BMP2 rs1005464 is associated with mandibular condyle size variation.

This study aimed to evaluate the association between single nucleotide polymorphisms (SNPs) in endochondral development-related genes and mandibular condyle shape, size, volume, and symmetry traits. Cone-beam Computed Tomographies and genomic DNA from 118 individuals were evaluated (age range: 15-66 years). Data from twelve 3D landmarks on mandibular condyles were submitted to morphometric analyses including Procrustes fit, principal component analysis, and estimation of centroid sizes and fluctuating asymmetry scores. Condylar volumes were additionally measured. Seven SNPs across BMP2, BMP4, RUNX2 and SMAD6 were genotyped. Linear models were fit to evaluate the effect of the SNPs on the mandibular condyles' quantitative traits. Only the association between BMP2 rs1005464 and centroid size remained significant after adjusting to account for the false discovery rate due to multiple testing. Individuals carrying at least one A allele for this SNP showed larger condylar size than common homozygotes GG (ß = 0.043; 95% CI: 0.014-0.071; P value = 0.028). The model including BMP2 rs1005464, age and sex of the participants explained 17% of the variation in condylar size. Shape, volume, and symmetry were not associated with the evaluated SNPs. These results suggest that BMP2 rs1005464 might be associated with variation in the mandibular condyles size.

Influence of root canal sealer composition on postoperative pain after endodontic treatment of permanent teeth: a systematic review and meta-analyses / Influência da composição do cimento endodôntico na dor pós-operatória de dentes permanentes tratados endodonticamente: uma revisão sistemática e meta-análise

Postoperative pain is a frequent complication after root canal treatment. Its management is an important aspect of endodontic practice. Some treatment-related parameters were associated with the development of postoperative pain, including the sealer composition and extrusion. Objective: This systematic review aimed to answer the clinical question: Do root canal sealers composition influence postoperative pain after endodontic treatment of permanent teeth? Material and Methods: Electronic searches were conducted in PubMed, Scopus, Web of Science, Cochrane, LILACS, and grey literature databases until September 2021. The studies were qualitatively assessed using the RoB2 tool (Cochrane) and the certainty of evidence (GRADE). Sensitivity and pooled estimates were calculated using a random-effects model. Twelve articles were included. Results: The risk of bias was high in one study, low in nine, and two had some concerns. Qualitative analyses showed no influence of sealer extrusion on postoperative pain. Meta-analyses showed no significant difference in postoperative pain with moderate to very low levels of certainty between AH Plus and calcium silicate-based sealers, in a 95% confidence interval. Analysis between AH Plus, Zinc Oxide and Eugenol (ZOE), and calcium hydroxide (Ca(OH)2)-based sealers were not performed due to heterogeneity and lack of data. Conclusion: Literature showed contrasting results in postoperative pain between AH Plus and ZOE-based sealers, with low to moderate certainty of evidence. Regarding Ca(OH)2-based sealers, a single study with a low level of certainty concluded that AH Plus presented less postoperative pain than Apexit Plus. Therefore, further studies are needed to assess the influence of these sealers on postoperative pain. Evidence showed no difference in postoperative pain between AH Plus and calcium silicate-based sealers. Sealer extrusion is a variable that requires further studies (AU)

