E-CADERIN, N-CADERIN, SLUG, SNAIL, and TWIST contribute to epithelial-mesenchymal transition in salivary gland tumors.

BACKGROUND: Transcription factors are important in the epithelial-mesenchymal transition process and are possibly related to the development of a more invasive tumor phenotype. Thus, the objective of this study was to analyze the expression and identify the localization of cellular markers related to the epithelial-mesenchymal transition process in salivary gland tumors. STUDY DESIGN: The expression and localization of E-CADERIN, N-CADERIN, SLUG, SNAIL, and TWIST were evaluated, using immunohistochemistry, in 48 salivary gland tumors, being 17 pleomorphic adenomas (PA), 14 adenoid cystic carcinomas (ACC), and 17 mucoepidermoid carcinomas (MEC). these proteins were compared to clinical and histopathologic parameters. normal gland tissues were included for immunohistochemical comparisons. RESULTS: ACC and MEC cases showed higher expression of SNAIL compared to PA. MEC showed high expression of SLUG and TWIST. Low expression of N-CADHERIN, SNAIL, and TWIST in ACC was frequent in T3 and T4. High expression of TWIST in MEC was more frequent at age ≥ 40 years A positive correlation was only observed between N-cadherin/SNAIL in ACC, between SNAIL/TWIST in MEC, and between SLUG/TWIST in PA. CONCLUSION: This study provided insight into EMT-related proteins (E-cadherin, N-cadherin, SNAIL, SLUG, and TWIST) and their contribution to the maintenance of morphogenesis and the development of the salivary gland tumors and showed a positive correlation among N-CADHERIN/SNAIL in ACC and SNAIL/TWIST in MEC.

Influence of keratinized mucosa on peri-implant diseases: a retrospective cohort study in humans.

OBJECTIVE: The present study aimed to assess the relationship between keratinized mucosa width and peri-implant diseases, namely peri-implant mucositis and peri-implantitis. MATERIALS AND METHODS: Ninety-one dental implants in function for ≥ 6 months from 40 partially or completely edentulous non-smoker subjects (24 females and 16 males) were evaluated clinically and radiographically. The width of keratinized mucosa, probing depth, plaque index, bleeding on probing, and marginal bone levels were assessed. Keratinized mucosa width was categorized as ≥ 2 mm or < 2 mm. RESULTS: There was no statistically significant association between keratinized buccal mucosa width and peri-implant mucositis or peri-implantitis (p ≥ 0.37). In the regression analysis, peri-implantitis was associated with longer implant function time (RR: 2.55, 95% CI: 1.25-11.81, p = 0.02) and implants in the maxilla (RR: 3.15, 95% CI: 1.61-14.93, p = 0.003). Mucositis was not associated with any of the factors analyzed. CONCLUSION: In conclusion, in the present sample, keratinized buccal mucosa width was not associated with peri-implant diseases, suggesting that a band of keratinized mucosa may not be necessary to maintain peri-implant health. Prospective studies are required to better understand its role in the maintenance of peri-implant health.

Is placental glutathione S-Transferase (GST-P) a suitable biomarker for oral carcinogenesis: A scoping review.

Placental Glutathione S-Transferase (GST-P) can be considered a useful marker of not only of preneoplastic lesion in rat hepatocarcinogenesis and hamster pancreatic carcinogen but also as a potential marker for premalignant and malignant lesions in cases of buccal pouch mucosa. In this context, the aim of this review is to elucidate the following question whether the GST-P is a suitable biomarker for oral carcinogenesis. A total of 16 studies were carefully selected. Our results demonstrate that GST-P expression is a useful and coherent marker for oral carcinogenesis. Regarding the samples, most studies evaluated hamsters, two evaluated GST-P expression in rats and three evaluated GST-P expression in human cells. All studies demonstrated positive findings allowing us to consider such studies reliable. In summary, our conclusion is that GST-P can be a suitable biomarker for oral carcinogenesis.

