Effects of Violet and IR LED Light on mast cell degranulation: in vivo study in a murine model.

The aim of this study was to evaluate the influence of IR (λ850 ± 10 nm) and violet (λ405 ± 10 nm) LED phototherapy on total mast cells counts and its ability to influence mast cell degranulation. For this, 27 Wistar rats were used and were randomly distributed into three groups: control, IR LED, and violet LED. When indicated, irradiation done and they were sacrificed, had their tongue removed immediately, 20-min, 45-min, and 2-h after irradiation. Samples were processed to wax, cut, and stained with Toluidine Blue. Intact and degranulated mast cells were counted under light microscopy, and statistical analysis was carried out. In the superficial connective tissue and muscular tissues, violet LED light caused a significant increase in both total number and degranulated mast cells when compared to the control group immediately after irradiation. The degranulation indexes were higher in the groups irradiated with Violet light, both in superficial connective tissue and muscular tissues in relation to the timing. Irradiation with IR LED caused immediate increase in the total number and degranulated of mast cells when compared to the control group only in the superficial connective tissue. In all times observed, the highest total amount of mast cells was seen immediately after irradiation, except in the muscular tissue, which presented the highest amount after 20-min. It was concluded that IR and violet LED light were able to increase the number of mast cells and inducing degranulation in oral mucosa. However, considering that violet LED light can be harmful in periodontal disease, it seems that the use of IR LED light could be the best option in Dentistry.

Expression and degranulation of mast cells in laser photobiomodulated mucositis chemo-induced: pilot study in hamsters.

This study aimed to evaluate the influence of laser photobiomodulation on the expression and degranulation of mast cells in chemo-induced oral mucositis (OM) lesions in hamsters. Twelve adult male Syrian hamsters (Mesocricetus auratus), golden lineage, were submitted to OM induction. They were divided into three groups: control-OM without treatment (C), OM treated with red laser (RL), OM treated with infrared laser (IL) and analyzed in the experimental time of 7 days. Three and 4 days after the intraperitoneal injection of the chemotherapy drug fluorouracil, the OM lesions were induced by making grooves in the right cheek pouch. Immediately after chemoinduction, the hamsters were submitted to photobiomodulation every 48 h for 7 days. The specimens were processed and stained using the hematoxylin-eosin and toluidine blue techniques. There was a predominance of mild chronic inflammation in the experimental groups and a greater persistence of neutrophils in the control group (C), although not statistically significant. The group irradiated with red laser (RL) had the highest mean mast cell expression (38.28 ± 19.05) (p < 0.001). As for the degranulation activity in mast cells, the control group (C) showed a greater number of fields with more than 50% of degranulated cells, presenting statistical significance when comparing it with the RL (p < 0.009) and IL (p = 0.036) group. It can be concluded that photobiomodulation, at both wavelengths, decreased mast cell degranulation, accelerating the inflammatory process. The use of infrared laser provided, in addition to less degranulation, the quantitative reduction of mast cells.

Willingness of health care providers to offer HIV self-testing from specialized HIV care services in the northeast of Brazil.

BACKGROUND: The insufficient knowledge regarding the serological status of people affected with human immunodeficiency virus (HIV) is a concern in Brazil. HIV self-testing (HIVST) has been proved to have great potential for increasing testing, especially among vulnerable populations. The large-scale distribution of HIVST by the Brazilian public health system has increased in recent years. We aimed to investigate the awareness of HIVST among health care providers (HCP) from specialized HIV/AIDS care services in the state of Bahia, Northeast Brazil. Further we investigated HCP acceptability and willingness to offer its use. METHODS: A cross-sectional study on HCP from 29 specialized care services (SCS) located in 21 cities in the state of Bahia. HCP working in the service for at least 6 months were included. Sociodemographic, occupational, and behavioral data were collected using a questionnaire. Descriptive statistics were carried out. Bivariate, and multivariate analyses estimating adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) using logistic regression were conducted. RESULTS: The awareness and acceptability of HIVST and the willingness to provide it were 79.8, 55.2, and 47.1%, respectively. Few HCP reported that the SCS where they worked dispensed HIVST (3.6%), and 13.5% received some information or training on HIVST. Factors associated with willingness to offer HIVST were: HIVST acceptability (aOR = 9.45; 95% CI: 4.53-19.71), willingness to use HIVST on themselves (aOR = 4.45; 95% CI: 1.62-12.24), confidence in offering HIVST to clients (aOR = 5.73; 95% CI: 2.26-12.72), and considering everyone eligible for HIVST (aOR = 2.88; 95% CI: 1.25-6.59). CONCLUSIONS: Although most HCP were aware of HIVST, acceptability and willingness to provide it to the clients was moderate. The scale up of HIVST as a mean for the HIV prevention and control policy in Brazil, requires further training of HCP and better implementation of this program.

