Impact of low-level laser therapy on the quality of life of patients with xerostomia undergoing head and neck radiotherapy: a systematic review.

PURPOSE: To carry out a systematic review to assess whether low-level laser therapy can improve the quality of life of patients with xerostomia undergoing head and neck radiotherapy. METHODS: A systematic search was performed through Embase, Medline/PubMed, Cochrane, Scopus, Web of Science, nonpeer-reviewed clinicaltrials.gov and LILACS. The strategy included clinical studies were selected that prospectively followed or evaluated the quality of life by directly comparing the use of low-level laser therapy for xerostomia induced by head and neck radiotherapy with alternative therapies without the use of a laser. The risk of bias in the studies was assessed by RoB 2.0 and Robins I. RESULTS: After all application of the predetermined criteria, four studies were included, dated between the years 2014 and 2023. Three studies described as randomized clinical trials were included, one of which was a randomized pilot study and only one was a prospective clinical trial. A total of 126 patients were evaluated, all four studies used the infrared wavelength, with two studies using the combination with the red wavelength. It was observed that low-level laser therapy can change the sensation of dry mouth, improving patients' quality of life. In addition, changes related to increased stimulated and unstimulated salivary flow were also identified. CONCLUSION: The use of low-level laser therapy has promising results on xerostomia, consequently improving the quality of life of patients undergoing radiotherapy in the head and neck region.

Maxillomandibular relationship record methods for computer-engineered complete dentures: a scoping review.

OBJECTIVES: The purpose of this scoping review was to identify different methods employed for recording the maxillomandibular relationship (MMR) for computer-aided designed and manufactured (CAD-CAM) complete dentures (CDs). MATERIALS AND METHODS: This scoping review followed the PRISMA-ScR guidelines and was developed according to Arksey and O'Malley and The Joanna Briggs Institute protocol. The methods were registered on the Open Science Framework (< osf.io/rf4xm> ). The focus question was: "What are the different techniques for recording the maxillomandibular relationship in the digital workflow used in CECDs?" Two investigators searched 3 online databases [MEDLINE (PubMed), Scopus, and Science Direct] independently. The inclusion criteria were clinical studies and reviews that assessed techniques for recording MMR using digital workflow for manufacturing of CECDs. A descriptive analysis was performed considering the study design, manufacturing system, clinical steps, and tools for the determination of MMR, and the difficulty level of procedures. RESULTS: 4779 articles were identified in the electronic search and 10 studies were included for data analysis. The review identified 4 commercially available CAD-CAM denture systems and 3 innovative methods suitable for abbreviating the number of appointments (2 to 4 visits). The trial denture is inherent to the procedure for the Baltic System and 3 innovative techniques. Three techniques (2 innovative and WholeYouNexteeth) demonstrated lower difficulty levels for performing the clinical procedures, regardless of the professional skills. CONCLUSIONS: The commercially available and innovative techniques for the recording of MMR may provide predictability of the treatment. The techniques are effective, however, rely on the learning curve and the patient's clinical condition. CLINICAL RELEVANCE: Recording of the maxillomandibular relationship is paramount for the manufacturing and functionality of complete dentures. Clinicians should be aware of the different tools and techniques described for registering the jaw relationship.

Clinical performance and patient-related outcome measures of digitally fabricated complete dentures: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: The demand to streamline workflow while increasing patient comfort and satisfaction in the manufacturing of removable complete dentures (CDs) is growing, and computer-aided design and computer-aided manufacturing (CAD-CAM) technology has gained prominence. However, a systematic review and meta-analysis of the clinical performance and patient-related outcome measures (PROMs) of digitally fabricated complete dentures is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to determine whether digitally fabricated CDs improve the clinical performance and PROMs compared with conventionally fabricated CDs. MATERIAL AND METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was registered at the International Prospective Register of Systematic Reviews (CRD42023433909). This review aimed to address the question "Do digitally fabricated CDs improve clinical performance and PROMs compared with conventional CDs?" Two independent authors conducted electronic searches up to September 2023. Denture base retention and patient satisfaction were analyzed through the continuous outcome evaluated by mean difference and standard deviation, with 95% confidence intervals. The risk of bias in each study was assessed using the Risk of Bias In Non-randomized Studies of Interventions and the Risk of Bias based on the Cochrane risk of bias tool for randomized trials. The certainty of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation. RESULTS: A total of 1505 articles were found during the search, and 16 were included in this review. The main outcomes were grouped into clinical performance (retention, adaptation or fit, clinician's denture quality assessment, masticatory efficiency, and occlusal force) and PROMs (patient satisfaction, oral health related quality of life, final choice, and willingness-to-pay). In terms of denture base retention, between conventional CDs and printed CDs analyzes, conventional CDs exhibited better retention (P=.02), but no significant difference was found between the conventional CDs and milled CDs (P=.20). In terms of patient satisfaction, no statistically significant difference was found between the manufacturing methods of digitally fabricated CDs (printed CD, P=.55; milled CD, P=.08). CONCLUSIONS: Digitally fabricated CDs showed similar or better clinical performance than conventional CDs, and different types of digital manufacturing processes for complete dentures did not influence PROMs.

