Challenges in the assessment of epithelial dysplasia in oral lichen planus and oral lichenoid lesion: Inter and intra-observer variability of the WHO criteria and binary system.

Background: Assessment of oral epithelial dysplasia is the gold standard for investigating the risk of malignant progression. The World Health Organization (WHO) methods and the binary system have limitations. This study assess the inter- and intra-observer variability of the architectural and cytological criteria and the classification of the presence and degree of epithelial dysplasia in oral lichen planus (OLP) and oral lichenoid lesion (OLL), using both the 2017 WHO criteria and the binary system. Material and Methods: The sample consisted of 65 biopsies from lesions classified as OLP and OLL according to the American Academy of Oral and Maxillofacial Pathology (AAOMP) criteria. The histological slides were reevaluated by two oral pathologists. Results: The individual alterations with most inter-observer disagreement were atypical mitotic figures (43.1%), loss of cohesion between epithelial cells (38.5%) and drop shape rete ridges ridges (38.5%). Inter-observer agreement analysis did not show statistically significant agreement regarding the classification of epithelial dysplasia grade by WHO criteria, only regarding the binary system classification (k=0.257; p=0.035). Intra-observer agreement analysis by evaluator 1 showed that the classification of epithelial dysplasia grade according to both methods had statistically significant agreement (k=0.546; p=0.004, k=0.861; p<0.001). Considering evaluator 2, only the evaluation of the WHO system classification showed statistically significant agreement (k=0.593; p=0.010). Conclusions: The evaluation of epithelial dysplasia is subjective and focal changes and inflammatory infiltrate, characteristic of OLP and OLL, can increase the degree of disagreement among evaluators. The binary system presents better inter-observer agreement, while the WHO system presents better intra-observer agreement. Key words:Oral lichen planus, oral lichenoid lesion, oral lichenoid disease, dysplasia, inter-observer variation.

Dental implants in individuals living with HIV-1: Results from a prospective study in patients undergoing highly active antiretroviral therapy.

OBJECTIVE: To assess survival and success rates of dental implants and the occurrence of peri-implant diseases (mucositis/peri-implantitis) in HIV-1-infected individuals. MATERIAL AND METHODS: In this prospective study, 13 HIV-1-infected individuals undergoing highly active antiretroviral therapy (with undetectable plasma HIV RNA levels, and CD4+ T cells > 350/mm3 ) were followed after implant placement, as well as 13 non-HIV-1-infected matched controls. Patients enrolled in this study were followed up to 120 months (mean = 40.6 months; standard deviation = 22.2; range 18 -120 months). Twenty-five implants were placed in pristine healed sites for each group and bone augmentation procedures, when needed, were done only for contour augmentation. Patients were enrolled in a strict periodontal/peri-implant supportive therapy protocol with three recalls per year. The two groups were compared regarding subject-level characteristics (age, gender, smoking, diabetes) and implant-level characteristics (marginal bone level, peri-implant health status). RESULTS: All the implants healed uneventfully and reached 100% survival rates (after at least 18 months) in both groups. There were no significant differences between groups for peri-implant diseases (mucositis/peri-implantitis) and for all subject-level co-variables (p > .05). Only the variables dental implant prosthesis type (DIPT) (p = .021, d = .86) and follow up (p = .011, d = .77) showed statistically significant differences between groups. CONCLUSION: The findings suggest that well-controlled HIV-1-infected individuals are eligible to undergo implant therapy, achieving survival and success rates comparable to non-HIV-1-infected controls.

Leukocyte-platelet rich fibrin on the treatment of a large paradental cyst: a novel regenerative approach.

Leukocyte-platelet rich fibrin (PRF) is an autologous biomaterial formed by platelets, cytokines, growth factors and cells imprisoned on a fibrin mesh, produced according to Choukroun's protocol. The aim of the present article was to report the use of PRF, associated with a bone substitute, on the regenerative treatment of a large bone defect resulting from the enucleation of a paradental cyst involving the posterior mandible. The treatment resulted in the maintenance of the bone volume, and radiographic evaluation showed new bone formation after 40 days, suggesting an osteogenic and osteoinductive effect. Also, the current literature was reviewed.

