Assessment of temporomandibular joint bone changes associated with anterior disc displacement: An MRI cross-sectional study.

OBJECTIVE: This cross-sectional study aimed to evaluate the presence of bone changes on magnetic resonance imaging (MRI) scans of patients with temporomandibular joint (TMJ) anterior disc displacement (ADD) with reduction (ADDWR) and without reduction (ADDWoR). METHODS: TMJ-MRI scans were screened for the presence of ADD. 285 scans presented ADD, being further divided into ADDWR (n = 188) and ADDWoR (n = 97). Bone changes on the mandibular condyle and articular eminence were also assessed and computed. The chi-square test compared the association of these bone changes with the presence of ADDWR and ADDWoR, with a significance level of 5 %. Also, the prevalence ratio (PR) was calculated. RESULTS: In the mandibular condyle, subchondral cyst (p = 0.035, PR = 1.08) and bone edema (p = 0.044, PR = 2.40), more prevalent on ADDWR, and generalized sclerosis (p = 0.015, PR = 1.04), more prevalent on ADDWoR, presented significant association with ADD. On the articular eminence, generalized sclerosis (p = 0.015, PR = 1.04) and articular surface flattening (p = 0.003, PR = 1.19) presented significant association with ADD, both more prevalent on ADDWoR. CONCLUSION: Bone changes are usual findings in TMJ with ADD diagnosis. The real influence of ADD is not fully clear, although clinicians should be aware of patients with this condition, to provide an early diagnosis and improve patient´s prognosis.

Influence of Population Size, the Human Development Index and the Gross Domestic Product on Mortality by COVID-19 in the Southeast Region of Brazil.

We evaluated the influence of population size (POP), HDI (Human Development Index) and GDP (gross domestic product) on the COVID-19 pandemic in the Southeast region of Brazil, between February 2020 and May 2021. METHODS: Cases, deaths, incidence coefficient, mortality rate and lethality rate were compared among states. The cities were divided into strata according to POP, GDP, and HDI. Data were compared by Welch's ANOVA, nonlinear polynomial regression, and Spearman's correlation test (rS). RESULTS: The highest incidence coefficient (p < 0.0001) and mortality rate (p < 0.05) were observed in the states of Espírito Santo and Rio de Janeiro, respectively. Until the 45th week, the higher the POP, the higher the mortality rate (p < 0.01), with no differences in the remaining period (p > 0.05). There was a strong positive correlation between POP size and the number of cases (rS = 0.92, p < 0.0001) and deaths (rS = 0.88, p < 0.0001). The incidence coefficient and mortality rate were lower (p < 0.0001) for low GDP cities. Both coefficients were higher in high- and very high HDI cities (p < 0.0001). The lethality rate was higher in the state of Rio de Janeiro (p < 0.0001), in large cities (p < 0.0001), in cities with medium GDP (p < 0.0001), and in those with high HDI (p < 0.05). CONCLUSIONS: Both incidence and mortality were affected by time, with minimal influence of POP, GDP and HDI.

Volumetric assessment of the dental crown for sex estimation by means of cone-beam computed tomography.

Sex estimation has a vital role in the solution of forensic cases when the identification of a large number of victims is needed. Considering the sexual dimorphism of the human teeth, the objective of this study was to estimate human sex by means of cone beam computed tomography (CBCT)-based volumetric assessment of the dental crown. A total of 78 CBCT images of the upper central incisors, upper and lower canines, and lower lateral incisors were equally selected from a Brazilian population aged between 8 and 36 years old. The dental crowns were subjected to image-based volumetric assessment by manual segmentation using the 3D slicer software, and the outcomes were compared by the Mann-Whitney test, unpaired t-test, Pearson correlation test, conditional backward stepwise logistic regression and intraclass correlation coefficient (α=0.05). The volumetric accuracy of the upper central incisor, upper canine and lower canine for sex estimation were 64.1%, 74.4% and 79.5%, respectively. The combined analysis of the upper and lower canines allowed an average accuracy of 83.7%. In conclusion, the combined volumetric analysis of the crown of the upper and lower canines can be applied for sex estimation in the studied population.