Dental Prosthesis Needs and Associated Factors in Native Brazilian Kiriri Indians: a CrossSectional Study / Necessidades de Próteses Dentárias e Fatores Associados em Índios Kiriri Nativos Brasileiros: um Estudo Transversal

This study evaluated the dental prosthesis needs and associated factors in indigenous Brazilian adults from Northeastern Brazil. Dental prosthesis needs were assessed in a representative sample of 225 Indians. Edentulous area and current indication for tooth extraction according to periodontal status or non-restorable condition were registered in a clinical chart. Bivariate and logistic analyses were applied to assess associations of dental prosthesis needs and prosthesis type with age, sex, income, education, smoking, moderate or severe periodontitis, plaque index, dental caries experience, and previous dental visit. Prosthetic treatment was necessary in 83% of the participants. These individuals required 339 dental prostheses, including removable partial dentures (60.2%), fixed (33.6%), and complete dentures (6.2%). Regression analysis showed that age ≥35 years [odds ratio (OR) 5.95, 95% confidence interval (CI) 1.97­17.91, p=0.002] and caries experience ≥3 [OR 4.01, 95%CI 1.78­9.02, p=0.001] were significantly associated with prosthesis needs. The type of prosthesis required was associated with sex, age, educational level, periodontitis, caries experience, and plaque index (p≤0.03). In conclusion, the need for prosthetic rehabilitation was high in this population, and sociodemographic factors, dental plaque level, caries experience, and periodontitis were associated with the required type of prosthesis. These data can be used to plan the allocation of resources to promote preventive and curative strategies in this population.(AU)

Este estudo avaliou as necessidades de prótese dentária e fatores associados em adultos indígenas brasileiros do Nordeste do Brasil. As necessidades de prótese dentária foram avaliadas em uma amostra representativa de 225 índios. A área edêntula e a indicação para extração dental, de acordo com o estado periodontal ou condição não restaurável, foram registradas em um prontuário clínico. Análises bivariadas e logísticas foram aplicadas para avaliar as associações das necessidades de prótese dentária e tipo de prótese com idade, sexo, renda, escolaridade, tabagismo, periodontite moderada ou grave, índice de placa, experiência de cárie dentária e consulta odontológica anterior. O tratamento protético foi necessário em 83% dos participantes. Esses indivíduos necessitaram de 339 próteses dentárias, incluindo próteses parciais removíveis (60,2%), fixas (33,6%) e próteses totais (6,2%). A análise de regressão mostrou que idade ≥35 anos [odds ratio (OR) 5,95, intervalo de confiança de 95% (IC) 1,97­17,91, p=0,002] e experiência de cárie ≥3 [OR 4,01, IC 95% 1,78­9,02, p=0,001] foram significativamente associados às necessidades de prótese. O tipo de prótese necessária foi associado ao sexo, idade, escolaridade, periodontite, experiência de cárie e índice de placa (p≤0,02). Em conclusão, a necessidade de reabilitação protética foi alta nesta população e fatores sociodemográficos, nível de placa dentária, experiência de cárie e periodontite foram associados ao tipo de prótese necessária. Estes dados podem ser usados para planejar a alocação de recursos para promover estratégias preventivas e curativas nessa população.(AU)

Surgical guides for flapless dental implant placement and immediate definitive prosthesis installation by using selective laser melting and sintering for 3D metal and polymer printing: A clinical report.

Integration between the phases of computer-based guided dental implant surgery can be used to optimize oral rehabilitation. Two new surgical guides prepared by using the 3D metal and polymer printing technology are presented for immediate implant loading and definitive fixed prosthesis construction in flapless dental implant surgery. Nine implants and 2 fixed prostheses were installed in 2 completely edentulous adult patients by using a metallopolymer surgical guide with a metal central bar attached to a polymer seal or a metal guide. Virtual planning was used to design the 3D-printed surgical guides, which were then constructed by using selective laser sintering (SLM) and selective laser melting (SLS). The 3D-printed surgical guides oriented the surgical placement of the implants and were welded to the abutments and attached to the denture framework. The technique allowed implants and prostheses to be installed on the same day.

Florid cemento-osseous dysplasia-related osteonecrosis: A series of cases.

OBJECTIVE: The aim of this study was to assess the clinicopathological features of florid cemento-osseous dysplasia (FCOD)-related osteonecrosis highlighting their histopathological aspects and bone structure. METHODS: Twenty-two FCOD-related osteonecrosis cases were evaluated retrospectively. Osteonecrosis, osteomyelitis, bacterial colonization, bone resorption, reactive bone, osteon-like structure, lamellar bone, and basophilic lines were analyzed. Specific staining and fluorescence and polarized light microscopy analyses were also performed. RESULTS: The mandible was more affected by FCOD-related osteonecrosis. There was a predominance of African-Brazilian women in the fifth and seventh decades of life. Osteomyelitis was present in 82 % of cases whereas bone resorption and bacterial colonization were present in 100 % of FCOD-related osteonecrosis cases. Thick basophilic lines were seen in all cases (100 %). Actinomycosis and osteoclasts were not often. CONCLUSIONS: This study showed female adult preference, mandibular location, and some findings such as osteomyelitis, bone resorption, and bacterial colonization were histopathological features more frequent in FCOD-related osteonecrosis. In the absence of a close clinical and radiographic correlation, the morphology of the necrotized bone similar to cementum could help to recognize FCOD.

