The impact of mental health and psychological stressors on menstrual cycle modulation: exploring the influence of age and hormonal contraceptives.

Stress, infections, and psychological and social well-being can affect the reproductive system. Activation of the hypothalamic-pituitary-adrenal axis can disrupt ovarian cyclicity. Estrogens can modulate stress responsiveness and mood. Thus, understanding this interaction and how it modulates the menstrual cycle is crucial for women's reproductive health. PURPOSE: The objective of this study was to analyze the influence of a stressor, a period of the Covid-19 pandemic when there were no vaccines available yet, on the psychological state of women aged 18 to 45 years; as well as the influence of mental health on the menstrual cycle, considering the influence of age and hormonal contraceptives. METHOD: Online questionnaire using the Google Forms platform was used. RESULTS: There is a high prevalence of the onset of new psychosocial symptoms. Moreover, most women reported some type of change in their menstrual cycles. The women who were using hormonal contraceptives demonstrated a higher frequency of spotting and menstrual color alterations, while women without hormonal contraceptives demonstrated a higher frequency of cycle duration and menstrual odor alterations. Women without hormonal contraceptives were more susceptible to the development of psychosocial symptoms. Younger adult women were more affected by menstrual changes and psychosocial symptoms. Close to 90% of women who reported several psychosocial symptoms had changes in their menstrual cycles. CONCLUSION: These data suggest the impact of stressors, such as a period of the pandemic, on mental health and menstrual cycles, and younger adult women can be more susceptible. This reflects the relationship between mental and reproductive health.

Adherence to mediterranean diet and aromatic plants intake are related with gustatory function: A case-study from a Portuguese region.

The Mediterranean Diet has been recognized as one of the healthiest and most sustainable dietary patterns and is flavor rich due to the use of different seasonings, such as aromatic plants, in dish confection. Based on the hypotheses that: 1) gustatory function will affect food choices; 2) seasoning flavors may be differently accepted according to individuals' gustatory functions; the aim of the present study was to assess the association between taste sensitivity and/or preference with Mediterranean Diet adherence and seasoning consumption. A total of 383 adults (18-59 years old; 198 female, 185 male) from North Alentejo region of Portugal were enrolled in this study, with 291 (145 female and 146 male) also evaluated for gustatory function. Recognition thresholds were obtained for four tastes (sweet, sour, salty, and bitter) and astringency, as well as preference level for the highest concentration of each stimulus tested. A validated Food Frequency Questionnaire was filled out, and MD adherence was extrapolated from the answers of the Food Frequency Questionnaire according to the Mediterranean Diet Adherence Screener (MEDAS) score. In total, 20.8% of the individuals presented low, 58.2% medium, and 21.0% high adherence. Adherence was higher in women than men and in older individuals than younger adults. Adherence to the Mediterranean Diet was positively correlated with aromatic plants consumption but not spices. Seasonings were associated with gustatory function, and the cluster with higher consumption presented higher preferences for bitter and salty tastes. Total sodium intake was also higher in this cluster, suggesting that these individuals prefer stronger oral sensations. In conclusion, this study shows that MD adherence is not high, even in regions with rural characteristics. The observed association of MD and seasoning intake with gustatory function do underline the usefulness of this information in strategies aimed at promoting healthy and sustainable eating patterns.

Thermal Facial Profile and Orofacial Myofunctional Aspects in Movement Disorder Patients: Comparison Between Parkinson Disease and Spinocerebellar Ataxia Type 3.

