Oral lesions of systemic lupus erythematosus: A collaborative Latin American study.

BACKGROUND: Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease that may affect the oral mucosa. The variable spectrum of oral lesions observed in SLE can pose challenges in diagnosis, particularly when the lesions occur in isolation. The aim of this study was to describe the oral lesions occurring in patients with SLE from Latin America. METHODS: This collaborative record-based study involving 11 oral and maxillofacial pathology and medicine services across Venezuela, Argentina, Chile, Brazil, and Mexico describes the clinicopathological profile of SLE-related oral lesions. RESULTS: Seventy patients with SLE and oral lesions were included in the study. The majority were females (75.7%; female/male ratio: 3.1:1) and white (62.1%), with a mean age of 38.4 years (range: 11-77 years). The most common site of oral lesions was the hard/soft palate (32.0%). Clinically, oral lesions predominantly presented as ulcers (26.6%), erosions (26.6%), and white lesions (23.4%). Isolated oral lesions occurred in 65.2% of individuals, while cutaneous manifestations occurred in 80.3%. The main clinical diagnostic hypothesis in 71.4% of cases was an immune-mediated disease. Oral biopsies followed by histopathological analysis were performed in 50 cases. CONCLUSION: Oral lesions of SLE exhibit a variety of clinical and histopathological features. A key point in diagnosis is that unusual oral changes without an obvious local cause may indicate a possible systemic condition presenting with oral lesions. A multidisciplinary approach, which includes regular oral examination, is warranted to identify oral lesions and provide treatment.

Ameloblastic carcinoma: A systematic review.

BACKGROUND: Ameloblastic carcinoma (AC) is the most common odontogenic malignancy, constituting approximately 30% of cases in this category. Literature is sparse on malignant odontogenic neoplasms, with a large proportion of current knowledge derived from case reports or small case series. METHODS: A systematic review of case series/case reports of AC was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Statement guidelines. Demographic and clinical information, including duration of the lesion, location, clinical presentation and radiologic features, were analysed. Additionally, the origin of the lesion (primary/secondary), Ki-67 proliferation index, treatment performed, metastasis, tumour recurrence and prognosis were collected for analysis. RESULTS: A total of 126 studies, including 285 individual cases of AC, were included in this review. Patients presented with a near-equal distribution of painless and painful swellings. ACs presented at a median age of 45 years, with a male-to-female ratio of 1:2. The mandible was most frequently involved, with rare cases extending to involve more than one region, including crossing the midline. Although most lesions presented with poorly-demarcated borders (52.6%), unilocular lesions with well-demarcated borders (47.4%) comprised a substantial number in the sample. The proliferation index was only reported in 27 cases, with a mean score of 42% and a wide range. The probability of tumour recurrence increased, and the survival probability decreased with prolonged follow-up duration. CONCLUSION: This study provides more comprehensive, up-to-date descriptive data on these rare odontogenic malignancies, aiding clinicians and Pathologists with the diagnosis and surgeons in their management of cases.

Neutrophil extracellular traps in rheumatoid arthritis and periodontitis: Contribution of PADI4 gene polymorphisms.

AIM: We sought to investigate the release of neutrophil extracellular traps (NETs) in neutrophils from individuals with rheumatoid arthritis (RA) and controls and compare the presence of NETs in gingival tissues according to periodontal status. Also, the association between single nucleotide polymorphisms (SNPs) of the peptidyl arginine deaminase type 4 (PADI4) gene and the GTG haplotype with RA, periodontitis and NETs was evaluated in vitro. MATERIALS AND METHODS: Peripheral neutrophils were isolated by density gradient, and NET concentration was determined by the PicoGreen method. Immunofluorescence was studied to identify NETs by co-localization of myeloperoxidase (MPO)-citrullinated histone H3 (H3Cit). Genotyping for SNPs (PADI4_89; PADI4_90; PADI4_92; and PADI4_104) was performed in 87 individuals with RA and 111 controls. RESULTS: The release of NETs in vitro was significantly higher in individuals with RA and periodontitis and when stimulated with Porphyromonas gingivalis. Gingival tissues from subjects with RA and periodontitis revealed increased numbers of MPO-H3Cit-positive cells. Individuals with the GTG haplotype showed a higher release of NETs in vitro and worse periodontal parameters. CONCLUSIONS: The release of NETs by circulating neutrophils is associated with RA and periodontitis and is influenced by the presence of the GTG haplotype.