Impact of using magnifying dental loupes on clinical performance during tooth preparation: A systematic review.

Background: To assess whether using magnification loupes affects tooth preparation working posture performed by undergraduate students and dentistry professionals and whether it influences the quality of the preparation, operator satisfaction and procedure time. Material and Methods: This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered in the International Prospective Register of Systematic Review (CRD42023482377). Electronic searches were conducted in PubMed/Medline, Cochrane Library, Web of Science, and Scopus databases for relevant articles published up to August 2023. Clinical or laboratory studies evaluating cavities or dental preparations performed with and without magnification loupes were considered eligible. The outcomes were operator working posture, dental preparation quality, operator satisfaction, and procedure time. The quality of the studies was evaluated using the JBI Critical Appraisal tools for Quasi-Experimental Studies. Results: The searches retrieved 1493 articles. Based on the eligibility criteria, 11 laboratory studies were included, where 410 undergraduate and graduate dental students conducted dental preparations in 1851 dental specimens. Of the 11 selected studies, 6 evaluated the working posture, 6 assessed the quality of the dental preparations, 5 reported operator satisfaction, and 2 assessed procedure time. The results showed that magnifying loupes significantly improved operator working posture, but did not influence the quality of tooth preparations. Although satisfaction reports about experiences with magnifying loupes were favorable, no significant difference was found. Conclusions: Magnification loupes improved operator working posture. However, clinical studies with more scientific evidence are needed for steady conclusions regarding operator satisfaction and procedural time. Key words:Magnification, dental loupes, tooth preparation, cavity preparation, dental education.

Evaluation of Masticatory Function, Satisfaction, and Quality of Life Among Users of Complete Dentures Relined with Resilient Materials: A Systematic Review.

PURPOSE: To evaluate whether complete dentures (CDs) relined with long-term resilient liners (LTRLs) favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to conventional CDs. MATERIALS AND METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in PROSPERO (the International Prospective Register of Systematic Reviews; CRD42021258700). The population, intervention, comparison, and outcome (PICO) purpose was to determine whether CDs relined with LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients when compared to CDs. Searches were performed in the PubMed/MEDLINE, Embase, Scopus, Lilacs, BBO, and OpenGrey databases. Manual searches were also performed to identify additional primary studies. RESULTS: Overall, 3,953 articles were found. After removing duplicates, reading the articles, and applying the inclusion and exclusion criteria, 15 articles were selected for qualitative analysis, totaling 422 patients with follow-up periods ranging from 1 week to 3 years. Among these, 8 studies assessed masticatory function using different methods, 2 assessed satisfaction, 1 assessed quality of life, and 4 assessed more than one outcome. Through qualitative analysis, LTRLs showed satisfactory results in most studies when compared to CDs in relation to masticatory function, satisfaction, and quality of life. CONCLUSIONS: LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to CDs.

Effectiveness of Elastic Therapeutic Tape in Reducing Edema, Pain and Trismus following Surgery for Facial Fractures: A Systematic Review and Meta-Analysis.

Facial fractures cause postoperative morbidity, including edema, pain, and trismus. Elastic therapeutic tapes are used for optimizing recovery. Background: The aim of the present systematic review and meta-analysis was to evaluate the effectiveness of elastic tape Kinesio taping (KT) in reducing postoperative morbidity in facial fractures surgeries. Methods: A systematic review was conducted in accordance with the PRISMA guidelines. Searches were conducted in the Cochrane, Medline, Scopus, Embase and Web of Science databases using a pre-established search strategy. Results: A total of 811 studies were retrieved after the duplicates were removed, and only randomized clinical trials were included. Eight trials, involving 319 participants, were deemed eligible. One study solely investigated the effect on edema, while the others analyzed at least two of the variables of interest. Results from two RCTs, where qualitative analysis was applicable, suggest a potential reduction in edema in the KT group compared to the control group on the second (RR -0.55, 95% CI -0.89 to -0.22; p = 0.01; I2 = 0%) and third postoperative days (RR -0.71, 95% CI -1.01 to -0.40; p < 0.00001; I2 = 0%). Conclusions: KT is effective in controlling postoperative edema following surgery for facial fractures. However, the effects on pain and trismus should be explored further in studies with standardized methods.