A dor pós-operatória é uma complicação frequente após o tratamento endodôntico. O seu manejo é um importante aspecto na prática endodôntica. Algumas variáveis relacionados ao tratamento foram associados com o desenvolvimento da dor pós-operatória, incluindo a composição e extrusão dos cimentos endodônticos. Objetivo: Esta revisão sistemática objetivou responder a seguinte pergunta clínica: A composição dos cimentos endodônticos podem influenciar a dor pós-operatória de dentes permanentes tratados endodonticamente?Material e Métodos: Buscas eletrônicas foram realizadas nas bases de dados no PubMed, Scopus, Web of Science, Cochrane, LILACS, e literatura cinzenta até setembro de 2021. Os estudos foram avaliados qualitativamente usando a ferramenta RoB2 (Cochrane) e a certeza de evidência (GRADE). A sensibilidade e as estimativas agrupadas foram calculadas usando um modelo de efeitos aleatórios. Doze artigos foram incluídos. Resultados: O risco de viés foi alto em um estudo, baixo em nove e dois tiveram algumas preocupações. A análise qualitativa mostrou que não há influência da extrusão do cimento na dor pós-operatória. A meta-análise mostrou que não houve diferença estatisticamente significante na dor pós-operatória entre o AH Plus e os cimentos a base de silicato de cálcio com moderada a muito baixa certeza de evdência. Análises entre os cimentos AH Plus, óxido de zinco e eugenol (OZE) e hidróxido de cálcio não foram realizados devido a heterogeneidade e falta de dados. Conclusão:A literatura sugere resultados contrastantes com relação a dor pós-operatória e entre os cimentos AH Plus e OZE, com baixa a moderada certeza de evidência. Já os cimentos a base de hidróxido de cálcio, um único estudo com baixa certeza de evidência concluiu que o AH Plus apresentou menos dor pós tratamento endodôntico do que o Apexit Plus. Portanto,mais estudos são necessários para avaliar a influência desses tipos de cimentos na dor pós-operatória. Com relação ao cimento AH Plus e os cimentos a base de silicato de cálcio não houve diferença estatística entre eles e a dor. A extrusão dos cimentos é uma variável que requer mais estudos (AU)

Single nucleotide polymorphisms in inducible nitric oxide synthase gene are not associated with persistent apical periodontitis.

The aim of this study was to investigate whether there is an association between inducible in single nucleotide polymorphisms in nitric oxide synthase (rs2297518 and rs2779249) and persistent apical periodontitis. A total of 291 Brazilian subjects were included: 125 with signs/symptoms of persistent apical periodontitis and 166 with root canal-treated teeth exhibiting healthy perirradicular tissues. Endodontically treated patients were followed up after 1 year. The two single nucleotide polymorphisms in nitric oxide synthase were analysed using real-time polymerase chain reaction. Chi-square test and odds ratio with 95% confidence intervals were performed to compare genotype distributions between 'healed' and 'persistent apical periodontitis' groups (p < 0.05). Logistic regression analysis was used to evaluate SNP-SNP interactions. The allele and genotype distributions for the polymorphisms between the persistent apical periodontitis and healed groups were not statistically significant (p > 0.05). In the logistic regression analysis, the polymorphisms were not associated with persistent apical periodontitis and SNP-SNP interactions.

Association between single-nucleotide polymorphisms in serotonin receptor 2A and melatonin receptor 1A genes and pain after root canal treatment.

AIM: This study aimed to investigate whether single-nucleotide polymorphisms (SNPs) in the genes encoding 5-HTR2A (5-Hydroxytryptamine (serotonin) receptor 2A) and MTNR1A (melatonin receptor 1A) may contribute to postoperative pain perception after root canal treatment. We hypothesised that SNPs in HTR2A and MTNR1A genes were associated with postoperative pain after root canal treatment. METHODOLOGY: This genetic cohort study enrolled patients with single-rooted teeth diagnosed with pulp necrosis and asymptomatic apical periodontitis before root canal treatment. Root canal treatment was performed in one session using a standardized protocol. Postoperative pain and tenderness were assessed using a visual analogue scale (recorded every day for 7 days and on the 14th and 30th days after root canal treatment). Genomic DNA was extracted from saliva and used to genotype the SNPs in HTR2A (rs4941573 and rs6313) and MTNR1A (rs6553010, rs6847693 and rs13140012) using real-time polymerase chain reaction. Genotypes were compared using univariate and multivariate Poisson regression with generalized estimating equations (p < .05). RESULTS: In total, 108 patients were enrolled in this study. The SNPs rs6553010 (MTNR1A), rs4941573 and rs6313 (HTR2A) were associated with an increased risk of developing pain after root canal treatment (p < .05). CONCLUSIONS: This study suggests that SNPs in HTR2A and MTNR1A influence pain response after root canal treatment.

Do Antimicrobial Photodynamic Therapy and Low-Level Laser Therapy Influence Oral Health-Related Quality of Life After Molar Extraction?