Dental caries and developmental defects of enamel in cerebral palsy: A meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to compare the occurrence of dental caries and developmental defects of enamel (DDE) in individuals with and without cerebral palsy (CP). MATERIALS AND METHODS: We conducted searches across five databases and the grey literature. Data were organized using EndNote 20. Reporting followed the MOOSE checklist. A random-effects model meta-analyses were conducted using RStudio, presenting results as mean difference (MD), odds ratio (OR), and 95% confidence interval (CI). The risk of bias of studies was analyzed using the Newcastle-Ottawa Scale, and the certainty of evidence was assessed using GRADE. RESULTS: Among 1336 identified records, 25 studies involving 59,997 participants (mean age: 11.1 years) were included. Data of 12 were pooled into meta-analyses. No significant differences were found between CP and non-CP individuals across indices: DMFT (k = 7) (MD = 0.31; 95% CI [-0.42-1.05]), dmft (k = 4) (MD = 0.31; 95% CI [-0.50-1.14]), DMFS (k = 2) (MD = -0.61; 95% CI [-20.56-19.33]), dmfs (k = 3) (MD = 0.54; 95% CI [-1.09-2.17]), and DDE (k = 3) (OR = 0.80, 95% CI [0.09-7.31]). The certainty of evidence was very low. CONCLUSION: Individuals with CP do not appear to differ significantly from those without CP in terms of dental caries experience and DDE.

Kinetics of neutrophil extracellular traps and cytokines in oral mucositis and Candida infection.

OBJECTIVE: This study investigated the concentrations of neutrophil extracellular traps (NET) and salivary cytokines (IL-1ß, IL-6, IL-8/CXCL8, TNF, and TGF-ß1) in patients undergoing chemotherapy and their associations with oral mucositis (OM) and Candida infection. MATERIALS AND METHODS: This prospective longitudinal study performed at a Brazilian service included 60 adults diagnosed with hematolymphoid diseases. Saliva samples were collected on days D0, D3, D10, and D15. Cytokines were analyzed by ELISA and NET formation by identification of the myeloperoxidase-DNA complex. Oral Candida spp. was cultured. RESULTS: OM occurred in 43.3% of patients and oral candidiasis in 20%. However, 66% of individuals had positive cultures for C. albicans. Higher concentrations of IL-6, IL-8/CXCL8, and TNF and lower concentrations of TGF-ß1 were observed in patients with OM. C. albicans infection contributed to the increase in IL-8/CXCL8, TGF-ß1, and TNF. Individuals with OM or with oral candidiasis had significant reductions in NET formation. In contrast, individuals with C. albicans and with concomitant C. albicans and OM exhibited higher NET formation. CONCLUSION: The kinetics of cytokine levels and NET formation in chemotherapy-induced OM appears to be altered by Candida infection, even in the absence of clinical signs of oral candidiasis.

Top 100 most-cited scientific articles in regenerative endodontics 2019-2023: A bibliometric analysis.

