Prevalence of red and orange microbial complexes in endodontic-periodontal lesions: a systematic review and meta-analysis.

OBJECTIVE: This systematic review assesses the prevalence of microbial complexes in endodontic-periodontal lesion. MATERIALS AND METHODS: Nine databases were searched through August 2020. Experts were consulted to indicate additional studies. Studies were blindly selected by two reviewers based on pre-defined eligibility criteria. Studies that evaluated the prevalence of microbial orange and red complexes among patients with endodontic-periodontal lesion were considered eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. RESULTS: From 572 articles found on all databases, 11 clinical studies were finally included. The following microorganisms were investigated: P. gingivalis, T. forsythia, T. denticola, F. nucleatum, F. periodonticum, P. micra, P. intermedia, P. nigrescens, S. constellatus, C. gracilis, C. rectus, C. showae and E. nodatum. Considering the orange complex, P. micra, E. nodatum and S. constellatus were prevalent in both root canal and periodontal pockets. P. gingivalis and T. forsythia belonging to the red complex were prevalent only in periodontal pockets. The red complex microorganisms were not found very frequently in root canal. CONCLUSIONS: There is a similarity between the microbiome of root canal and periodontal pockets, with prevalence of the three microorganisms of the orange complex. Two microorganisms from the red complex were prevalent only in periodontal pockets. CLINICAL RELEVANCE: The prevalence of specific microorganisms in endodontic-periodontal lesion is important to understand the microbiological profile of the patients involved and to correlate it with possible clinical and repair conditions of this pathology.

Oral leukoplakia-epidemiological survey and histochemical analysis of 107 cases in Brazil.

OBJECTIVE: To perform an epidemiological survey comparing the cell proliferative activity of 107 cases of oral leukoplakia with their clinical and histopathological characteristics. MATERIALS AND METHODS: A cross-sectional, observational, and histological-histochemical study. The cases came from the Histopathological Diagnostic Service of UPF/RS and the School of Dentistry of Araçatuba FOA/UNESP/SP (1986-2016). The histopathological sections were stained using the silver staining (AgNOR) technique and the nuclei of 100 epithelial cells selected randomly were recorded to count the number of nucleolar organizer regions (NORs). The mean NORs per lesion were correlated to clinical and histological characteristics using ANOVA, at 5% significance. RESULTS: Most of the cases included men (62.62%), white (64.49%), and with an average age of 53.94 years. The most probable etiological factors were smoking (44.7%) and alcohol consumption (9.85%). The evolution time of most lesions was fast (33.65%), manifesting mainly in the form of plaques (70.37%) and without symptoms (58.88%). They were located mainly in the cheek mucosa (26.62%) and presented white color (66.35%), well-defined edges (59.81%), firm consistency (47.5%), and keratinized surface (49.53%). Etiological factor (p = 0.003), evolution time (p = 0.006), symptoms (p = 0.029), location (p = 0.020), consistency (p = 0.047), histopathological characteristics (p = 0.004), and superficial keratinization (p = 0.001) were statistically significant regarding the mean NORs of the leukoplakias studied. CLINICAL RELEVANCE: Oral leukoplakias caused by alcohol consumption and/or tobacco use, considering an evolution time of fewer than 12 months, asymptomatic, located in the lower lip or tongue, and with a firm consistency and increased superficial keratinization should be treated more aggressively by the clinician to avoid cancerization.

Hepatitis C and Oral Lichen Planus: Evaluation of their Correlation and Risk Factors in a Longitudinal Clinical Study.

OBJECTIVE: The aim of this study is to evaluate the correlation between hepatitis C virus (HCV) infection and oral lichen planus (OLP), and further examine the relationship between age, sex, systemic diseases and drugs with the presence of HCV infection or OLP. MATERIAL AND METHODS: A longitudinal clinical study was carried out from March 2010 to December 2013 with 51 individuals, of whom 33 had been presented with HCV (HCV-positive group) and 18 had OLP (OLP-positive group), in Passo Fundo, RS, Brazil. Hepatitis C virus-positive individuals who presented lesions compatible with OLP were subjected to an intraoral biopsy for histopathological diagnosis, while OLP-positive individuals underwent anti-HCV serological test for diagnosis of HCV infection. Data on age, sex, systemic diseases and drugs used were recorded for later analysis. The data were analyzed using descriptive statistics of frequency and by Pearson's Chi-square test, with a 5% significance level (p < 0.05). RESULTS: Out of the 33 HCV-positive individuals, only one was clinically and pathologically positive for OLP, demonstrating a significant relationship between the presence of HCV infection and the manifestation of OLP (Chi-square test -46.852, p = 7.65 × 10(-12)). None of the individuals in OLP-positive group had HCV infection. The most common systemic diseases were hypertension and diabetes, and the most commonly used drugs were antihypertensives. However, there was no significant relationship between these factors and the presence of OLP or HCV infection (p > 0.05). CONCLUSION: There was a significant relationship between HCV infection and manifestation of OLP. Age, sex, systemic diseases and drugs were not identified as risk factors for the development of these diseases. CLINICAL SIGNIFICANCE: The OLP could serve as an indicative of HCV infection in asymptomatic patients, thus enabling early diagnosis and treatment of hepatitis and hence, a better prognosis.

