Psychological profile and α-amylase levels in oral lichen planus patients: A case-control preliminary study.

OBJECTIVE: To investigate psychological (anxiety, depression, and stress) and salivary (flow and concentration of α-amylase) profile associated with oral lichen planus. MATERIALS AND METHODS: A case-control preliminary study with oral lichen planus patients and age-gender matched controls was conducted. The participants underwent psychological tests (Beck depression and anxiety inventories and perceived stress scale) and saliva collection to determine the unstimulated salivary flow and α-amylase levels at three moments along the day. The data were analyzed statistically using Mann-Whitney, McNemar chi-square and Friedman tests, and the Spearman correlation coefficient. The significance level adopted was 5%. RESULTS: A total of 46 case-control pairs were recruited. There was a significant correlation between anxiety, depression, stress, and oral lichen planus, as well as the stress and decline of salivary α-amylase levels. Higher concentrations of this biomarker were found in the case group thirty minutes post-awakening. CONCLUSION: The applied psychological tests indicated that factors such as anxiety, depression, and stress were associated with oral lichen planus. Salivary analyses demonstrated a higher concentration of α-amylase thirty minutes post-awakening on individuals with the disease and its decline correlated with stress, suggesting the role of α-amylase as a promising biomarker for future studies.

Salivary biomarkers to evaluate psychological disorders in oral lichen planus: A systematic review with meta-analysis.

OBJECTIVE: To analyze the use of salivary biomarkers to identify psychological disorders (anxiety, depression, and stress) in individuals with oral lichen planus (OLP). MATERIALS AND METHODS: The search was made in Medline/Pubmed, Scopus, Web of Science, Virtual Health Library, ProQuest, and by cross-reference. Original case-control, cross-sectional, and cohort studies, in human subjects (age ≥18 years) with clinical and histopathological diagnosis, with or without the use of psychometric scales, published until June 2021, were included. Random-effects meta-analyses, subgroup analyses, and sensitivity were performed. Publication bias was measured using the Egger test and visual inspection of the funnel plot. RESULTS: A total of 67 articles were found, of which 12 were included in the meta-analysis. Among the different biomarkers identified, it was only possible to perform a meta-analysis for cortisol. The mean difference between salivary cortisol levels in patients with OLP compared to controls was 3.43 ng/ml (95% CI: 1.20-5.65) with I2  = 98.9%. Studies considered outliers were removed and based on sensitivity analyses, results did not change, therefore, being stable. CONCLUSION: The studies analyzed demonstrated that cortisol was the most quantified biomarker to identify psychological disorders; however, DHEA, IgA, adiponectin, and α-amylase were also evaluated.

Catastrophizing is associated with pain-related disability in temporomandibular disorders.

This study aimed to evaluate the association of pain-related disability with biopsychosocial factors in temporomandibular disorders (TMD) patients. The study was carried out at the Orofacial Pain Outpatient Clinic of the State University of Feira de Santana, Bahia, from September 2018 to March 2020. The sociodemographic aspects, TMD subtypes, presence of pain-induced disability, pressure pain threshold, perceived stress, anxiety, depression, and catastrophizing were evaluated in 61 patients. The studied variables were compared between patients with and without pain-induced disability. Crude and adjusted logistic regression were performed to obtain estimates of odds ratios (OR) and 95% confidence intervals. With the exception of catastrophizing, there was no association between the biopsychosocial factors and pain-induced disability. The presence of catastrophizing increased the chance of having chronic pain-induced disability by 4.02 times. The results of this study indicate a strong association between pain catastrophizing and disability in individuals with chronic painful TMD.

Salivary immunoglobulin A responses in professional top-level futsal players.