PURPOSE: Most individuals experience significant deterioration in their oral health-related quality of life (OHRQoL) in the first few days after tooth extraction. This study aimed to evaluate the impact of antimicrobial photodynamic therapy (aPDT) and low-level laser therapy (LLLT) protocols on OHRQoL after extraction of lower molars. METHODS: The investigators designed a double-blind, randomized controlled clinical trial study. Patients with indications for lower molar extraction were included in the study and randomized into four groups: control group, antimicrobial photodynamic therapy group, LLLT group (LLLT.G), and aPDT and LLLT group (aPDT + LLLT.G).The Oral Health Impact Profile (OHIP-14) questionnaire was used through an interview with the participants before the extraction (T0 - baseline) and on the 7th (T1) and 30th (T2) days after extraction. Other variables were age, sex, ethnicity, decayed-missing-filled teeth (DMFT) and tooth types. Appropriate univariate and bivariate statistics were computed, and statistical significance was set at a value P < .05. RESULTS: The sample was composed of 40 patients with a mean age of 41.25 ± 13.97 and 25 (62.5%) were women. The mean OHIP-14 scores were significantly different in the intervals at T0 versus T1 and T0 versus T2 for all domains (P < .001), demonstrating a positive impact on the OHRQoL. The total scores indicated a significant improvement in the OHRQoL in the aPDT (7.10, standard deviation 4.18, P = .043), LLLT (6.40, SD 5.87, P = .025), and aPDT + LLLT (5.30, SD 3.59, P = .012) groups compared to that in the control group (12.90, SD 6.64) at T1. Patients undergoing extraction of lower mandibular molars with aPDT + LLLT had the lowest mean OHIP-14 total score at T1 (5.30) and T2 (0.70). CONCLUSION: The aPDT and LLLT protocols had a positive impact on the participants' OHRQoL. These procedures can be applied in everyday surgical practice.

Dental trauma in primary dentition and the importance of its preservation until the eruption of permanent successor: a 6-year follow-up case report.

Traumatic dental injuries (TDIs) are a public health concern that requires special attention in primary dentition due to the sequel that can be originated in permanent dentition. This paper aims to report a dental trauma injury highlighting the importance of follow-up the traumatized primary tooth until the eruption of its permanent successor. A 3-year-old female patient referred to a Dental Trauma Care Program (DTCP) in a Brazilian Public University after falling from her own height with the involvement of the deciduous maxillary left central incisor. The child's mother did not seek immediate care. The patient did not have any complaint and the tooth presented an enamel fracture during the clinical examination without radiographic alterations. The procedure performed was occlusal wear and insertion of the patient into the DTCP. After a 6-months clinical and radiographic follow-up, the primary maxillary left central incisor presented crown discoloration and periapical bone rarefaction. The treatment was pulpectomy followed by restoration of the tooth. In the 3-year follow-up, prolonged retention occurred and tooth extraction was the treatment of choice. After a 6-year follow-up, the permanent teeth erupted without any sequelae. TDIs are frequent in the primary dentition and, in some circumstances may interfere with the normal development of the permanent tooth causing irreversible sequelae. This case report reinforces the importance of seeking immediate care whenever dental traumas occur. Besides, a long-term follow-up of the traumatized tooth is essential for successful outcomes. Clinical and radiographic monitoring is fundamental to help dental professionals to decide the best treatment and to minimize potential complications.

Aesthetic-functional reconstruction of dental fracture and its impact on the psychosocial aspect.

Traumatic dental injury (TDI) constitutes a public health concern. This injury occurs mainly in anterior teeth and brings disadvantageous psychosocial consequences that affect adolescents, as well as impairing their speech and eating habits. A healthy smile and facial aesthetic have an influence on social interaction, especially in the way individuals are seen, felt, and perceived by other people. Therefore, this paper aimed to report a dental trauma injury and its impact on the Oral Health-Related Quality of Life (OHRQoL). A 14-years old boy was referred to a Dental Trauma Care Program in a Brazilian Public University after falling from his own height. The patient had a crown fracture involving enamel and dentin without pulp exposure in the upper left central incisor. The oral rehabilitation was performed by using a composite resin associated with the silicone guide technique. Taking into account the integrality of the patient, the OHRQoL was assessed before and after the rehabilitation treatment with the application of the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14)-Impact Short Form (ISF: 16). TDI in the anterior tooth had a negative impact on the social wellbeing of this adolescent. After the oral rehabilitation, the patient showed improvement on OHRQoL demonstrating autonomy and self-confidence in his reintegration into the social environment.

