Efficacy of photobiomodulation in the treatment of avulsed teeth: A systematic review of animal studies.

The objective of this systematic review was to evaluate the effectiveness of photobiomodulation therapy (PBM) in managing avulsed teeth. This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (i.e., "PRISMA") statement 2020 and was registered in the International Prospective Register of Systematic Reviews (i.e., PROSPERO) with number CRD42022362198. The participants, intervention, comparison, outcomes, and study design (i.e., PICOS) for the present study considered the following question: "Does the use of laser PBM in the treatment of teeth with avulsion influence tissue repair performance?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and ProQuest databases until January 2023. The SYRCLE's RoB tool (Systematic Review Center for Laboratory Animal Experimentation) for animal studies were used for quality assessment. A total of 7 in vivo studies published between 2011 and 2018 were included in this systematic review for qualitative analysis. All studies used Wistar rats, totaling 368 specimens that simulated tooth avulsion trauma. The effect of photodynamic therapy in the treatment of avulsed teeth was positive in 5 studies (significant increase in tissue repair) and negative in 2 studies, in which both studies with negative results kept teeth in saline solution before reimplantation and showed the longest time and power of laser application. PBM appears to be effective for tissue repair in the treatment of avulsed teeth, depending on the means of conservation of the avulsed tooth and the laser application protocol.

Efficacy of acellular xenogeneic dermal matrix graft in the treatment of multiple gingival recessions: systematic review and meta-analysis.

OBJECTIVE: This study aimed to compare the efficacy of acellular xenogeneic dermal matrix graft (AXDM) compared to connective tissue graft (CTG) in treating multiple gingival recessions. MATERIALS AND METHODS: A systematic search of electronic databases was conducted to identify randomized clinical trials (RCTs) that compared AXDM and CTG. The selected studies were subjected to bias risk assessment, data extraction, and meta-analyses. Parameters such as gingival recession height, width, mean percentage of root coverage, and complete root coverage were analyzed. RESULTS: Seven RCTs involving 146 patients were included. The meta-analyses indicated that CTG was statistically superior to AXDM in reducing gingival recession height at the final follow-up (mean difference: -0.104 mm, 95% confidence interval [CI]: -0.180-0.028, p = 0.008) and width at the final follow-up (mean difference: -0.285 mm, 95% CI: -0.541-0.030, p = 0.029). CTG also demonstrated a significantly higher mean percentage of root coverage at the 6-month follow-up (difference in means: -2.761 mm, 95% CI: -4.932-0.590, p = 0.013) and a higher percentage of complete root coverage at the 6-month follow-up (odds Ratio [OR]: 0.598, 95% CI: 0.4-0.892, p = 0.012) compared to AXDM. However, there was no significant difference in the number of teeth with complete root coverage between CTG and AXDM (OR: 1.610, 95% CI: 0.983-2.636, p = 0.058) and aesthetic outcomes (mean difference: 0.148, 95% CI: -0.277-0.573, p = 0.494). CONCLUSIONS: CTG is more effective than AXDM in treating multiple gingival recessions. This is evidenced by significant reductions in gingival recession height and width, a higher mean percentage of root coverage, and a greater percentage of complete root coverage at the 6-month follow-up. CLINICAL RELEVANCE: In some clinical situations an alternative to CTG is required for the treatment of multiple gingival recessions. AXDM, despite presenting clinical outcomes that are not as satisfactory as CTG, can be used for this purpose.

Efficacy of denture cleansers on Candida albicans adhesion and their effects on the properties of conventional, milled CAD/CAM, and 3D-printed denture bases.