Accuracy and time efficiency of conventional and digital outlining of extensions of denture foundation on preliminary casts.

PURPOSE: The purpose of this diagnostic study was to assess the accuracy and time efficiency of a digital method to draw the denture foundation extension outline on preliminary casts compared with the conventional technique. MATERIALS AND METHODS: A total of 28 preliminary edentulous casts with no anatomical landmarks were digitized using a laboratory scanner. The outlining of the entire basal seat of the denture was performed on preliminary casts and digitized. Casts with no extension outline were digitized and outlines were drawn using software (DWOS, Straumann). The accuracy of the extension outlined between both techniques was evaluated in the software (GOM Inspect; GOM GmbH) by file superimposition. Specificity and sensitivity tests were applied to measure accuracy. The paired t-test (95% CI) was used to compare the mean total area and the working time. RESULTS: The accuracy ranged from 0.57 to 0.92. The buccal and labial frenulum showed a lower value in the maxilla (0.57); while the area between the retromolar pad and buccal frenulum (0.64) showed a lower score in the mandible. The maxillary denture foundation and the working time for both arches were significantly longer for the digital method (P < .001). CONCLUSION: The denture foundation extension outline exhibited a sufficiently excellent accuracy for the digital method, except for the maxillary anterior region. However, the digital method required a longer working time.

Applicability of terahertz spectroscopy in dentistry: a scoping review.

OBJECTIVE: This study aimed to analyze the scope, nature, and extent of the applicability of terahertz (THz) spectroscopy in dentistry. STUDY DESIGN: A scoping review was conducted following the 5-step methodology of Arksey and O'Malley, the PRISMA-ScR checklist, and the Evidence Synthesis Manual of the Joanna Briggs Institute. Electronic literature searches were performed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases, including full-text articles with no specific publication period. The following research question was formulated: "What are the applications of THz spectroscopy in the field of dentistry?" RESULTS: Seventeen laboratory studies were identified, detailing oral and dental applications of THz. In restorative dentistry, 8 investigations sought to identify the properties of human and animal dental tissues and differentiate between healthy and decayed tissue. In oral pathology, 5 articles analyzed the identification of cancer cells in comparison to the identification of these cells in histological or cytological analysis. In biomaterials, 4 papers studied the changes in properties of restorative materials and effects on polymerization. CONCLUSION: While the potential for early diagnosis using THz spectroscopy in dentistry is evident, our findings underscore its limitations. The studies were exclusively conducted in vitro, emphasizing the need for innovative clinical research using intraoral devices. Bridging this gap is essential to unlock the full potential of this noninvasive technology for early diagnosis and informed clinical decision-making.

Factors Associated with Nonadaptation to New Mandibular Complete Dentures: A Scoping Review.

PURPOSE: To identify and map the scientific evidence regarding factors associated with the nonadaptation of completely edentulous patients to mandibular complete dentures. MATERIALS AND METHODS: This scoping review followed the PRISMA-ScR statement for Scoping Reviews and was based on guidelines proposed by Arksey and O'Malley and the Joanna Briggs Institute Manual for Evidence Synthesis. The methodology was registered on the Open Science Framework. An electronic search strategy was conducted in PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, Virtual Health Library, ClinicalTrials.gov, Google Scholar, and ProQuest databases was conducted. Studies that evaluated factors associated with adaptation to and acceptance of mandibular complete dentures were included, such as sociodemographic, psychologic, patient-related, and denture-related items. RESULTS: The search conducted in March 2022 yielded 9,978 studies. In total, 24 studies were included for data extraction. Sociodemographic factors did not interfere with adaptation to a mandibular complete denture. Psychologic factors and patient-related aspects showed greater association with nonadaptation to mandibular complete dentures than denture-reported factors. CONCLUSION: Although it is suggestive that psychologic and patient-related factors have higher association with the acceptance of new dentures, data must be interpreted with caution due to the variability of methodologies of the studies included in this review.