BACKGROUND: Bibliometric analysis is a critical indicator of the influence and relevance of scientific papers, whilst also highlighting key contributors and gaps in knowledge in a scientific field. OBJECTIVES: To update and analyse the 100 most-cited papers in regenerative endodontics from 2019 to 2023. METHODS: A search of the most-cited recent papers focusing on regenerative endodontics using journals included in the category, 'Dentistry, Oral Surgery & Medicine', in the Clarivate Web of Science database from 2019 to 2023 was performed. Three researchers conducted the study selection and data extraction. Data extraction included publication title and year, authors, number and mean number of citations, institution, country and continent, study design, journal title, keywords and research topic. Citation counts were also collected in Google Scholar and Scopus databases. Graphical bibliometric networks were created using VOSviewer software. RESULTS: The number of citations of the 100 most-cited articles ranged from 6 to 85. Most were published in 2020 (n = 48), principally in the Journal of Endodontics (47%), followed by International Endodontic Journal (13%), Journal of Dental Research (6%) and Dental Materials (6%). Laboratory study was the most common study design amongst the included papers (n = 47), followed by narrative reviews (n = 17) and observational studies (n = 16). The most frequent first author on the top three most-cited papers was Hacer Aksel, whilst Adham A. Azim (n = 6; 89 citations) contributed most to the top 100 articles. The institution from which most articles originated was the University of Hong Kong (China) (n = 5; 81 citations), whereas the corresponding authors were predominantly from the United States of America (USA) (n = 31; 560 citations). The VOSviewer map of co-authorship demonstrated research collaborative clusters. 'Regenerative endodontics' and 'stem-cells' were the most employed keywords (37 and 36 occurrences respectively). DISCUSSION: The current study was designed not only to showcase the most influential papers in regenerative endodontics since 2019 but also to provide a better understanding of global research in this area over the last five years. CONCLUSIONS: This bibliometric analysis highlighted papers, authors, institutions and keywords in regenerative endodontics. The 100 most-cited papers primarily consisted of laboratory studies published in the USA, focusing on evaluating biomaterials and scaffold design strategies in contact with stem cells. Clinical studies and systematic reviews representing higher levels of scientific evidence are currently not the most influential in the regenerative endodontic field.

Influence of dental bleaching on the pulp tissue: A systematic review of in vivo studies.

BACKGROUND: Although several studies indicate the harmful effects of bleaching on pulp tissue, the demand for this procedure using high concentrations of hydrogen peroxide (HP) is high. OBJECTIVES: To investigate the influence of bleaching on the pulp tissue. METHODS: Electronic searches were conducted (PubMed/MEDLINE, Scopus, Cochrane Library and grey literature) until February 2021. Only in vivo studies that evaluated the effects of HP and/or carbamide peroxide (CP) bleaching gels on the inflammatory response in the pulp tissue compared with a non-bleached group were included. Risk of bias was performed according to a modified Methodological Index for Non-Randomized Studies scale for human studies and the Systematic Review Centre for Laboratory Animal Experimentation's RoB tool for animal studies. Meta-analysis was unfeasible. RESULTS: Of the 1311 studies, 30 were eligible. Of these, 18 studies evaluated the inflammatory response in animal models. All these studies reported a moderate-to-strong inflammatory response in the superficial regions of pulp, characterized by cell disorganization and necrotic areas, particularly during the initial periods following exposure to 35%-38% HP, for 30-40 min. In the evaluation of human teeth across 11 studies, seven investigated inflammatory responses, with five observing significant inflammation in the pulp of bleached teeth. In terms of tertiary dentine deposition, 11 out of 12 studies noted its occurrence after bleaching with 35%-38% HP in long-term assessments. Additionally, three studies reported significant levels of osteocalcin/osteopontin at 2 or 10 days post-treatment. Other studies indicated an increase in pro-inflammatory cytokines ranging from immediately up to 10 days after bleaching. Studies using humans' teeth had a low risk of bias, whereas animal studies had a high risk of bias. DISCUSSION: Despite the heterogeneity in bleaching protocols among studies, High-concentrations of HP shows the potential to induce significant pulp damage. CONCLUSIONS: High-concentrations of bleaching gel increases inflammatory response and necrosis in the pulp tissue at short periods after bleaching, mainly in rat molars and in human incisors, in addition to greater hard tissue deposition over time. However, further well-described histological studies with long-term follow-up are encouraged due to the methodological limitations of these studies. REGISTRATION: PROSPERO (CRD42021230937).

Clinical, immunological, and microbiological analysis of the association between periodontitis and COVID-19: a case-control study.