OBJECTIVES: Evaluate the efficacy of denture cleaners on the adhesion of Candida albicans and their effects on the surface, optical, and mechanical properties of resins for conventional, milled, and 3D-printed denture bases. MATERIALS AND METHODS: A total of 240 resin samples were made, 120 for testing Candida albicans adhesion, optical stabilities (ΔE00), roughness (Ra), hydrophilicity (°), surface free energy (Owens-Wendt) and 120 samples for testing Candida albicans adhesion, surface microhardness (Knoop), flexural strength and modulus of elasticity in a three-point test, in which they were divided into 3 groups of denture resin (n = 40) and subdivided into 5 cleaners of dentures (n = 8). Data were evaluated by two-way ANOVA and Tukey's test for multiple comparisons (α = 0.05). RESULTS: Denture cleaners with an alkaline solution and dilute acid composition were those that showed the greatest effectiveness in reducing Candida albicans (P < 0.001), however 1% NaOCl significantly affected the properties of the resins (P < 0.05). Denture 3D-printed showed that the surface microhardness was significantly lower for all cleansers (P < 0.05). CONCLUSIONS: Listerine demonstrated superior efficacy in reducing Candida albicans with minimal effect on denture properties, whereas 1% NaOCl had a significant negative impact on the properties. The mechanical properties were significantly lower in 3D-printed resin than in other resins for all denture cleansers. CLINICAL RELEVANCE: Denture base materials are being sold to adapt to the CAD/CAM system, increasing the number of users of dentures manufactured with this system. Despite this, there is little investigation into denture cleaners regarding the adhesion capacity of microorganisms and the optical, surface and mechanical properties of dentures, thus requiring further investigation.

Trend and spatial clustering of medical education in Brazil: an ecological study of time series from 2010 to 2021.

CONTEXT: Studies that analyze the temporal trend and spatial clustering of medical education indicators are scarce, especially in developing countries such as Brazil. This analysis is essential to subsidize more equitable policies for the medical workforce in the states and regions of Brazil. Thus, this study aimed to analyze the temporal trend and identify spatial clusters of medical education indicators in Brazil disaggregated by public and private education, states, and regions. METHODS: A time-series ecological study was conducted using data from the Higher Education Census of the Ministry of Education from 2010 to 2021. The study analyzed vacancy density indicators of active and former students/100,000 population, disaggregated by public and private education, 27 states, and 5 regions in Brazil. Prais-Winsten regression was used for trend analyses of indicators. Hot Spot Analysis (Getis-Ord Gi*) was used to identify spatial clusters of indicators. RESULTS: The number of medical schools increased by 102.2% between 2010 and 2021. A total of 366 medical schools offered 54,870 vacancies at the end of 2021. Vacancy density and active and former students increased significantly in the period, but this increase was greater in private institutions. Most states and regions showed an increasing trend in the indicators, with higher increase percentages in private than in public schools. Hot spot spaces changed over time, concentrated in the southeast, center-west, and north at the end of 2021. Medical education remains uneven in Brazil, with a low provision in regions with low socioeconomic development, academic structure, and health services, represented by regions in the north and northeast. CONCLUSIONS: There is a growing trend in medical education indicators in Brazil, especially in the private sector. Spatial clusters were found predominantly in the southeast, center-west, and north. These results indicate the need for more equitable medical education planning between the regions.

Do dental implants placed in patients with osteoporosis have higher risks of failure and marginal bone loss compared to those in healthy patients? A systematic review with meta-analysis.

PURPOSE: This systematic review and meta-analysis aimed to compare the dental implant survival rate and marginal bone loss between patients with and without osteoporosis. MATERIALS AND METHODS: This systematic review was registered in PROSPERO (CRD42022356377). A systematic search was performed using five databases: MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to July 2022. Additional searches in ClinicalTrials.gov and the reference lists of included studies were performed. The eligibility criteria comprised observational studies with a direct comparison between patients with and without osteoporosis, with a minimum follow-up of 1 year and 10 implants placed in each group, which consider data analysis based on implant level, without restrictions on period or language of publication. The meta-analysis was performed using RevMan 5.4 program. Risk of bias analysis of the included studies was performed using the Newcastle-Ottawa scale (NOS). RESULTS: Twelve studies met the eligibility criteria, totaling 1132 patients with a mean age range from 54 to 76.6 years. Most of the included patients were women (73.6%). A total of 3505 implants were evaluated-983 in patients with osteoporosis and 2522 in patients without osteoporosis. The meta-analysis indicated no difference in implant survival rates between patients with and without osteoporosis (OR, 1.78; 95% confidence interval [CI], 0.86-3.70; P = 0.12). However, significant bone loss was observed around dental implants placed in patients with osteoporosis (SMD, 0.71 mm; 95% CI, 0.06-0.87 mm). The NOS indicated a low risk of bias in the studies included. However, the certainty of the evidence was classified as very low and low for implant survival rates and bone loss, respectively. CONCLUSION: According to the limitations of the present review, the data suggest that dental implants are a viable treatment option for the rehabilitation of patients with osteoporosis. However, clinical care by professionals is necessary to ensure the maintenance of peri-implant bone stability, as these patients may be susceptible to increased bone loss.