Are exercises with or without occlusal splints more effective in the reduction of pain in patients with temporomandibular disorders of myogenic origin? A systematic review

Abstract Temporomandibular disorders (TMD) is a term used to describe a set of clinical conditions that may compromise the temporomandibular joint (TMJ) and masticatory muscles and/or associated structures, considered the most frequent cause of orofacial pain of non-dental origin. In recent years, many forms of physical therapy have been used in the treatment of TMD to reduce pain and improve the range of mandibular movement present in this impairment. Among these resources are kinesiotherapy (exercise), electrothermal and manual therapy, acupuncture, training posture, mobilizations, and biofeedback. Objectives To determine if exercises with or without occlusal splints are effective in reducing pain in patients with temporomandibular disorders (TMD) of myogenic origin. Methodology This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD 42019134244). Controlled trials published in PubMed, Scopus, and Cochrane Library following PRISMA guidelines up to April 2022 were randomized and included. The population above 18 years, which evaluated the effectiveness of exercise with or without occlusal splints in reducing pain in patients with TMD of myogenic origin, diagnosed through the Research Diagnostic Criteria for Temporomandibular Disorders, was also included. There was no restriction on the period of publication. Cochrane risk of bias analysis was performed. Results Of the five included articles, all showed a reduction of pain, but without significant differences between the interventions performed. Additionally, studies that evaluated the quality of life and mandibular movements showed a reduction in pain, but no significant differences between therapies. Conclusion The analyzed studies showed no difference in the improvement of pain, quality of life, and mandibular movements between the groups that performed only exercises or the associated treatments.

Dispositivos intraorais no tratamento da apneia obstrutiva do sono em pacientes desdentados: uma revisão sistematizada de literatura / Intraoral devices in the treatment of obstructive sleep apnea in edentulous patients: a systematized literature review

Objetivo: elucidar aspectos envolvidos no uso dos dispositivos intraorais para apneia obstrutiva do sono em indivíduos desdentados totais, como a eficácia dos dispositivos, o conforto e retenção/estabilidade. Metodologia: essa revisão seguiu o checklist do PRISMA, no qual foram incluídos estudos clínicos em inglês, sem restrição de tempo, em que foram utilizados dispositivos para apneia obstrutiva do sono em pacientes desdentados bimaxilares. As buscas foram realizadas nas bases de dados PubMed / MEDLINE, Cochrane e SCOPUS até março de 2021. Resultados: Após as diferentes etapas do processo de seleção dos artigos, foram selecionados 6 estudos para esta revisão, sendo 5 relatos de caso e 1 ensaio clínico. Os estudos relataram uma redução no índice apneia-hipopneia. Em três estudos houve redução expressiva, proporcionando a redução no grau de apneia, de severa para moderada e moderada para leve. A protrusão alcançada com os dispositivos foi adequada para o efeito desejado, em todos os dispositivos. Os estudos não reportam deslocamento do dispositivo e apenas um relata desconforto temporário. Conclusão: Os dispositivos intraorais foram eficazes no tratamento da apneia obstrutiva do sono em pacientes desdentados e os usuários não tiveram queixas quanto ao conforto e estáveis... (AU)

Objective: to elucidate aspects involved in the use of intraoral devices for obstructive sleep apnea in complete edentulous patients, such as the effectiveness of these devices, comfort and retention/stability. Methodology: this review followed the PRISMA checklist, included clinical studies in English, without publication restrictions, in which intraoral devices were used for obstructive sleep apnea in edentulous bimaxillary patients. The search was carried out in PubMed/MEDLINE, Cochrane and SCOPUS databases, until March 2021. Results: After the different stages of the article selection process, 6 studies were selected for this review, 5 case reports and 1 clinical trial. The studies reported a reduction in the apnea-hypopnea index. In three studies there was a significant reduction in the degree of apnea, from severe to moderate and moderate to mild. The protrusion achieved with the devices was adequate for the desired effect, in all devices. Studies did not report displacement of the device and only one reports temporary discomfort. Conclusion: Intraoral devices were effective in treating obstructive sleep apnea in edentulous patients and users had no complaints about comfort and stability... (AU)

Existe relação entre doenças respiratórias e próteses dentárias removíveis contaminadas? Uma revisão sistematizada da literatura / Relationship between respiratory diseases and contaminated removable dental prostheses

Objetivo: O objetivo dessa revisão sistematizada da literatura foi analisar a associação entre o uso de próteses dentárias removíveis e doenças respiratórias prevalentes. Materiais e métodos: Este estudo foi conduzido seguindo os critérios do PRISMA check-list (Preferred Reporting Items for Systematic Review and Meta-Analysis). A base de dados eletrônica selecionada foi a PubMed/MEDLINE, sem restrições do ano de publicação. Estudos prospectivos e retrospectivos (ensaios clínicos randomizados, ensaios clínicos controlados, estudos de coorte, estudos caso-controle e estudos transversais), estudos in vitro e publicados em inglês foram escolhidos como critérios de elegibilidade. Resultados: A busca inicial na base de dados obteve 553 artigos e 8 deles foram selecionados baseados nos critérios de elegibilidade e subdivididos em dois tópicos: doença pulmonar obstrutiva crônica e pneumonia por aspiração. Conclusão: Com base nos estudos avaliados existe associação entre as próteses dentárias removíveis contaminadas e doenças respiratórias... (AU)