OBJECTIVE: To evaluate the orofacial myofunctional characteristics, masticatory performance and facial thermal profile in individuals with Parkinson disease (PD) and spinocerebellar ataxia (SCA3), comparing with healthy control ones. METHOD: Seventy-two participants aged between 30 and 85 years were evaluated and divided into PD, SCA3 and control groups. The assessments included clinical evaluation using the Orofacial Myofunctional Evaluation with Scores protocol (orofacial structures, mastication, swallowing and breathing aspects), masticatory performance assessed with a colour-changeable chewing gum and infrared thermography. The Kruskal-Wallis, one-way ANOVA and Wilcoxon tests were applied. RESULTS: With the exception of face and tongue, a difference was seen in the cheek, maxillomandibular relationship, lips, mentalis muscle and palate appearance and posture between patients and healthy control participants. Orofacial mobility, swallowing and masticatory function also scored higher in the control group. The SCA3 and PD groups required more time to eat the test-food and showed greater facial temperature asymmetries than the control one (p < 0.05). Masticatory performance measured by chewing gum did not differ. CONCLUSION: Facial temperature asymmetries, swallowing and masticatory function scores and the time needed by the SCA3 and PD groups to eat the test-food were different from healthy participants, drawing attention to the impaired orofacial functions in patients with neurodegenerative disorders.

Bypass gastroplasty impacts oral health, salivary inflammatory biomarkers, and microbiota: a controlled study.

OBJECTIVES: Knowledge about the impact of gastroplasty on oral health and salivary biomarkers is limited. The aim was to prospectively evaluate oral health status, salivary inflammatory markers, and microbiota in patients undergoing gastroplasty compared with a control group undergoing a dietary program. MATERIALS AND METHODS: Forty participants with obesity class II/III were included (20 individuals in each sex-matched group; 23-44 years). Dental status, salivary flow, buffering capacity, inflammatory cytokines, and uric acid were assessed. Salivary microbiological analysis (16S-rRNA sequencing) assessed the abundance of genus, species, and alpha diversity. Cluster analysis and mixed-model ANOVA were applied. RESULTS: Oral health status, waist-to-hip ratio, and salivary alpha diversity were associated at baseline. A subtle improvement in food consumption markers was observed, although caries activity increased in both groups, and the gastroplasty group showed worse periodontal status after three months. IFNγ and IL10 levels decreased in the gastroplasty group at 3 months, while a decrease was observed in the control group at 6 months; IL6 decreased in both groups (p < 0.001). Salivary flow and buffering capacity did not change. Significant changes in Prevotella nigrescens and Porphyromonas endodontalis abundance were observed in both groups, while alpha diversity (Sobs, Chao1, Ace, Shannon, and Simpson) increased in the gastroplasty group. CONCLUSIONS: Both interventions changed in different degrees the salivary inflammatory biomarkers and microbiota, but did not improve the periodontal status after 6 months. CLINICAL RELEVANCE: Although the observed discrete improvement in dietary habits, caries activity increased with no clinical improvement in the periodontal status, emphasizing the need of oral health monitoring during obesity treatment.

Mechanical stress distribution over the palate by different pacifiers assessed by finite element analysis and clinical data.

The mechanical behavior of each type of pacifier on rigid structures and their various impacts on orofacial growth have yet to be discovered. The study aimed to evaluate the stress distribution over a child's palate by three types of pacifiers using finite element analysis and clinical and laboratory data. Modulus of elasticity was obtained from 30 specimens comprising 10 of each conventional (A), orthodontic (B), and breast-shaped (C) pacifiers. Tongue strength was assessed in eight 3-year-old children (kPa). A hemi-maxilla model was obtained from 2- to 3-year-old skull tomography, and the images of pacifiers A, B, and C were captured using 3D scanning. The Hypermesh® program generated a mesh of 6-node tetrahedral elements for applying forces in the X, Y, and Z directions to enable a nonlinear analysis. Pacifier B exhibited the highest values for distributed stress on the palate, followed by pacifier A. Pacifier B stimulated the maxilla forward and sideways. In contrast, pacifier A promoted a forward and upward load, favoring a more atresic palate. Pacifiers A and B tended to rotate in the sagittal plane, generating tensions in the anterior incisors and favoring the open bite. Pacifier C exhibited lateral expansion by stress induction over the mid-palatal suture with less influence on incisor inclination. Pacifiers showed different detrimental stress distributions on the palate. This information can be helpful for improving recommendations given to parents.

Fear of COVID-19 influences physical activity practice: a study in a Brazilian sample.