Prevalence of species of yellow, purple and green microbial complexes in endo-perio lesions: a systematic review.

This review aimed to determine the prevalence of species of yellow, purple and green microbial complexes in root canals (RC) and periodontal pockets (PP) of teeth with endodontic-periodontal lesions. For this purpose, two reviewers searched the literature up to January 2022. Studies reporting the prevalence of species of the yellow, purple and green microbial complexes in teeth diagnosed with endodontic-periodontal lesions were included. The risk of bias of the included studies was assessed using the 14 criteria from the NIH Quality Assessment Tool. Of 1,611 references identified in the initial search, only four studies were eligible and included in the qualitative analysis. The profile and prevalence rates of bacterial species in RC and PP varied among the included studies: levels of Agregatibacter actinomycetemcomitans (12% RC, 58% PP), Capnocytophaga granulosa (10% RC, 35% PP), Capnocytophaga sputigena (15-70% RC, 0-30% PP), Streptococcus mitis (30% RC, 35% PP), Streptococcus sanguinis (30% RC, 35% PP), and Veillonella parvula (70% RC, 50% PP) were identified. The high methodological heterogeneity prevented grouping and quantitative analysis of data. The risk of bias was considered 'moderate' for all studies. The included studies identified the presence of seven bacterial species belonging to the yellow, purple, and green microbial complexes in RC and PP, but with different prevalence rates. Future clinical studies are encouraged to investigate the presence and role of these species in the occurrence and development of endodontic-periodontal lesions.

Accuracy of the third molar maturity index (I3M) for diagnosing the legal majority of young southern Brazilians.

Background: The numerous techniques for identifying adulthood require research testing the accuracy of each method in different populations. This study verified the accuracy of the third molar maturity index (I3M) proposed by Cameriere et al. (2008) for diagnosing the age of majority in a southern Brazilian population sample. Material and Methods: Panoramic radiographs of patients with dental element 38 treated at the School of Dentistry of the University of Passo Fundo (UPF), RS, Brazil, were analyzed. The patients were separated into age groups between 15.00 and 22.99 years. The Cameriere (2008) method was applied to each radiograph. The study sample comprised 671 individuals, with 385 women (mean age 19.67 ± 2.05) and 286 men (mean age 19.5 ± 2.11). Results: The original cut-off value of I3M≤0.08 classified individuals younger and older than 18 years. ROC curve plotting resulted in an overall accuracy of 0.69 and 0.84 for women and men, respectively. The most favorable cut-off value for southern Brazilian men was 0.06, and women showed better results with an I3M adjusted to 0.13. The new cut-off values produced an accuracy of 0.78 for women and 0.84 for men. The original cut-off point to the I3M (0.08) was not the most appropriate for the studied sample. Conclusions: Thus, index adjustments to 0.13 for women and 0.06 for men may improve method performance among southern Brazilian individuals. Key words:Molar, third, radiography, panoramic, forensic dentistry, age groups, imputability.

Uncommon case of histoplasmosis with oral manifestation: A case report of diagnosis in a South American patient.

INTRODUCTION: Histoplasmosis is a systemic fungal disease caused by the H. capsulatum fungus, which is mainly present in feces and guano of birds and bats. This condition manifests in several ways and it is more severe in its disseminated form and in immunosuppressed patients, putting the patient at risk of death if not diagnosed in time. CASE PRESENTATION: This report presents the case of a 39-year-old white female patient, a seller of agricultural machinery, with a history of lupus erythematosus, who attended a private dental office complaining of a tongue lesion. The patient reported having been subjected to an incisional biopsy of this lesion and the histopathological examination identified an inflammatory process. Considering the inefficient management of the lesion with intralesional application of corticosteroids, squamous cell carcinoma or granulomatous fungal infection was suspected, and a new biopsy was performed allowing the diagnosis of histoplasmosis already spread to the liver, intestines, and bone marrow. The diagnosed disease led the patient to undergo extensive antifungal treatment, including a period of hospitalization. DISCUSSION: The diagnosis of histoplasmosis can be delayed due to several factors, mainly due to its diverse clinical presentation between acute, chronic and disseminated forms. However, achieving an early diagnosis for histoplasmosis is very important to maintain the patient's quality of life. CONCLUSION: Greater education, information, and awareness about histoplasmosis among health professionals are required for managing these cases, especially in endemic areas to H. capsulatum.