Objective: The purpose of this review was to analyze the association between the use of removable dental prostheses and the prevalence of respiratory diseases. Methodology: This study was conducted following the criteria of PRISMA check-list (Preferred Reporting Items for Systematic Review and Meta-Analysis). The database selected was PubMed/MEDLINE, with no restrictions on the year of publication. Prospective and retrospective studies (randomized clinical trials, controlled clinical trials, cohort studies, case-control studies and cross-sectional studies), in vitro studies and published in English were selected in tehe eligibility criteria. Results: The search in the database obtained 553 articles and 8 of them were selected based on the eligibility criteria and subdivided into two topics: chronic obstructive pulmonary disease and aspiration pneumonia. Conclusion: Based on the studies evaluated, there is an association between contaminated removable dental prostheses and respiratory diseases... (AU)

Polymorphisms of the serotonin receptors genes in patients with bruxism: a systematic review

Abstract This study aimed to investigate if SNP rs6313, SNP rs2770304, SNP rs4941573, and SNP rs1923884 of the 5-HT2A receptor gene and SNP rs6295 of the 5-HT1A receptor gene are associated with bruxism etiology. Methodology This systematic review was registered in PROSPERO (CRD42018094561). A search was conducted for articles published in or before May 2021. To qualify for eligibility in this review, the studies had to be case-controls, cohort or cross-sectional. The inclusion criteria were the articles with a group of patients with bruxism and a control group in which the presence of these SNPs was evaluated. The exclusion criteria were the investigations of other polymorphisms, the studies that did not consider a control group for comparison, case reports, and reviews. The NOS and JBI were used to evaluate the methodological quality of studies. Results We conducted this study with databases, such as Web of Science, Scopus, Embase, PubMed/MEDLINE, and ProQuest. We considered four studies eligible. A total of 672 participants were included,187 with sleep bruxism, 105 with awake bruxism, 89 with sleep and awake bruxism, and 291 controls. One study found a strong association between the SNPs rs6313, rs2770304 and rs4941573 of the 5-HT2A receptor gene and sleep bruxism. In one study, we considered the C allele of the SNP rs2770304 a risk factor for sleep bruxism. We found no significant results of other SNPs in sleep bruxers compared to controls. We found no positive association concerning the SNPs and groups of awake bruxism and sleep and awake bruxism. Conclusion The different results regarding the SNPs in sleep bruxers could be explained by the genetic distinction between Chilean, Mexican, Japanese, and Polish population. More clinical trials and prospective studies must be conducted with larger sample size and in different ethnicities to confirm the results of this review.

Perfil sociodemográfico e odontológico de usuários de próteses totais do programa de extensão universitária Resgatando Sorrisos / Sociodemographic and dental profile of users of total protheses in the university extention program "Resgatando Sorrisos"

Objetivo: Realizar uma análise transversal do perfil sociodemográfico e clínico de pacientes edêntulos bimaxilares e dos hábitos de uso das suas próteses totais (PT) antigas. Posteriomente, os participantes foram reabilitados com próteses totais, em um período de 3 anos (2017- 2019)), em três municípios do estado de Pernambuco - Brasil, por meio de um programa de extensão universitária. Métodos: 58 participantes foram avaliados por meio de um questionário composto de 73 questões. Os dados coletados permitiram uma avaliação quantitativa, e o nível de significância considerado foi de 0,05. Resultados: Destaca-se um perfil de pacientes idosos com uma média de tempo de desdentado total de 24,3±15,3 anos (maxila) e 22,14±14,22 (mandíbula), havendo uma maior prevalência de usuários com próteses bimaxilares (74%). Destaca-se em 57,1% da amostra, a predo-minância da escovação com creme dental e, em 42,9%, a utilização de sabão/detergente, solução de hipoclorito de sódio (NaClO) e/ou bicarbonato de sódio (NaHCO3) como coadjuvantes na higienização. Além disso, 66,6% da amostra apresentou necessidade de intervenção clínica para reparos na PT. Com relação aos hábitos deletérios, os idosos apre-sentaram menos o hábito de dormir com a prótese quando comparados a adultos (p≤0,001). Conclusão: O perfil dos participantes apresentou prevalência do gênero feminino e idade média de 63 anos, além de uma média de 20 anos desdentados (maxila e mandíbula), um tempo elevado de uso das próteses (>10 anos) e o hábito de uso contínuo. Mais da metade dos participantes utilizava métodos de higienização inadequados.

