Single-step genome-wide association studies and post-GWAS analyses for the number of oocytes and embryos in Gir cattle.

Genome-Wide Association Studies (GWAS) are used for identification of quantitate trait loci (QTL) and genes associated with several traits. We aimed to identify genomic regions, genes, and biological processes associated with number of total and viable oocytes, and number of embryos in Gir dairy cattle. A dataset with 17,526 follicular aspirations, including the following traits: number of viable oocytes (VO), number of total oocytes (TO), and number of embryos (EMBR) from 1641 Gir donors was provided by five different stock farms. A genotype file with 2093 animals and 395,524 SNP markers was used to perform a single-step GWAS analysis for each trait. The top 10 windows with the highest percentage of additive genetic variance explained by 100 adjacent SNPs were selected. The genomic regions identified in our work were overlapped with QTLs from QTL database on chromosomes 1, 2, 5, 6, 7, 8, 9, 13, 17, 18, 20, 21, 22, 24, and 29. These QTLs were classified as External, Health, Meat and carcass, Production or Reproduction traits, and about 38% were related to Reproduction. In total, 117 genes were identified, of which 111 were protein-coding genes. Exclusively associations were observed for 42 genes with EMBR, and 1 with TO. Also, 42 genes were in common between VO and TO, 28 between VO and EMBR, and four genes were in common among all traits. In conclusion, great part of the identified genes plays a functional role in initial embryo development or general cell functions. The protein-coding genes ARNT, EGR1, HIF1A, AHR, and PAX2 are good markers for the production of oocytes and embryos in Gir cattle.

Reporting quality of scoping reviews in dental public health.

BACKGROUND: The study aimed to explore reporting characteristics of scoping reviews in dental public health and the impact of some factors on the reporting quality. METHODS: This study searched for dental public health scoping reviews in PubMed and Scopus without year restrictions and restricted to English-language publications. Study selection was undertaken by two reviewers independently. One reviewer, after training, extracted data from included studies considering general study characteristics and reporting characteristics. The impact of PRISMA-ScR publication, journal endorsement, and use of study protocol on the reporting was explored. RESULTS: Eighty-one scoping reviews were included. Five items presented rates of appropriate reporting higher than 80% considering the overall percentage. Related to the impact of PRISMA-ScR publication, six items were found more often in scoping reviews published after the publication of PRISMA-ScR than in scoping reviews published before the publication of PRISMA-ScR. With regards to journals endorsement, only two reporting characteristics were found more often in scoping reviews published in journals that endorse the PRISMA-ScR statement than in scoping reviews published in non-endorsers journals. Last, regarding the use of the pre-specified protocol, five reporting characteristics presented differences in studies reporting the use of pre-specified protocol than in studies that did not mention the use of a protocol. All differences were statistically significant. CONCLUSIONS: Important information is missing in the included scoping reviews demonstrating crucial reporting problems.

Endodontic therapy in patients with inherited bleeding disorders: a scoping review.

This systematic scoping review aimed to map available evidence regarding endodontic therapy in patients with inherited bleeding disorders (IBDs). Studies in medicine or dentistry were selected if they reported on endodontic therapy in individuals with IBDs such as hemophilia A, hemophilia B, or von Willebrand disease. Two independent researchers performed searches and screening in PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library. The search initially yielded 676 potentially relevant studies, 14 of which were included in the final analysis. Of these 14 studies, 3 were classified as consensus statements or guidelines, 3 as observational studies, 2 as reviews, 5 as case reports, and 1 as an editorial. Most of the evidence regarding prophylactic treatment (eg, blood transfusion, replacement therapy, or medication administration) prior to endodontic therapy was derived from observational studies. The most frequently reported procedure was endodontic therapy, while 1 case report described a surgical endodontic procedure. Most studies included in the analysis reported that these procedures could be performed under local anesthesia. Two case reports and 1 observational study described complications after endodontic therapy in patients with IBDs. This scoping review revealed a lack of well-designed studies related to the topic of endodontic therapy in patients with IBDs. The available evidence suggests that endodontic therapy in patients with IBDs can be considered a low-risk procedure; local anesthesia should be used in most cases when patients with IBDs are treated, but the use of prophylactic measures is preferred when nerve block anesthesia is required; endodontic therapy can be conducted in a clinical setting without the need for hospital admittance; and, although the number of reported complications is small, the risk should not be ignored.