The purpose of this study was to investigate the responses of salivary immunoglobulin A (SIgA) in 10 professional top-level Brazilian futsal players after 2 highly competitive games separated by 7 days. Unstimulated saliva was collected over a 5-minute period at PRE- and POST-match. The SIgA was measured by an enzyme-linked immunosorbent assay and expressed as the absolute concentration (SIgAabs) and secretion rate of IgA (SIgArate). Rate of perceived exertion and heart rate were used to monitor the exercise intensity. A 2-way analysis of variance with repeated measures showed nonsignificant differences between matches to SIgAabs, SIgArate, and saliva flow rate (p > 0.05). However, significant time differences were observed for all these parameters. In summary, we showed that a competitive training match induced a decrease in SIgA levels in top-level futsal players, which suggests an increment of the vulnerability to infections meditated by the training stimulus. This decrease suggests that the athletes were at an increased risk of developing an upper respiratory tract infection, and therefore, it could be necessary to take protective actions to minimize contact with cold viruses or even reduce the training load for athletes.

Effect of a kickboxing match on salivary cortisol and immunoglobulin A.

The hypothesis that salivary cortisol would increase and salivary immunoglobulin A (IgA) decrease after a kickboxing match was tested among 20 male athletes. Saliva samples collected before and after the match were analyzed. Salivary cortisol and salivary IgA concentrations (absolute concentration, salivary IgAabs) and the secretion rate of IgA (salivary IgArate) were measured by enzyme-linked immunosorbent assay. A Wilcoxon test for paired samples showed significant increases in salivary cortisol from pre- to postmatch. No significant changes were observed in salivary IgAabs or secretory IgArate and saliva flow rate. This study indicates that a kickboxing match might increase salivary concentration and thereafter it could be considered a significant source of exercise-related stress. On the other hand, the effect of a kickboxing match on mucosal immunity seems not to be relevant.

Relationship of psychological factors with salivary flow rate and cortisol levels in individuals with oral lichen planus: A case-control study.

OBJECTIVE: The objective of this study was to analyze the relationship between psychological factors and salivary flow rate and cortisol levels in individuals with oral lichen planus. STUDY DESIGN: A case-control study of 21 individuals with clinical and histopathological diagnosis of oral lichen planus and 21 individuals without the disease (controls), matched by sex and age, was performed. The Beck Anxiety and Depression Inventories and Perceived Stress Scale were administered, and the salivary flow rate and salivary cortisol secretion pattern were determined. Data were statistically analyzed using Mann-Whitney U, McNemar's χ2, and Student's t tests and the Spearman correlation coefficient. The significance level adopted was 5%. RESULTS: Individuals with oral lichen planus had higher anxiety (P = .001), depression (P = .005), and perceived stress (P = .026) scores, but no association was found between the disease and salivary flow rate (P = .29) or with the pattern of salivary cortisol secretion (at awakening: P = .98; 30 min post-awakening: P = .95; at bedtime: P = .97). CONCLUSION: An association was observed between oral lichen planus and anxiety, depression, and stress scores through psychological tests but not in relation to salivary flow rate and the pattern of salivary cortisol secretion.

Salivary cortisol in top-level professional soccer players.

We have tested the hypothesis that salivary cortisol increases after a competitive training match in top-level male professional soccer players divided in team A (n = 11) versus team B (n = 11). Saliva samples collected before and after the match were analyzed. Salivary cortisol concentrations were measured by enzyme-linked immunosorbent assay. The results from a two-way ANOVA with repeated measures showed no significant changes in salivary cortisol between either teams or time points (P > 0.05). Further investigation regarding competitive matches in a competition environment is warranted. In summary, the influence of intensive competitive training match alone appears to be minimal on salivary cortisol changes in top-level soccer adapted to this type of stress. From a practical application, the variability of the responses among the players leads us to suggest that there is a need to individually analyse the results with team sports.

Salivary immunoglobulin a response to a match in top-level brazilian soccer players.