Objective: To conduct a cross-sectional analysis of the sociodemographic and clin-ical profile of edentulous bimaxillary patients and their habits of using old complete den-tures (CD).Subsequently, the participants were rehabilitated with complete dentures, in three years (2017-2019), in three municipalities located in the state of Pernambuco, - Bra-zil, through a university extension program. Methods: We evaluated a total of 58 partici-pants through a questionnaire with 73 questions. Data collected were used for quantitative assessment, and the level of significance was set at 0.05. Results: Most of the participants were elderly patients with an average total edentulous time of 24.3 ± 15.3 years, and 22.14 ± 14.22 years at the maxilla and mandible, respectively. In addition, there was a high prev-alence of users who had bimaxillary prostheses (74%). In 57.1% of the sample, there was a predominance of brushing with toothpaste, 42.9% used soap/detergent, sodium hypochlo-rite solution, and (or) sodium bicarbonate as adjuvants in cleaning. Moreover, 66.6% of the patients needed a clinical intervention for CD repairs. About the harmful habits, the elderly showed a less frequent habit of sleeping with their prostheses compared to the adults (p ≤ 0.001). Conclusion: Most of the participants were female with an average age of 63 years. They presented an average of 20 years of edentulousness (maxilla and mandible) and the extended use of the dentures (> 10 years), in addition to the habit of continuous use. More than half of the participants used inadequate cleaning methods.

Three-Dimensional Finite Element Analysis of Varying Diameter and Connection Type in Implants with High Crown-Implant Ratio

Abstract The aim of this study was to evaluate the effect of varying the diameter, connection type and loading on stress distribution in the cortical bone for implants with a high crown-implant ratio. Six 3D models were simulated with the InVesalius, Rhinoceros 3D 4.0 and SolidWorks 2011 software programs. Models were composed of bone from the posterior mandibular region; they included an implant of 8.5 mm length, diameter Ø 3.75 mm or Ø 5.00 mm and connection types such as external hexagon (EH), internal hexagon (IH) and Morse taper (MT). Models were processed using the Femap 11.2 and NeiNastran 11.0 programs and by using an axial force of 200 N and oblique force of 100 N. Results were recorded in terms of the maximum principal stress. Oblique loading showed high stress in the cortical bone compared to that shown by axial loading. The results showed that implants with a wide diameter showed more favorable stress distribution in the cortical bone region than regular diameter, regardless of the connection type. Morse taper implants showed better stress distribution compared to other connection types, especially in the oblique loading. Thus, oblique loading showed higher stress concentration in cortical bone tissue when compared with axial loading. Wide diameter implant was favorable for improved stress distribution in the cortical bone region, while Morse taper implants showed lower stress concentration than other connections.

Resumo O objetivo deste estudo foi avaliar o efeito da variação do diâmetro e dos tipos de conexão na distribuição do estresse no osso cortical para implantes com a proporção coroa-implante. Seis modelos 3D foram simulados com os programas InVesalius, Rhinoceros 3D 4.0 e SolidWorks 2011. Os modelos foram compostos de osso da região mandibular posterior. Foram incluídos implantes de 8,5 mm de comprimento, diâmetro Ø 3,75 mm ou Ø 5,00 mm, e tipos de conexão como hexágono externo (EH), hexágono interno (IH) e cone Morse (MT). Os modelos foram processados usando os programas Femap 11.2 e NeiNastran 11.0 e usando uma força axial de 200 N e força oblíqua de 100 N. Os resultados foram registrados em termos da tensão principal máxima. O carregamento oblíquo mostrou alta tensão no osso cortical em comparação com a carga axial. Os resultados mostraram que os implantes com maior diâmetro apresentaram distribuição de tensões mais favorável, independentemente do tipo de conexão, enquanto que os implantes cone Morse apresentaram melhores distribuição de tensões comparado aos outros tipos de conexão, especialmente no carregamento oblíquo. Assim, os implantes de maior diâmetro foram mais favoráveis para distribuição das tensões na região de tecido ósseo cortical, enquanto que os implantes cone Morse apresentam menores concentrações de tensões do que as outras conexões.