Assessment of anesthetic properties and pain during needleless jet injection anesthesia: a randomized clinical trial.

OBJECTIVE: Pain due to administration of local anesthetics is the primary reason for patients' fear and anxiety, and various methods are used to minimize it. This study aimed to measure the degree of pain during administration of anesthesia and determine the latency time and duration of pulpal anesthesia using two anesthetic methods in the maxilla. MATERIALS AND METHODS: A randomized, single-blind, split-mouth clinical trial was conducted with 41 volunteers who required class I restorations in the maxillary first molars. Local anesthesia was administered with a needleless jet injection system (experimental group) or with a carpule syringe (control) using a 30-gauge short needle. The method of anesthesia and laterality of the maxilla were randomized. A pulp electric tester measured the latency time and duration of anesthesia in the second molar. Visual analogue scale (VAS) was used to measure the degree of pain during the anesthetic method. Data were tabulated and then analyzed by a statistician. The t-test was used to analyze the differences between the groups for basal electrical stimulation. Duration of anesthesia and degree of pain were compared using the Mann-Whitney test. A 5% significance level was considered. RESULTS: There was no statistical difference in the basal electrical stimulation threshold (mA) and degree of pain between the two methods of anesthesia (p>0.05). Latency time was 2 minutes for all subjects. The duration of pulpal anesthesia showed no statistical difference (minutes) between the two methods (p<0.001), with a longer duration for the traditional method of anesthesia (median of 40 minutes). CONCLUSIONS: The two anesthetics methods did not differ concerning the pain experienced during anesthesia. Latency lasted 2 minutes for all subjects; the traditional infiltration anesthesia resulted in a longer anesthetic duration compared with the needleless jet injection.

Assessment of Oral Conditions and Quality of Life in Morbid Obese and Normal Weight Individuals: A Cross-Sectional Study.

The aim of this study was to identify the impact of oral disease on the quality of life of morbid obese and normal weight individuals. Cohort was composed of 100 morbid-obese and 50 normal-weight subjects. Dental caries, community periodontal index, gingival bleeding on probing (BOP), calculus, probing pocket depth, clinical attachment level, dental wear, stimulated salivary flow, and salivary pH were used to evaluate oral diseases. Socioeconomic and the oral impacts on daily performances (OIDP) questionnaires showed the quality of life in both groups. Unpaired Student, Fisher's Exact, Chi-Square, Mann-Whitney, and Multiple Regression tests were used (p<0.05). Obese showed lower socio-economic level than control group, but no differences were found considering OIDP. No significant differences were observed between groups considering the number of absent teeth, bruxism, difficult mastication, calculus, initial caries lesion, and caries. However, saliva flow was low, and the salivary pH was changed in the obese group. Enamel wear was lower and dentine wear was higher in obese. More BOP, insertion loss, and periodontal pocket, especially the deeper ones, were found in obese subjects. The regression model showed gender, smoking, salivary pH, socio-economic level, periodontal pocket, and periodontal insertion loss significantly associated to obesity. However, both OIDP and BOP did not show significant contribution to the model. The quality of life of morbid obese was more negatively influenced by oral disease and socio-economic factors than in normal weight subjects.