It has been suggested that several parameters of mucosal immunity, including salivary immunoglobulin A (s-IgA), are affected by heavy exercise either in field sports or in the laboratory environment. Few observations have been made during a true sporting environment, particularly in professional soccer. We tested the hypothesis that salivary IgA levels will be decreased after a 70-minute regulation in a top-level professional soccer friendly match. Saliva samples from 24 male professional soccer players collected before and after the match were analyzed. Salivary immunoglobulin A concentration was measured by enzyme-linked immunosorbent assay and expressed as the absolute concentration (s-IgAabs), s-IgA relative to total protein concentration (IgA-Pro), and the secretion rate of IgA (s-IgArate). Rate of perceived exertion (RPE) was used to monitor the exercise intensity. The paired t-test showed no significant changes in s-IgAabs and s-IgArate (p > 0.05) from PRE to POST match. However, a significant (p < 0.05) increase in total protein concentration (1.46 +/- 0.4 to 2.00 +/- 07) and a decrease in IgA-Pro were observed. The best and most significant correlation was obtained with the RPE and changes in IgA-Pro (rs = -0.43) and could indicate that this expression may be an interesting marker of intensity in a soccer match. However, further investigation regarding exercise intensity, protein concentration, and immune suppression, particularly in team sports, is warranted. From a practical application, the variability of the responses among the players leads us to suggest that there is a need to individually analyze the results with team sports. Some athletes showed a decrease in s-IgA expressions, suggesting the need for taking protective actions to minimize contact with cold viruses or even reducing the training load.

Antigen-presenting cells in human immunosuppressive drug-induced gingival enlargement.

An immunoperoxidase technique was used to compare the number of CD1a+ and factor XIIIa+ dendritic cells (DCs), and CD68+ Macrophages (M) in 30 gingival samples from subjects with clinically healthy periodontitium (HP) and 10 samples from subjects with drug-induced gingival enlargement (DIGE). Fewer CD1a+ and factor XIIIa+ DCs were found in areas with inflammatory infiltration (II) of the lamina propria (LP) in the group with immunosuppressed DIGE (IDIGE) compared to the group with HP. In the sulcular and junctional/pocket epithelia, the number of CD1a+ DCs was decreased in the group with IDIGE (p<0.05). There was a tendency toward a reduced number of CD1a+ DCs and CD68+ M in areas without inflammatory infiltrate of the LP in the group with IDIGE. The alterations in the number of antigen-presenting cells (APCs) may be the reason for the decreased periodontal inflammation and breakdown clinically observed in subjects who are immunosuppressed.

The impact of a 17-day training period for an international championship on mucosal immune parameters in top-level basketball players and staff members.

This investigation examined the impact of a 17-d training period (that included basketball-specific training, sprints, intermittent running exercises, and weight training, prior to an international championship competition) on salivary immunoglobulin A (SIgA) levels in 10 subjects (athletes and staff members) from a national basketball team, as a biomarker for mucosal immune defence. Unstimulated saliva samples were collected at rest at the beginning of the preparation for the Pan American Games and 1 d before the first game. The recovery interval from the last bout of exercise was 4 h. The SIgA level was measured using enzyme-linked immunosorbent assay and expressed as absolute concentrations, secretion rate, and SIgA level relative to total protein. The decrease in SIgA levels following training was greater in athletes than in support staff; however, no significant differences between the two groups were detected. A decrease in SIgA level, regardless of the method used to express IgA results, was verified for athletes. Only one episode of upper respiratory tract illness symptoms was reported, and it was not associated with changes in SIgA levels. In summary, a situation of combined stress for an important championship was found to decrease the level of SIgA-mediated immune protection at the mucosal surface in team members, with greater changes observed in the athletes.

Exposure to fluoride of children during the critical age for dental fluorosis, in the semiarid region of Brazil. / Exposição a fluoreto por crianças na faixa etária crítica para fluorose dentária, residentes no semiárido brasileiro.

