocolos para o diagnóstico de estruturas periodontais e correlacionar os achados com a razão contraste-ruído (RCR). Uma mandíbula dentada seca foi digitalizada por seis dispositivos CBCT: Accuitomo 3D 170, CS 9000, CS 9300, Eagle 3D, i-CAT Classic e Orthophos XG 3D. Todos os dispositivos CBCT foram ajustados para fornecer uma resolução espacial próxima a 0,2 mm e uma altura de FOV limitada a menos de 100 mm. Imagens transversais foram avaliadas aleatoriamente. A cobertura óssea vestibular, o espaço do ligamento periodontal e a quantidade de ruído da imagem foram avaliados. As estatísticas foram calculadas com base em um modelo de regressão logística com nível de significância de 5%. Protocolos com grandes FOVs demonstraram qualidade de imagem significativamente inferior. Não foram encontradas diferenças estatísticas em relação à cobertura óssea vestibular entre os dispositivos CBCT. O CNR apresentou o maior valor para o Accuitomo 60mm x 60mm HiFi 180°, seguido pelo Accuitomo 60mm x 60mm HiFi 360°, e valores menores para os dispositivos i-Cat Classic e Orthophos XG 3D. A maioria dos protocolos estudados apresentou boa qualidade de imagem na avaliação da cobertura óssea vestibular e do espaço do ligamento periodontal. Entretanto, o exame com menor FOV do aparelho Accuitomo 60mm x 60mm HiFi 180° apresentou superioridade em relação aos demais. (AU)

Aplicação do ultrassom microfocado no rejuvenescimento facial: uma revisão da literatura / Application of microfocused ultrasound in facial rejuvenation: a literature review

Introdução: O aumento da expectativa média de vida leva a população a buscar, com maior frequência, tratamentos estéticos que visem o rejuvenescimento da face e do pescoço. O Ultrassom microfocado (MFU) é descrito como uma opção de tratamento não-invasiva para a flacidez facial e o envelhecimento. Objetivo: Revisar a literatura científica quanto ao uso do MFU no processo de rejuvenescimento facial e correção da flacidez da pele. Metodologia: Trata-se de uma revisão narrativa da literatura, baseada na pesquisa de artigos científicos nas bases de dados PubMed e Biblioteca Virtual em Saúde realizada durante o mês de março de 2022, através da seguinte estratégia de busca: "Microfocused Ultrasound AND Facial Rejuvenation AND Skin Laxity Treatment". Um total de 19 manuscritos foram incluídos em síntese qualitativa. Desenvolvimento: O MFU pode ser aplicado no tecido subcutâneo, produzindo pequenos pontos de coagulação térmica dentro da camada reticular média a profunda da derme e subderme. A aplicação de calor nesses discretos pontos de coagulação térmica faz com que haja neossíntese de colágeno e consequente enrijecimento da pele. Estudos recentes evidenciaramresultados promissores quanto a aplicação do MFU em regiões de sulco nasolabial, linha da mandíbula, sobrancelhas, região infraorbital, palpebra inferior e ligamentos de retenção zigomático-bucais. Considerações finais: O MFU tem se mostrado uma técnica segura, sendo considerado eficaz, não-invasiva, bem tolerada pelos pacientes e viável para a prática clínica médica e odontológica.

Introduction: The increase in average life expectancy leads the population to seek, with greater frequency, aesthetic treatments aimed at rejuvenating the face and neck. Microfocused ultrasound (MFU) is described as a non-invasive treatment option for facial sagging and aging. Objective: To review the scientific literature regarding the use of MFU in the process of facial rejuvenation and correction of sagging skin. Methodology: This is a narrative review of the literature, based on the search for scientific articles in the PubMed and Virtual Health Library databases carried out during the month of March 2022, using the following search strategy: "Microfocused Ultrasound AND Facial Rejuvenation AND Skin Laxity Treatment". A total of 19 manuscripts were included in a qualitative synthesis. Development: MFU can be applied to the subcutaneous tissue, producing small points of thermal coagulation within the middle to deep reticular layer of the dermis and subdermis. The application of heat to these discrete points of thermal coagulation causes collagen neosynthesis and consequent skin tightening. Recent studies have shown promising results regarding the application of MFU in regions of the nasolabial sulcus, jaw line, eyebrows, infraorbital region, lower eyelid and zygomatic-buccal retention ligaments. Final considerations: MFU has been shown to be a safe technique, being considered effective, non-invasive, well tolerated by patients and viable for clinical medical and dental practice.

Oral manifestations in patients diagnosed with psoriasis: A systematic review.