Orthognathic surgery and orthodontics associated with orofacial harmonization: Case report.

INTRODUCTION AND IMPORTANCE: Orthognathic surgery aims to restore the functional and esthetic standards of the face and non-surgical or minimally invasive procedures have been optimizing the results of facial orthosurgical treatments. This case report aimed to show the use of minimally invasive techniques that, associated with orthognathic surgery, represent a trend in current oral and maxillofacial rehabilitation. CASE PRESENTATION: A female patient, 28 years old, white, sought care from the Dentistry team of the São Vicente de Paulo Hospital, in Passo Fundo, Brazil, complaining of mandibular prognathism, anteroposterior maxillary deficiency, dental crowding, malocclusion, functional and esthetic changes that negatively affected her psychosocial interactions and stomatognathic function. The treatment involved orthodontics, orthognathic surgery, and orofacial harmonization with dermal fillers. CLINICAL DISCUSSION: The multidisciplinarity among the specialties of Oral and Maxillofacial Surgery and Traumatology, Orthodontics, and Orofacial Harmonization add and contribute to the process of planning and implementing the treatment proposed, as well as the prognosis toward patient satisfaction. CONCLUSION: The surgical procedure associated with minimally invasive facial harmonization not only corrected the functional complaint of the patient but also played an important role in improving facial harmony, contributing significantly to self-esteem.

Clinical and satisfaction outcomes of using one or two dental implants for mandibular overdentures: preliminary short-term follow-up of a randomized clinical trial.

OBJECTIVE: This randomized clinical trial aimed to evaluate the marginal bone loss and peri-implant aspects in patients with mandibular overdentures retained by one or two implants and assess patient satisfaction, prosthesis-related clinical outcomes, and masticatory efficiency. METHODS: Patients from the School of Dentistry of the University of Passo Fundo (UPF) with lower conventional complete dentures dissatisfied with prosthetic retention were selected. Eighteen patients were analyzed and divided into randomized treatment groups: GA, installation of one implant in the midline of the mandibular symphysis (8 patients), and GB, installation of two implants in the lower canine region (10 patients). Implant survival and prosthetic maintenance were assessed by clinical and radiographic examinations performed 6 months after implant placement and 3 months after loading. Finally, the masticatory efficiency of the prostheses was evaluated with the QoLIP-10 (Quality of Life with Implant-Prostheses) questionnaire, and the degree of patient satisfaction used the visual analog scale (VAS). RESULTS: Regarding the esthetic satisfaction of the patients, there was no statistical difference between the two groups studied (p = 0.680). Patients who received two implants presented easier chewing (p = 0.049) and a lower average number of prosthesis maintenance. There was no difference between the groups regarding peri-implant bone resorption 3 months after the use of prostheses. CONCLUSIONS: The use of two dental implants showed higher masticatory ability and lower need for maintenance appointments when compared with one implant in mandibular overdentures but did not affect peri-implant aspects and patient satisfaction. The treatment using one implant was effective for the aspects evaluated, but further clinical studies are required on the subject.

Building oral health assignments for community health workers through the Delphi technique. / Construção de atribuições em saúde bucal para agentes comunitários de saúde através da técnica Delphi.

The literature does not clearly define the assignments of Community Health Workers (CHW) in the field of oral health. This study aimed to redefine the main assignments of CHW regarding their work processes in oral health in basic health care. A theoretical-logical model based on an official publication from the Brazilian Ministry of Health, with six dimensions of work, was used. The model was built based on the assignments of CHW in Dentistry and sent to 30 experts chosen intentionally for the consensual study, using the Delphi technique. The matrix presented the following dimensions: registration of families, mapping the coverage area, home visits, work with community health education, participation in the community, and intersectoral work. These dimensions were detailed with sub-dimensions and measurable criteria. After the study participants analyzed the dimensions, two criteria were excluded. Fourteen experts concluded the study. The final matrix showed the need for CHW to be trained in several oral health topics. This study provides an objective framework of the work process of CHW in oral health and shows their ability to perform oral health promotion, surveillance, prevention, and education actions.