There is a concern about the increasing prevalence of dental fluorosis, which depends on the dose of fluoride (F) to which children are subjected during tooth formation. Environmental temperature affects water intake and therefore it would be important to assess whether children living in the semiarid region are exposed to an excessive dose of F. Therefore, the objective of this study was to determine the total dose of F to which children are exposed during the critical age for dental fluorosis, with diet (water and food) and toothpaste as F sources, in the semiarid region of Brazil. METHODOLOGY: 26 children aged 25.2 ± 9.1 months, residents in Feira de Santana, State of Bahia (with F in the public water supply) were selected. Duplicate-diet, water, products from toothbrushing and toothpaste samples were collected. F concentration was determined using an ion-specific electrode, after proper sample preparation. RESULTS: the mean and standard deviation of dose (mg F/kg/day) from diet, toothpaste and total were respectively: 0.016 ± 0.010; 0.030 ± 0.039 and 0.047 ± 0.043. CONCLUSIONS: the children evaluated living in the semiarid region are not exposed to a risk dose for dental fluorosis.

Psychological disorders and oral lichen planus: A systematic review.

The aim of the present study was to identify and analyze scientific evidence available in the literature to answer the following question: Are psychological disorders associated with the development of oral lichen planus (OLP)? Using scientific databases (PubMed, LILACS, and Science Direct), a literature search was conducted between December 2016 and January 2017, using previously selected keywords. Two independent reviewers critically assessed the results in three stages, strictly obeying the inclusion and exclusion criteria defined in the study protocol. We assessed paper quality based on STROBE (Strengthening The Reporting of Observational studies in Epidemiology). After analysis, we selected 14 papers, of which 10 showed evidence of association between psychological disorders (in particular, stress, anxiety, and depression) and the development of OLP. The paper-quality assessment by means of STROBE showed that 13 papers presented intermediate quality and one paper presented high quality. In the present systematic review, we found an association between psychological disorders and the development of OLP.

Catastrophizing is associated with pain-related disability in temporomandibular disorders

Abstract This study aimed to evaluate the association of pain-related disability with biopsychosocial factors in temporomandibular disorders (TMD) patients. The study was carried out at the Orofacial Pain Outpatient Clinic of the State University of Feira de Santana, Bahia, from September 2018 to March 2020. The sociodemographic aspects, TMD subtypes, presence of pain-induced disability, pressure pain threshold, perceived stress, anxiety, depression, and catastrophizing were evaluated in 61 patients. The studied variables were compared between patients with and without pain-induced disability. Crude and adjusted logistic regression were performed to obtain estimates of odds ratios (OR) and 95% confidence intervals. With the exception of catastrophizing, there was no association between the biopsychosocial factors and pain-induced disability. The presence of catastrophizing increased the chance of having chronic pain-induced disability by 4.02 times. The results of this study indicate a strong association between pain catastrophizing and disability in individuals with chronic painful TMD.

Toxicidades orales de la terapia contra el cáncer en niños y adolescentes: un estudio descriptivo / Toxicidades orais da terapia oncológica em crianças e adolescentes: um estudo descritivo / Oral toxicities of oncology therapy in children and adolescents: a descriptive study

Resumen Introducción y objetivo: El cáncer es la segunda causa de muerte entre niños y adolescentes en Brasil. Evaluar la prevalencia de toxicidades orales derivadas del tratamiento oncológico en niños y adolescentes atendidos en el Hospital Estadual da Criança, de 2016 a 2017. Materiales y métodos: Se trata de un estudio descriptivo con datos obtenidos de historias clínicas. Se estudiaron variables relacionadas con la neoplasia, el portador, las toxicidades orales y el tratamiento oncológico, las cuales fueron analizadas de forma descriptiva y se realizó la prueba de la χ2 de Fisher para algunas de ellas. Resultados: Se identificaron 58 pacientes, en su mayoría mujeres (53%) y con edades entre 3 y 5 años (28%), con una media de 6,62 años. La neoplasia más común fue la leucemia linfoide aguda (38%), siendo la quimioterapia sola, la modalidad terapéutica más utilizada (67%), especialmente con el uso de citarabina (60%) y vincristina (56%). Veintitrés (40%) de los niños y adolescentes presentaron alguna toxicidad oral durante la terapia oncológica, por lo que a 4 (17,4%) se les interrumpió el tratamiento antineoplásico. La mucositis oral (70%) fue la toxicidad más común, afectando los labios en el 55% y fue asociada a dolor en el 64% de los casos. Dieciocho (78,2%) pacientes recibieron tratamiento por toxicidad oral, prescribiéndose nistatina en el 88,9% de los casos. Además, hubo una asociación significativa entre el estado de supervivencia y el lugar de residencia (p=0,03). Conclusiones: Entre los 58 niños y adolescentes estudiados, el 40% presentó toxicidades orales y 4 tuvieron interrumpido el tratamiento antineoplásico por este motivo. Así, se refuerza la importancia y la necesidad de la actuación del odontólogo en el equipo multidisciplinario en oncología.