Comparison of material properties and biofilm formation in interim single crowns obtained by 3D printing and conventional methods.

STATEMENT OF PROBLEM: Three-dimensionally printed interim restorations are among the recent technological advancements in dentistry. However, evidence of their performance is lacking. PURPOSE: The purpose of this in vitro study was to compare the properties of interim restorations made by 3D printing with different technologies, laser stereolithography (SLA), technology and selective laser sintering (SLS) with those obtained by conventional techniques from acrylic resin and bis-acryl resin. MATERIAL AND METHODS: Four different groups (acrylic resin, bis-acryl resin, SLS, SLA) were tested for flexural strength, Vickers microhardness, fatigue test, compressive strength, surface roughness before and after polishing, and biofilm formation. Specimens were made in the form of rectangular blocks, disks, and single crowns by following the manufacturing technique of each material. One-way ANOVA was used to test biofilm formation, Vickers microhardness, and the results of the 3-point bend flexural test, while the paired t test was used to assess differences in surface roughness between the materials (α=.05 for all tests). RESULTS: The highest Vickers microhardness value was for acrylic resin interim crowns, while the elastic moduli were lower for both the 3D printed materials. Only the SLA resin fractured during the fatigue test. For surface roughness, a statistically significant difference was found among the studied materials (P<.001), with SLA resin and bis-acryl resin having the lowest values. No statistically significant differences were found for biofilm formation (P>.05). CONCLUSIONS: SLS resin had favorable results for the Vickers microhardness, higher maximum flexural strength, and peak stress in load-to-fracture tests, the fatigue test, and biofilm formation compared with acrylic resin and bis-acryl resin, while SLA resin showed favorable results only for biofilm formation and surface roughness.

Delayed Bleeding in a Hemophilic Patient After Sinus Floor Elevation and Multiple Implant Placements: A Case Report.

Dental treatments in hemophilic patients are challenging, and the absence of adequate preparation for the procedures can be life-threatening. This letter describes a delayed postoperative bleeding after multiple dental implants with sinus floor elevation in a patient with mild hemophilia A.

Preliminary validation of the Dental Clinical Learning Environment Instrument in a Brazilian dental school.

INTRODUCTION: This study aimed to perform a preliminary validation of the Dental Clinical Learning Environment Instrument (DECLEI) in a Brazilian dental school. MATERIAL AND METHODS: Dental Clinical Learning Environment Instrument was translated into Brazilian-Portuguese, and Brazilian DECLEI's items relevance and content validity were assessed using the content validity index (CVI). DECLEI was then distributed to 155 Brazilian undergraduate dental students attending the 7th and 8th semester of dental studies. Principal Component Analysis (PCA) was used as an initial exploration of the Brazilian DECLEI's internal structure. Item-total correlations for the remaining items were calculated to identify items with poor discrimination coefficients. The internal consistency reliability for the final set of 17 items was calculated using Cronbach's alpha coefficient. The sensitivity of the instrument to measure differences between groups regarding year in dental school, race and sex was also assessed. RESULTS: The CVI was ≥0.80 for all 24 items of the Brazilian DECLEI indicating that all items were relevant to the local culture. Principal Components Analysis (PCA) provided evidence of a single dominant component containing 17 items (Cronbach's α = .86), and all 17 items met the benchmark of acceptable item-total correlation. Significant differences were found only when comparing 7th- and 8th-semester students. CONCLUSIONS: Dental Clinical Learning Environment Instrument has the potential to be used as a reliable instrument to measure clinical learning environments for Brazilian dental students.

Protocol registration improves reporting quality of systematic reviews in dentistry.