As atribuições dos Agentes Comunitários em Saúde (ACS) na área da saúde bucal não estão claramente especificadas na literatura. Este estudo objetivou redefinir as principais atribuições dos ACS em relação aos processos de trabalho em saúde bucal na atenção básica à saúde. Utilizou-se um modelo teórico lógico baseado em publicação oficial do Ministério da Saúde, com seis dimensões de trabalho. O modelo construído sobre as atribuições dos ACS na Odontologia foi enviado a trinta "experts" escolhidos de forma intencional para o estudo consensual através da técnica Delphi. A matriz apresentou como dimensões: cadastramento das famílias, mapeamento da área de atuação, visita domiciliar, trabalhando educação em saúde na comunidade, participação na comunidade e atuação intersetorial. O detalhamento dessas dimensões foi realizado com subdimensões e critérios mensuráveis. Depois de analisadas as dimensões pelos participantes do estudo, dois critérios foram excluídos. Quatorze experts realizaram o estudo por completo. A matriz final demonstrou a necessidade do ACS estar capacitado em diversos tópicos de saúde bucal. Este estudo fornece uma imagem-objetivo do processo de trabalho do ACS em saúde bucal e demonstra a capacidade do mesmo de realizar atividades de promoção, vigilância, prevenção e educação em saúde bucal.

Treatment of facial myiasis in an elderly patient with oral squamous cell carcinoma: Case report.

Myiasis is caused by the infestation of fly larvae in human tissues and it presents immunodeficiency, poor hygiene, or malignant neoplasias as predisposing chronic diseases. OBJECTIVE: To describe a clinical case of myiasis associated with oral squamous cell carcinoma (OSCC) in an elderly patient. CASE PRESENTATION: A 60-year-old male, black, smoker, and alcoholic patient with OSCC, who refused initial cancer treatment and sought hospital care with an extensive facial lesion and approximately 150 larvae in the extraoral region. The treatment was given through the administration of 6 mg of Ivermectin associated with the surgical removal of the larvae. Subsequently, palliative chemotherapy began. DISCUSSION: Myiasis can sometimes be associated with OSCC and it commonly occurs in individuals who live in unhealthy locations and present poor hygiene and low immunity. In addition to medication, the surgical removal of the larvae is important in the treatment of myiasis. CONCLUSION: Patient adherence to cancer treatment is essential to avoid the negative evolution of the tumor. The social component linked to the development of myiasis makes it an important public health topic, as it is related directly to the lack of primary care. Surgical and drug treatments are required to cure myiasis.

Influência da utilização de ácido glicólico e adesivos universais na qualidade da camada híbrida em restaurações adesivas: Revisão de Literatura / Influence of the use of glycolic acid and universal adhesives on the quality of the hybrid layer in adhesive restorations: literature review

A camada híbrida é definida pela zona de inter difusão do polímero do adesivo e o substrato dental. Os sistemas adesivos universais são materiais que foram criados com o intuito de substituir a estrutura dental que foi perdida a fim de diminuir essa área de interação adesiva e os espaços desmineralizados da dentina. O objetivo do seguinte estudo é realizar uma revisão de literatura acerca da influência dos adesivos universais e o uso do ácido glicólico como condicionante dental. Foi realizada uma busca na literatura atual, nas seguintes bases de dados: PubMed, Scielo, Medline e Google Acadêmico nos idiomas inglês e português usando os termos de pesquisa: "adhesive systems" AND "phosphoricacid" OR/AND "glycolicacid" OR/AND "hybridlayer" OR/AND "universal adhesive system". As pesquisas realizadas utilizando o ácido glicólico como agente condicionante dental demonstraram que a substância tem potencial e efetividade, diminuindo consideravelmente a região de fibras colágenas expostas para a fusão do adesivo universal. O ácido glicólico utilizado como agente condicionante de esmalte e dentina mostrou-se eficaz e promissor, tendo em vista que a camada híbrida se apresentou com menor espessura sem alterar a estrutura dentinária. Porém, faz-se necessário mais pesquisas utilizando o ácido glicólico juntamente com o sistema adesivo universal, por curto, médio e longo prazo.

