Does Addition of 10-MDP Monomer in Self-etch Adhesive Systems Improve the Clinical Performance of Noncarious Cervical Lesion Restorations? A Systematic Review and Meta-analysis.

BACKGROUND: Functional acidic monomers are able to chemically interact with hydroxyapatite, and this bond appears to be very stable. Therefore, this aspect of the 10-MDP molecule made it attractive and added to self-etch adhesives. OBJECTIVES: The objective of this Systematic Review (SR) and Meta-analysis (MA) was to determine whether systems with the 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) functional monomer in their formula showed better clinical performance in restorations placed in noncarious cervical lesions (NCCL) when compared to systems without it. The PROSPERO registration number of the MA is CRD42016050538. DATA AND SOURCES: An e-search was conducted through MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, OpenGrey, Clinical Trials, Current Controlled Trials, and EU Clinical Trials Register, and a search through the references of included studies was also performed. Randomized Controlled Clinical Trials, in which the effectiveness of self-etch adhesive systems, with or without the 10-MDP functional monomer for NCCL, was discussed, were included. Risk of bias was performed according to the Cochrane Collaboration tool, and the certainty of evidence was evaluated through GRADE. STUDY SELECTION: The data were grouped, heterogeneity (I2) was tested, and after duplicate removal, 4208 manuscripts were retrieved. From these, 11 studies were included in the qualitative analysis (risk of bias), with nine classified as low risk and two unclear. GRADE analysis detected moderate-to-high certainty of evidence, so the quantitative synthesis [Meta-analysis (MA)] was performed including the 11 studies. RESULTS AND CONCLUSION: There were no statistical differences in the clinical performance of restorations conducted using "with or without 10-MDP" adhesive types, for all evaluated criteria (p=0.05), with heterogeneity ranging from 0% to 53%. Thus, the presence of 10-MDP functional monomer did not influence the clinical performance of restorations placed in NCCL.

The unit-Weibull distribution as an alternative to the Kumaraswamy distribution for the modeling of quantiles conditional on covariates.

The Beta distribution is the standard model for quantifying the influence of covariates on the mean of a response variable on the unit interval. However, this well-known distribution is no longer useful when we are interested in quantifying the influence of such covariates on the quantiles of the response variable. Unlike Beta, the Kumaraswamy distribution has a closed-form expression for its quantile and can be useful for the modeling of quantiles in the absence/presence of covariates. As an alternative to the Kumaraswamy distribution for the modeling of quantiles, in this paper the unit-Weibull distribution was considered. This distribution was obtained by the transformation of a random variable with Weibull distribution. The same transformation applied to a random variable with Exponentiated Exponential distribution generates the Kumaraswamy distribution. The suitability of our proposal was demonstrated to model quantiles, conditional on covariates, with two simulated examples and three real applications with datasets from health, accounting and social science. For such data sets, the obtained fits of the proposed regression model were compared with those provided by the Beta and Kumaraswamy regression models.

Evaluation of whole-body tumor burden with 68Ga-PSMA PET/CT in the biochemical recurrence of prostate cancer.

BACKGROUND: 68 Ga-PSMA-PET has an increasing importance in the evaluation of prostate cancer patients due to its high sensitivity and specificity in identifying neoplastic lesions in the clinical setting of elevated prostate-specific antigen (PSA). The objective of this study was to calculate the whole-body tumor burden using volumetric quantification of lesions detected in 68Ga-PSMA-PET of prostate cancer patients with biochemical recurrence and correlate these findings with clinical and image parameters. METHODS: Each patient had their 68Ga-PSMA-PET analyzed for the presence of neoplastic lesions. Their PSA levels and clinical information were recorded. In positive cases, the tumor burden (TL-PSMA) was calculated with a semi-automatic software and manually, and the results are analyzed and tested. RESULTS: We analyzed 100 prostate cancer patients, mean age of 69.9 ± 9.7 years and a median PSA of 1.73 ng/dL. 68Ga-PSMA-PET identified neoplastic lesions in 72% of them. The median TL-PSMA was 55.95 ml (1.1-28,080 ml). TL-PSMA and PSA were strongly correlated (rho = 0.71, p < 0.0001, 95% CI 0.60-0.80). TL-PSMA and PSA levels groups had a significant correlation and TL-PSMA and Gleason score were independent variables associated with PSA levels (p < 0.05). CONCLUSION: TL-PSMA strongly and independently correlates with PSA levels in prostate cancer patients and could be used as a biomarker to separate them into groups with high or low tumor burden, instead of considering only the number of lesions.