BACKGROUND: The aims of this study were to assess whether the previous registration of a systematic review (SR) is associated with the improvement of the quality of the report of SRs and whether SR registration reduced outcome reporting bias. METHODS: We performed a search in PubMed for SRs in dentistry indexed in 2017. Data related to SR registration and reporting characteristics were extracted. We analyzed if the reporting of 21 characteristics of included SRs was associated with the prospective registration of protocols or reporting of a previously established protocol. The association between prospective registering of protocols, reporting of funding and number of included studies versus outcome reporting bias was tested via multivariable logistic regression. RESULTS: We included 495 SRs. One hundred and 62 (32.7%) SRs reported registering the SR protocol or working from a previously established protocol. Thirteen reporting characteristics were described statistically significant in SRs registered versus SRs that were not. Publication bias assessment and Report the number of participants showed the highest effects favoring the register (RR 1.59, CI 95% 1.19-2.12; RR 1.58, CI 95% 1.31-1.92 respectively). Moreover, Registration was not significantly linked with the articles' reporting statistical significance (OR 0.96, CI 95% 0.49-1.90). CONCLUSION: There is a positive influence of previously registering a protocol in the final report quality of SRs in dentistry. However, we did not observe an association between protocol registration and reduction in outcome reporting bias.

Alpha and beta cortical activity during guitar playing: task complexity and audiovisual stimulus analysis.

PURPOSE: Some studies have explored the relationship between music and cortical activities; however, there are just few studies investigating guitar performance associated with different sensory stimuli. Our aim was to evaluate alpha and beta activity during guitar playing. MATERIALS AND METHOD: Twenty healthy right-handed people participated in this study. Cortical activity was measured by electroencephalogram (EEG) during rest and 4 tasks (1: easy music with an auditory stimulus; 2: easy music with an audiovisual stimulus; 3: complex music with an auditory stimulus; 4: complex music with an audiovisual stimulus). The peak frequency (PF), median frequency (MF) and root mean square (RMS) of alpha and beta EEG signals were assessed. RESULTS: A higher alpha PF at the T3-P3 was observed, and this difference was higher between rest and task 3, rest and task 4, tasks 1 and 3, and tasks 1 and 4. For beta waves, a higher PF was observed at C4-P4 and a higher RMS at C3-C4 and O1-O2. At C4-P4, differences between rest and tasks 2 and 4 were observed. The RMS of beta waves at C3-C4 presented differences between rest and task 3 and at O1-O2 between rest and task 2 and 4. CONCLUSION: The action observation of audiovisual stimuli while playing guitar can increase beta wave activity in the somatosensory and motor cortexes; and increase in the alpha activity in the somatosensory and auditory cortexes and increase in the beta activity in the bilateral visual cortexes during complex music execution, regardless of the stimulus type received. Abbreviations: bpm: beats per minute; C: central; EEG: electroencephalogram; F: frontal; Hz: hertz; LABCOM: Laboratory of Motor Control and Biomechanics; MD: mean difference; MF: median frequency; O: occipital; P: parietal; PF: peak frequency; R: rest; RMS: root mean square; T: temporal; T1: task 1; T2: task 2; T3: task 3; T4: task 4; UFTM: Federal University of Triângulo Mineiro.

Novel bendable abutments as a solution to correct unfavorable implant inclination. A clinical report.

OBJECTIVE: This clinical case report describes a novel bendable abutment as a prosthetic solution for implants presenting with an unfavorable inclination. CLINICAL CONSIDERATIONS: A metal-ceramic screw-retained single crown was made on this novel bendable abutment in a patient presenting with a pronounced buccal inclination of an implant. A plastic reference guide is used to define the correct inclination and then this inclination is transferred to the abutment using a specific bending device at the same appointment. CONCLUSIONS: Bendable abutments can be used as a solution to correct unfavorable implant inclinations. This abutment can be customized at the same appointment considering a case-specific inclination rather than conventional pre-angled abutments. CLINICAL SIGNIFICANCE: Bendable abutments can be customized according to each case specificities while conventional pre-angled abutments may not be adequate for all patients. Also, the abutment customization could be easily done by dentists at their own practices using a specific bending device with hand pressure only, saving time, and the need to order pre-angled abutments or having it in stock.