Aging as a Risk Factor on the Immunoexpression of Pro-Inflammatory IL-1ß, IL-6 and TNF-α Cytokines in Chronic Apical Periodontitis Lesions.

Persistent inflammatory responses in the elderly may act as modifiers on the progression and repair of chronic apical periodontitis lesions (CAPLs). While the involvement of IL-1ß, IL-6 and TNF-α in inflammatory responses and, particularly, in CAPL has been documented, their expression in elderly patients needs to be further characterized. Therefore, the purpose of this study was to evaluate and compare the expressions of pro-inflammatory cytokines in CAPL from elderly individuals with young/middle-aged individuals. Thirty CAPL (15 cysts and 15 granulomas) from elderly patients (>60 years) and 30 CAPL (15 cysts and 15 granuloma) from young/middle-aged individuals (20-56 years) were selected. Immunohistochemical reactions were performed against IL-1ß, IL-6 and TNF-α. The slides were subdivided into five high-magnification fields and analyzed. The number of positive stains was evaluated for each antibody. There was no significant difference between the cytokines when the cysts and granuloma were compared in the two groups. In the young/middle-aged, only IL-1ß showed a difference and was significantly higher in granulomas (p = 0.019). CAPL pro-inflammatory cytokine levels in the elderly were significantly higher than in young/middle-aged individuals (p < 0.05). The pro-inflammatory cytokines IL-1ß, IL-6 and TNF-α were significantly higher in CAPL in the elderly compared with the young/middle-aged group. Further elaborate research studies/analyses to elucidate the reasons for and consequences of inflammation in the elderly are recommended.

Expression of Inflammatory Markers RANK, MMP-9 and PTHrP in Chronic Apical Periodontitis from People Living with HIV Undergoing Antiretroviral Therapy.

To compare the expression of the receptor activator of nuclear factor-kappa B (RANK), matrix metalloproteinase 9 (MMP-9) and parathyroid hormone-related protein (PTHrP) in primary chronic apical periodontitis lesions (CAPLs) between people living with HIV (PLWHIV) undergoing antiretroviral therapy (ART) and HIV- individuals, 32 CAPLs (16 lesions from each group) were submitted to histopathological and immunohistochemical analyses and compared between groups. The majority of the PLWHIV group had undetectable plasma viral loads (n = 13; 81.3%). The means of TCD4+ lymphocytes, exposure to HIV-1 and the time of the use of ART were 542.1 cells/mm3 (SD = 256.4), 6.3 years (SD = 2.9) and 5.0 years (SD = 2.5), respectively. Of all variables studied, only histopathological diagnosis showed a significant difference between groups (LWHIV: granuloma n = 11 (68.0%); cyst n = 5 (31.2%); HIV-: granuloma n = 15 (93.8%); cyst n = 1 (6.2%); p = 0.015). When comparing the expressions of the three inflammatory markers between the groups, no significant differences were seen. There was no difference in the expression of RANK, PTHrP and MMP-9 in primary chronic apical periodontitis lesions between PLWHIV under ART and HIV- individuals.

Oral mycobiome identification in atopic dermatitis, leukemia, and HIV patients - a systematic review.

INTRODUCTION: Oral mycobiome profiling is important to understand host-pathogen interactions that occur in various diseases. Invasive fungal infections are particularly relevant for patients who have received chemotherapy and for those who have HIV infection. In addition, changes in fungal microbiota are associated with the worsening of chronic conditions like atopic dermatitis (AD). This work aims, through a systematic review, to analyze the methods used in previous studies to identify oral fungi and their most frequent species in patients with the following conditions: HIV infection, leukemia, and atopic dermatitis. METHODS: A literature search was performed on several different databases. Inclusion criteria were: written in English or Portuguese; published between September 2009 and September 2019; analyzed oral fungi of HIV-infected, leukemia, or AD patients. RESULTS: 21 studies were included and the most identified species was Candida. The predominant methods of identification were morphological (13/21) and sugar fermentation and assimilation tests (11/21). Polymerase chain reaction (PCR) was the most used molecular method (8/21) followed by sequencing techniques (3/21). CONCLUSIONS: Although morphological and biochemical tests are still used, they are associated with high-throughput sequencing techniques, due to their accuracy and time saving for profiling the predominant species in oral mycobiome.