Abstract Introduction and objective: Cancer is the second leading cause of death among children and adolescents in Brazil. To evaluate the prevalence of oral toxicities resulting from cancer treatment in children and adolescents treated at the Hospital Estadual da Criança, from 2016 to 2017. Material and methods: This is a descriptive study with data obtained from medical records. Variables related to neoplasia, carrier, oral toxicities and cancer treatment were studied, which were analyzed descriptively and thFisher χ2 test was performed for some of them. Results: Fifty eigth patients were identified, mostly female (53%) and aged between 3 and 5 years (28%), with an average of 6.62 years. The most frequent neoplasm was acute lymphoid leukemia (38%), with chemotherapy alone being the most used therapeutic modality (67%), especially with the use of cytarabine (60%) and vincristine (56%). Twenty-three (40%) of the children and adolescents exhibited some oral toxicity during cancer therapy, and for this reason, 4 (17.4%) had their antineoplastic treatment interrupted. Oral mucositis (70%) was the most common toxicity, affecting the lips in 55% and being associated with pain in 64% of cases. Eighteen (78.2%) patients received treatment for oral toxicities, with nystatin being prescribed in 88.9% of cases. In addition, there was a significant association between survival status and place of residence (p=0.03). Conclusions: Among the 58 children and adolescents studied, 40% had oral toxicities and 4 had their antineoplastic treatment interrupted for this reason. Thus, the importance and the need for the performance of the dentist in the multidisciplinary team in oncology is reinforced.

Resumo Introdução e objetivo: O câncer é a segunda maior causa de morte entre crianças e adolescentes no Brasil. Avaliar a prevalência de toxicidades orais decorrentes do tratamento oncológico em crianças e adolescentes atendidos no Hospital Estadual da Criança, no período de 2016 a 2017. Materiais e métodos: Trata-se de um estudo descritivo com dados obtidos de prontuários médicos. Foram estudadas variáveis relacionadas à neoplasia, ao portador, às toxicidades orais e ao tratamento oncológico, que foram analisadas descritivamente e o teste χ2 de Fisher foi aplicado para algumas delas. Resultados: Foram identificados 58 pacientes, com maioria do sexo feminino (53%) e idade entre 3 e 5 anos (28%), com média de 6,62 anos. A neoplasia maligna mais frequente foi a leucemia linfóide aguda (38%), sendo a quimioterapia isolada a modalidade terapêutica mais empregada (67%), especialmente com uso de citarabina (60%) e vincristina (56%). Vinte e três (40%) das crianças e adolescentes exibiram alguma toxicidade oral durante a terapia oncológica, e por esta razão, 4 (17,4%) tiveram o tratamento antineoplásico interrompido. A mucosite oral (70%) foi a toxicidade mais comum, acometendo os lábios em 55% e estando associada a dor em 64% dos casos. Dezoito (78,2%) pacientes receberam tratamento para as toxicidades orais, sendo a nistatina prescrita em 88,9% dos casos. Ademais, observou-se associação significante entre status de sobrevida e local de residência (p=0.03). Conclusões: Dentre as 58 crianças e adolescentes estudadas, 40% apresentou toxicidades orais e 4 tiveram o tratamento antineoplásico interrompido por esta razão. Desta forma, reforça-se a importância e a necessidade da atuação do cirurgião-dentista na equipe multiprofissional em oncologia.