Evaluation of bond strength of glass and resin-ceramics with laser phototherapy: A systematic review and meta-analysis of in vitro studies.

STATEMENT OF PROBLEM: Laser phototherapy has been studied as a surface treatment capable of increasing the adhesion of cement to the ceramic surface. However, the bond strength of glass and resin-ceramics after laser phototherapy is unclear. PURPOSE: The objective of this systematic review and meta-analysis was to compare the bond strength of glass and resin-ceramics using laser therapy and conventional hydrofluoric acid etching. MATERIAL AND METHODS: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the Open Science Framework (OSF) for in vitro studies. A population, intervention, control, and outcome (PICO) question was formulated: "Does phototherapy promote better bond strength in glass and resin-ceramics than conventional hydrofluoric acid etching?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases up to January 2023. The Joanna Briggs Institute critical assessment guidelines for quasi-experimental studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (α=.05). RESULTS: A total of 6 in vitro studies published between 2007 and 2019 with a total number of 348 specimens were included for qualitative analysis; 1 study had a positive effect. Five of the studies were included in the meta-analysis, which indicated a significant decrease for feldspathic ceramics that received laser phototherapy and lithium disilicate (P=.002; MD: -2.15; 95% CI: -3.53 to -0.77; I2=89%, P<.01) and (P<.01; MD: -2.13; 95% CI: -2.99 to -1.27; I2=82%, P<.01), respectively. CONCLUSIONS: Laser irradiation as surface etching of glass ceramics does not produce a bond strength equal to that of conventional hydrofluoric acid etching.

Color stability and surface roughness of resin-ceramics with different surface treatments: A systematic review and meta-analysis of in vitro studies.

STATEMENT OF PROBLEM: Surface treatments for resin-ceramics have been developed to obtain a smooth surface and improve color stability. However, a consensus on the best treatment for these materials is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the color stability and roughness of glass-ceramics versus resin-ceramics with different surface treatments. MATERIAL AND METHODS: The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed, and the study was registered in the open science framework (OSF) for in vitro studies. The population, intervention, control, and outcome (PICO) question was "Is there a difference in color stability and roughness between resin-ceramic vs vitreous ceramics in different surface treatment protocols?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases up to January 2023. The Joanna Briggs Institute's critical assessment guidelines for quasi-experimental studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (α=.05). RESULTS: A total of 18 laboratory studies were published between 2015 and 2022, with a total of 2160 specimens, all of which were analyzed qualitatively. The meta-analysis indicated significantly less optical alteration for lithium disilicate ceramics (P<.01; MD: 2.69; 95% CI: 2.00-3.39; I²=89%, P<.01), even when compared with resin-ceramics with polish or sealants (P<.01; MD: 2.45; 95% CI: 1.59-3.30; I²=87%, P<.01) and (P<.01; MD: 3.24; 95% CI: 2.02-4.47; I²=89%, P<.01), while there was no significant difference in surface roughness (P=.08; MD: -0.71; CI 95%: -1.52 to 0.09; I²=87%, P<.01) (P=.33; MD: -0.31; CI 95%: -0.94 to 0.32; I²=87%, P<.01), respectively. CONCLUSIONS: Resin-ceramics that have been polished or treated with sealants have lower color stability than glazed glass-ceramics; however, they are similar in terms of surface roughness.