The suspension of social activities combined with health insecurity, uncertainty and fear of COVID-19 may influence physical activity practice. We aimed to investigate the relationship between the fear of COVID-19 and anxiety on physical activity patterns during the pandemic period. This cross-sectional study was performed in a sample of 520 Brazilian participants recruited by online sampling and snowball method. We assessed demographic variables, health perceptions, anxiety, fear of COVID-19 and physical activity characteristics. Both fear scores and anxiety were higher in woman (p < 0.0001). We observed a remarkable reduction in the frequency and intensity of physical activity and a modification in the exercise practice environment (from gym or sports centers to home-based physical activity) (p < 0.05). Sedentary (sitting) behavior increased during pandemic both in the weekdays and in the weekend (p < 0.0001). Participants who have never been infected were more prone of being classified in higher levels for physical activity (OR: 1.916, CI = 1.043-3.521) versus those who were previously infected (p = 0.05). Participants with a low or moderate level of physical activity before the pandemic presented lower chances of being classified as high physical activity level during the pandemic in comparison to those with high level before pandemic (p < 0.001). The Fear of Covid-19 score was negatively associated with the physical activity level (the higher the fear, the lower the level of physical activity); that is, for every increase in scale score, the odds of vigorous physical activity decreased 3%. In conclusion, fear of COVID-19 and previous contact with the virus negatively influenced physical activity practice.

Relation between caries experience and the consumption of sweetened drinks and processed food in children: A population-based study.

OBJECTIVES: Diet can play a role in caries disease and the consumption of ultra-processed foods has increased over the years. The purpose was to propose predictive models on the relation between caries experience, diet, sex, and oral health aspects. METHODS: This cross-sectional study included 5213 schoolchildren aged 2-11 years and a questionnaire based on WHO Oral Health Survey was applied to assess the intake of sugary foods, oral hygiene practices, access to health services and parents' perception; dmft/DMFT index, biofilm accumulation and orthodontic treatment need were assessed by 6 calibrated dentists. RESULTS: The logistic model showed that female sex and presence of biofilm increased the chance of having early childhood caries; besides, this chance increased by 17% for each additional day of sweetened drink intake. In children aged 6-11 years, a negative binomial regression model showed that the absence of biofilm and frequency of toothbrushing were related to lower caries index, while male sex and the consumption of salty snacks and cake/cookies were related to higher dmft+DMFT index. Disagreement or weak agreement between caregivers' perception of the presence of dental caries and children's need for dental treatment was found. CONCLUSION: Early childhood caries was dependent on the consumption of sweetened drinks and the presence of biofilm, while in older children the caries experience was predicted by the consumption of snacks, cakes and biscuits, biofilm accumulation and toothbrushing frequency, emphasizing the need of health education to encourage healthy eating habits and oral care with an approach to parents/caregivers to prevent dental caries development.

Evaluation of masticatory behavior and taste sensitivity after pacifier removal in preschool children: a 1-year follow-up.

OBJECTIVE: The aim was to investigate the influence of pacifier removal on the development of masticatory function and taste sensitivity in preschool children. METHODS: Sixty children (mean age 48.2 months) were divided into two groups: pacifier group (n = 28) and a control group (n = 32), which were evaluated and followed up for a period of 12 months (at baseline, 6 months, and 1 year). Masticatory and swallowing functions were assessed using the Mastication Observation and Evaluation (MOE) protocol and Orofacial Myofunctional Rating (MBGR), respectively. Detection thresholds for sucrose and urea were measured by the staircase method. The two-way ANOVA mixed model was used for time*group interaction analysis. RESULTS: MOE scores improved significantly over time in both groups, although a significant difference between groups persisted after 1 year. On the other hand, swallowing scores were significantly different at baseline, but within 1 year, the scores were no longer different between groups. Chewing time and the number of cycles were not different between groups and both decreased after 1 year. Sucrose sensitivity was significantly greater in the control group at baseline and changed over time (p < 0.05), being no longer different between groups after 6 months. Bitter sensitivity did not differ over time nor between groups. CONCLUSIONS: Detection threshold for sucrose differed significantly between children with and without pacifier habit at a mean age of 42 months. Total masticatory function did not self-correct after sucking habit removal within a 1-year period. CLINICAL RELEVANCE: Children with pacifier habit showed important changes in masticatory function that did not self-correct 1 year after cessation of the habit, highlighting the need for prevention and habit interruption as early as possible.