PURPOSE: Periodontitis and coronavirus disease (COVID-19) share risk factors and activate similar immunopathological pathways, intensifying systemic inflammation. This study investigated the clinical, immunological and microbiological parameters in individuals with COVID-19 and controls, exploring whether periodontitis-driven inflammation contributes to worsening COVID-19 endpoints. METHODS: Case (positive RT-PCR for SARS-CoV-2) and control (negative RT-PCR) individuals underwent clinical and periodontal assessments. Salivary levels of TNF-α, IL-6, IL-1ß, IL-10, OPG, RANKL, neutrophil extracellular traps, and subgingival biofilm were analyzed at two timepoints. Data on COVID-19-related outcomes and comorbidity information were evaluated from medical records. RESULTS: Ninety-nine cases of COVID-19 and 182 controls were included for analysis. Periodontitis was associated with more hospitalization (p = 0.009), more days in the intensive care unit (ICU) (p = 0.042), admission to the semi-ICU (p = 0.047), and greater need for oxygen therapy (p = 0.042). After adjustment for confounders, periodontitis resulted in a 1.13-fold increase in the chance of hospitalization. Salivary IL-6 levels (p = 0.010) were increased in individuals with COVID-19 and periodontitis. Periodontitis was associated with increased RANKL and IL-1ß after COVID-19. No significant changes were observed in the bacterial loads of the periodontopathogens Porphyromona gingivalis, Aggregatibacter actinomycetemcomitans, Tanerella forsythia, and Treponema denticola. CONCLUSIONS: Periodontitis was associated with worse COVID-19 outcomes, suggesting the relevance of periodontal care to reduce the burden of overall inflammation. Understanding the crosstalk between SARS-CoV-2 infection and chronic conditions such as periodontitis that can influence disease outcome is important to potentially prevent complications of COVID-19.

Diagnosis and rehabilitation of an infant with palatal mucormycosis: A clinical report and systematic literature review.

STATEMENT OF PROBLEM: Oral mucormycosis is uncommon in pediatric patients with hematolymphoid diseases. Prosthetic rehabilitation is challenging, and protocols are scarce in the literature. PURPOSE: The purpose of this clinical report and systematic literature review of case reports and case series was to describe the clinicopathologic aspects of oral mucormycosis and the interim prosthetic rehabilitation of an affected infant. MATERIAL AND METHODS: The clinical lesions were ulcerative and necrotic with underlying bone exposure that affected the hard palate. The affected area underwent surgical debridement, and histopathologic analysis was performed. A literature search in PubMed/MEDLINE, Embase, Scopus, and Web of Science up to October 2023 was performed. RESULTS: The histopathological features were consistent with mucormycosis. Topical and systemic antifungals were prescribed. Tooth eruption was insufficient, and an acetate plate without clasp retention, but still with adequate retention, was fabricated. Articulatory, masticatory, and swallowing functions were restored, preventing the passage of food and fluids into the oroantral cavities. Twenty-five articles describing 26 patients with oral mucormycosis related to hematolymphoid disorders affecting the pediatric population were identified. None of the authors of these articles provided information about oral rehabilitation. CONCLUSIONS: Early diagnosis and treatment are essential to increasing the chances of survival for infants affected by oral mucormycosis. Custom-made rehabilitation should be provided to restore oral function and improve the patient's general health.

Probable sleep and awake bruxism in adolescents: A path analysis.

BACKGROUND: Bruxism has a multifactorial etiology, including the influence of sleep characteristics and chronotypes. AIM: To identify the pathways that influence the occurrence of probable sleep bruxism (PSB) and probable awake bruxism (PAB) in adolescents. DESIGN: A total of 403 adolescents, aged 12-19 years, participated in the study. Parents/caregivers filled out a questionnaire about sociodemographic issues and the adolescent's health conditions, and the adolescents about sleep characteristics, occurrence of bruxism (based on previous study and the International Consensus of Bruxism), and chronotype (Circadian Energy Scale). Clinical examinations were performed. Statistical analysis included descriptive analysis and path analysis. RESULTS: PSB and PAB are related to each other, with moderate and positive correlation (ß = .390). Poor sleep quality and higher household income had a direct effect on both PSB (ß = -.138; ß = .123, respectively) and PAB (ß = -.155; ß = .116, respectively). Chronotype had a direct effect on PSB, in such a way that adolescents with a morningness chronotype tend to have PSB (ß = -.102). Adolescents that drool on the pillow (ß = .184) and/or have agitated sleep (ß = .104) tend to have PSB. CONCLUSION: Poor sleep quality, household income, morningness chronotype profile, drooling on the pillow, and agitated sleep influence the paths taken by PSB. PAB was influenced by the quality of sleep and family income.

Impact of treament with orthodontic aligners on the oral health-related quality of life.