Prevalence of proximal contact loss between implant-supported prostheses and adjacent natural teeth: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Proximal contact loss between implant-supported prostheses and adjacent natural teeth is a complication that has been reported in clinical practice. However, the prevalence of the condition is unclear. PURPOSE: The purpose of this systematic review and meta-analysis was to assess the proportion of reported proximal contact loss between implant-supported prostheses and adjacent natural teeth. MATERIAL AND METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology criteria and was registered on the international prospective register of systematic reviews (PROSPERO) platform (CRD42021225138). The electronic search was conducted by using the PubMed/MEDLINE, Embase, and Cochrane Library databases to September 2020. The formulated population, intervention, comparison, outcome (PICO) question was "Is there a correlation of the proximal contact loss between implant-supported prostheses and the adjacent natural tooth?" A single-arm meta-analysis of proportion was performed to evaluate the cumulative prevalence of survival and complication rates. RESULTS: This review included 10 studies, half of which presented proximal contact loss rates higher than 50%. In the general analysis, the open proximal contact showed a cumulative proportion of 41% (confidence interval: 30% to 53%; heterogeneity: I2=98%; t2=0.578; P<.01). From the subanalysis, the mesial contact (47%; confidence interval: 32% to 62%; heterogeneity: I2= 96%; t2=0.657; P<.01) and the mandibular arch (41%; confidence interval: 30% to 52%; heterogeneity: I2=92%; t2=0.302; P<.01) were found to have higher prevalence. CONCLUSIONS: The prevalence of proximal contact loss was high, occurring more frequently with the mesial contact and in the mandibular arch. Significant differences were not found in relation to sex or between the posterior and anterior regions.

Is the clinical performance of internal conical connection better than internal non-conical connection for implant-supported restorations? A systematic review with meta-analysis of randomized controlled trials.

PURPOSE: To evaluate bone loss, prosthodontics and biological complications, and implant survival rates of internal conical connections (ICC) compared with internal non-conical connection (INCC) implants. METHODS: The systematic review was registered on PROSPERO (CRD42021237170). Meta-analysis was performed using standardized mean difference (SMD) for bone loss and risk ratio (RR) for implant survival and complication rates. Risk of bias analysis was evaluated using RoB 2.0, whereas the GRADE tool was used to evaluate the certainty of evidence. A systematic search of the PubMed, Web of Science, Embase, Cochrane, and ProQuest databases was performed independently by two reviewers for articles published up to March 2022. The search criteria had no language or publication date restrictions. Handsearching analysis was performed in the reference list of potential articles. RESULTS: Twelve randomized clinical trials, including 678 patients and 1006 implants (ICC [n = 476]; INCC [n = 530]), were included. Meta-analysis revealed that ICC demonstrated a lower risk for marginal bone loss (SMD: -0.80 mm; p = 0.004) and prosthodontics complications (RR: 0.16; p = 0.01) than INCC. However, both internal connections demonstrated no significant difference in implant survival rates (RR: 0.54; p = 0.10) and biological complications (RR: 0.90; p = 0.82). The overall risk of bias revealed some concerns and a low risk of bias for most of the included studies. However, the certainty of evidence of outcomes was considered low to moderate. CONCLUSION: ICC may be considered a more favorable treatment option than INCC owing to greater preservation of peri-implant bone tissue and a lower probability of prosthodontics complications. However, well-conducted studies with long-term follow-up are warranted.

Root-supported overdenture in a patient with a cleft palate and extensive bone loss after traumatic injury.

Maxillofacial trauma caused by automobile accidents can result in extensive loss of alveolar bone, teeth, and gingival tissues as well as a cleft palate. Patients who have undergone such trauma may experience a loss of vertical dimension of occlusion, esthetic deformity, and difficulties in speaking, chewing, and swallowing. Both prosthodontic and surgical treatment are required in these cases. This case report describes the use of palatoplasty and maxillary and mandibular complete overdentures with a ball attachment system supported by natural roots as rehabilitative treatment for a 65-year-old man who had been injured in an automobile accident 24 years previously. Palatoplasty was performed to close the cleft palate that resulted from the trauma. Other procedures, including tooth extractions, endodontic treatment, cementation of ball attachments, and fabrication of temporary removable partial dentures to reestablish the vertical dimension of occlusion, were performed before the overdentures were placed. This treatment reestablished the patient's chewing, phonetic, and esthetic functions at a lower cost than other treatment options. At the 1-year follow-up evaluation, the patient's oral health was satisfactory, with no loss of abutment teeth, and the prostheses were functioning correctly.

Polyetheretherketone materials for removable partial denture frameworks: an integrative review.