Profile of the orthodontist practicing in the State of São Paulo--part 2.

INTRODUCTION: The choice of brackets, bands and wires is a very important aspect of orthodontic treatment. Stainless steel prevailed for a long time, but new alloys and resources have emerged to diversify the orthodontic wire mechanics. OBJECTIVE: This study aimed to investigate the profile and materials used by orthodontists practicing in the State of São Paulo, Brazil. METHODS: A questionnaire was sent to 2,414 specialists in Orthodontics and Dentofacial Orthopedics registered with the Regional Board of Dentistry of São Paulo State (CRO-SP). To assess the association between qualitative variables, the Chi-square association test was employed at 5% significance level. RESULTS: Five hundred and ninety-three (24.65%) questionnaires were completed and sent back. Efficiency was the key reason given by the professionals for choosing a particular material. The majority showed a preference for metal brackets (98%), followed by ceramics (32%) and polycarbonate (7.8%). The most widely used brackets had 0.022 x 0.028-in slots (73.2%). Regarding orthodontic wires, 88.2% employed round steel wires and conventional round NiTi wires, while 52.6% used round heat-activated NiTi and 46.5% rectangular TMA wires. Elastics (92.9%) were the most widely used method to tie the orthodontic archwire to the bracket. CONCLUSIONS: In this survey, the orthodontists claimed that efficiency was the major motivator for choosing orthodontic materials. Conventional brackets tied with conventional elastic ligatures are still the most used by the professionals. Among steel and conventional Nitinol wires, round wires ranked first. The use of resources recently available to Brazilian orthodontists, such as self-ligating brackets and mini-implants, was not significant.

Exposição a fluoreto por crianças na faixa etária crítica para fluorose dentária, residentes no semiárido brasileiro / Exposure to fluoride of children during the critical age for dental fluorosis, in the semiarid region of Brazil

Resumo Há uma preocupação com o aumento da prevalência de fluorose dentária, que depende da dose de fluoreto (F) a que as crianças são submetidas durante a formação dos dentes. A temperatura ambiental afeta a ingestão de água e, portanto, seria importante avaliar se as crianças que vivem em uma região de clima semiárido estão expostas a uma dose excessiva de F. Assim, o objetivo do presente estudo foi determinar a dose total de F a que as crianças são expostas durante a idade crítica para a fluorose dentária, tendo dieta (água e alimentos) e dentifrício como fontes de F, em uma região de clima semiárido no Brasil. Metodologia: foram selecionadas 26 crianças com idade de 25,2 ± 9,1 meses, residentes em Feira de Santana-BA. Foram coletadas amostras de dieta-duplicada, água, produtos de escovação e dentifrícios. A concentração de F foi determinada após o devido preparo das amostras, utilizando um eletrodo específico. Resultados: a média e o desvio padrão de dose (mg F / kg / dia) em função da dieta, dentifrício e total foram, respectivamente: 0,016 ± 0,010; 0,030 ± 0,039 e 0,047 ± 0,043. Conclusões: as crianças avaliadas, residentes em uma região de clima semiárido, não estão expostas a uma dose de risco de fluorose dentária.