The hybrid layeri s defined by the interdiffusion zone of the adhesive polymer and the dental substrate. Universal adhesive systems are materials that have been created with the aim of replacing the tooth structure that has been lost in order to reduce this area of adhesive interaction and the demineralized spaces of dentin. The aim of the following study is to perform a literature review on the influence of universal adhesives and the use of glycolic acid as a dental conditioning agent. A search was conducted in the current literature in the following databases: PubMed, Scielo, Medline and Google Scholar in English and Portuguese using the search terms: "adhesive systems" AND "phosphoric acid" AND "glycolic acid" AND "hybrid layer" OR "universal adhesive system". Research using glycolic acid as a dental conditioning agent has shown that the substance has potential and effectiveness, considerably reducing the region of collagen fibers exposed for the fusion of the universal adhesive. Glycolic acid used as a conditioning agent for enameland dent inproved to be effective and promising, considering that the hybrid layer was presented with less thickness without altering the dentin structure. However, further research his needed usinggly colic acid together with the universal adhesive system, for short, medium and long term.

Prevalence of species of yellow, purple and green microbial complexes in endo-perio lesions: a systematic review

Abstract This review aimed to determine the prevalence of species of yellow, purple and green microbial complexes in root canals (RC) and periodontal pockets (PP) of teeth with endodontic-periodontal lesions. For this purpose, two reviewers searched the literature up to January 2022. Studies reporting the prevalence of species of the yellow, purple and green microbial complexes in teeth diagnosed with endodontic-periodontal lesions were included. The risk of bias of the included studies was assessed using the 14 criteria from the NIH Quality Assessment Tool. Of 1,611 references identified in the initial search, only four studies were eligible and included in the qualitative analysis. The profile and prevalence rates of bacterial species in RC and PP varied among the included studies: levels of Agregatibacter actinomycetemcomitans (12% RC, 58% PP), Capnocytophaga granulosa (10% RC, 35% PP), Capnocytophaga sputigena (15-70% RC, 0-30% PP), Streptococcus mitis (30% RC, 35% PP), Streptococcus sanguinis (30% RC, 35% PP), and Veillonella parvula (70% RC, 50% PP) were identified. The high methodological heterogeneity prevented grouping and quantitative analysis of data. The risk of bias was considered 'moderate' for all studies. The included studies identified the presence of seven bacterial species belonging to the yellow, purple, and green microbial complexes in RC and PP, but with different prevalence rates. Future clinical studies are encouraged to investigate the presence and role of these species in the occurrence and development of endodontic-periodontal lesions.

Perception of Dental Students, Dentists and Patients on the Esthetics of Gingival Recession.

BACKGROUND: This cross-sectional study verified the self perception of different observers on gingival recession. METHODS: Areas of gingival recession were digitally modified using software simulating different clinical conditions in the esthetic area. A total of 180 individuals (60 dentists, 60 patients, and 60 dental students) participated in this study. From an original photograph of the smile of a volunteer, five cases of gingival recession (GR), including unilateral recession (lateral incisor and canine), bilateral recession (lateral incisor and canine), and generalized recession in upper anterior teeth, were intentionally created with Adobe Photoshop 2015™ image-editing software. The participants analyzed the photographs with scores of 1 (very pleasant), 2 (pleasant), and 3 (unpleasant). The data were evaluated using Student's t-test and ANOVA with Tukey's post hoc test at p less than 0.05. RESULTS: Unilateral recession was considered more esthetically pleasing when compared to bilateral recession, showing a signifi cant difference for all groups (p less than 0.05). Patients considered generalized recession and bilateral recession of upper canines less esthetic (p less than 0.05). CONCLUSION: Within the limits of this study, it could be concluded that dentists have better visual perception when compared to dental students, who in turn were more perceptive than patients.

Generalized Periodontal Disease Treated with Conservative Periodontal Therapy ­ Case Report and Literature Review / Doença Periodontal Generalizada Tratada com Terapia Periodontal Conservadora ­ Relato de Caso e Revisão da Literatura

Periodontal disease is an infectious-inflammatory disease caused by the presence of bacteria in the dental biofilm, leading in many cases to tooth loss. The objective of this work is to report a clinical case of generalized periodontal disease. Female patient, sought the Dental Clinic of the University of Passo Fundo, complaining that her upper dental arch was increasingly "crooked" and felt a little "mobility". , being diagnosed with stage II periodontitis, due to the pandemic, the patient was only able to return to the Dental Clinic after 5 months, when new exams were carried out, with an increase in the probing depth reaching 7mm in some sites, having a new diagnosis periodontal disease, periodontitis stage III of the disease. The patient's treatment plan consisted of adapting the oral environment, through oral hygiene guidance, prophylaxis, supragingival and subgingival scaling. After 6 months of follow-up, it can be noted that the proposed treatment it was not satisfactory, because, after doing a new periogram, there was no regression of the disease. as for oral hygiene, the patient did not cooperate with the treatment and the installation of orthodontic appliances was not recommended. Periodontal maintenance along with the patient's cooperation is essential to achieve successful periodontal treatment, but in the following case report there was no success in periodontal therapy, and the patient's lack of cooperation could be one of the reasons. (AU)