BACKGROUND: There is an increasing interest in information on the effects of orthodontic aligners on the oral health-related quality of life (OHRQoL) of people. AIM: To compare the impact of orthodontic aligners versus conventional fixed appliances on OHRQoL, using a validated tool and controlling for sociodemographic and clinical variables. METHOD: Sixty-one individuals participated in this study. Group 1 (G1) consisted of 33 individuals under treatment with orthodontic aligners and Group 2 (G2) comprised 28 individuals under treatment with conventional fixed appliances. OHRQoL was evaluated with the Oral Health Impact Profile (OHIP-14) in which 14 items are distributed across seven dimensions: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The higher the score, the more negative is the perception of the individual regarding his/her OHRQoL. Descriptive statistics, Mann-Whitney test, and Poisson regression were performed. Effect Size (ES) and Minimal Clinically Important Difference (MCID) were also determined. RESULTS: Participants' mean age was 30.69 years. Individuals in G1 had a significantly lower score for physical pain and the total score of OHIP-14 compared to individuals in G2 (p < 0.05). The ES was large (ES = 0.74) for physical pain and moderate (ES = 0.46) for the total score. The ES was moderate for physical disability (ES = 0.50). The difference between groups for physical pain (1.30) and for physical disability (0.90) was greater than the MCID (0.87 and 0.88, respectively). Poisson regression showed that G2 individuals showed a score for physical pain 1.39 times higher than those of G1 in the adjusted model (OR = 1.39, [1.03-1.89], p = 0.031). CONCLUSION: Those under treatment with orthodontic aligners have a more positive perception of OHRQoL compared to those wearing fixed appliances.

Association of anxiety and depression with oral mucositis: A systematic review.

OBJECTIVE: Anxiety and depression are frequent conditions among individuals undergoing antineoplastic therapy, but their relationship with oral mucositis is unclear. This systematic review evaluated the potential association of anxiety and depression with frequency and severity of chemo/radiotherapy-induced oral mucositis. MATERIALS AND METHODS: Electronic searches were undertaken in five databases supplemented by manual scrutiny and gray literature searches in three other databases. The risk of bias was assessed using the Joanna Briggs Institute tool. RESULTS: Eight observational studies conducted on 954 individuals (male-to-female ratio: 1.1:1; age range: six-82 years). Three (37.5%) studies included patients with solid tumors, two (25%) studies included hematopoietic/lymphoid tissue tumors, and two (25%) studies comprised mixed types of malignant neoplasms. Eight different instruments were used to assess oral mucositis, while seven different instruments were used to evaluate anxiety and depression. Associations of anxiety and/or depression with oral mucositis severity were reported in six (75.0%) studies. Oral mucositis-related symptoms, especially pain, were linked with depression in three (37.5%) studies. CONCLUSION: A relatively low number of cases and data heterogeneity hamper definitive conclusion about the potential association between anxiety/depression and oral mucositis. Further studies that could guide more personalized treatments are warranted to investigate this plausible bidirectional interaction.

Leukemia/lymphoma oral infiltration and its impact on disease outcomes: A Brazilian study.

OBJECTIVE: Oral malignant infiltrations (OMI) are relevant for the diagnosis and prognosis of leukemia/lymphoma. This study analysed the oral health status and OMI of individuals with leukemia/lymphoma. MATERIALS AND METHODS: A retrospective analysis (2010-2021) of data from individuals seen at a specialized hospital-based dental service in Brazil. RESULTS: A total of 781 cases of leukemia/lymphoma were surveyed. Acute lymphoblastic leukemia (30.1%), acute myeloid leukemia (AML; 26.0%), and non-Hodgkin lymphoma (22.2%) were the most common diagnoses. The first (21.3%) and second (19.3%) decades of life were the most affected. Overall, dental caries (36.7%) and periodontal changes (34.6%) were the most frequent oral conditions. OMI occurred in 25 (3.2%) individuals. Lesions mainly involved the gingiva (80%) and patients diagnosed with AML (64%). Death (p < 0.001) and worse periodontal condition (p = 0.036) were more frequent among adults with OMI than among those without OMI. Death (p = 0.002) was more frequent among paediatric individuals with OMI than among those without OMI. When controlling for underlying disease, no association was observed between OMI and these outcomes. CONCLUSION: Oral status of individuals with leukemia, particularly those with acute leukemia or lymphoma, should be closely monitored since one or multiple conditions may occur, including OMI, which may influence disease outcomes.