Complications with PMMA compared with other materials used in cranioplasty: a systematic review and meta-analysis

Abstract Polymethyl methacrylate (PMMA) has been considered a suitable material for cranioplasty. However, no consensus has been reached concerning the best material for cranioplasty with regard to minimizing complications. Thus, this systematic review and meta-analysis aimed to compare the complication rates of PMMA with those of autologous bone and titanium mesh. This review was registered with PROSPERO (CRD42016042725). Systematic searches were conducted on PubMed/MEDLINE, Scopus, and Web of Science. The focus question was, "Do PMMA prostheses used in cranioplasty have complications rates similar to those of autologous bone and titanium mesh?" A meta-analysis of complication rates was performed on the basis of dichotomous outcomes assessed by risk ratio (RR) with corresponding 95% confidence intervals (CI). From 1014 data sources, 11 articles were selected according to eligibility criteria. These articles involved 1,256 individuals and 1,278 cranioplasties using autologous bone (n = 408), PMMA (n = 379), or titanium (n = 151). The follow-up period ranged from 63 days to 54.3 months. No difference was observed between the complication rates of PMMA and autologous bone (p = 0.94; RR, 0.98; 95%CI, 0.54-1.75) or between PMMA and titanium (p = 0.38; RR, 1.59; 95%CI, 0.57-4.48). Sub-analysis of the reasons for craniotomy (trauma/non-trauma) was conducted, which revealed no significant difference (p = 0.91; RR, 0.95; 95%CI, 0.37-2.42). The meta-analysis indicated that the use of PMMA yields complication rates that are near those of autologous bone and titanium mesh.

Conhecimento sobre uso, conservação e higienização de próteses totais em população desfavorecida socioeconomicamente assistida por um projeto de extensão universitária / Knowledge of use, maintenance and cleaning of dentures in socioeconomically disadvantaged population assisted by a university extension project

Introdução: a prótese dentária total é um órgão artificial que deve promover a saúde e a qualidade de vida. O modo de uso, conservação e higienização é parte fundamental para o sucesso e longevidade da mesma. Uma ferramenta que parece ser eficaz na detecção e disseminação desse tipo de informação é a extensão universitária. Objetivo: analisar o nível de conhecimento sobre o uso, conservação e higienização de próteses totais em uma população de baixa renda, através de estudo epidemiológico transversal. Métodos: a amostra de conveniência foi composta por 37 usuários de próteses totais atendidos em uma ação do programa de extensão universitária Resgatando Sorrisos da Universidade de Pernambuco, que promove ações terapêuticas e informativas sobre as áreas de prótese dentária, dentística, patologia e pacientes com necessidades especiais. Após assinatura do termo de consentimento livre e esclarecido (TCLE), foram coletadas informações sociodemográficas e sobre hábitos de uso e higiene das próteses, através de um questionário aplicado por pesquisadores em ambiente reservado. Os dados foram interpretados por meio de análise descritiva e analítica entre as variáveis com nível de significância considerado, p < 0,05. Resultados e Discussão: dos pacientes, 70,27% dormem com as próteses; sobre frequência de higienização, 43,2% relatam fazer pelo menos 3 vezes ao dia, sendo o uso da escova e creme dental o método mais utilizado (83,78% - 31 entrevistados); características como bases e dentes desgastados, presença de biofilme/tártaro foram encontradas em mais 50% das próteses totais. Não foi observada nenhuma correlação estatisticamente significativa entre as variáveis (p>0,05). Conclusão: o nível de conhecimento sobre o uso, conservação e higienização de próteses totais da população estudada precisa ser melhorado, uma vez parte da população ainda apresenta hábitos de uso e higiene de próteses totais inadequados.(AU)

Introduction: the dental total prosthesis is an artificial organ that should promote health and quality of life. The way of use, conservation and hygiene is fundamental for the success and longevity of it. One tool that seems to be effective in detecting and disseminating this type of information is activities of University extension. Objectives: to analyze the level of knowledge about the use of complete sets of dentures and their conservation in a low-income population through a cross-sectional epidemiological study. Methods: This research had a convenience sample of 37 users of complete sets of dentures. Datawas collected using a questionnaire applied by two trained examiners. The data were interpreted via descriptive and statistical analysis (tests of Kruskal-wallis e Kolmogorov ­ Smirnov/ p =0,05). Results: The average income of the sample was R$ 668.00. The average time of denture use was 7.3 years; 70.27% of the patients sleep with their dentures, and 83.78% of them sanitize the dentures with a toothbrush and toothpaste. Conclusion: Regarding the variables association, we noticed tendencies yet to be explored in the habits of the complete denture wearer. Moreover, we conclude that the population's level of knowledge on the subject needs to be improved. Thereby, once these conditions are detected and transmitted to government officials, the extension project through the research tool will be able to assist government's course of action regarding oral health.(AU)