High-throughput nucleotide sequencing for bacteriome studies in oral squamous cell carcinoma: a systematic review.

PURPOSE: Dysbiosis has been identified in oral squamous cell carcinoma (OSCC). The aim of this study was to carry out a systematic review of an electronic research that was carried out on articles published between January 2008 and September 2018. METHODS: Eight studies were selected after applying the inclusion and exclusion criteria. RESULTS: All articles targeted the hypervariable regions of the 16S rRNA gene. At the phylum level, it was found reduction of Bacteroidetes (2/8 studies) and increase of Firmicutes (2/8 studies). At the genus level, Rothia increased (1/8 studies) and decreased (2/8 studies) in tumor samples, and Streptococcus also was found increased (3/8 studies) and reduced (3/8 studies). Fusobacterium only increased in OSCC samples (3/8 studies). At species level, an increase in F. nucleatum subsp. polymorphum was more associated to OSCC (2/8 studies) than with controls, as was P. aeruginosa (3/8 studies). CONCLUSION: In summary, the results corroborated dysbiosis in OSCC patients, with enrichment of microbial taxa that are associated with inflammation and production of acetaldehyde. However, variations of study design and sample size were observed among the studies, as well as a shortage of more detailed analyses of possible correlations between risk habits and OSCC. This lack of more detailed analysis may be the cause of the inconsistencies in regard of the alterations reported for certain genera and species. In conclusion, there is an association between OSCC and oral microbiota dysbiosis, but its role in oral carcinogenesis needs to be clarified in more detail.

CONHECIMENTO SOBRE BEIJO NA BOCA DE ADOLESCENTES DE UM GRUPO DE ESCOLAS PRIVADAS DE NOVA IGUAÇU/RIO DE JANEIRO ­ ESTUDO PILOTO / KNOWLEDGE ABOUT KISSING IN THE MOUTH OF ADOLESCENTS FROM A GROUP OF PRIVATE SCHOOLS IN NOVA IGUAÇU / RIO DE JANEIRO - PILOT STUDY

Objetivo: Descrever os conhecimentos sobre o beijo na boca e sua possibilidade de transmissão de doenças infecciosas em um grupo de adolescentes de escolas privadas de Nova Iguaçu/Rio de Janeiro, através deste estudo piloto. Metodologia: Estudo seccional em que foi aplicado um roteiro de perguntas semi-estruturado autoaplicável em adolescentes (de 18 e 19 anos) de ambos os gêneros, pertencentes a três escolas da rede de ensino privado do município de Nova Iguaçu no Estado do Rio de Janeiro. Resultados: De um total de 100 adolescentes que participaram deste estudo, mais da metade eram solteiros e do gênero feminino (61%), apenas estudantes como ocupação (88% do total) e 96% já haviam beijado na boca. A amostra selecionada demonstrou características próprias, com a alta frequência do conhecimento da possibilidade de transmissão de doenças infecciosas pelo beijo na boca e saliva (71%), que possivelmente se confirmou pela baixa ocorrência de lesões após o ato do beijo e pela observação da boca do parceiro antes de beijar. Conclusão: A pratica do beijo na boca e o sexo oral devem ser temáticas consideradas na assistência fornecida a adolescentes. O uso de estratégias preventivas e o acesso às redes sociais podem contribuir para a redução de situações de risco advindos de situações de vulnerabilidade.