Quality of life, physical activity and burnout syndrome during online learning period in Brazilian university students during the COVID-19 pandemic: a cluster analysis.

The COVID-19 pandemic caused several changes in the teaching-learning process, as it abruptly replaced the conventional classes into online classes despite social distancing requirements. Such changes may be associated with several mental health problems and negatively affect the quality of life and academic performance of university students. We performed a cluster analysis in a large sample of Brazilian undergraduate students, considering sociodemographic data, physical activity frequency, study areas, Burnout Syndrome (BS), Quality of Life (QoL) and perception of online learning (OL) during COVID-19 pandemic. Seven hundred and three students (between 17 and 62 years, from 67 higher education institutions) participated in the study. We identified three different profiles of students regarding psychological aspects and OL perception. The first profile, called as the 'Low QoL' group was composed of younger students, mainly females, with higher frequency of psychological disorders (as evidenced by the self-report of depression and/or anxiety), in addition to higher Burnout scores, lower QoL and worse OL perception. The second profile called 'Intermediate QoL' comprised participants with an average age of 45 years, with a greater number of men, married, with kids and working in addition to studying. They presented better OL scores than the 'Low QoL' group. The third profile called 'Better QoL' comprised students with higher scores in all domains of QoL and better OL perception, with greater frequency of physical activity and lower BS scores. Students from Health courses showed higher scores for general QoL, and also for the psychological and environmental domains in relation to the other areas. Besides, students of the Exact Sciences courses showed higher scores on all OL perception items in comparison to the other courses. Our results provide insights regarding the mental health profile of undergraduate students, allowing educational managers to outline specific coping strategies to assist students during the pandemic.

Validation of the Brazilian Portuguese version of the Obsession with COVID-19 Scale (BP-OCS) using a large University Sample in Brazil.

We aimed to validate a Brazilian Portuguese version of the Obsession with COVID-19 Scale (BP-OCS) using a large sample of university students in Brazil (N = 1454). The scale showed solid psychometric characteristics in terms of internal consistency (α = .78), test-retest reliability (ICC = .86), factorial validity (PAF and CFA support), and construct validity. Additionally, BP-OCS scores were found to be higher among females, participants with diagnosed depression, anxiety, and self-reported anxiety. These findings suggest that the BP-OCS is a reliable and valid measure of persistent and disturbed thinking about COVID-19 for Brazilian university students.

Perceived fear of COVID-19 infection according to sex, age and occupational risk using the Brazilian version of the Fear of COVID-19 Scale.

We investigated the fear of COVID-19 infection after proper translation and cultural adaptation of the "Fear of COVID-19 Scale" to the Brazilian Portuguese language. A sample of 1,743 Brazilian participants were included. The scale showed excellent psychometric characteristics. Women showed higher anxiety levels. Fear of COVID-19 scores were lower in males with occupational risk of contamination. On the other hand, women and younger individuals showed higher fear of COVID-19 infection scores. The Brazilian Fear of COVID-19 Scale proved to be a reliable tool with excellent psychometric properties for identifying fear of COVID-19 infection in the Brazilian population.

Impact of gastroplasty on salivary characteristics, dental health status and oral sensory aspects: A controlled clinical study.