AIMS: To identify the main types of oral lesions associated with psoriasis. METHODS AND RESULTS: It was a systematic review, based on a search performed in the PubMed/Medline, and Scielo databases, and an associated manual search. Descriptors were selected from DeCs/MeSH and the PICOS strategy (population, intervention, comparison, outcomes, and study design) was applied. Randomized clinical trials and retrospective and prospective studies published from 2000 to 2022 were included, according to the PRISMA parameters (Preferred Reporting Items for Systematic Reviews and Meta-Analysis), registered in the PROSPERO platform. The STROBE quality scale (Strengthening the Reporting of Observational studies in Epidemiology) was also used. One hundred fourteen articles were identified using the search strategy, and nine articles were found in the manual search. Of the sixty-six preselected articles, seven were included in the study. Although it was not possible to identify a specific oral lesion associated with psoriasis, there was a greater occurrence of geographic tongue, fissured tongue, and Candida sp. infection CONCLUSION: Evidence shows that although patients with psoriasis may exhibit lesions in the oral mucosa, they are not specific to this condition. Further epidemiological studies are needed to address the association of psoriasis with possible changes in the oral mucosa.

Effects of Photodynamic Therapy with Laser Photobiomodulation as an Adjunct to Scaling and Root Planing: Systematic Review / Efeitos da Terapia Fotodinâmica com Fotobiomodulação Laser Adjuvante a Raspagem e Alisamento Radicular: Revisão Sistemática

Scaling and root planing is the gold standard procedure in the periodontal disease treatment. Although this therapy has the ability to reduce or eliminate periodontopathogens mthrough periodontal instrumentation, sometimes the response to treatment may not promote the complete eradication of pathogens, affecting the healing process and leading to the presence of residual periodontal pockets. The aim of this study was to analyze the effectiveness of photodinamic therapy with laser photobiomodulation and as an adjunct to scaling and root planing (having as a conductive agent a fiber optic tip radiating inside the periodontal pocket), compared to scaling and root planing alone in patients with periodontitis on randomized trials. This systematic review was carried out complying with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta Analyses. The databases used were Pubmed, Lilacs, Biblioteca Virtual em Saúde - Odontologia and Medline. "Periodontal Disease" OR "Periodontal Treatment" AND m"Photodinamic Theraphy" were the descriptors used. A total of five articles were included. Two studies have shown superior results in relation to the referred association; a study indicated benefits in biochemical and/or microbiological aspects; it suggests, however, that clinical relevance needs to be better evaluated; two studies did not reveal benefits that categorize photodynamic therapy + scaling and root planning as superior to conventional treatment. The association in question, when well standardized and performed, can result in promising responses in the control of periodontal disease; however, the clinical benefits that demonstrate its superiority will certainly be subject to new researches. (AU)

A raspagem e alisamento radicular é o procedimento padrão-ouro no tratamento da doença periodontal. Embora essa terapia seja capaz de reduzir ou eliminar os periodontopatógenos por meio da instrumentação periodontal, algumas vezes a resposta ao tratamento pode não promover completa erradicação dos patógenos, afetando assim, o processo de cicatrização e levando à presença de bolsas periodontais residuais. O objetivo do presente estudo foi analisar a eficácia da terapia fotodinâmica com fotobiomodulação laser adjuvante a raspagem e alisamento radicular (tendo como agente condutor uma ponta de fibra óptica que irradia o interior da bolsa periodontal), em comparação com a raspagem e alisamento radicular isoladamente em pacientes com periodontite, avaliados em estudos clínicos randomizados. Esta revisão sistemática foi realizada de acordo com as recomendações Principais Itens para Relatar Revisões sistemáticas e Meta-análises. As bases de dados utilizadas foram Pubmed, Lilacs, Biblioteca Virtual em Saúde - Odontologia e Medline. "Doença periodontal" OR "Tratamento periodontal" AND "Terapia fotodinâmica" foram os descritores utilizados. Um total de cinco artigos foram incluídos. Dois estudos mostraram resultados superiores em relação à referida associação; um estudo indicou benefícios nos aspectos bioquímicos e/ou microbiológicos; sugere, no entanto, que a relevância clínica precisa ser melhor avaliada; dois estudos não revelaram benefícios que categorizassem a terapia fotodinâmica + raspagem e alisamento radicular como superiores ao tratamento convencional. A associação em questão, quando bem padronizada e realizada, pode resultar em respostas promissoras no controle da doença periodontal; entretanto, os benefícios clínicos que demonstram sua superioridade certamente serão alvo de novas pesquisas. (AU)