Improvement on OHRQoL after endodontic treatment associated with aPDT in traumatized primary teeth: a 12-month follow-up case report.

Dental trauma is often associated with a negative impact on the oral health-related quality of life (OHRQoL). The management of traumatized teeth is a challenge in the daily pediatric dentistry clinic, due to the sequels generated over time. Pulp necrosis is a frequent sequel that requires a pulpectomy. Antimicrobial photodynamic therapy (aPDT) is an adjuvant technique, effective in eradicating microorganisms from the root canals. This case report aimed to describe OHRQoL after endodontic treatment associated with aPDT in traumatized primary teeth of a 4-year-old female patient attended at a Dental Trauma Care Program considering a period of 12-month follow-up. The Brazilian version of the Oral Health Early Childhood Impact Scale (B-ECOHIS) was used to evaluate the OHRQoL. The dental trauma and its sequels had a negative impact on the child's OHRQoL. The proposed treatments (endodontic and restorative procedures) improved the patient's OHRQoL. The association of aPDT with conventional endodontic treatment was effective in this case. It allowed the sinus tract regression and new bone formation. Besides that, this case report emphasizes the need and importance to follow-up dental trauma cases in the pediatric dentistry clinic.

The impact of traumatic dental injury on sensory perception and oral health-related quality of life of a child/adolescent before and after the treatment with aesthetic prosthesis: case report.

Children and adolescents are most frequently affected by Traumatic Dental Injuries (TDIs). Scientific evidence shows that TDIs have a negative impact on the oral health-related quality of life (OHRQoL) of children/adolescents and their families. This article aimed to report two cases of avulsion and how the treatment influenced the oral sensory perception and OHRQoL. Two patients (8 and 14 years) from a "Dental Trauma Care Program" (DTCP) presenting avulsion were evaluated. The stereognosis test assessed oral sensory perception. This test obtains the average of right and wrong answers, as well as the time spent to perceive 6 silicone objects with different geometric shapes. Child Perceptions Questionnaire (CPQ) was applied to evaluate the OHRQoL through interviews. Based on the two reports, it was possible to observe a satisfactory improvement in the OHRQoL of the child/adolescent and their families. TDI influenced negatively the oral sensory perception of both patients. Since the aesthetic prosthesis did not entirely improve the patients' oral tactile perception, it may be considered a temporary solution.

The clinical practice of Pediatric Dentistry post-COVID-19: The current evidences.

The Severe Acute Respiratory Syndrome (SARS) caused by SARS-CoV-2 virus has quickly spread all over the world, directly affecting the dentistry practice. This study aimed to perform a literature review about the current evidences on biosafety practices and clinical recommendations regarding the return to the elective dental care in the practice of Pediatric dentistry. An electronic search was performed in PubMed, Scopus, Web of Science and Grey literature databases using the terms "Pediatric dentistry" and "COVID-19". Initially, 38 studies were retrieved. After title and abstract were read, it was identified that 22 studies referred specifically to children's dental practice. A total of 19 studies were included in this study. The COVID-19 pandemic will imply significant changes in the reorientation of dental practices, from biosafety issues to technical procedures. Greater rigor in the use of Personal Protective Equipment (PPE) may cause strangeness for children. Consequently, an improvement in the management of patient's behavior before and during the treatment and new approaches to perform the procedures will be demanded. Non-aerosol techniques and minimally invasive procedures will be preferable whenever possible. Professionals will need to be constantly updated based on what the scientific literature recommends. The moment is suitable for the use of preventive practice and minimally invasive techniques.