Accuracy Evaluation of the Computer-Designed Selective Laser Sintering Surgical Guide for Flapless Immediate Loading Dental Implants Surgery in Edentulous Jaws.

This study was designed to evaluate the accuracy of a novel computer-designed and selectively laser sintered surgical guide for flapless dental implant placement in the edentulous jaw. Fifty dental implants were placed in 11 patients with at least 1 totally edentulous jaw. Initially, cone-beam computed tomography (CBCT) was performed in each patient to define the virtual position of the dental implants based on the assessment of bone availability and the proposed dental prosthesis. After virtual planning, 3D surgical guides were printed using selective laser sintering. CBCT was repeated after the surgery, and the pre- and postoperative images were overlapped in computer-assisted design software to compare the planned and actual positions of the dental implants using a 1-sample t test. The mean ± angular standard deviation between the long axes of the planned and final dental implant positions was 4.58° ± 2.85°; the linear deviation in the coronal position was 0.87 ± 0.49 mm and in the apical region of the dental implants was 1.37 ± 0.69 mm. These differences were statistically significant (P < .001). The proposed modifications reduced the deviations, resulting in an improvement in the technique. We were able to place implants and temporary prostheses using the present protocol, taking into account the differences between the planned and final positions of the dental implants.

Impact of photobiomodulation therapy on the morphological aspects of submandibular gland submitted to excretory duct ligation and hypothyroidism: an animal study.

The aim of this study was to evaluate the impact of photobiomodulation therapy (PBMT) on histomorphological aspects of submandibular gland (SMG) submitted to salivary gland duct obstruction in hypothyroid rats. Fifty-six male Wistar rats (250 to 300 g) were divided into 4 groups (n = 14): euthyroid (EU), EU + PBMT, hypothyroid (HYPO), and HYPO + PBMT. Duct obstruction of the left submandibular gland (LSMG) was performed in all animals by a ligature procedure. For the induction of hypothyroidism, total thyroidectomy was performed. PBMT groups received irradiation with AlGaInP diode laser (808 nm, 0.04 W, 0.04cm2 spot size, 60 s, 2.4 J per point, 60 J/cm2, 1 W/cm2). Irradiation was performed immediately, 24 h, and 48 h after the obstruction of the salivary gland duct, in one point, extra oral and perpendicular to the gland. Animals were sacrificed after 24 h and 72 h after duct ligature. Our results indicated that salivary duct obstruction and hypothyroidism caused negative modifications on the salivary glands' histomorphology, especially acinar atrophy, after 24 h and 72 h. HYPO + PBMT showed a significant reduction of the inflammatory infiltrate, congested blood vessels, and acinar atrophy in the SMG submandibular salivary gland in 72 h compared to 24 h (p < 0.05). In conclusion, obstruction of the salivary gland excretory duct and hypothyroidism causes severe sialoadenitis with expressive atrophy of the glandular parenchyma. However, PBMT was able to modulate the inflammatory process and delaying acinar atrophy. This study provided insights to better understand the role of the PBMT on the altered salivary gland by duct ligation and associate hypothyroidism.

Chlorhexidine mouthwash reduces the salivary viral load of SARS-CoV-2: A randomized clinical trial.

OBJECTIVES: This study aimed to evaluate the effect of 0.12% chlorhexidine gluconate on the salivary load of SARS-CoV-2. MATERIALS AND METHODS: A randomized, double-blind, placebo-controlled trial was performed on 100 participants positive for SARS-CoV-2. In the test group (n = 50), volunteers gargled with a mouthwash containing 15 ml of 0.12% chlorhexidine gluconate for 1 min, while the control group (n = 50) used a placebo. Saliva samples were obtained before (baseline) and 5 and 60 min after using the solutions. Real-time reverse transcription polymerase chain reaction assays (qRT-PCR) were carried out and the cycle threshold (Ct) was computed. The chi-square test and t-test were used for group comparison (p ≤ 0.05). RESULTS: The differences in Ct values between the 5-min evaluation and baseline (test group: 2.19 ± 4.30; control: -0.40 ± 3.87, p = 0.002) and between 60 min and baseline (test group: 2.45 ± 3.88; control: 0.76 ± 4.41, p = 0.05) were significantly greater in the test group, revealing a reduction of viral load. Furthermore, there was a reduction in the load of SARS-CoV-2 in 72% of the volunteers using chlorhexidine versus 30% in the control group (p = 0.001). CONCLUSIONS: Chlorhexidine gluconate (0.12%) was effective in reducing salivary SARS-CoV-2 load for at least 60 min.

Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study

ABSTRACT Objective: The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. Methods: This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). Results: In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. Conclusions: In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.

RESUMO Objetivo: O presente estudo teve como objetivo investigar a relação entre a inclinação dentária e as dimensões ósseas e gengivais em dentes anteriores superiores. Métodos: Esse estudo transversal incluiu imagens de tomografia computadorizada de feixe cônico (TCFC) de 160 dentes anteriores superiores divididos em três grupos (incisivo central, incisivo lateral e canino). Todos os pacientes tinham 18 anos ou mais, não tinham tratamento ortodôntico prévio nem história clínica que pudesse afetar as dimensões ósseas ou gengivais. A inclinação dentária, a espessura do osso e da gengiva e as distâncias da junção cemento-esmalte à crista óssea alveolar e à margem gengival foram medidas na face vestibular. As correlações foram analisadas por meio dos testes de Pearson e de correlação parcial (p≤0,05). Resultados: Nos incisivos centrais, a inclinação dentária foi positiva e significativamente relacionada à espessura do osso apical (R = 0,34, p= 0,001). Nos caninos, a inclinação dentária foi negativa e significativamente relacionada à espessura do osso cervical (R = - 0,34, p= 0,01) e positivamente associada à espessura do osso apical (R = 0,36, p= 0,01) e à distância entre a margem gengival e a junção cemento-esmalte (R = 0,31, p= 0,03). Nos incisivos laterais, a inclinação do dente não foi associada às dimensões do osso ou da gengiva. Conclusões: Nos incisivos centrais, quanto maior a inclinação vestibular do dente, maior a espessura do osso apical. Nos caninos, quanto maior a inclinação vestibular do dente, menor a espessura do osso cervical, maior a espessura do osso apical e maior a margem gengival. As dimensões ósseas e gengivais devem ser avaliadas ao se planejar o tratamento ortodôntico envolvendo a movimentação vestibular dos incisivos centrais e caninos.

Indicação de exodontias e fatores associados: estudo transversal na população indígena Kiriri / Recommendation of tooth extraction and associated factors: cross-sectional study in the Kiriri indigenous population

Resumo O objetivo deste artigo foi avaliar a prevalência e os fatores associados à indicação de exodontia em uma população adulta de índios Kiriri do Nordeste do Brasil. 225 indígenas (≥19 anos) foram avaliados. Os critérios de indicação de exodontia adotados foram: dentes com perda de inserção clínica ≥50%, em pelo menos 3 sítios, e, também, raízes residuais. Modelos estatísticos foram utilizados para avaliar associações entre necessidade de exodontia e as variáveis selecionadas. A porcentagem de dentes com indicação de exodontia foi de 4,98%, caracterizando uma média de 1,24 dente por indivíduo. A análise de regressão mostrou associação positiva entre indicação de exodontia e idade ≥35 anos (OR=2,24, 95%IC: 1,13-4,43, p=0,02), renda <R$ 570,00 (OR=3,34, 95%IC: 1,19-9,37, p=0,02) e índice de placa ≥40% (OR=2,38, 95%IC: 1,24-4,56, p=0,01). Uma prevalência de 33% de indivíduos com indicação de um ou mais dentes para exodontia está, principalmente, relacionada aos fatores de risco: idade maior que 35 anos, índice de placa ≥40% e renda inferior a um salário mínimo. Esse estudo reflete tanto a importância da priorização da prevenção em saúde bucal, como a necessidade de ampliação do acesso aos serviços de maior complexidade.

Abstract The scope of this cross-sectional study was to evaluate the prevalence and the associated factors of the recommendation of dental extraction in the adult Kiriri Indigenous population of northeastern Brazil. A total of 225 natives (≥19 years) were evaluated. The extraction criteria were teeth with clinical attachment loss ≥50% in at least 3 sites, and residual roots. Statistical models were used to evaluate associations between the need for dental extraction and selected variables. The percentage of teeth recommended for dental extraction was 4.98%, characterizing a mean of 1.24 tooth per individual. A regression analysis showed that age ≥35 years (OR=2.24, 95%CI: 1.13-4.43, p=0.02), income <R$ 570.00 (OR=3.34, 95%CI: 1.19-9.37, p=0.02) and plaque index ≥40% (OR=2.38, 95%CI: 1.24-4.56, p=0,01) were significantly associated with indication for dental extraction. A prevalence of 33% of subjects with dental extraction recommendation were associated with age older than 35 years, plaque index ≥40% and income less than a minimum wage were related with the recommendation for extraction. This study reflects the importance of prioritizing oral health prevention, as well as the need to expand complex dental services.