Polyetheretherketone (PEEK) resin is a high-performance thermoplastic polymer that has been introduced as a possible candidate to replace metallic components in dental prostheses. The objective of this integrative review was to compare, through analysis of studies in the literature, the mechanical performance of removable partial denture frameworks and clasps manufactured with PEEK with the performance of cobalt-chromium (Co-Cr) frameworks and clasps. The guiding question was, "Does the use of PEEK as a substitute for Co-Cr alloys for the construction of removable partial denture frameworks result in better mechanical properties?" The PubMed/ MEDLINE, Embase, Web of Science, Scopus, and SciELO databases were searched for articles published through October 2021. The JBI Critical Appraisal Checklist for Quasi-Experimental Studies was used to assess the methodologic quality of the selected in vitro studies. A total of 208 articles were identified. After the exclusion of duplicates and articles that did not meet the inclusion criteria, 7 studies- -4 in vitro and 3 three-dimensional finite element analyses- -published between 2012 and 2021 were included in the integrative review. The appraisal checklist revealed that the reviewed studies had a low risk of bias and high methodologic quality. The results of the review showed that PEEK alloys have adequate mechanical properties for use in clasps and removable partial denture frameworks, but Co-Cr alloys exhibit better mechanical properties and are more suitable in most circumstances.

Impact of tilted implants for implant-supported fixed partial dentures: A systematic review with meta-analysis.

STATEMENT OF PROBLEM: The use of tilted implants has been considered a suitable option for completely edentulous patients. However, consensus on their clinical performance is lacking, specifically for partial rehabilitation. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the marginal bone loss and implant survival rate of tilted implants compared with those of axial implants for implant-supported fixed partial dentures (ISFPDs). MATERIAL AND METHODS: A systematic search of the MEDLINE/PubMed, Web of Science, Embase, Cochrane, and ProQuest databases and reference lists for articles published until May 2022 was performed by 2 independent reviewers without language or publication date restrictions. A meta-analysis was performed using the RevMan version 5.4 program. Quality assessments were performed using the Newcastle-Ottawa scale. RESULTS: Nine studies were included, totaling 258 participants and 604 implants (269 tilted implants and 335 axial implants). No significant differences were found between the tilted and axial implants for the implant survival rate (P=.81; risk ratio: 1.14). However, higher marginal bone loss values were observed for tilted implants (P=.001; mean difference: 0.12 mm). No significant heterogeneity was observed in either analysis. CONCLUSIONS: No significant relationship was found between tilted and axial implants for ISFPD rehabilitation. However, tilted implants presented greater risks of marginal bone loss than axial implants.

Comparison of 3- and 90-day bond strengths of 3 types of cement to nickel-chromium alloy.

The purpose of this in vitro study was to compare the 3- and 90-day bond strengths of 3 cements used for luting metal-ceramic crowns. Zinc phosphate cement (ZPC; SS White), resin-modified glass ionomer cement (RMGIC; Fuji Plus), and self-adhesive resin cement (SARC; RelyX U200) were assessed in 2 different treatment conditions (with and without microsandblasting of the alloy) and at 2 experimental times (3 days [E1] and 90 days [E2] after cementation). The buccal surfaces of 84 bovine teeth were ground until the dentin was exposed, and 84 nickel-chromium alloy plates cast from a resin model were cemented to the dentin surfaces with 1 of the 3 cements (n = 28). In half of the specimens of each group (n = 14), the bonding surfaces of the nickel-chromium plates received 6 seconds of microsandblasting with 45-µm aluminum oxide particles prior to cementation. The compressive shear bond strengths of the specimens were evaluated in a universal testing machine at E1 and E2 (n = 7). The SARC group showed the greatest bond strength, followed by the RMGIC group, while the bond strength of the ZPC group was significantly lower (P < 0.01). For the RMGIC specimens subjected to microsandblasting, there was a statistically significant difference between the mean bond strengths at E1 and E2 (P = 0.040). All of the other cement and treatment groups showed statistically similar adhesion results at E1 and E2 (P > 0.05). The complementary test by Sidák revealed that the cements Fuji Plus and RelyX U200 showed higher values at E2 and were statistically similar to each other (P > 0.05). Although RMGIC specimens showed a lower initial bond strength than SARC specimens, the fact that the microsandblasted RMGIC subgroup was the only one that demonstrated a significant increase in bond strength with aging suggests that RMGIC can be a material of first choice because it also costs less than SARC.