A doença periodontal é uma doença infecto-inflamatória, causada pela presença de bactérias do biofilme dentário, levando em muitos casos a perda dentária. O objetivo do trabalho é relatar um caso clínico de doença periodontal generalizada. Paciente do sexo feminino, procurou a Clínica Odontológica da Universidade de Passo Fundo, reclamando que sua arcada dentária superior estava cada vez mais "torta" e sentia uma pequena "mobilidade". No exame clínico, a sondagem periodontal foi superior de 3mm chegando até 5mm, sendo diagnosticada com periodontite estágio II, por motivos da pandemia a paciente só conseguiu retornar a Clínica Odontológica depois de 5 meses, quando novos exames foram realizados, sendo verificado um aumento da profundidade de sondagem chegando até 7mm em alguns sítios, tendo um novo diagnostico periodontal, periodontite estágio III da doença. O plano de tratamento da paciente consistia em adequação do meio bucal, por meio de orientação de higiene oral, profilaxia, raspagem supragengival e subgengival. Após 6 meses de acompanhamento, pode-se destacar que o tratamento proposto não foi satisfatório, pois, após fazer um novo periograma, não houve regressão da doença. Com intuito de motivar a paciente com hábitos de higiene bucal, a paciente não colaborou com o tratamento e não sendo indicado a realização a instalação de aparelho ortodôntico. A manutenção periodontal junto com a cooperação do paciente é essencial para alcançar o êxito do tratamento periodontal, mas no seguinte relato de caso não houve sucesso da terapia periodontal, podendo ser um dos motivos a falta de colaboração da paciente. (AU)

Prevalence of oral injuries and salivary changes in patients with chronic renal failure on hemodialysis: systematic review and meta-analysis

The objective of this study was to evaluate whether individuals with chronic renal failure (CRF) undergoing hemodialysis treatment have more salivary and oral mucosa alterations when compared to healthy individuals, through a systematic review followed by meta-analysis. A systematic literature review was performed, evaluating randomized clinical trials found in the Proquest, Embase, Scopus, Cochrane Library, Web of Science, Lilacs and Pubmed databases, using MeSH terms and other keywords. Initially, 40 articles were included in the study and, after reading the complete articles, only 15 clinical trials that analyzed oral lesions and salivary changes in patients with CRF undergoing hemodialysis treatment were eligible. Most of the clinical studies included were cross-sectional and composed of a study group and a control group. The mean age of participants in the study group was 50.19 years and in the control group, 48.95 years. The most common oral alterations found in the CRF group in relation to the control group were xerostomia, uremic breath, dysgeusia, coated tongue, gingival bleeding and pale mucosa. The salivary flow of patients with CRF was 46.6% lower than the control group. The salivary pH in the study group was also more alkaline when compared to the control group. Greater amounts of urea, phosphate, C-reactive protein and total proteins were found in the saliva of individuals with CRF. Individuals with CRF undergoing hemodialysis are more prone to changes in both the quantity and quality of saliva, as well as having a greater amount of oral changes.

Influence of nicotine on machined- and anodized-surface implants. Histometric analysis.

BACKGROUND: The nicotine may generate a influence on bone repair and longevity of dental implants. This fact makes studies to improve the surface of the implants are constantly conducted. This study aimed to evaluate the influence of subcutaneous nicotine injection in the osseointegration process on different implant surfaces, through histomorphometric analysis. MATERIAL AND METHODS: Therefore, twenty-two male rabbits were randomly distributed into two groups according to the subcutaneous injections: (1) nicotine, 3 mg/day/kg and (2) 0.9% NaCI, 3 mL/day/kg, three times a day. Subgroups were then designated - machined and anodized dental implants were installed in the right and left tibia bones, respectively. The animals were subjected to euthanasia after periods of eight weeks for histomorphometric analysis. The bone samples with implants were removed and the routine histological processing was performed. Next, the images obtained from the blades were evaluated by the Image Tool™ software, assessing the osseointegrated areas of implants (BIC), in pixels. Data obtained were subjected to intergroup statistical analysis through the Kruskal-Wallis non-parametric test (α=5%). RESULTS: The test result showed no statistically significant difference among the groups studied (p=0.446). CONCLUSIONS: Based on the methodology studied, it is concluded that the daily application of low doses of nicotine did not interfere with the osseointegration of machined and anodized implants. Key words:Bone-implant interface, implants, osseointegration.