Evaluation of alveolar process resorption after tooth extraction using the socket shield technique without immediate installation of implants: a randomised controlled clinical trial.

Our aim was to evaluate resorption of the alveolar ridge using the socket shield technique (SST) without immediate placement of dental implants. This randomised controlled clinical trial included 27 patients: 14 maxillary non-molar teeth were partially extracted using the SST (test group) and 13 were extracted using a minimally traumatic extraction approach (control group). Alterations in height and thickness of the alveolar ridge were evaluated by cone beam computed tomograms taken immediately after, and 100 days after, surgery. Minor resorption was observed in the height of the buccal and palatal plates, without intergroup difference (p ≥ 0.10). The test group showed significantly better preservation of the buccal-to-palatal crest dimension (p ≤ 0.05). In the control group, preservation of buccal plate thickness was significantly greater (p ≤ 0.05), but intragroup vertical resorption of the buccal plate and reduction in the buccal-to-palatal crest distance were greater (p ≤ 0.05). The SST without the immediate placement of implants showed greater preservation of the buccal-to-palatal crest dimension and lower preservation of buccal wall thickness compared with minimally traumatic extraction. In addition, it provided superior maintenance of the baseline buccal wall height. The modified SST is a promising approach, but factors that interfere with the results should be investigated.

Association between occupational exposure to domestic solid waste and dental caries: a cross-sectional study.

Studies have shown that domestic waste collectors are exposed to toxicants including infectious pathogens, which may be linked to their oral health conditions. This cross-sectional study evaluated the dental caries and its associated factors among domestic waste collectors. A total of 301 adult men who worked for a waste collection corporation were included; 171 men worked in direct contact with domestic solid waste and 130 did not. Sociodemographic data, working, and medical history were assessed. The decayed, missing, and filled permanent teeth (DMFT) index was examined. Logistic regression analysis was used to identify factors associated with dental status with a significance level of 5%. The overall mean DMFT score was 8.36±5.64. The mean DMFT, missing teeth (MT), and filled teeth (FT) were significantly higher in workers who did not have any direct contact with waste (p≤0.04). In the logistic analysis, DMFT ≥8 was only associated with older age (OR=8.41 [95% confidence interval (95%CI), 5.01-14.12], p<0.001). Decayed teeth (DT) ≥2 was associated with no previous oral hygiene instruction (OR=2.70 [1.50-4.81], p=0.001) and no daily dental flossing (OR=4.26 [1.92-9.43], p<0.001). MT ≥9 was associated with lower education level (OR=3.33 [1.57-7.10], p= 0.002). FT≥3 had a negative association with low income (OR= 0.42 [0.25-0.70], p<0.001) and no daily flossing (OR=0.42 [0.23-0.76], p=0.004). In conclusion, occupational exposure to domestic solid waste was not associated with poor dental status. Instead, age, education, income level, and oral hygiene were associated with dental health status. Missing teeth constituted the major component of the DMFT index. Therefore, prevention and oral rehabilitation programs are necessary to improve dental health.

Mast Cells and Proteins Related to Myofibroblast Differentiation (PAR-2, IL-6, and TGFß1) in Salivary Cancers: A Preliminary Study.

Salivary gland neoplasms represent an important group of cancers in the head and neck and myoepithelial cells play a key role on the development these tumors. This study evaluated the distribution of mast cells and related proteins (PAR-2, TGFß1, IL-6) to the myofibroblastic differentiation in malignant tumors of salivary glands with and without myoepithelial differentiation. Immunohistochemical assessement for tryptase mast cells, SMA, PAR-2, TGFß1, IL-6 was performed in 10 cases of polymorphous low-grade adenocarcinoma, 14 cases of mucoepidermoid carcinoma (MEC) and 10 cases of adenoid cystic carcinoma. When the density of mast cells were compared between tumors, their density was significantly higher in MEC (P=0.08). Tumors with high expression of PAR-2 (79.4%) exhibited a high density of mast cells. Myofibroblasts were more frequent in malignant tumors with low expression (<50%) of cell masts. Individual analysis of the tumors showed no significant difference between the expression of PAR-2, IL-6, TGFß1, and myofibroblasts. When the density of mast cells, myofibroblasts and the expression of PAR-2 protein, IL-6, and TGFß1 were compared, it was no statistically significant difference between tumors with and without myoepithelial differentiation. The results of present study suggest a possible participation of mast cells and especially of PAR-2 in the development and progression of malignant salivary cancers, regardless of myoepithelial content.