Do dental implants installed in different types of bone (I, II, III, IV) have different success rates? A systematic review and meta-analysis.

Purpose: The objective of this systematic review and meta-analysis was to evaluate the survival rate of implants installed in bone type IV (Lekholm and Zarb, 1995) compared to that of implants installed in bone types I, II, and III. Material and methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and was registered in the PROSPERO International Database of Systematic Reviews (CRD42021229775). The PubMed/MEDLINE, Scopus, and Cochrane databases were searched through July 2021. The PICO question was: "Dental implants installed in type IV bone have a lower success rate when compared to implants installed in type I bone, II and III?". The established inclusion criteria were: 1) controlled and randomized clinical trials (RCT), 2) prospective and retrospective studies with at least 10 participants with dental implants, and 3) patients with dental implants installed in bone tissue types I, II, III, and IV (Lekholm and Zarb, 1985). The minimum followup duration was 1 year. Results: After searching the identified databases, 117 articles were selected for full reading and 68 were excluded. Thus, 49 studies were included for qualitative and quantitative analyses. The total number of participants included was 12,056, with a mean age of 41.56 years and 29,905 implants installed. Bone types I, II, and III exhibit a lower implant failure rate when compared to bone type IV. Conclusion: Dental implants installed in bone types I, II, and III showed significantly higher survival rates than those installed in type IV. The bone type I success rate was not significantly different than that of type II; however, the success rate of bone type I and II was higher than that of type III.

What Is the Survival Rate of Implants Loaded Immediately with a Branemark Protocol Prosthesis? A Review.

The aim of this review was to determine the survival rate of implants loaded immediately with a Branemark protocol prosthesis. An electronic search was performed in the PubMed/MEDLINE database from 2006 to February 2024, using a combination of Medical Subject Headings descriptors: "completely edentulous" and "immediate loading." Human clinical articles in English that evaluated the survival rate of implants loaded immediately with a Branemark protocol prosthesis after placement in the bone were included. A total of 546 articles were identified, of which 15 were included in this study. The 15 articles included in the literature showed a high implant survival rate (more than 93%) after immediate loading.

Steel drills versus zirconia drills on heat generation at the surgical site of dental implants: A systematic review and meta-analysis.

Objective: The aim was to evaluate the difference in the heat generated between zirconia (Zr) and steel (SS) drills, during implant site preparation. Material and methods: This systematic review followed the PRISMA methodology criteria and used the JBI Critical Assessment Guidelines for Quasi-Experimental Studies for quality assessment. The electronic search was conducted by using the PubMed/MEDLINE, Embase, and Cochrane Library databases to January 2023. The formulated population, intervention, comparison, outcome (PICO) question was "Do zirconia drills generate less heat than steel drills during implant site preparation?". The meta-analysis was based on an inverse variance (IV) method. Results: This review included 10 studies in vitro that used zirconia drills compared to steel drills with or without coatings. The meta-analysis indicated a significant difference between Zr drills and SS drills, with a lower bone temperature variation with Zr drills. Conclusions: Despite the limitations of this review, it was concluded that Zr drills had significantly less temperature variation than SS drills.

Assessment of the gut microbiota of children with obstructive sleep apnea syndrome: A systematic review.

Sleep-disordered breathing promotes not only unfavorable craniofacial changes in untreated pediatric patients but also neurocognitive, metabolic, cardiovascular, and even long-term social alterations. This systematic review evaluated whether children diagnosed with obstructive sleep apnea syndrome (OSAS) have different intestinal microbiota constitutions from healthy children and was based on the PRISMA guidelines (PROSPERO: CRD42022360074). A total of 1562 clinical studies published between 2019 and 2023 were selected from the PubMed/MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library databases, of which five were included in the qualitative analysis, three being randomized and two prospective. The methodological quality was assessed (RoB 2.0 and ROBINS-I) and all studies showed a negative effect of intervention. Sleep deprivation and intermittent hypoxia in children with OSAS seem to trigger a cascade of inflammatory pathways that exacerbate the tissue response to the release of reactive oxygen species and the generation of oxidative stress, leading to a reduction in oxygen supply to the intestinal mucosa and the integral destruction of the intestinal barrier. More evidence-based investigations are needed to optimize the identification of possible alterations in the gut microbiota of pediatric patients, given that its composition may be influenced by the patient's sleep quality and, consequently, by OSAS, showing quantitative and qualitative alterations compared to that found in healthy individuals.