Translation and preliminary validation of an ageism scale for dental students in Brazil (ASDS-Braz).

BACKGROUND AND OBJECTIVE: Ageism is a major barrier for age-appropriate care. The aim of this study was to translate and perform a preliminary validation of an ageism scale for dental students (ASDS) in Brazil (ASDS-Braz). METHODS: The 27-item original ageism scale was translated from English into Brazilian Portuguese. A panel of five Brazilian dental educators revised the scale to establish content validity. The translated version was completed by 156 dental students in the Federal University of Pelotas in Brazil. Principal component analysis, internal consistency reliability and discriminant validity were estimated. RESULTS: All items in the Brazilian Portuguese version received a content validity index score ≥0.80 indicating that they were relevant to the topic. The principal component analysis produced a 12-item scale with three components that accounted for 51% of the overall variance. The first component contained six items associated with a negative view of older adults; the second component contained three items dealing with the complexity of providing care for older adults; and the third component contained three items associated with a positive view of older people. Discriminant validity did not show any differences related to demographic factors, the semester of studies and history of living with older people. CONCLUSIONS: The preliminary validation of the ASDS-Braz produced a 12-item scale with three components with acceptable validity and reliability. Future research in a larger, multi-institutional sample is now warranted.

Modelling of sulphur amino acid requirements and nitrogen endogenous losses in kittens.

The objective of this study was to estimate the sulphur amino acid (methionine + cystine) requirements and nitrogen endogenous losses in kittens aged 150 to 240 d. Thirty-six cats were distributed in six treatments (six cats per treatment) consisting of different concentrations of methionine + cystine (M + C): T1, 6.5 g/kg; T2, 8.8 g/kg; T3, 11.3 g/kg; T4, 13.6 g/kg; T5, 16.0 g/kg; and control, 6.5 g/kg. Diets were formulated by serial dilution of T5 (a diet relatively deficient in M + C but containing high protein concentrations) with a minimal nitrogen diet (MND). Thus, crude protein and amino acid concentrations in diets T1-T5 decreased by the same factor. The control diet was the T1 diet supplemented with adequate concentrations of M + C (6.5 g/kg; 8.8 g/kg; 11.3 g/kg; 13.6 g/kg and 16.0 g/kg). All diets were based on ingredients commonly used in extruded cat diets. Digestibility assays were performed for the determination of nitrogen balance. Nitrogen intake (NI) and nitrogen excretion (NEX) results data were fitted with an exponential equation to estimate nitrogen maintenance requirement (NMR), theoretical maximum for daily nitrogen retention (NRmaxT), and protein quality (b). M + C requirements were calculated from the limiting amino acid intake (LAAI) equation assuming a nitrogen retention of 45 to 65% NRmaxT. The NMR of kittens aged 150, 195, and 240 d was estimated at 595, 559, and 455 mg/kg body weight (BW)0.67 per day, respectively, and M + C requirements were estimated at 517, 664, and 301 mg/kg BW0.67 per day, respectively.

Industry sponsorship bias in clinical trials in implant dentistry: Systematic review and meta-regression.

AIM: Industry sponsorship might distort the conduct and findings of studies in a large range of medical disciplines. The objective of this study was to assess whether industry sponsorship bias is present in randomized controlled trials (RCTs) on dental implants. MATERIAL AND METHODS: Two databases were searched (MEDLINE; Web of Science) to identify RCTs published between 1996 and 2016 assessing different implant systems, components or techniques, such as implant-abutment connections, geometries, surfaces, loading protocols or regions of placement. Studies' sponsorship status was classified as unclear, non-sponsored or sponsored. Our outcome was marginal bone loss per year (MBL/year) of follow-up. Random-effects meta-analysis of MBL/year with subgroup analysis according to sponsorship status was performed. Moreover, multivariable stepwise-selection meta-regression was performed to assess whether sponsorship status, among other covariates, was associated with MBL/year. RESULTS: One hundred and two RCTs (4,775 patients, 8,806 implants) were included. Overall mean (95% confidence interval) MBL/year was 0.74 mm (95% CI 0.67/0.82). There was no significant difference in MBL/year among sponsorship categories; unclear: 0.64 (95% CI 0.37/0.91); non-sponsored: 0.65 (095% CI 0.55/0.75); and sponsored: 0.82 (95% CI 0.71/0.94). CONCLUSION: Meta-regression did not demonstrate a significant association of MBL/year with sponsorship status or other covariates was found. We did not detect significant sponsorship bias in RCTs on dental implants.