Evaluation of the Association of Early Implant Failure With Local, Environmental, and Systemic Factors: A Retrospective Study.

PURPOSE: This study aimed to assess the association of early implant failure (EIF) with demographic, local, environmental, and systemic factors. METHODS: Clinical charts of 594 individuals with 2,537 dental implants were assessed. EIF was characterized by implant loss before and up to the abutment connection. Logistic regression analysis was used to verify the association between EIF and local, environmental, and systemic factors at the individual and implant levels. The chosen level of significance was 5%. RESULTS: EIF occurred in 144 implants (5.68%) and in 97 individuals (16.3%). At the individual level, smoking habits (odds ratio [OR] = 2.54; 95% confidence interval [CI] = 1.00 to 6.47; P = .05), absence of postoperative antibiotic therapy (OR = 2.73; CI = 1.22 to 6.13; P = .02), and bone augmentation (OR = 1.83; CI = 1.17 to 2.85; P = .01) were significantly associated with EIF. At the implant level, smoking habits (OR = 2.90; CI = 1.60 to 5.26, P < .001), absence of postoperative antibiotic therapy (OR = 2.77; CI = 1.36 to 5.63, P = .005), postoperative complications (OR = 28.35; CI = 6.79 to 118.45, P < .001), implant length ≤8.5 mm (OR = 1.79; CI = 1.07 to 2.99; P = .03), and diameter <3.75 mm (OR = 1.65; CI = 1.08 to 2.52, P = .02) were associated with EIF. Age, sex, alcohol abuse, diabetes, hypertension, and long-term medication use were not associated with EIF at both individual and implant levels (P ≥ .12). CONCLUSIONS: Smoking habits, absence of antibiotic therapy, bone augmentation, postoperative complications, implant diameter <3.75 mm, and implant length ≤8.5 mm were associated with EIF. Clinicians should be aware of these associations that should be controlled for when feasible. Future cohort studies are required to confirm the risk factors.

The effect of dental plaque level and self-performed oral hygiene on periodontal status: a cross-sectional study in Brazilian Indigenous / O efeito do nível da placa dentária e da higiene bucal autorrealizada no estado periodontal: um estudo transversal em indígenas brasileiros

Objective: This study evaluated the associations of periodontal status with dental plaque index and frequency of toothbrushing and flossing in Kiriri Brazilian Indigenous people. Methods: Gingival bleeding, periodontal clinical attachment level, and dental plaque index were clinically evaluated in 204 adult Brazilian indigenous. They were categorized as healthy, gingivitis, or periodontitis. Sociodemographic data and oral hygiene habits were registered. Bivariate and logistic regression analyses were performed (p≤0.05). Results: Gingivitis [odds ratio (OR): 2.83; 95% confidence interval (CI), 1.52­5.25; p=0.001] and periodontitis (OR: 6.88; 95%CI, 1.44­32.78; p=0.02) were associated with plaque index level, but not with toothbrushing or flossing frequency (p ≥0.55). Conclusion: Gingivitis and periodontitis were associated with higher plaque index, but not with the frequency of toothbrushing and flossing. To enhance this population's periodontal health, a prevention program focused on improving the quality of self-performed oral hygiene should be planned and implemented.

Objetivo: avaliar as associações do estado periodontal com o índice de placa dentária, a frequência de escovação e o uso do fio dental em Indígenas Brasileiros Kiriri. Métodos: sangramento gengival, nível de inserção clínica periodontal e índice de placa dentária foram avaliados, clinicamente, em 204 indígenas brasileiros adultos. Eles foram classificados como saudáveis, com gengivite ou periodontite. Dados sociodemográficos e hábitos de higiene bucal foram registrados. Foram realizadas análises bivariadas e de regressão logística (p≤0,05). Resultados: gengivite [Odds Ratio (OR): 2,83; Intervalo de confiança de 95% (IC), 1,52-5,25; p = 0,001] e periodontite (OR: 6,88; IC 95%, 1,44­32,78; p = 0,02) foram associados ao nível de índice de placa, mas não à frequência de escovação ou uso do fio dental (p ≥0,55). Conclusão: gengivite e periodontite foram associados a maior índice de placa, mas não com frequência de escovação e uso do fio dental. Para melhorar a saúde periodontal dessa população, um programa de prevenção com foco na melhoria da qualidade da higiene bucal autorrealizada deve ser planejado e implantado.

Does protein supplementation and exercise interfere with renal function and structure? / A suplementação de proteína e o exercício interferem na função e estrutura renal? / ¿la suplementación de proteínas y el ejercicio interfieren en la función y estructura renal?