BACKGROUND: Saliva is a non-invasive source of biomarkers useful in the study of different pathophysiological conditions. The qualitative and quantitative study of saliva, as well as the assessment of oral health, can be particularly useful for a better understanding of obesity due to its importance in the food oral perception and ingestion. OBJECTIVES: To evaluate the effect of treatment of morbid obesity (dietary counselling versus gastroplasty) on salivary characteristics, oral sensory perception and dental health in a controlled study. METHODS: Seventy-three adults (60 females; 19-59 years) with morbid obesity were divided in: Control group (CG; n = 34) followed-up during a 6-months dietary programme, and Gastroplasty group (GG; n = 39) evaluated immediately before, 3 and 6 months after gastroplasty. Dietary habits, Oral Health Impact Profile and xerostomia complaints were investigated by interview. The clinical examination included anthropometric and caries experience evaluation. Salivary flow rate, buffering capacity, total protein and alpha-amylase levels, and sensitivity for the four basic tastes were assessed. Two-way mixed model and sign test were applied. RESULTS: Physical and clinical aspects did not differ between groups in the beginning of the study, and GG showed a rapid weight loss after surgery (p < .001). An improvement in most of the dietary aspects was observed, especially in the GG. A worsening in the dental health status was observed over time in both groups, with an increase in the number of filled and decayed teeth. CG showed a better oral health-related quality of life, while xerostomia complains increased in GG after gastroplasty. Salivary flow rate remained stable in both groups, but a decrease in buffering capacity, total protein and alpha-amylase activity was observed in GG after 6-months; taste sensitivity increased from baseline to 6-months in GG (p < .05). CONCLUSION: After 6-months of follow-up, patients undergoing gastroplasty presented an improvement in dietary habits and taste sensitivity. However, changes in saliva composition and a worsening in dental health status and xerostomia complaints were also observed.

Examining the Relationship between Social and School Environment and Children's Caries Experience Using Primary and Secondary Data: A Cluster Analysis.

Dental caries is still prevalent worldwide, even with advances in preventive and curative measures. The aim was to examine clustering patterns of socioeconomic and environmental characteristics of schools and their associations with caries experience of schoolchildren. An epidemiological survey with cross-sectional design was conducted in 2014/2015 and included 5,213 students (aged 2-11 years) from 38 public schools of Carapicuíba (SP, Brazil). Primary data consisted of dental examinations performed at schools by 6 calibrated examiners to evaluate caries experience (dmf/DMFT index). Secondary data were extracted from the last official Demographic Census (2010) and School Census (2014 and 2015) to assess the socioeconomic and environmental characteristics of the territorial units and infrastructure of each school, respectively. Cluster analysis and ANOVA were applied to identify schools with similar social and environmental aspects and children's caries experience. A logistic regression model was used to ascertain the effects of cluster variables on the likelihood that participants have caries experience, controlling for the stage of dentition and sex. Two valid and reliable clusters were identified: cluster 1 ("advantaged group"), characterized by 33 schools with the highest percentages of children without caries experience and located in regions with better socioenvironmental indicators, and cluster 2 ("least advantaged group"), characterized by 5 schools with higher percentages of children with caries experience, lower percentages of households with sanitary sewer and water supply, higher residents/household ratio and higher percentages of families living with up to 1 minimum wage. An increase in the odds of having caries experience for each percent of houses with well water and families which live with up to 1 minimum wage was observed. By using primary and secondary data, the study draws attention to the relationship between socioeconomic and environmental indicators and caries experience, identifying least advantaged regions and helping to design strategic health plans for this target population.

Relation between oro-facial thermographic findings and myofunctional characteristics in patients with obstructive sleep apnoea.

AIM: To evaluate the thermographic characteristics of oro-facial structures and submental triangle of participants with obstructive sleep apnoea (OSA), as well as to investigate its correlation with the anatomy, posture and functions of the oro-facial structures. METHOD: Eighteen patients diagnosed with OSA by polysomnography (OSA group; 57.4 ± 15.8 years) and 13 healthy participants screened for OSA (control group; 57.8 ± 18.1 years) were included. All participants answered to questionnaires for OSA and excessive daytime sleepiness, and were submitted to infrared image thermography analysis of facial regions of interest (ROIs), oro-facial myofunctional evaluation (OMES-E protocol) and masticatory performance. Statistical analysis included one-way ANOVA and Pearson/Spearman correlation test. RESULTS: Obstructive sleep apnoea group showed lower thermographic measures in many ROIs in the frontal and lateral views of the face, including the submental triangle region, and lower scores of aspect/posture and performance of oro-facial structures, as well lower total score of OMES-E evaluation (P < .05). Scores of aspect/posture and mobility were correlated with the temperature of some ROIs in the frontal and lateral views. CONCLUSION: Lower facial skin and submental triangle region temperatures, measured by infrared thermography, and a worse oro-facial myofunctional condition were identified in the group of individuals with OSA. The higher temperatures of the ROIs were correlated with the better status of aspect/posture and performance of the oro-facial myofunctional structures.