Aim: To describe the knowledge about the kiss on the mouth and its possibility of transmission of infectious diseases in a group of adolescents from private schools in Nova Iguaçu / Rio de Janeiro, through this pilot study. Methodology: Cross-sectional study in which a self-administered semi-structured question script was applied to adolescents (18 and 19 years) of both genders, belonging to three schools of the private school system of Nova Iguaçu, Rio de Janeiro State. Results: Of a total of 100 adolescents who participated in this study, more than half were single and female (61%), only students as occupation (88% of the total) and 96% had already kissed the mouth. The selected sample demonstrated its own characteristics, with the high frequency of the knowledge of the possibility of transmission of infectious diseases by kissing in the mouth and saliva (71%), which was possibly confirmed by the low occurrence of lesions after the kiss and the observation of the mouth. of the partner before kissing. Conclusion: The practice of kissing on the mouth and oral sex should be thematic considered in the care provided to adolescents. The use of preventive strategies and access to social networks can contribute to the reduction of risk situations arising from vulnerability situations. Keywords: mouth, infectious diseases, adolescent (s), health education, strategies and oral health

Análise de limas endodônticas submetidas a biocorrosão por bactérias redutoras de sulfato in vitro / Analysis of endodontic files submitted to biocorrosion by sulfate reducing bacteria in vitro

Objetivo: Avaliar as alterações químicas presentes na superfície metálica de limas endodônticas fraturadas em canais radiculares, in vitro, após a inoculação intrarradicular de culturas de BRS de três cepas microbianas, Desulfovibrio desulfuricans (uma cepa oral e outra ambiental) e Desulfovibrio fairfieldensis. Métodos: foram analisadas 5 limas kerr #90, sendo uma Lima Kerr nova, sem tratamento, e as outras 4 limas fraturadas dentro de canais radiculares in vitro, com posterior inoculação de Desulfovibrio desulfuricans, cepa oral e ambiental, e Desulfovibrio fairfieldensis e um grupo controle sem inoculação bacteriana, por 477 dias. Os grupos foram analisados no modo EDS (Espectrometria de Energia Dispersiva de Raios-x) do microscópio eletrônico de varredura (FEI-Inspect-S50). Resultados:A presença do S, Cl e O foram relacionados ao processo biocorrosivo, assim como a redução dos elementos de liga nesta área. Conclusão:As análises no modo EDS demonstraram biocorrosão ao longo da superfície metálica das limas quando empregado o biofármaco BACCOR, nas três diferentes cepas empregadas, indicada pela redução dos elementos formadores da liga metálica, Fe, Ni e Cr, com a associação da presença de elementos indicadores de biocorrosão como O, Cl e S. (AU)

Aim:To evaluate the chemical alterations present on the metallic surface of root canal fractured endodontic files in vitro after the intraradicular inoculation of BRS cultures of three microbial strains, Desulfovibrio desulfuricans (one oral and one environmental strain), and Desulfovibrio fairfieldensis. Methods: Five kerr #90 files were analyzed, one new untreated Kerr file and the other 4 files fractured within root canals in vitro, with a subsequent inoculation of Desulfovibrio desulfuricans (oral and environmental strains), and Desulfovibrio fairfieldensis, as well as a control group without bacterial inoculation for 477 days. The groups were analyzed using the scanning electron microscope (FEI-Inspect-S50) EDS (X-ray Dispersive Energy Spectrometry) mode. Results:The presence of S, Cl, and O were related to the biocorrosive process, as well as the reduction of alloying elements in this area. Conclusion: The EDS mode analysis showed biocorrosion along the metallic surface of the files when the BACCOR biopharmaceutical was used in the three different strains employed in this study, indicated by the reduction of the alloying elements ­ Fe, Ni, and Cr ­ with the association of the presence of indicator elements of biocorrosion, such as O, Cl, and S. (AU)

Dysphagia due to macroglossia in a patient with amyloidosis associated with multiple myeloma: A case report.

Amyloidosis is a group of heterogeneous conditions characterized by the deposition of extracellular proteinaceous substances called amyloids. The diagnosis is usually confirmed after a particular body organ has been affected. However, oral manifestations have been identified in 39% of affected patients. Systemic amyloidosis may be primary or in association with multiple myeloma and typically affecting elder adults. The diagnosis of amyloidosis is usually associated with clinical features with histopathological findings, which reveal the presence of acellular eosinophilic deposits. The aim of this report is to describe a clinical case of an elderly patient with dysphagia related to macroglossia and enlargement caused by primary amyloidosis associated with multiple myeloma.