Impacto de uma experiência extensionista na formação universitária / Impact of an extension experience in university education

Este estudo teve como objetivo analisar o impacto do projeto de extensão universitária, Resgatando Sorrisos, na formação de estudantes do curso de Odontologia da FOP - UPE, nos anos de 2013 e 2014. Foram utilizados 02 questionários em momentos distintos, tendo como amostra 71 alunos. Foi utilizado o teste de hipótese estatística Wilcoxon para comparar as respostas de antes e depois da ação. Diante da elevada frequência de respostas, como "muitíssimo" e "bastante", observamos um alto grau de aceitação e entendimento da importância do projeto na formação do aluno, assim como no que se refere à capacidade de mudança que o projeto pode causar na vida dos pacientes e sua possível aplicabilidade no sistema público de saúde, dentre outras questões. Contudo, observa-se no ano de 2014 em quesito referente ao grau de expectativa inicial e satisfação final do projeto, uma diferença estatística entre a ida e a volta, p=o,o1. Conclui-se que os alunos apresentam um entendimento positivo em relação à ação extensionista, considerando-a importante para sua formação profissional e pessoal... (AU)

The aim of this study was to analyze the impact of the University Extension Project, ResgatandoSorrisos, in the graduation process of students of Dentistry course FOP - UPE in the years of 2013 and 2014. There were 02 questionnaires used, at different times, with a sample size 71 students. Wilcoxon statistical hypothesis test was used to compare responses before and after the action. Such high frequency responses of "vital" and "enough", a high degree of acceptance and understanding of the importance of the project in the formation of the student was observed, as well as the capacity of a change that the project may cause in the lives of patients and its possible applicability in the public health system, among other issues. However, in 2014, there was a statistical difference between the outward and return (p = o, o1) in a question referring to initial degree of expectation and ultimate satisfaction of the project. It was concluded that students have a positive understanding about the extension action, and they consider it important for their professional and personal training... (AU)

Implantes curtos do tipo cone - Morse: Proporção coroaimplante / Morse Taper implants short: crown-to-implant ratio.

A proposta deste estudo foi analisar as interações biomecânicas no tecido ósseo entre implantes curtos e coroas implantossuportadas com diferentes alturas. Dois modelos foram confeccionados usando os programas Invesalius 3.0, Rhinoceros 4.0 e Solidworks 2010. Esses modelos foram constituídos de um bloco ósseo com implante curto (3,75 x 8,5 mm) cone Morse. A altura da coroa (cimentada) foi estabelecida em 10.00 mm e 15.00 mm. Os modelos foram processados pelos programas Femap 10 e NeiNastran 10.0. A força aplicada foi de 200N (vertical) e 100N (oblíqua). Os resultados foram plotados em mapas de Tensão Máxima Principal. A análise estatística foi realizada com ANOVA. Os resultados apontaram que o aumento da altura da coroa ampliou a concentração de tensões na coroa de 15 mm, sob carregamento oblíquo (p<0.001), e a carga oblíqua ampliou consideravelmente a área de concentração de tensões (p<0.001). O aumento da coroa ampliou a concentração de tensões sendo estatisticamente significante para implantes curtos do tipo cone Morse. A região distal e mesial apresentaram a maior concentração de tensões, sob carregamento oblíquo. O carregamento oblíquo foi o mais prejudicial, quando comparado com o carregamento axial, sendo estatisticamente significante.

The purpose of this study was to analyze the biomechanical interactions in bone tissue between short implants and implant-supported crowns with different heights. Two models were made using the programs InVesalius 3.0, Rhinoceros 4.0 and Solidworks 2010. The models were established from a bone block with the short implant (3.75 x 8.5 mm) with geometry Morse taper connection (MT). The height of the crown (cemented) was set at 10.0 mm and 15.00 mm. The models were processed by programs and 10 NEiNastran Femap 10.0. The force applied was 200N (vertical) and 100N (oblique). The results were plotted on maps Voltage Maximum Principal. Statistical analysis was performed using ANOVA. The results showed that the increase in crown height, increased stress concentration in the crown of 15 mm under oblique loading (p <0.001), the oblique loading has significantly expanded the area of stress concentration (p <0.001). Conclusion: the increase of the crown increased the stress concentration, being statistically significant for short implants Morse taper. The mesial and distal region had the highest concentration of stresses under oblique loading. The oblique loading was more harmful when compared with axial loading, being statistically significant.