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.

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.

Potential role of Hedgehog signaling pathway and myofibroblastic differentiation in central giant cell granuloma-A preliminary study.

OBJECTIVE: This study investigated components of the Hedgehog (HH) signaling pathway (SHH, GLI1), cyclin D1, and smooth muscle actin (SMA) in central giant cell granulomas (CGCG). The relationship between these proteins and myofibroblasts was also studied. MATERIAL AND METHODS: Twelve cases of non-aggressive CGCG and 11 cases of aggressive CGCG were studied using immunohistochemistry for SHH, GLI1, Cyclin D1, and SMA. RESULTS: Associations between all proteins in non-aggressive and aggressive CGCG were not significant (P > .05). All cases of CGCG showed significantly higher expression of SMA compared with the other proteins (P < .01). A positive correlation (P = .04) was only observed between SHH and GLI1 for all cases of CGCG. Furthermore, a positive correlation between SHH and GLI1 in non-aggressive CGCG (P = .04) and between GLI1 and cyclin D1 in aggressive CGCG (P = .03) were observed. There was also a negative correlation between the expression of SHH and SMA in non-aggressive CGCG (P = .031). CONCLUSIONS: This study provided insights into the activation of the HH signaling pathway in CGCG. In addition, the activation of this pathway (SHH and GLI1) might play some role in the differentiation of stromal myofibroblasts, although these markers including Cyclin D1 and SMA do not indicate aggressiveness of the CGCG. Furthermore, this myofibroblastic differentiation process would occur at the expense of maturation of these lesions.

Does the vertical position of maxillary central incisors in men influence smile esthetics perception?

INTRODUCTION: The aim of this study was to investigate whether there is any influence on the perception of smile esthetics among orthodontists and laypersons, with regard to different vertical positions of the maxillary central incisors. METHODS: Frontal smile photographs digitally altered at full-face view and close-up view of 2 adult men aged between 20 and 30 years were used. Six vertical positions of the central incisors were created, with changes of 0.5 mm. The images were randomly assembled in an album that was presented to 53 orthodontists and 53 laypersons, who evaluated the attractiveness of the images by using visual analog scales. Comparison among the images was performed using 1-way analysis of variance, with Tukey post-hoc test. To compare the distribution of the mean scores between the full-face and close-up smile views, and between orthodontists and laypersons, the Student t test was used. The level of significance was established at 5%. RESULTS: The best evaluations presented the following: (a) the gingival margins of the central incisors corresponded to, or were up to, 1 mm below the line of the canine gingival margins, and (b) the incisal step between the central and lateral incisors was from 1.0 to 2.0 mm. The smiles considered least attractive showed (a) the central incisor gingival margins were 1.0 mm above or 1.5 mm below the canine gingival margins, and (b) no step, or a step of 2.5 mm, between the central and lateral incisors. CONCLUSIONS: The results of this study suggested that, in men, slightly extruded central incisors were esthetically more attractive than intruded incisors.

Biochemical changes on the repair of surgical bone defects grafted with biphasic synthetic micro-granular HA + ß-tricalcium phosphate induced by laser and LED phototherapies and assessed by Raman spectroscopy.

This work aimed the assessment of biochemical changes induced by laser or LED irradiation during mineralization of a bone defect in an animal model using a spectral model based on Raman spectroscopy. Six groups were studied: clot, laser (λ = 780 nm; 70 mW), LED (λ = 850 ± 10 nm; 150 mW), biomaterial (biphasic synthetic micro-granular hydroxyapatite (HA) + ß-tricalcium phosphate), biomaterial + laser, and biomaterial + LED. When indicated, defects were further irradiated at a 48-h interval during 2 weeks (20 J/cm2 per session). At the 15th and 30th days, femurs were dissected and spectra of the defects were collected. Raman spectra were submitted to a model to estimate the relative amount of collagen, phosphate HA, and carbonate HA by using the spectra of pure collagen and biomaterials composed of phosphate and carbonate HA, respectively. The use of the biomaterial associated to phototherapy did not change the collagen formation at both 15 and 30 days. The amount of carbonate HA was not different in all groups at the 15th day. However, at the 30th day, there was a significant difference (ANOVA, p = 0.01), with lower carbonate HA for the group biomaterial + LED compared to biomaterial (p < 0.05). The phosphate HA was higher in the groups that received biomaterial grafts at the 15th day compared to clot (significant for the biomaterial; p < 0.01). At the 30th day, the phosphate HA was higher for the group biomaterial + laser, while this was lower for all the other groups. These results indicated that the use of laser phototherapy improved the repair of bone defects grafted with the biomaterial by increasing the deposition of phosphate HA.