Effect of photobiomodulation adjunct to periodontal therapy on individuals with type 2 diabetes mellitus regarding periodontal clinical parameters: a systematic review and meta-analysis.

The purpose of this study is to evaluate the scientific evidence on the impact of photobiomodulation adjunct to non-surgical periodontal treatment on individuals with type 2 diabetes mellitus (T2DM). The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. A protocol was registered in the International Prospective Registry of Systematic Reviews (PROSPERO #CRD42022310756). The research was carried out in seven databases, with no restrictions regarding the year of publication. Our work included studies that compared periodontal clinical parameters among individuals undergoing non-surgical periodontal therapy associated with photobiomodulation and a control group of individuals undergoing non-surgical periodontal treatment. Study selection, data extraction, and risk of bias assessment (RoB 2.0) were performed by two review authors. Meta-analysis was performed. Mean difference (MD) and a 95% confidence interval (CI) were provided. Three hundred forty-one studies were identified, of which eight studies were included. The meta-analysis demonstrated that photobiomodulation adjunctive to periodontal therapy in individuals with diabetes resulted in a greater reduction in probing depth and greater attachment gain in comparison to periodontal treatment alone (p < 0.05). The included studies exhibited a low risk of bias. Photobiomodulation adjunct to periodontal therapy contributes to the improvement of periodontal clinical parameters in individuals with T2DM.

Proposal of a prophylactic photobiomodulation protocol for chemotherapy-induced oral and oropharyngeal mucositis: a randomized clinical trial.

Photobiomodulation therapy (PBMT) is widely used in oncology settings, but lack of assessment standardization is the main barrier to optimization of clinical protocols. This study analyzed three PBMT protocols for preventing oral and oropharyngeal mucositis (OM) in patients undergoing chemotherapy (CT) and/or hematopoietic stem cell transplantation (HSCT). This is a preliminary randomized blind clinical trial. Group 1 received intraoral prophylactic PBMT, Group 2 received intraoral and oropharyngeal PBMT, and Group 3 received intraoral, oropharyngeal, and extraoral PBMT. The applications were from the first day of CT to day + 10. Clinicodemographic data, CT regimens, types of HSCT, hematological exams, occurrence/severity of OM, odynophagia, and OM-related opportunistic infections were assessed. Sixty participants (age range: 18-74 years) were included; 70% of them underwent CT and 30% HSCT. About 43.3% of patients had OM, while odynophagia was reported by 23.3%. Both Groups 1 and 2 revealed better results. Multivariate analysis showed that HSCT directly influenced the occurrence of OM. Individuals who had undergone allogeneic HSCT were 1.93 times more likely to develop OM (p < 0.001). Group 3 exhibited a higher frequency of OM, albeit of lower grades. This group consisted of half the population who had undergone HSCT, had the highest percentage of melphalan use, and had the lowest mean leukocyte count. The three proposed protocols were effective in preventing and reducing OM, with good tolerance and no reported adverse effects. PBMT is a safe and effective approach to OM prophylaxis in adults undergoing CT/HSCT.

Management of oral leukoplakia with an 808-nm high-power diode laser: a single-center experience.

PURPOSE: High-power diode laser emerges as a promising approach to the treatment of oral leukoplakia (OL); however, its short- and long-term effects have been barely explored. This study evaluated the postoperative endpoints and the recurrence rate of high-power diode laser treatment in a well-defined series of patients with OL. METHODS: A prospective analysis was performed on 22 individuals comprising 31 OL. The lesions were irradiated using the following protocol: Indium-Gallium-Arsenide diode laser, 808 nm, continuous-wave mode, 1.5-2.0 W, 780.0 ± 225.1 J, and 477.1 ± 131.8 s. Postoperative pain was assessed with a visual analog scale at three endpoints. Clinical follow-up was performed on all patients and the Kaplan-Meier test was used to analyze the probability of recurrence. RESULTS: The series consisted mostly of women (72.7%) with a mean age of 62.8 years. A single laser session was performed in 77.4% of cases. The median score on the scale that assessed pain on the 1st, 14th and 42nd postoperative day was 4, 1, and 0, respectively. The mean follow-up period per lesion was 28.6 months (range: 2-53 months). A complete response was observed in 93.5% of OL cases, while 6.5% had recurrence. The probability of recurrence at 39 months was 6.7%. No patient experienced malignant transformation. CONCLUSION: High-power diode laser for the treatment of OL is safe and effective during the trans- and postoperative period. These findings represent an alternative approach to the management of OL, mainly because a low recurrence rate was observed.