Assessing Predictive Factors of COVID-19 Outcomes: A Retrospective Cohort Study in the Metropolitan Region of São Paulo (Brazil).

Background and Objectives: The aim of this retrospective cohort study was to search individual, sociodemographic and environmental predictors of COVID-19 outcomes. Materials and Methods: A convenience sample of 1036 COVID-19 confirmed patients (3-99 years, mean 59 years; 482 females) who sought treatment at the emergency units of the public health system of Diadema (Brazil; March-October 2020) was included. Primary data were collected from medical records: sex, age, occupation/education, onset of symptoms, presence of chronic diseases/treatment and outcome (death and non-death). Secondary socioeconomic and environmental data were provided by the Department of Health. Results: The mean time spent between COVID-19 symptom onset and admission to the health system was 7.4 days. Principal component analysis summarized secondary sociodemographic data, and a Poisson regression model showed that the time between symptom onset and health system admission was higher for younger people and those from the least advantaged regions (availability of electricity, a sewage network, a water supply and garbage collection). A multiple logistic regression model showed an association of age (OR = 1.08; 1.05-1.1), diabetes (OR = 1.9; 1.1-3.4) and obesity (OR = 2.9; 1.1-7.6) with death outcome, while hypertension and sex showed no significant association. Conclusion: The identification of vulnerable groups may help the development of health strategies for the prevention and treatment of COVID-19.

Shifts in the bacterial community of saliva give insights on the relationship between obesity and oral microbiota in adolescents.

The current study aimed at the determination of the impact of obesity on the salivary microbiome in adolescents. Sixty subjects ranging 14-17 years old were enrolled (obese: n = 30-50% females, and normal weight: n = 30-50% females). Stimulated saliva was collected for denaturing gradient gel electrophoresis (DGGE) band patterns and massive 16S rRNA gene sequencing using the Ion Torrent platform. Overall, data analysis revealed that male subjects harbored a higher diverse salivary microbiome, defined by a significant higher richness (32.48 versus 26.74) and diversity (3.36 versus 3.20), higher Simpson values (0.96 versus 0.95) and distinct bacterial community structure considering either sex or condition (p < 0.05). Bacterial community fingerprinting analysis in human saliva showed a positive correlation with increased body mass index (BMI) in adolescents. Veillonella, Haemophilus and Prevotella occurrence was found to be affected by BMI, whereas Neisseria and Rothia occurrence was significantly impacted by sex in obese subjects. Our findings suggest that male and female adolescents may harbor a naturally distinct salivary microbiota and that obesity may specifically have an impact on their oral bacterial community. The potential dysbiotic oral microbiome in obese adolescents raises new insights on the etiology and prevention of future conditions in these populations.

Evaluation of oral mechanical and gustatory sensitivities and salivary cotinine levels in adult smokers.

Objective: The aim was to examine oral mechanical and gustatory sensitivities in adult smokers and to estimate salivary levels of cotinine by tobacco consumption. A total of 54 adults (20-45 years old; 28 males/26 females) were divided into two sex-paired groups: smoker group (n = 27), tobacco consumers with no other chronic disease/use of chronic medication, and a control non-smoker non-exposed group with similar age (n = 27).Materials and Methods: 24 h-Recall was used to gather information about tobacco consumption, date of onset and duration of the habit. Oral mechanical evaluation comprised touch detection threshold (MDT) of upper and lower lips and tongue tip and two-point discrimination (TPD) assessments. Taste sensitivities for sweet, salty, sour and bitter were evaluated in four concentrations. Salivary cotinine was determined by high performance liquid chromatography. Statistical analysis comprised Mann-Whitney, Two-way ANOVA test and regression analysis.Results: The mean smoking time was 13.6 years (mean 8.4 mg/day; 13 cigarettes/day). A sex-effect was observed on MDT of tongue tip (higher sensitivity in females), while group-effect was observed on TPD of lower lip, showing a smaller sensitivity among smokers (p < .05; moderate effect: Eta partial2 = 0.076). Although the total score of gustatory sensitivity did not differ between groups, smokers exhibited an irregular pattern of correctly identified tastants among the different concentrations of salty, sour and bitter. The predictive model showed that salivary cotinine was dependent on "nicotine consumption on the day before" (R2 = 49%).Conclusion: A difference in tactile sensitivity of the lower lip and qualitative changes in taste sensitivity were observed in smokers.