Influence of Implant Inclination and Prosthetic Abutment Type on the Biomechanics of Implant-Supported Fixed Partial Dentures.

Obtaining parallelism during implant placement is often difficult, leading to inclination of implants. The present study evaluated the stress distribution in 3-unit fixed partial dentures supported by 2 implants with different inclinations and prosthetic abutments. Universal castable long abutments (UCLAs) or tapered abutments were used considering 17° of implant angulation in different directions (mesial, distal, buccal, or lingual). To do so, 3-dimensional finite element models were built and exported to specific analysis software. Forces were applied to the functional cusps. Data were obtained with regard to the maximum principal and von Mises stresses (in MPa). No relevant differences were observed in the stress values in the cortical and cancellous bone nor in the prosthesis with UCLA or tapered abutments. However, a relevant stress reduction in the prosthetic screws of the tilted implant was observed when using UCLA abutments. According to the obtained results, it is possible to suggest that both UCLA or tapered abutments can be used for 3-unit fixed partial dentures when 1 of the implants is tilted. UCLA abutment might lead to less biomechanical problems related to screw loosening or fracture.

Influence of Different Implant Geometry in Clinical Longevity and Maintenance of Marginal Bone: A Systematic Review.

PURPOSE: To assess, through a systematic review, the influence of different implant geometries on clinical longevity and maintenance of marginal bone tissue. METHODS: An electronic search was conducted in MEDLINE, Scopus, and Web of Science databases, limited to studies written in English from 1996 to 2017 using specific search strategies. Only randomized controlled trials (RCTs) that compared dental implants and their geometries were included. Two reviewers independently selected studies, extracted data, and assessed the risk of bias of included studies. RESULTS: From the 4006 references identified by the search, 24 were considered eligible for full-text analysis, after which 10 studies were included in this review. A similar behavior of marginal bone loss between tapered and cylindrical geometries was observed; however, implants that had micro-threads in the neck presented a slight decrease of marginal bone loss compared to implants with straight or smooth neck. Success and survival rates were high, with cylindrical implants presenting higher success and survival rates than tapered ones. CONCLUSIONS: Implant geometry seems to have little influence on marginal bone loss (MBL) and survival and success rates after 1 year of implant placement; however, the evidence in this systematic review was classified as very low due to limitations such as study design, sample size, and publication bias. Thus, more well-designed RCTs should be conducted to provide evidence regarding the influence of implant geometry on MBL and survival and success rates after 1 year of implant placement.

Filters from taxis air conditioning system: A tool to characterize driver's occupational exposure to bioburden?

Bioburden proliferation in filters from air conditioning systems of taxis represents a possible source of occupational exposure. The aim of this study was to determine the occurrence of fungi and bacteria in filters from the air conditioning system of taxis used for patient transportation and to assess the exposure of drivers to bioburden. Filters from the air conditioning systems of 19 taxis and 28 personal vehicles (used as controls) operating in three Portuguese cities including the capital Lisbon, were collected during the winter season. The occurrence and significance of bioburden detected in the different vehicles are reported and discussed in terms of colony-forming units (CFU) per 1 m2 of filter area and by the identification of the most frequently detected fungal isolates based on morphology. Azole-resistant mycobiota, fungal biomass, and molecular detection of Aspergillus species/strains were also determined. Bacterial growth was more prevalent in taxis (63.2%) than in personal vehicles (26.3%), whereas fungal growth was more prevalent in personal vehicles (53.6%) than in taxis (21.1-31.6%). Seven different azole-resistant species were identified in this study in 42.1% taxi filters. Levels of fungal biomass were above the detection limit in 63% taxi filters and in 75% personal vehicle filters. No toxigenic species were detected by molecular analysis in the assessed filters. The results obtained show that bioburden proliferation occurs widely in filters from the air conditioning systems of taxis, including the proliferation of azole-resistant fungal species, suggesting that filters should be replaced more frequently. The use of culture based-methods and molecular tools combined enabled an improved risk characterization in this setting.