Influence of Different Intellectual Disability Levels on Caries and Periodontal Disease.

Oral health care is fundamental to preserve the individual integrity and consequently influences the general health. This observational, cross-sectional and analytical study evaluated the oral condition of 129 intellectually disabled individuals from the Association of Parents and Friends of Exceptional Children (APAE) in three southern Brazilian cities. Dental caries (DMFT and dmft indices) and periodontal disease (PSR index) were evaluated considering the intellectual disability level. A questionnaire on socioeconomic status (income and education level) and the last visit to a dentist was answered by the subjects' parents/guardians. The data were statistically evaluated using analysis of variance (ANOVA) and Tukey test (α=0.05). The mean DMFT values were 2.27, 3.76 and 0.58 (p<0.05), and the mean dmft values were 1.48, 1.55 and 2.75, respectively for subjects with mild, moderate and severe disabilities. Regarding the PSR index, 43% of the subjects presented gingivitis without retention factor (no calculus or defective margins) with no significant differences among the three disability levels. Considering the population and the limitations of this study, the subjects presenting severe disabilities showed significantly lower mean DMFT values compared to other disability levels, probably because the caretakers are responsible for the oral hygiene of such subjects.

Construção de atribuições em saúde bucal para agentes comunitários de saúde através da técnica Delphi / Building oral health assignments for community health workers through the Delphi technique

Resumo As atribuições dos Agentes Comunitários em Saúde (ACS) na área da saúde bucal não estão claramente especificadas na literatura. Este estudo objetivou redefinir as principais atribuições dos ACS em relação aos processos de trabalho em saúde bucal na atenção básica à saúde. Utilizou-se um modelo teórico lógico baseado em publicação oficial do Ministério da Saúde, com seis dimensões de trabalho. O modelo construído sobre as atribuições dos ACS na Odontologia foi enviado a trinta "experts" escolhidos de forma intencional para o estudo consensual através da técnica Delphi. A matriz apresentou como dimensões: cadastramento das famílias, mapeamento da área de atuação, visita domiciliar, trabalhando educação em saúde na comunidade, participação na comunidade e atuação intersetorial. O detalhamento dessas dimensões foi realizado com subdimensões e critérios mensuráveis. Depois de analisadas as dimensões pelos participantes do estudo, dois critérios foram excluídos. Quatorze experts realizaram o estudo por completo. A matriz final demonstrou a necessidade do ACS estar capacitado em diversos tópicos de saúde bucal. Este estudo fornece uma imagem-objetivo do processo de trabalho do ACS em saúde bucal e demonstra a capacidade do mesmo de realizar atividades de promoção, vigilância, prevenção e educação em saúde bucal.

Abstract The literature does not clearly define the assignments of Community Health Workers (CHW) in the field of oral health. This study aimed to redefine the main assignments of CHW regarding their work processes in oral health in basic health care. A theoretical-logical model based on an official publication from the Brazilian Ministry of Health, with six dimensions of work, was used. The model was built based on the assignments of CHW in Dentistry and sent to 30 experts chosen intentionally for the consensual study, using the Delphi technique. The matrix presented the following dimensions: registration of families, mapping the coverage area, home visits, work with community health education, participation in the community, and intersectoral work. These dimensions were detailed with sub-dimensions and measurable criteria. After the study participants analyzed the dimensions, two criteria were excluded. Fourteen experts concluded the study. The final matrix showed the need for CHW to be trained in several oral health topics. This study provides an objective framework of the work process of CHW in oral health and shows their ability to perform oral health promotion, surveillance, prevention, and education actions.