An unusual osteoma in the mandibular condyle and the successful replacement of the temporomandibular joint with a custom-made prosthesis: a case report.

BACKGROUND: An osteoma is a benign tumor of bone with unknown etiology and is considered rare, mostly restricted to the craniofacial skeleton. CASE PRESENTATION: This case report describes an uncommon condylar osteoma in a 67 years old white female patient with laterognathism to the left side, limited mouth opening, aesthetic change and pain associated with the right temporomandibular joint (TMJ). The histopathological examination confirmed osteoma. The lesion was surgically excised and immediate reconstruction was carried out using a custom-made total TMJ prosthesis. The patient has been in follow-up for 2 years, with no symptoms. CONCLUSIONS: Unilateral total TMJ prosthesis can be considered to replacement of TMJ after osteoma excision with resection of the condyle.

Low Survival Rates of Oral and Oropharyngeal Squamous Cell Carcinoma.

AIM: To assess the epidemiological and clinical factors that influence the prognosis of oral and oropharyngeal squamous cell carcinoma (SCC). METHODS: One hundred and twenty-one cases of oral and oropharyngeal SCC were selected. The survival curves for each variable were estimated using the Kaplan-Meier method. The Cox regression model was applied to assess the effect of the variables on survival. RESULTS: Cancers at an advanced stage were observed in 103 patients (85.1%). Cancers on the tongue were more frequent (23.1%). The survival analysis was 59.9% in one year, 40.7% in two years, and 27.8% in 5 years. There was a significant low survival rate linked to alcohol intake (p = 0.038), advanced cancer staging (p = 0.003), and procedures without surgery (p < 0.001). When these variables were included in the Cox regression model only surgery procedures (p = 0.005) demonstrated a significant effect on survival. CONCLUSION: The findings suggest that patients who underwent surgery had a greater survival rate compared with those that did not. The low survival rates and the high percentage of patients diagnosed at advanced stages demonstrate that oral and oropharyngeal cancer patients should receive more attention.

Dental bleaching with and without LED/Laser association: a split-mouth controlled study

Objective: The aim of this study was to compare dental color changes after a one-session tooth bleaching procedure using 35% hydrogen peroxide with and without hybrid light (LED/diode laser) activation. Material and Methods: 20 volunteers were included in a split-mouth controlled clinical trial. A 35% hydrogen peroxide gel was applied directly on the buccal surface and adjacent areas of all upper anterior teeth. The six teeth were divided into two groups: the upper right incisors and canine were submitted to the tooth bleaching with the gel and the hybrid light (LED/diode laser) while the left incisors and canine were submitted to tooth bleaching with only the gel. Dental color was measured with a visual color scale and a spectrophotometer at five different moments: initial appointment, immediately after prophylaxis, and 14, 30 and 180 days after bleaching. Results: The comparison between the results of both treatments (with and without LED/laser) did not show any statistically significant differences (p > 0.05; Wilcoxon test) neither for objective (spectrophotometer) nor for subjective evaluations (visual color scale). Conclusion: The results of the present study showed that there are no differences in dental color changes between dental bleaching with gel and LED/Laser activation and dental bleaching with only gel.

Study of the causes of facial fractures in a reference center in Rio de Janeiro, Brazil from 2003-2012.

OBJECTIVE: This study describes the facial fractures of patients at a reference center in oral and maxillofacial surgery of a Public University Hospital in the city of Rio de Janeiro, from January 2003 to December 2012. METHODS: The data were collected from medical records and included the fractured bones, etiology, gender, and age of the patients. A total of 202 cases were identified, and 159 were included in the study (129 men and 30 women). RESULTS: The mandible was the most commonly injured bone (90 cases, 73 men and 17 women) with a mean age of 33.7 years old (±15.2), and traffic accidents (75 cases) were shown to be the major cause. CONCLUSION: In the city of Rio de Janeiro, young men in their fourth decade of life are prone to trauma to their facial bones, especially the mandible, and they are most commonly caused by traffic accidents.