[Effect of Aging on the Mechanical Properties of CAD/CAM-Milled and 3D-Printed Acrylic Resins for Denture Bases].

PURPOSE: The purpose of this study was to investigate the mechanical properties of acrylic resins at different aging times for denture bases manufactured using the conventional method, microwave processing, milling, and 3D printing. MATERIALS AND METHODS: A total of 160 rectangular samples (64 Å~ 10 Å~ 3.3 ± 0.03 mm) were prepared, divided among the four main resin groups, and subdivided into four analysis times (T0, T1, T2, and T3), resulting in 10 samples per subgroup. The samples were stored in distilled water at 37° ± 2°C for 24 hours (T0), then subjected to thermocycling at temperatures of 5° ± 1°C and 55° ± 1°C in different numbers of cycles: 5,000 (T1); 10,000 (T2); and 20,000 (T3). The mechanical properties evaluated were surface microhardness, flexural strength, and modulus of elasticity. Statistical differences between resin groups and aging time were evaluated using two-way analysis of variance (P < .05). RESULTS: The 3D-printed resin showed the significantly lowest values of microhardness, flexural strength, and modulus of elasticity compared to other resins (P < .001). CONCLUSIONS: The CAD/CAM-milled denture resin showed mechanical properties similar to those of traditional resins (conventional and microwave-processed). The 3D-printing resin did not show adequate mechanical properties for long-term clinical use. Despite this, new studies are developing better properties of this resin for long-term use.

Effects of Overnight Denture Cleaners on Surface and Optical Properties of Conventional, CAD/CAM Milled, and 3D Printed Dentures.

OBJECTIVE: Evaluate the roughness and color stability of different types of resins used to immerse denture bases in various denture cleansers overnight. METODOLOGY: A total of 150 resin samples were made, which were divided into 3 groups of denture resin (conventional thermally activated, milled and 3D printed) (n= 50) and subdivided into 5 denture cleaners (Distilled water, Corega Tabs, Efferdent, NaOCl 1.0%, Listerine Cool Hint) (n= 10). The roughness properties (Ra) and chromatic difference (ΔE00) were evaluated during 90 days and 180 days of overnight cleaning. Data were evaluated by two-way ANOVA and Tukey's test for multiple comparisons (P<.05). RESULTS: Listerine had significantly higher Ra and ΔE values (P<.001) compared to other solutions, being significant in conventional resin at 180 days (P<.001). CONCLUSIONS: The use of Listerine as an overnight cleaner presents greater damage to the optical and surface properties of denture base resins, mainly with conventional resin, with 1% NaOCl being a valid option in relation to cost-benefit.

Influence of antimicrobial photodynamic therapy on the bond strength of endodontic sealers to intraradicular dentin: A systematic review and meta-analysis.

BACKGROUND: The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of endodontic sealers to intraradicular dentin. METHODS: This SRMA followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022319856). A population, intervention, control, and outcome (PICO) question was formulated: "Does antimicrobial photodynamic therapy decrease the bond strength of root canal sealers?". A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases until July 2022. Joanna Briggs Institute Critical Assessment Guidelines for Quasi-Experimental Studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (p<0.05). RESULTS: Out of an initial 345 articles, 8 in vitro studies were included, published between 2013 and 2022. The studies were qualitatively analyzed; two studies showed a positive effect, two studies a negative effect, and the other studies showed no effect on bond strength of endodontic sealers to intraradicular dentin. Seven of the studies were included in the SRMA, which indicated that there was no significant difference in bond strength when using aPDT (P = 0.90; MD: -0.03; 95% CI: -0.46 to -0.41). There was a high level of evidence for each meta-analysis outcome. CONCLUSION: It can be concluded that the use of aPDT as a method of root canal disinfection does not negatively influence the bond strength of endodontic sealers in the root canal.