Speed sintering translucent zirconia for chairside one-visit dental restorations: Optical, mechanical, and wear characteristics.

The fabrication of zirconia dental restorations is a time-consuming process due to traditional slow sintering schemes; zirconia (Y-TZP) produced by these conventional routes are predominantly opaque. Novel speed sintering protocols have been developed to meet the demand for time and cost effective chairside CAD/CAM-produced restorations, as well as to control ceramic microstructures for better translucency. Although the speed sintering protocols have already been used to densify dental Y-TZP, the wear properties of these restorations remain elusive. Fast heating and cooling rates, as well as shorter sintering dwell times are known to affect the microstructure and properties of zirconia. Thus, we hypothesize that speed sintered zirconia dental restorations possess distinct wear and physical characteristics relative to their conventionally sintered counterparts. Glazed monolithic molar crowns of translucent Y-TZP (inCoris TZI, Sirona) were fabricated using three distinct sintering profiles: Super-speed (SS, 1580 °C, dwell time 10 min), Speed (S, 1510 °C, dwell time 25 min), and Long-term (LT, 1510 °C, dwell time 120 min). Microstructural, optical and wear properties were investigated. Crowns that were super-speed sintered possessed higher translucency. Areas of mild and severe wear were observed on the zirconia surface in all groups. Micropits in the wear crater were less frequent for the LT group. Groups S and SS exhibited more surface pits, which caused a scratched steatite surface that is associated with a greater volume loss. Tetragonal to monoclinic phase transformation, resulting from the sliding wear process, was present in all three groups. Although all test groups had withstood thermo-mechanical challenges, the presence of hairline cracks emanating from the occlusal wear facets and extending deep into the restoration indicates their susceptibility to fatigue sliding contact fracture.

Spectrophotometric analysis of clinical factors related to the color of ceramic restorations: A pilot study.

STATEMENT OF PROBLEM: Shade matching natural teeth with ceramic restorations is still an esthetic, clinical challenge. PURPOSE: The purpose of this prospective clinical study was to evaluate the influence of color-related factors on the color variation of ceramic restorations based on spectrophotometric analysis. MATERIAL AND METHODS: Color records were obtained from 11 participants who received 38 lithium disilicate restorations. CIELab color coordinates were measured with a spectrophotometer on the ceramic restoration, tooth (baseline), prepared tooth, and luted ceramics. Color variation (ΔE00) was calculated for each variable (luting agent and restoration type, tooth substrate shade, ceramic thickness, and translucency parameters) measured at baseline on the prepared tooth and after cementation of the restorations. Confidence intervals (CI) for the means (95% CI) were calculated, and the ΔE00 values and CIELab individual color coordinates were compared for each pair of variable by using the Student t test or Welch test (α=.05). RESULTS: Greater color variation values were observed between measurements obtained on the prepared tooth and luted restoration. The lower ΔE00 values were observed over darker tooth substrate measured at baseline and after luting (P=.007). CONCLUSIONS: The 3 conditions evaluated presented clinically visible color differences, highlighting the importance of clinical evaluations on the visual color acceptability limits for restorations, which are usually defined in laboratory studies. The lithium disilicate ceramic showed lower masking ability over darker tooth substrate, whereas the coordinates L*, a*, and b* were cementation-dependent.

Occupational Exposure to Aflatoxin B1 in a Portuguese Poultry Slaughterhouse.