Caracterização do atraso no diagnóstico do câncer de boca e orofaringe em dois centros de referência / Characterization of diagnostic delay in oral and oropharyngeal cancer at two referral centers

Resumo Objetivo Estimar se variáveis clínicas e epidemiológicas influenciam no atraso do diagnóstico em dois centros de referência. Métodos Foi realizado um estudo analítico longitudinal retrospectivo. Todos os prontuários de pacientes maiores de 18 anos diagnosticados no período de junho de 2005 a junho de 2013 foram analisados por meio do SPSS® 20. Para testar associações entre as variáveis epidemiológicas e clínicas com os atrasos do paciente e do profissional, foram utilizados os testes: ANOVA, t de Student e Kruskal-Wallis. Resultados Foram incluídos no estudo 121 prontuários. Prevaleceram pacientes do sexo masculino, com idade média de 64,3 anos (DP=12,94), pardos, procedentes do interior, analfabetos, tabagistas e etilistas. A grande maioria (85,1%) foi diagnosticada nos estádios avançados. O maior atraso estava relacionado ao paciente, com média de tempo de 197,8 dias (DP=323,9). O atraso no diagnóstico profissional foi de 20 dias (DP=25,9), e aquele relacionado ao sistema de saúde foi de 71,1 dias (DP=71,7). Não houve associação entre as variáveis clínicas/epidemiológicas e o atraso no diagnóstico (do paciente e do profissional). Conclusão De acordo com os resultados do presente estudo, as variáveis clínicas e epidemiológicas não influenciam no atraso do diagnóstico.

Abstract Objectives To analyze the chronology of diagnosis and determine whether clinical and epidemiological variables have an influence on diagnostic delay at two referral centers. Methods The medical records of all patients older than 18 years diagnosed with oral/oropharyngeal cancer from June 2005 to June 2013 were analyzed using SPSS® 20. The association between epidemiological and clinical variables with patient and professional delay was performed using ANOVA, Student’s t-test, and Kruskal-Wallis test. Results In total, 121 medical records were included in the study. Patients were predominantly brown, male, illiterate, living in country towns, smokers, and heavy drinkers (mean age 64.3 years, SD=12.94). The majority (85.1%) of patients were diagnosed at advanced stages of their disease. The greatest delay was patient-related, mean 197.8 days (SD=323.9). Delay in establishing the medical diagnosis averaged 20 days (SD=25.9), and health care system-related delay was 71.1 days (SD=71.7). There was no association of clinical and epidemiological variables with delayed diagnosis (patient and professional). Conclusion Data from the present study suggest that clinical and epidemiological variables do not influence diagnostic delay.

Cellular Profile and Expression of Immunologic Markers in Chronic Apical Periodontitis from HIV-infected Patients Undergoing Highly Active Antiretroviral Therapy.

INTRODUCTION: This study tested the hypothesis that the inflammatory cell profile (CD3-, CD4-, CD8-, CD20-, and CD68-positive cells) and the expression of immunologic markers (tumor necrosis factor α, interferon-γ, interleukin-6, and interleukin-18) in chronic apical periodontitis are the same between non-HIV-infected patients and HIV-infected patients undergoing highly active antiretroviral therapy (HAART). METHODS: Thirty-four surgically excised chronic apical periodontitis lesions were sampled from 34 patients (17 HIV-infected and 17 non-HIV-infected). The lesions were extracted from teeth with no previous endodontic treatment. All HIV-infected patients were undergoing HAART. The specimens were submitted to histopathologic and immunohistochemical analyses by using an optical microscope. Immunoexpression was graded into 2 levels, focal to weak and moderate to strong. The χ(2), Fisher exact, and Mann-Whitney tests were used to analyze all significant differences between groups. RESULTS: Periapical cysts represented 70.6% and 52.9% of the lesions in the HIV-infected and non-HIV-infected groups, respectively; however, no statistically significant difference was observed (P = .481). There were no statistically significant differences between groups for the inflammatory cell profile and for any of the immunologic markers (P > .05). CONCLUSIONS: There are no statistically significant differences of the cellular profile and expression of immunologic markers in chronic apical periodontitis between non-HIV-infected patients and HIV-infected patients undergoing HAART.