Abstract There is a concern about the increasing prevalence of dental fluorosis, which depends on the dose of fluoride (F) to which children are subjected during tooth formation. Environmental temperature affects water intake and therefore it would be important to assess whether children living in the semiarid region are exposed to an excessive dose of F. Therefore, the objective of this study was to determine the total dose of F to which children are exposed during the critical age for dental fluorosis, with diet (water and food) and toothpaste as F sources, in the semiarid region of Brazil. Methodology: 26 children aged 25.2 ± 9.1 months, residents in Feira de Santana, State of Bahia (with F in the public water supply) were selected. Duplicate-diet, water, products from toothbrushing and toothpaste samples were collected. F concentration was determined using an ion-specific electrode, after proper sample preparation. Results: the mean and standard deviation of dose (mg F/kg/day) from diet, toothpaste and total were respectively: 0.016 ± 0.010; 0.030 ± 0.039 and 0.047 ± 0.043. Conclusions: the children evaluated living in the semiarid region are not exposed to a risk dose for dental fluorosis.

Liquid nitrogen cryosurgery for treatment of mucoceles in children.

A mucocele is a common benign lesion of the minor salivary gland mucosa that most frequently affects children and young adults. Several treatments have been described in the literature, including liquid nitrogen cryosurgery--a therapeutic alternative for treating mucoceles in children that has many applications in clinical oral pathology. The purpose of this paper was to present the treatment of lower lip mucoceles in 2 children via liquid nitrogen cryosurgery performed without local anesthesia. Also discussed are the mechanisms of action, current protocol of cryosurgery recommended in the management of mucoceles, clinical advantages and disadvantages, clinical outcomes, and pediatric patients' safety.

Brazilian dentists' attitudes about medical emergencies during dental treatment.

The main objective of this study was to evaluate the prevalence of emergencies in dental practices and the prepared-ness and the training experience in cardiopulmonary resuscitation (CPR) of Brazilian dentists in dealing with emergencies. The volunteer participants in the study were 498 Brazilian dentists who were present at the 27th International Congress of Dentistry in São Paulo. The most prevalent emergency was presyncope (reported by 54.20 percent of respondents), followed by orthostatic hypotension (44.37 percent), moderate allergic reactions (16.86 percent), hypertensive crisis (15.06 percent), asthma (15.06 percent), syncope (12.65 percent), angina (6.82 percent), convulsion (6.22 percent), hypoglycemia (5.62 percent), hyperventilation crisis (5.22 percent), choking (2.20 percent), and cerebrovascular accident (0.8 percent). Anaphylaxis, myocardial infarction, and cardiac arrest were the rarest emergencies, reported by only 0.4, 0.2, and 0.2 percent of dentists, respectively. Only 41 percent of the dentists judged themselves capable to diagnose the cause of an emergency during a dental visit. The majority responded that they would be capable of performing initial treatment of presyncope, syncope, orthostatic hypotension, convulsion, and choking. However, most of them felt unable to treat anaphylaxis, myocardial infarction, or cardiac arrest. Further, the majority felt unable to perform CPR or undertake an intravenous injection. It was concluded that the most prevalent medical emergencies in dental practice of Brazilian dentists are presyncope and orthostatic hypotension. The occurrence of life-threatening medical emergencies like anaphylaxis, myocardial infarction, cardiac arrest, and cerebrovascular accident is rare. Brazilian dentists are not fully prepared to manage medical emergencies and have insufficient experience training in CPR.

Profile of the orthodontist practicing in the State of São Paulo - Part 2

INTRODUCTION: The choice of brackets, bands and wires is a very important aspect of orthodontic treatment. Stainless steel prevailed for a long time, but new alloys and resources have emerged to diversify the orthodontic wire mechanics. OBJECTIVE: This study aimed to investigate the profile and materials used by orthodontists practicing in the State of São Paulo, Brazil. METHODS: A questionnaire was sent to 2,414 specialists in Orthodontics and Dentofacial Orthopedics registered with the Regional Board of Dentistry of São Paulo State (CRO-SP). To assess the association between qualitative variables, the Chi-square association test was employed at 5% significance level. RESULTS: Five hundred and ninety-three (24.65%) questionnaires were completed and sent back. Efficiency was the key reason given by the professionals for choosing a particular material. The majority showed a preference for metal brackets (98%), followed by ceramics (32%) and polycarbonate (7.8%). The most widely used brackets had 0.022 x 0.028-in slots (73.2%). Regarding orthodontic wires, 88.2% employed round steel wires and conventional round NiTi wires, while 52.6% used round heat-activated NiTi and 46.5% rectangular TMA wires. Elastics (92.9%) were the most widely used method to tie the orthodontic archwire to the bracket. CONCLUSIONS: In this survey, the orthodontists claimed that efficiency was the major motivator for choosing orthodontic materials. Conventional brackets tied with conventional elastic ligatures are still the most used by the professionals. Among steel and conventional Nitinol wires, round wires ranked first. The use of resources recently available to Brazilian orthodontists, such as self-ligating brackets and mini-implants, was not significant.