Aflatoxin B1 (AFB1) is a secondary metabolite produced by the fungi Aspergillus flavus and is the most potent hepatocarcinogen known in mammals and has been classified by the International Agency of Research on Cancer as Group 1 carcinogen. Although dietary exposure to AFB1 has been extensively documented, there are still few studies dedicated to the problem of occupational exposure. Considering recent findings regarding AFB1 occupational exposure in poultry production, it was considered relevant to clarify if there is also exposure in poultry slaughterhouses. Occupational exposure assessment to AFB1 was done with a biomarker of internal dose that measures AFB1 in the serum by enzyme-linked immunosorbent assay. Thirty workers from a slaughterhouse were enrolled in this study. A control group (n = 30) was also considered in order to know AFB1 background levels for Portuguese population. Fourteen workers (47.0%) showed detectable levels of AFB1 with values from 1.06 to 4.03ng ml(-1), with a mean value of 1.73ng ml(-1). No AFB1 was detected in serum of individuals used as controls. Despite uncertainties regarding the exposure route that is contributing more to exposure (inhalation or dermal) is possible to state that exposure to AFB1 is occurring in the slaughterhouse studied. It seems that reducing AFB1 contamination in poultry production can have a positive result in this occupational setting.

Higher Dental Caries Prevalence and Its Association with Dietary Habits and Physical Limitation in Epidermolysis Bullosa Patients: A Case Control Study.

AIM: Epidermolysis bullosa (EB) represents a highly rare subgroup of skin diseases that affects skin and mucous membrane. The aim of the present study was to assess caries prevalence and its associated factors in EB subjects. Salivary status was also assessed. MATERIALS AND METHODS: Ten subjects with EB who were under supervision were selected (cases) and matched by age and gender with unaffected individuals (controls). Dental caries were recorded using the World Health Organization (WHO) criteria. Oral hygiene and dietary habits were investigated by clinical examination and questionnaires. Both nonstimulated and stimulated saliva were collected and salivary pH, buffering capacity and mouth opening were evaluated. RESULTS: The results showed that the median decay-missing-filled teeth was significantly higher (p = 0.0094) in EB cases 5 (3.9-20.3) than in controls 3 (2-3.25). The groups also differed when food consistency was analyzed. Individuals with EB have a higher intake of soft food. In addition, the median mouth-opening values from cases (0.84-2.84 cm) and controls (4.3-4.9 cm) have shown to be statistically different (p = 0.007). Considering the salivary parameters, none of them showed significant differences among groups. CONCLUSION: Epidermolysis bullosa subjects present higher caries scores and might be related to their physical condition and dietary habits. CLINICAL SIGNIFICANCE: There is a lack of information about oral status in EB subjects. Hence, our findings add useful information regarding the relationship between caries prevalence and associated risk factors in EB subjects.

Overdenture retaining bar stress distribution: a finite-element analysis.

OBJECTIVE: Evaluate the stress distribution on the peri-implant bone tissue and prosthetic components of bar-clip retaining systems for overdentures presenting different implant inclinations, vertical misfit and framework material. MATERIALS AND METHODS: Three-dimensional models of a jaw and an overdenture retained by two implants and a bar-clip attachment were modeled using specific software (SolidWorks 2010). The studied variables were: latero-lateral inclination of one implant (-10°, -5°, 0°, +5°, +10°); vertical misfit on the other implant (50, 100, 200 µm); and framework material (Au type IV, Ag-Pd, Ti cp, Co-Cr). Solid models were imported into mechanical simulation software (ANSYS Workbench 11). All nodes on the bone's external surface were constrained and a displacement was applied to simulate the settling of the framework on the ill-fitted component. Von Mises stress for the prosthetic components and maximum principal stress to the bone tissue were evaluated. RESULTS: The +10° inclination presented the worst biomechanical behavior, promoting the highest stress values on the bar framework and peri-implant bone tissue. The -5° group presented the lowest stress values on the prosthetic components and the lowest stress value on peri-implant bone tissue was observed in -10°. Increased vertical misfit caused an increase on the stress values in all evaluated structures. Stiffer framework materials caused a considerable stress increase in the framework itself, prosthetic screw of the fitted component and peri-implant bone tissue. CONCLUSIONS: Inclination of one implant associated with vertical misfit caused a relevant effect on the stress distribution in bar-clip retained overdentures. Different framework materials promoted increased levels of stress in all the evaluated structures.