Sex hormone replacement therapy in periodontology-A systematic review.

OBJECTIVE: To analyse whether sex hormone replacement therapy (HRT) improves periodontal parameters and dental implants osseointegration in humans. MATERIALS AND METHODS: Electronic databases and hand searches were performed from June to August 2018 in SciELO, LILACS and PubMed/MEDLINE. Human observational and interventional studies that evaluated the following parameters were included: clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BOP), radiographic bone loss (RBL) or osseointegration. RESULTS: Initial search retrieved 1,282 non-duplicated articles. Fifteen studies were selected after inclusion criteria were applied. All studies were performed in postmenopausal women. Mean differences for PPD reduction ranged from 0.02 to 0.2 mm in HRT-positive patients; mean CAL gain -0.18 to 0.54 mm; mean RBL reduction -0.87 to 0.15 mm; and mean BOP reduction 9%-30.3%. Failure rate of dental implants increased -5.5% to 11.21% when HRT was used. CONCLUSIONS: Very low but consistent evidence suggests a reduction in BOP and no impact on RBL in postmenopausal women receiving HRT. There are inconsistent reports that suggest that HRT in postmenopausal women: (a) improves or does not impact PPD reduction and CAL gain; and (b) does not impact or increase implant loss. In summary, there is no evidence to support HRT prescription for either men or women for periodontal/implant placement purposes.

Mandibular-related bone metabolism in orchiectomized rats treated with sex hormones.

OBJECTIVE: This study aimed to compare the impact of testosterone and estrogen replacement therapy on mandibular bone density and bone-related markers. DESIGN: Forty male adult rats were randomly allocated to 4 experimental groups (n = 10/group): Sham (Control); Orchiectomy; Orchiectomy plus testosterone replacement; and orchiectomy plus estradiol replacement. Twenty-four days after orchiectomy, the hemi-mandibles were collected and processed for analysis of microhardness in cortical and trabecular bone, radiographic bone density and histomorphometric evaluation. Serum was collected for the analysis of calcium, phosphorus, alkaline phosphatase and magnesium. RESULTS: The orchiectomy group had the lowest mandibular bone density (p < 0.01) and also their serum levels of alkaline phosphatase were higher than all other experimental groups (p < 0.001). Estradiol replacement significantly reduced microhardness when compared to orchiectomy in cortical bone (p < 0.05). Both testosterone and estrogen replacement reverted orchiectomy impact on this parameter (p < 0.01); and decreased alkaline phosphatase to levels comparable to the Sham-Control group. The effect of estrogen was more pronounced than testosterone, and a statistically significant difference was observed between Sham-Control and testosterone replacement (p < 0.05) but not between Sham-Control and estradiol replacement groups. CONCLUSION: Our findings demonstrated that both estradiol and testosterone replacement therapies play a role in mandibular bone metabolism, but suggest different pathways.

Can NLR be a biomarker for mucositis and gvhd in patients undergoing allogeneic HSCT?

Allogeneic hematopoietic stem cell transplantation (HSCT) is a treatment for many diseases; however, it can induce complications such as Oral Mucositis (OM) and Graft-versus- Host Disease (GVHD). The neutrophil-lymphocyte ratio (NLR) is a peripheral biomarker of systemic inflammation and an independent prognostic factor for several inflammatory diseases. Aim: This study aimed to evaluate the association of NLR with OM and GVHD in patients undergoing allogeneic HSCT. Methods: Patients who underwent allogeneic HSCT at the Bone Marrow Transplant Service of the Hospital de Clínicas Complex of the Federal University of Paraná were included in the study. Socio-demographic data and blood counts were collected from patients' medical records. The NLR was calculated and associated with OM and GVHD. Results: 45 patients were included in the study. Although NLR was higher in patients with OM and oral GVHD, no statistical difference was observed, and no relationship between OM and GVHD with NLR could be stated. Conclusion: Although both OM and GVHD are associated with an inflammatory response as well as the immune system, it was not associated with NLR. Further investigation considering other variables related to HSCT might find possible associations, as it could favor patient management and prevention

Avaliação contínua da aprendizagem por meio da aplicação de quiz semanal no ensino da Periodontia / Continuous learning evaluation through the application of weekly quiz in Periodontics

A avaliação contínua e rotineira mantém o estudante sob constante estudo, leitura e aprendizado, além de suavizar o impacto das avaliações teóricas formais sobre os critérios tradicionais de aprovação. O objetivo deste estudo foi avaliar o impacto da aplicação de quiz semanal sobre a nota da avaliação teórica formal no componente curricular Periodontia I do Curso de Odontologia da Universidade Federal do Paraná. Para este estudo observacional retrospectivo, avaliaram-se os campos "nota quiz" e "nota avaliação" dos diários de classe das turmas do primeiro e segundo semestres de 2016, respectivamente "sem quiz" (n=53) e "com a realização de quiz semanal" (n=55). As avaliações teóricas formais foram idênticas para as duas turmas. Os dados referentes ao número de quizzes realizados e média das notas de quiz foram tabulados. As análises estatísticas utilizadas foram teste t de Student e coeficiente de correlação de Spearman. A aplicação de quiz semanal deslocou a curva referente às notas de avaliação teórica à direita, sendo que as notas foram significativamente maiores neste grupo (p<0.01). Além disso, houve correlação significativa entre a nota da avaliação teórica e o número de quizzes realizados por cada estudante (r=0,39; p<0,01), bem como com a média da nota do quiz (r=0,47; p<0,01). Concluiu-se que a utilização de quiz semanal como instrumento de avaliação da aprendizagem influi positivamente no grau de conhecimento adquirido, provavelmente devido a um maior estímulo à leitura e estudo constante (AU).

Continuous and routine evaluation keeps the student studying, reading and learning permanently, as well as lightens the impact of formal theoretical exams on the traditional criteria for passing a course. The aim of this study was to evaluate the impact of weekly quiz application on the formal theoretical exam score in the course of Periodontics I ­ a theoreticalpractical course ­ at the School of Dentistry at Federal University of Paraná, Brazil. For this retrospective observational study, the fields "quiz score" and "exam score" of the register book from students of the first and second term of 2016, "no quiz" (n=53) and "weekly quiz application" (n=55), respectively, were analyzed. Formal theoretical exams were identical for both students groups. Data related to the number of quizzes taken by each student and quiz scores were tabulated. Student's t-test and Spearman correlation coefficient test were used for statistical analyses. Weekly quiz application moved the theoretical exam scores curve to the right and scores were significantly greater in this group (p<0.01). Besides, there was a significant correlation between theoretical exam score and the number of quizzes taken by each student (r=0.39; p<0.01), as well as with mean quiz score (r=0.47; p<0.01). We concluded that weekly application of quiz as an evaluation instrument in Periodontics positively influences acquired knowledge, probably due to stimulating permanent studying (AU).