ABSTRACT Introduction: During physical activity, the body diverts blood to essential areas such as skeletal muscle, reducing the supply to non-essential areas such as the kidney. Whey protein is one of the most widely used supplements in gyms. Objectives: To evaluate renal function and renal structure in rats submitted to physical exercise with and without the use of protein supplementation. Methods: The protein used was Whey Hydro PRO 2 - Probiotica®. It was administered orally (by gavage), diluted in mineral water (1.8 g/kg of body weight, shortly after swimming training). The rats were divided into four groups: rats with exercise (Exc), rats without exercise (ñExc), rats with exercise and with protein supplementation (Prot/Exc) and rats without exercise and with protein supplementation (Prot/ñExc). The training consisted of swimming for 30 minutes, using load equivalent to 2% of body weight, five times a week for a total of 10 weeks. The protein was administered by gavage, once daily, immediately after the training. Results: A reduced glomerular filtration rate was observed in the animals of the Exc group compared to those of the Prot/Exc group. Plasma creatinine values were similar between the groups submitted to exercise and those not submitted to exercise. Plasma sodium and the sodium excretion fraction were lower in the Prot/Exc group compared to the Exc group. Urinary excretion was similar between groups. Histological analysis: Significant hydropic degeneration was observed in the animals that received protein supplementation and submitted to exercise. Conclusion: These results show that exercise associated with protein supplementation (2g/day/kg) leads to changes in the tubular mechanisms of sodium adjustments and structural changes in the renal parenchyma. Level of evidence II; Therapeutic studies - Investigation the results of treatment.

RESUMO Introdução: Durante a atividade física o corpo faz remanejamento sanguíneo para áreas essenciais como a musculatura esquelética, reduzindo o suprimento em áreas não essenciais como o rim. O whey protein (proteína do soro do leite) é um dos suplementos mais usados nas academias. Objetivos: Avaliar a função e a estrutura renal em ratos submetidos ao exercício físico sem e com o uso da suplementação de proteína. Métodos: A proteína usada foi Whey Hydro PRO 2 - Probiótica®, sendo administrada por via oral (gavagem), diluída em água mineral (1,8 g/kg de peso corporal logo após o treino de natação). Os ratos foram divididos em quatro grupos: ratos com exercício (Exc), ratos sem exercício (ñExc), ratos com exercício e com suplementação alimentar de proteína (Prot/Exc) e ratos sem exercício e com suplementação alimentar de proteína (Prot/ñExc). O treinamento consistia em natação por 30 minutos, com utilização de carga, equivalente a 2% do peso corporal, 5 vezes por semana em um total de 10 semanas. A proteína foi administrada por gavagem, uma vez ao dia e logo depois do treino. Resultados: Observou-se queda da filtração glomerular renal nos animais do grupo Exc vs. Prot/Exc. Os valores de creatinina plasmática foram semelhantes entre os grupos que praticaram o exercício vs. os que não praticaram. Para o sódio plasmático e a fração de excreção de sódio, os valores foram menores no grupo Prot/Exc quando comparados com o grupo Exc. A excreção urinária de ureia foi semelhante entre os grupos. Análise histológica: Observou-se degeneração hidrópica significativa nos animais que receberam a suplementação de proteína e realizaram o exercício. Conclusão: Esses resultados mostram que o exercício em conjunto com a suplementação de proteína (2 g/dia/Kg), determina alterações nos mecanismos tubulares de ajustes do sódio e alterações estruturais no parênquima renal. Nível de evidência II; Estudos terapêuticos - Investigação dos resultados do tratamento.