Avaliação dos efeitos da ropivacaína sobre a reatividade vascular em artéria mesentérica de rato / Assessment of the effects of ropivacaine on vascular reactivity in rat mesenteric artery

Introdução: A ropivacaína (ROPI) é um anestésico local de longa duração de ação, introduzido mais recentemente em Medicina, mas ainda não disponível para uso odontológico em tubetes. Estudos clínicos e com animais confirmam que a ROPI é um anestésico local eficaz e que possui um efeito vasoconstritor intrínseco. Objetivo: Avaliar os efeitos da ROPI sobre a reatividade vascular em artéria mesentérica isolada de rato, além de comparar esse efeito ao da lidocaína (LIDO) e avaliar o possível envolvimento do endotélio vascular na resposta induzida pela ROPI em anel de artéria mesentérica isolada de rato. Material e Método: Foram utilizados 14 ratos Wistar machos (250-300g). Os animais foram eutanasiados e, através de uma incisão no abdome do animal, foi retirada a artéria mesentérica. Desta artéria, foram obtidos anéis (1-2 mm), que foram mantidos em cubas contendo 10 mL de solução nutritiva de Tyrode mantida a 37 °C e gaseificada com carbogênio. Para o registro das contrações isométricas, cada anel foi suspenso, por linhas de algodão, a um transdutor de força conectado a um sistema de aquisição. RESULTADO: Tanto a LIDO como a ROPI não apresentaram efeito vasoconstritor sobre o tônus basal de anéis com endotélio funcional. Porém, quando os anéis foram pré-contraídos com fenilefrina, ambas as drogas foram capazes de induzir vasorrelaxamentos dependentes da concentração (Emáx = 31,7 ± 3,3%; n = 6, para a LIDO; Emáx = 69 ± 8%; n = 6, para a ROPI), que não foram alterados após a remoção do endotélio (Emáx = 28,7 ± 1,3%; n = 7, para a LIDO; Emáx = 58,8 ± 5,9%; n = 6, para a ROPI). Em anéis sem endotélio ...

Introduction: Ropivacaine (ROPI) is a local anesthetic of long duration of action, more recently introduced in medicine, however is not available for dental use in tubes yet. Clinical and animal studies have confirmed that bupivacaine is an effective anesthetic that also has an intrinsic vasoconstrictor effect. Objective: To evaluate the effects of ropivacaine on vascular reactivity in isolated rat mesenteric artery, compare this to the effect of lidocaine (LIDO) and evaluate the possible involvement of the vascular endothelium induced by ROPI in isolated rat mesenteric artery ring response. Material and Method: It was used 12 male Wistar rats (250-300g). The animals were euthanized and through an incision in the abdomen of the animal, the mesenteric artery was removed. Artery rings (1-2 mm) were obtained by the mesenteric artery, which were kept in vats containing 10 ml of Tyrode's nutrient solution kept at 37 °C and gassed with carbogen. For the recording of isometric contractions, each ring was suspended by cotton lines to a force transducer connected to a data acquisition system. RESULT: Both the LIDO as ROPI showed no vasoconstrictor effect on the basal tone of rings with functional endothelium. However, when the rings were precontracted with phenylephrine, both drugs were able to induce concentration-dependent vasorelaxation (Emax = 31.7 ± 3.3%, n = 6 for LIDO and 69 ± 8%, n = 6 for ROPI) that were not altered after removal of the endothelium (Emax = 28.7 ± 1.3%, n = 7 for LIDO and Emax = 58.8 ± 5.9%, n = 6 for ROPI). In rings without functional endothelium and precontracted with depolarizing Tyrode solution (80 mM KCl), the LIDO-induced vasorelaxation was no significantly changed (Emax = 29 ± 3%, n = 7). However, ROPI-induced vasorelaxation was reduced in this protocol and the presence of 1 mM tetraethylammonium (TEA) (Emax = 21.2 ± 5.1%, n = 7 and Emax = 17.4 ± 3.7, n = 4, ...

Prescrição de medicamentos em odontologia - o que muda com a portaria 344/98? / New brazilian governamental degree and drugs prescription in dentistry

Embora há mais de um ano em vigor, muitos Cururgiões-Dentitas ainda não avaliaramo impacto da Portaria 344/98 da Secretaria de Vigilância Sanitária que, além de outras providências, normatiza a prescrição de drogas sujeitas à controle especial, onde se incluem os psicotrópicos e analgésicos de ação central. Os autores descrevem e comentam as principais mudanças regulamentadas por esta Portaria