Sobredentadura retida por sistema barra-clipe: revisão de literatura / Overdenture retained by bar-clip system: literature review

Introdução: as overdentures são próteses totais removíveis, mucoimplanto-suportadas, estabilizadas por elementos instalados sobre raízes residuais e/ou sobre implantes. Uma variedade de sistemas de encaixe tem sido utilizada para suportar as sobredentaduras, dentre os quais os sistemas barra-clipe, bolas, magnetos e coroas telescópicas. Objetivo: avaliar, por meio de uma revisão de literatura, as sobredentaduras retidas por sistema barra-clipe, expondo um correto planejamento, bem como descrevendo protocolos de confecção de tais aparelhos. Métodos: foi realizada uma revisão de literatura nas bases de dados do Centro Latino-americano e do Caribe de Informações em Ciências da Saúde (LILACS), Medline, Bibliografia Brasileira de Odontologia (BBO), na biblioteca virtual (SCIELO), e no acervo de livros da Universidade de Passo Fundo/RS (UPF). Revisão de literatura: o sistema barra-clipe consiste de uma barra plástica para fundição (ou já em metal) e de um clipe de retenção. Em algumas situações, o sistema de encaixes por barra-clipe é mais indicado do que os demais sistemas, apresentando, todavia, limitações em determinados cenários clínicos. O sistema barra-clipe permite considerável retenção e estabilidade, resultando num restabelecimento da função mastigatória, maior segurança e grande satisfação do paciente. Considerações finais: a maior parte dos estudos mostrou uma melhora da qualidade de vida relacionada à saúde bucal dos pacientes após tratamento com overdenture em comparação com a prótese total removível convencional.

Introduction: overdentures are removable, muco-implantsupported, complete dentures, stabilized by elements installed on residual roots or implants. A variety of docking systems have been used to support overdentures, including bar-clip systems, balls, magnets and telescoping crowns. Objective: to evaluate, through a literature review, the overdentures retained by bar-clip system, exposing a correct planning, as well as describing protocols of making such devices. Methods: a literature review was carried out in the databases of the Latin American and Caribbean Center on Health Sciences Information (LILACS), Medline, Brazilian Dentistry Bibliography (BBO), the virtual library (SCIELO) and the collection of books from the University of Passo Fundo/RS (UPF). Literature Review: the bar-clip system consists of a plastic bar for casting or already metal and a retention clip. In some situations, the clip-on system is more suitable than other systems, although it has limitations in certain clinical scenarios. The bar-clip system allows considerable retention and stability, resulting in a restoration of the masticatory function, greater safety and great patient satisfaction. Final considerations: most of the studies showed an improvement in the quality of life related to the oral health of the patients after treatment with overdenture compared to the conventional total removable prosthesis.

Alterações estomatológicas mais frequentes e seu processo diagnóstico ­ revisão de literatura / Most frequent stomatological changes and their diagnostic process ­ literature review

Introdução: os estudos epidemiológicos exercem um importante papel na Saúde Pública, indicando a prevalência e a incidência das lesões do complexo bucomaxilofacial, e revelando fatores associados, como perfil socioeconômico, fatores genéticos e ambientais, e permitindo o direcionamento de ações de promoção e de prevenção de saúde. Objetivo: o objetivo do presente trabalho é realizar uma revisão de literatura acerca dos aspectos mais importantes para o estabelecimento do diagnóstico das alterações estomatológicas. Revisão de literatura: um dos principais obstáculos dos profissionais da saúde diante de um caso de lesão bucal é o estabelecimento de um diagnóstico preciso, devido à grande quantidade de diagnósticos diferenciais que tais condições podem apresentar. É viável, através do auxílio dos estudos de prevalência, reduzir o número de diagnósticos diferenciais, identificando a frequência das lesões para cada região, ao considerar também variáveis, como faixa etária, etnia e gênero. Considerações finais: conhecer a prevalência das lesões e saber identificar as variáveis associadas a cada uma é de suma importância para o estudante de odontologia e mesmo para o profissional, uma vez que este conhecimento contribuirá para o melhor manuseio e proservação de seu paciente.

Introduction: epidemiological studies performs an important role in Public Health, indicating the prevalence and incidence of injuries of the bucomaxillofacial complex, and revealing associated factors such as socioeconomic profile, genetic and environmental factors, and allowing the promotion of prevention and Cheers. Objective: the aim of the present study is to carry out a literature review about the most important aspects for establishing the diagnosis of stomatologic alterations. Literature review: one of the main obstacles faced by health professionals in the case of oral lesions is the establishment of an accurate diagnosis, due to the large number of differential diagnoses that such conditions may be present. It is feasible, through the aid of prevalence studies, to reduce the number of differential diagnoses, identifying the frequency of lesions for each region, as well as variables such as age, ethnicity and gender. Final considerations: knowing the prevalence of lesions and knowing how to identify the variables associated with each one is of paramount importance for the student of dentistry and even for the professional, since this knowledge will contribute to the better handling and proservation of his patient.