Prevalence, extent and severity of peri-implant diseases. A cross-sectional study based on a university setting in Brazil.

BACKGROUND AND OBJECTIVE: Peri-implant diseases are a growing concern among clinicians. Epidemiological studies following recently recommended case definitions for peri-implant diseases are emerging worldwide. Although a small number of studies on the prevalence of peri-implant diseases has been conducted in Brazil, no information on the extent and severity of the condition has been made available so far. The objective of this study was to estimate the prevalence, extent and severity of peri-implant diseases in patients treated in a university setting in Brazil. MATERIAL AND METHODS: Patients with dental implants with at least 1 year in function were clinically and radiographically examined and classified according to recently recommended case definitions. A descriptive analysis on the prevalence, extent and severity of the peri-implant status at patient and implant level was performed. Risk indicators for peri-implantitis were also identified with binary logistic regression analysis. RESULTS: Of the 211 participating individuals, 4 (1.9%) presented peri-implant health, 8 (3.8%) clinical stability, 115 (54.5%) mucositis and 84 (39.8%) peri-implantitis. Of the 748 implants analyzed, 47 (6.3%) presented peri-implant health, 30 (4%) clinical stability, 518 (69.2%) mucositis and 153 (20.5%) peri-implantitis. The extent of implants with peri-implantitis and peri-implant mucositis was 41.5% and 90.4%, respectively. Severe peri-implantitis was found in 36 patients (17.1%) and 67 implants (9%). Gender male, number of implants ≥4, implants installed in the maxilla, cemented prosthesis and keratinized mucosa width <2 mm were significantly associated with the event peri-implantitis. CONCLUSION: In the studied population, the prevalence, extent and severity of the peri-implant diseases were similar to those reported elsewhere. Peri-implant diseases were a common finding, with only 5.7% of patients and 10.3% of implants presenting peri-implant health or clinical stability. About 17% of patients studied presented the severe form of peri-implantitis.

Evaluation of the effects of hyperbaric oxygen therapy for spinal cord lesion in correlation with the moment of intervention.

STUDY DESIGN: Experimental, controlled, animal study. OBJECTIVES: To evaluate the functional effect of hyperbaric oxygen therapy administered shortly, one day after, and no intervention (control) in standardized experimental spinal cord lesions in Wistar rats. SETTING: São Paulo, Brazil. METHODS: In all, 30 Wistar rats with spinal cord lesions were divided into three groups: one group was submitted to hyperbaric oxygen therapy beginning half an hour after the lesion and with a total of 10 one-hour sessions, one session per day, at 2 atm; the second received the same treatment, but beginning on the day after the lesion; and the third received no treatment (control). The Basso, Beattie and Bresnahan scales were used for functional evaluation on the second day after the lesion and then weekly, until being killed 1 month later. RESULTS: There were no significant differences between the groups in the functional analysis on the second day after the lesion. There was no functional difference comparing Groups 1 and 2 (treated shortly after or one day after) in any evaluation moment. On the 7th day, as well as on the 21st and 28th postoperative days, the evaluation showed that groups 1 and 2 performed significantly better than the control group (receiving no therapy). CONCLUSION: Hyperbaric chamber therapy is beneficial in the functional recovery of spinal cord lesions in rats, if it is first administered just after spinal cord injury or within 24 h.

Potentializing the effects of GM1 by hyperbaric oxygen therapy in acute experimental spinal cord lesion in rats.

STUDY DESIGN: Experimental, controlled, animal study. OBJECTIVES: To evaluate the effect of GM1 ganglioside, hyperbaric oxygen and both in combination, in the treatment of experimental spinal cord lesions in rats. SETTING: Brazil. METHODS: Thirty-two Wistar rats with spinal cord lesions were divided into four groups: one group received GM1 ganglioside, one was submitted to hyperbaric oxygen therapy (HBOT), the third received both treatments and the fourth received no treatment (control). RESULTS: There were no significant differences between the groups in the histological analysis, for any of the variables (necrosis, hemorrhage, hyperemia, cystic degeneration, P>0.06). Neither were there any significant differences in the comparison of left and right sides in the functional tests (P>0.06 for all). No significant differences were found in the locomotor ratings, in the comparison of groups at 2, 7, 21 and 28 days after the surgical procedure. However, in the evaluation on day 14, group 3, which received the combined therapy, showed a significantly higher Basso Beattie and Bresnahan score than the other groups (P=0.015). CONCLUSION: The therapeutic effect of GM1 in locomotor evaluation of rats submitted to spinal cord lesion is anticipated by HBOT.