Influence of sodium hypochlorite on cyclic fatigue resistance of nickel-titanium instruments: A systematic review and meta-analysis of in vitro studies.

OBJECTIVE: This systematic review/meta-analysis investigated the influence of NaOCl on cyclic fatigue resistance of endodontic NiTi instruments. MATERIALS AND METHODS: A systematic search until July 2022 in PubMed/MEDLINE, Embase, Scopus, Web of Science, SciELO, Cochrane Library, and grey literature was conducted. According to the PECOS strategy, only in vitro studies evaluating the effects of NaOCl on the cyclic fatigue resistance of NiTi instruments were eligible. Cyclic fatigue resistance was the primary outcome. A modified Joanna Briggs Institute's Checklist was used for risk of bias assessment. RESULTS: Of the 2,445 records screened, 37 studies were included. Most studies used simulated canals made of stainless-steel block with severe to moderate curvatures. NaOCl concentration varied from 1-6%, mainly at 37 °C. Regarding fatigue resistance, 23 studies using 1.2% to 6% NaOCl showed a reduction in the resistance compared to the control groups, especially when pre-heated. Four meta-analyses were performed according to the tested NiTi systems. The meta-analyses indicated that the PTU F2 files had higher reduction of fatigue resistance after exposure to 5.25% NaOCl; no differences between NaOCl and no immersion were observed for Reciproc R25, WaveOne 25.08, and WaveOne Gold Primary files. Included studies had low risk of bias. CONCLUSION: NaOCl appears to reduce cyclic fatigue resistance of certain NiTi files, especially when they are pre-heated, particularly in conventional NiTi files compared to some heat-treated instruments. It is possible that the temperature of the solution may have a greater influence on resistance than NaOCl itself. Important to note that an overall tendency toward no significant influence was observed among various systems. CLINICAL RELEVANCE: Precautions are necessary when a pre-heated high-concentration NaOCl is used to enhance its properties during root canal preparation, mainly using conventional wire.

Noncarious cervical lesions in the aging population analyzed through digital scanning: occlusal risk factors, dimensions, and morphology.

OBJECTIVES: To evaluate noncarious cervical lesions (NCCL) in older adults by analyzing each lesion's morphology, dimension, and occlusal risk factors using intraoral scanning and clinical evaluation. MATERIALS AND METHODS: Individuals over 60 treated at the School of Dentistry in Minas Gerais, Brazil, were invited to participate in this cross-sectional study. We clinically evaluated 1245 teeth for the presence of NCCL and dentin hypersensitivity (DH) in 53 individuals. Three-dimensional models were obtained using Omnicam, and occlusal risk factors were evaluated through the presence of wear facets, intense occlusal contacts, and interferences. The 3Shape 3DViewer software was used to classify NCCL morphology and to measure their height. NCCL depth, width, and area measurements were determined using ImageJ. Descriptive analyses were performed. The Kolmogorov-Smirnov test showed that quantitative data exhibited non-normal distribution. For bivariate analyses of quantitative data, the Mann-Whitney test was employed. The results were reported with mean, standard deviation, median, minimum, and maximum. For bivariate analyses of categorical data, the Pearson chi-square test was used. The results were reported with frequencies (counts) and percentages. A regression model evaluating the association between occlusal risk factors and the absence/presence of NCCL was built. RESULTS: Most participants were female (58.5%), with a mean age of 66. The frequency of NCCL was 28.27%, corresponding to 352 teeth. Of these, 68.18% exhibited saucer morphology and 31.82% wedge-shaped morphology. The frequency of DH was 13.92% in teeth with NCCL. Saucer NCCL exhibited significantly greater height (p = 0.02), while wedge-shaped lesions showed greater depth (p < 0.001). Also, teeth with NCCL had a higher proportion of wear facets (66.8%; p < 0.001), intense occlusal contacts (39.8%; p = 0.008), and occlusal interferences (21.9%; p = 0.05). The regression model showed that teeth with wear facets were 1.50 times more likely to exhibit NCCL than teeth without wear facets (p < 0.001). Teeth with intense occlusal contact were 1.22 times more likely to exhibit NCCL than teeth without intense occlusal contact (p = 0.031). CONCLUSIONS: NCCL is a common dental condition in the older adults evaluated in this study. Wedge-shaped NCCL exhibited greater depth, while saucer NCCL had more expressive height. Occlusal risk factors may represent a crucial mechanism for the occurrence of NCCL in this population. CLINICAL RELEVANCE: Understanding the mechanisms involved in developing NCCL is helpful in diagnostic and preventive practices. The study showed the importance of dental occlusion and characteristics of different NCCL morphologies that help the clinician in decision-making.