Masticatory behaviour and chewing difficulties in young adults with temporomandibular disorders.

BACKGROUND: Difficulties and limitations on masticatory function are among the main reasons why patients with temporomandibular disorder (TMD) seek care. OBJECTIVE: To evaluate the masticatory behaviour and perception of chewing difficulties in adults with mild TMD of recent onset, considering the presence of malocclusion. METHODS: Eighty-one young adults were divided into groups according to the presence of TMD and malocclusion: Non-TMD Normal Occlusion (n = 18), Non-TMD Malocclusion (n = 22), TMD Normal Occlusion (n = 18) and TMD Malocclusion (n = 23). TMD was assessed using the TMD Research Diagnostic Criteria and volunteers also answered questionnaires regarding their perception about jaw functional limitation and difficulty to chew foods of different textures. Masticatory and swallowing behaviours were assessed using the Orofacial Myofunctional Evaluation with Scores (OMES) protocol. Chewing time and chewing frequency taken to ingest the test-food were also obtained. Two-way-ANOVA was used to analyse the TMD, occlusion and TMD × occlusion interaction effects. RESULTS: Temporomandibular disorder effect was observed on vertical jaw mobility and jaw function limitation total scores, meaning that groups differed in the perception of opening limitation and mandibular limitation according to TMD status with a medium effect size. Also, more changes in chewing function (OMES-chewing score) and higher chewing frequency was observed in the presence of TMD (P < 0.05). Occlusion effect was only observed on OMES-swallowing score and no TMD × occlusion interaction effect was observed. CONCLUSION: Changes in chewing behaviour, frequency and perception of mandibular limitation was observed in the presence of TMD, pointing out the importance of functional evaluation when planning and establishing a treatment plan.

Long-term survival analysis of standard-length and short implants with multifunctional abutments.

BACKGROUND: Spherical shape and connecting bypass screw of the OT Equator abutment (Rhein83, Italy) provides several retentive possibilities, even in non-parallel implants. OBJECTIVE: This study assessed the long-term survival of standard-length and short implants receiving this multifunctional abutment. METHODS: Partially, edentulous patients (44 males and 64 females) (mean age 58.2 ± 10.5 years) rehabilitated with a fixed implant-supported prosthesis where the OT Equator abutments (Rhein83) were applied. Follow-up evaluations were performed up to 5 years following prosthesis delivery. Kaplan-Meier survival analysis and Cox regression analysis were used to determine whether the distribution of time to failure differed based on implant characteristics (length and region), adjusting for sex (α = 0.05). RESULTS: In total, 216 implants (5 × 8 mm, n = 126; 5 × 6 mm, n = 90) (Betwice, Mech & Human, Italy) were installed. The average follow-up period was 25.3 months (±19.3 months). Eight failures occurred, with most observed before loading (n = 6). Cumulative survival rates (CSR) at implant and abutment levels were 94.3% and 97.1%, respectively. Regarding implant length, CSRs were 97.8% and 90.6% for short and standard-length implants, respectively, with no difference between subgroups (logrank: χ2  = 1.34, df = 1, P = 0.25). No significant difference was also found between implants of maxilla (CSR = 92.2%) and mandible (CSR = 95.5%; logrank: χ2  = 0.08, df = 1, P = 0.78). CONCLUSION: The OT Equator abutment (Rhein83) showed a stable clinical performance, with continuous and predictable survival.