INTRODUÇÃO: a escolha do tipo de braquetes, ligaduras e fios são fatores importantes no tratamento ortodôntico. O aço inoxidável predominou por muito tempo, mas novas ligas metálicas diversificaram o universo de fios disponíveis, assim como surgiram outros recursos. OBJETIVO: analisar o perfil do ortodontista do estado de São Paulo em relação aos materiais que utiliza. MÉTODOS: foi enviado um questionário a 2414 especialistas em Ortodontia e Ortopedia Facial inscritos no Conselho Regional de Odontologia do estado de São Paulo. Para avaliar a associação entre as variáveis qualitativas, foi utilizado o teste qui-quadrado, ao nível de significância de 5%. RESULTADOS: houve o retorno de 593 (24,65%) questionários preenchidos. A eficácia do material ortodôntico foi o principal motivo alegado para sua escolha. A maioria demonstrou preferência por braquetes metálicos (98%), cerâmicos (32%) e de policarbonato (7,8%). O slot mais citado foi o de 0,022" x 0,028" (73,2%). Sobre os fios ortodônticos, 88,2% empregam fio de aço redondo e o NiTi convencional redondo; 52,6% o NiTi termoativado redondo e 46,5% o TMA retangular. A ligadura elástica foi a forma mais empregada (92,9%) para fixar o arco ortodôntico ao braquete. CONCLUSÕES: os ortodontistas analisados alegaram ser a eficácia o principal motivo de escolha do material; os braquetes convencionais unidos com ligaduras elásticas ainda são os mais utilizados. Entre os fios ortodônticos, os de secção redonda apareceram em primeiro lugar, tanto os de aço como os de nitinol convencional. Recursos recentes na Ortodontia brasileira, como os braquetes autoligáveis e os mini-implantes, não apresentaram uso significativo.

The influence of sex and ovarian hormones on temporomandibular joint nociception in rats.

UNLABELLED: The aim of this study was to investigate the influence of sex and ovarian hormones on formalin- and glutamate-induced temporomandibular joint (TMJ) nociception in rats. The influence of sex and ovarian hormones on the nociceptive behavior induced by formalin or glutamate was virtually the same. The nociceptive behavior of males was similar to that of females in the proestrus phase of the estrous cycle but was significantly lower than that in the diestrus phase. Since the serum level of estradiol but not of progesterone was significantly higher in the proestrus than in the diestrus phase, these data suggest that females with lower endogenous serum level of estradiol have an exacerbation of TMJ nociception. The nociceptive behavior of ovariectomized rats was similar to that of diestrus females and significantly greater than that of proestrus females. Although the administration of estradiol or progesterone in ovariectomized females significantly reduced TMJ nociception, the combination of both hormones did not increase the antinociceptive effect induced by each of them. These findings suggest that estradiol and progesterone decrease TMJ nociception in an independent way. PERSPECTIVE: We report that ovarian hormones have an antinociceptive effect on the TMJ formalin and glutamate nociceptive behavior models. Therefore, the greater prevalence and severity of TMJ pain in women of reproductive age may be a consequence of hormonal fluctuation during the reproductive cycle, in that during low endogenous estradiol serum level TMJ pain sensitivity is increased, enhancing the risk of females experiencing TMJ pain.