Facial and Cephalometric Features of Individuals With Mucopolysaccharidosis: A Cross-Sectional Study.

OBJECTIVE: The aim was to assess craniofacial features through facial anthropometric and lateral cephalometry measurements of individuals with mucopolysaccharidosis (MPS) and compare them with individuals without MPS. DESIGN: Cross-sectional study. PATIENTS: A total of 14 individuals with MPS and 28 non-MPS age- and sex-matched were enrolled in this study. METHODS: A clinical facial analysis to evaluate the soft tissues and cephalometric analysis that comprised linear and angular measurements were performed. The calculation of the method error suggested no systematic errors (p > .05). Random errors for linear and angular measurements were low (less than 0.5° and 1.6 mm). Chi-square test and independent t-test were performed. RESULTS: Most individuals with MPS were dolichofacial, presented altered facial proportions with an increased anterior lower facial height (ALFH) and lip incompetence (all p < .05), when compared with non-MPS individuals. Six angular measurements (1s.Na, 1s.NB, FMA, IMPA, AFI, and Po.Or_Go.Me; all p < .05) were significantly increased among individuals with MPS, and two (1s.1i and Ba.N-Ptm.Gn, all p < .05) were significantly decreased among them. Four linear measurements were significantly increased among individuals with MPS (1s-NA, 1i-NB, S-UL, and S-LL; all p < .05) and five (PogN-Perp, Co-A, Co-Gn, Nfa-Nfp, and overbite; all p < .05) were significantly decreased among them. CONCLUSION: In summary, most individuals with MPS were dolichofacial with increased ALFH. Proclined upper and lower incisors, reduced nasopharyngeal space, and reduced overbite was also noted.

Malocclusion in individuals with osteogenesis imperfecta: A systematic review and meta-analysis.

OBJECTIVE: To evaluate whether individuals with osteogenesis imperfecta (OI) are more affected by malocclusion than individuals without OI. MATERIALS AND METHODS: Searches in PubMed, Ovid, Web of Science, Scopus, Lilacs and gray literature were performed. Data extraction was conducted by two researchers. Risk of bias assessment employing the Newcastle-Ottawa Scale and meta-analysis were conducted. Results were provided with mean difference (MD), odds ratio (OR) and 95% confidence interval (CI). Strength of evidence was determined. RESULTS: Six cross-sectional studies were included. In comparison with individuals without OI, the group with OI had 19.69-fold greater chance of exhibiting Angle Class III malocclusion (OR = 19.69, CI: 9.00-43.09) and presenting anterior crossbite greater (MD = 6.08, CI: 2.40-9.77). Individuals without OI had a significantly greater ANB angle (MD = 3.88, CI: 1.15-6.61) and SNA angle (MD = 2.11, CI: 0.24-3.98) in comparison with those with OI. No difference between groups was found for SNB (MD = -0.50, CI: -2.21 to 1.21) and open bite (MD = 0.98, CI: -0.29 to 2.25). Most studies included had moderate methodological quality. Strength of evidence was low or very low. CONCLUSIONS: The occurrence of Angle Class III malocclusion and anterior crossbite was greater among individuals with OI compared to those without OI. These findings can assist stakeholders about the occlusal abnormalities affecting OI individuals.