RESUMEN Introducción: Durante la actividad física el cuerpo hace reubicación sanguínea hacia áreas esenciales como la musculatura esquelética, reduciendo el suministro en áreas no esenciales como el riñón. La whey protein (proteína del suero de la leche) es uno de los suplementos más usados en los gimnasios. Objetivos: Evaluar la función y la estructura renal en ratones sometidos al ejercicio físico sin y con el uso de la suplementación de proteína. Métodos: La proteína utilizada fue Whey Hydro PRO 2 - Probiótica® siendo administrada vía oral (gavaje), diluida en agua mineral (1,8 g/kg de peso corporal luego después del entrenamiento de natación). Los ratones fueron divididos en cuatro grupos: ratones con ejercicio (Exc), ratones sin ejercicio (ñExc), ratones con ejercicio y con suplementación alimentaria de proteína (Prot/Exc) y ratones sin ejercicio y con suplementación alimenticia de proteína (Prot/ñExc). El entrenamiento consistía en natación por 30 minutos, con uso de carga, equivalente al 2% del peso corporal, 5 veces por semana en un total de 10 semanas. La proteína fue administrada por gavaje, una vez al día y luego después del entrenamiento. Resultados: Se observó caída de la filtración glomerular renal en los animales del grupo Exc vs Prot/Exc. Los valores de creatinina plasmática fueron semejantes entre los grupos que practicaron el ejercicio vs los no practicaron. Para el sodio plasmático y la fracción de excreción de sodio, los valores fueron menores en el grupo Prot/Exc cuando comparados con el Exc. La excreción urinaria de urea fue semejante entre los grupos. Análisis histológico: Se observó degeneración hidrópica significativa en los animales que recibieron la suplementación de proteínas y no realizaron el ejercicio. Conclusión: Estos resultados muestran que el ejercicio en conjunto con la suplementación de proteína (2 g/día/Kg), determina alteraciones en los mecanismos tubulares de ajustes del sodio y alteraciones estructurales en el parénquima renal. Nivel de evidencia II; Estudios terapéuticos - Investigación de los resultados del tratamiento.

Systemic risk indicators for peri-implant diseases in individuals with implant-supported fixed prostheses: A cross-sectional study.

PURPOSE: The present study aimed to identify the systemic risk indicators associated with peri-implant mucositis and peri-implantitis in individuals with implant-supported fixed prostheses. MATERIALS AND METHODS: In this cross-sectional study, clinical evaluations of periodontal and peri-implant conditions were performed by a single examiner in a sample of 71 volunteers with 360 implants. Peri-implant mucositis was defined as the occurrence of bleeding on probing in association with redness and swelling or suppuration, without bone loss. Peri-implantitis was defined based on a radiograph of bone loss ≥ 3 mm and/or a probing depth ≥ 6 mm with bleeding and/or suppuration on probing. The systemic factors evaluated were obesity, hormone replacement therapy, osteopaenia and osteoporosis, high blood pressure and hypercholesterolaemia. Logistic models were applied to assess the associations between peri-implant diseases and systemic factors. RESULTS: Mucositis and peri-implantitis were found in 83.1% and 16.9% of the individuals, respectively. The regression analysis showed that obesity (prevalence ratio = 5.23; 95% confidence interval, 1.91 to 96.83; P = 0.01) and high systolic blood pressure (prevalence ratio = 4.23; 95% confidence interval, 1.66 to 12.87; P = 0.03) were associated with peri-implantitis at the individual and implant levels, respectively. No systemic factor was associated with peri-implant mucositis (P ≥ 0.06). CONCLUSION: Obesity and high systolic blood pressure were associated with peri-implantitis, whereas no systemic factor was associated with peri-implant mucositis. Future prospective studies are required to confirm these as true risk factors. Patients with obesity and/or high systolic blood pressure could be informed of the likely association with peri-implantitis, preferably before implant placement.

Central giant cell granuloma: A clinicopathological and immunohistochemical study of macrophages, blood vessels, lymphatic vessels and regulatory proteins.

OBJECTIVE: This study seeks to investigate immunohistochemical parameters that could distinguish non-aggressive Central giant cell granuloma (CGCG) from aggressive CGCG, two groups of lesions which differ in their clinical and radiographic features and prognosis. MATERIAL AND METHODS: 12 cases of non-aggressive CGCG and 11 cases of aggressive CGCG were investigated and associated the immunohistochemical expression of macrophages (CD68 and CD163), blood vessels (CD34 and CD105), lymphatic vessels (D2-40) and regulator proteins (p63 and Ki-67). Clinical and radiographic features were also studied. RESULTS: Associations between all proteins in non-aggressive and aggressive CGCG were not significant (p > 0.05). With respect to non-aggressive CGCG, there were no significant correlations, while in aggressive CGCG there was a significant positive correlation between CD68 and CD163 (p = 0.031), between CD34 and D2-40 proteins (p = 0.04), whereas a significant negative correlation was observed between CD105 and CD68 (p = 0.040). However, regardless of aggressiveness of CGCG, there was a significant positive correlation between CD68 and CD163 (p = 0,04). Among the clinical and immunohistochemical aspects, only the symptomatology was a significant risk factor for the occurrence of aggressive CGCG (OR = 12.00/p = 0.016). CONCLUSION: Macrophages and angiogenesis contribute to their maintenance and development of CGCG. In addition, immunohistochemistry used here was not able to differentiate their aggressiveness. However, symptomatology was proved to be a risk factor for the occurrence of aggressive CGCG. It is possible that clinical features, particularly symptomatology, represent the most appropriate parameter to attempt to distinguish GCCG.