Bisphosphonate-related osteonecrosis of the jaws: Report of a case using conservative protocol.

Bisphosphonates have been the first-line treatment option for osteometabolic diseases, such as osteoporosis, hypercalcaemia in malignant bone diseases, and in bone metastasis. It is possible to observe a growing number of cases of osteonecrosis of the jaws in patients using this medication, called bisphosphonate-related osteonecrosis of the jaws. The purpose of this study was to report a conservative treatment for bisphosphonate-related osteonecrosis of the jaws--Stage 2, using antibacterial solution and low-level laser therapy. At the end of the treatment, the patient presented improvement of the lesion with the healing of the mucosa. The literature still lacks successful definite protocols, thus the present case may contribute with another option for conservative management for bisphosphonate-related osteonecrosis of the jaws. More research is necessary in order to develop a good protocol management for bisphosphonate-related osteonecrosis of the jaws.

Drugs or disease: evaluating salivary function in RA patients

Abstract Oral complications of RA may include temporomandibular joint disorders, mucosa alterations and symptoms of dry mouth. The aim of this study was to evaluate the salivary gland function of subjects with rheumatoid arthritis (RA) comparing it to healthy controls. Subjects with other systemic conditions known to affect salivary functions were excluded. A questionnaire was applied for the evaluation of xerostomia. Resting and chewing-stimulated salivary flow rates (SFR) were obtained under standard conditions. There were 145 subjects included of the study (104 RA and 38 controls). About 66.7% of the RA subjects and 2.4% in control group presented xerostomia. The median resting SFR were 0.24 ml/min for RA subjects and 0.40 mL/min for controls (p = 0.04). The median stimulated SFR were 1.31 mL/min for RA subjects and 1.52 ml/min for controls (p = 0.33). No significant differences were found between resting and stimulated SFR of RA subjects not using xerogenic medications and controls. There was significantly higher number of subjects presenting hyposalivation in the RA group than among controls, even when subjects using xerogenic medications were eliminated from the analysis. In conclusion, hyposalivation and xerostomia were more frequent among RA subjects not using xerogenic medication than among controls, although there were no significant differences in the median SFR between groups.

Biocorrosion of Endodontic Files through the Action of Two Species of Sulfate-reducing Bacteria: Desulfovibrio desulfuricans and Desulfovibrio fairfieldensis.

AIM: This study assessed the biocorrosive capacity of two bacteria: Desulfovibrio desulfuricans and Desulfovibrio fairfieldensis on endodontic files, as a preliminary step in the development of a biopharmaceutical, to facilitate the removal of endodontic file fragments from root canals. MATERIALS AND METHODS: In the first stage, the corrosive potential of the artificial saliva medium (ASM), modified Postgate E medium (MPEM), 2.5 % sodium hypochlorite (NaOCl) solution and white medium (WM), without the inoculation of bacteria was assessed by immersion assays. In the second stage, test samples were inoculated with the two species of sulphur-reducing bacteria (SRB) on ASM and modified artificial saliva medium (MASM). In the third stage, test samples were inoculated with the same species on MPEM, ASM and MASM. All test samples were viewed under an infinite focus Alicona microscope. RESULTS: No test sample became corroded when immersed only in media, without bacteria. With the exception of one test sample between those inoculated with bacteria in ASM and MASM, there was no evidence of corrosion. Fifty percent of the test samples demonstrated a greater intensity of biocorrosion when compared with the initial assays. CONCLUSION: Desulfovibrio desulfuricans and D. fairfieldensis are capable of promoting biocorrosion of the steel constituent of endodontic files. CLINICAL SIGNIFICANCE: This study describes the initial development of a biopharmaceutical to facilitate the removal of endodontic file fragments from root canals, which can be successfully implicated in endodontic therapy in order to avoiding parendodontic surgery or even tooth loss in such events.