Laser and LED phototherapy on midpalatal suture after rapid maxilla expansion: Raman and histological analysis.

The aim of this study was to analyze the effect of laser or LED phototherapy on the acceleration of bone formation at the midpalatal suture after rapid maxilla expansion. Forty-five rats were divided into groups at 7 days (control, expansion, expansion and laser irradiation, and expansion and LED irradiation) and into 14 days (expansion, expansion and laser in the 1st week, expansion and LED in the 1st week, expansion and laser in the 1st and 2nd weeks, expansion and LED in the 1st and 2nd weeks). Laser/LED irradiation occurred every 48 h. Expansion was accomplished with a spatula and maintained with a triple helicoid of 0.020-in stainless steel orthodontic wire. A diode laser (λ780 nm, 70 mW, spot of 0.04 cm2, t = 257 s, SAEF of 18 J/cm2) or a LED (λ850 ± 10 nm, 150 ± 10 mW, spot of 0.5 cm2, t = 120 s, SAEF of 18 J/cm2) was applied in one point in the midpalatal suture immediately behind the upper incisors. Raman spectroscopy and histological analyses of the suture region were carried and data was submitted to statistical analyses (p ≤ 0.05). Raman spectrum analysis demonstrated that irradiation increases hydroxyapatite in the midpalatal suture after expansion. In the histological analysis of various inflammation, there was a higher production of collagen and osteoblastic activity and less osteoclastic activity. The results showed that LED irradiation associated to rapid maxillary expansion improves bone repair and could be an alternative to the use of laser in accelerating bone formation in the midpalatal suture.

Interaction of stromal and microvascular components in keratocystic odontogenic tumors.

OBJECTIVE: Little is known about the interaction of stromal components in odontogenic tumors. Thus, the aim of this study was to investigate mast cells (MCs), myofibroblasts, macrophages, and their possible association with angiogenesis and lymphangiogenesis in keratocystic odontogenic tumors (KCOTs). MATERIAL AND METHODS: Thirty cases of KCOTs were included and analyzed by immunohistochemistry for mast cell tryptase, α-SMA, CD34, CD163, and D240. For comparative purpose, 15 radicular cysts (CRs) and 7 pericoronal follicles (PFs) were included. RESULTS: There was an increase in MCs for RCs and this difference was significant when they were compared to KCOTS and PFs. A significant increase in the density of MFs was observed for KCOTs when compared to RCs and PFs (P = 0.00). No significant difference in CD163-positive macrophages (P = 0.084) and CD34-positive vessels (P = 0.244) densities was observed between KCOTs, RCs, and PFs, although KCOTs showed a higher density of all proteins. Significant difference in lymphatic vessel density was observed for KCOTs when compared to RCs and PFs (P = 0.00). Positive correlation was observed between mast cell tryptase and CD34 in KCOTs (P = 0.025). CONCLUSIONS: A significant interaction between the MC population and CD34-positive vessels in KCOTs supported the hypothesis that MCs and blood vessels contribute to the stromal scaffold of KCOT.

Evaluation of laser phototherapy (λ 780 nm) after dental replantation in rats.

BACKGROUND/AIM: Tooth replantation is the treatment of choice in cases of avulsion although the outcomes are variable. The teeth can be lost due to external root resorption. The aim of this study was to histologically assess of the effect of laser phototherapy (λ780 nm) on replanted teeth in rats. MATERIAL AND METHODS: Sixty Wistar Albinus rats had their maxillary right incisors extracted and were then divided into four groups: G1-absence of storage medium; G2-milk as storage medium; G3-milk as storage medium followed by a laser irradiation of the root surfaces and entrance of the alveolus (λ = 780 nm; P = 70 mW; CW; DE = 21 J/cm2 ); G4-milk as storage medium, laser irradiation as in G3 before replantation. After this procedure, laser irradiation was performed on the buccal and palatal mucosa (8.4 J/cm2 per session) every 48 h for 15 days. The animals were euthanized 15, 30, and 60 days after replantation. RESULTS: The histological results showed that after 15 days, G4 exhibited intense chronic inflammation with the presence of clastic cells and moderate external inflammatory root resorption (P < 0.05) when compared with G3, in which these outcomes were not observed. At the 30th day, G1, G2, and G4 showed chronic inflammation varying from discrete to moderate, as well as intense external inflammatory root resorption. G3 remained without any inflammation and external inflammatory root resorption up to the 60th day. CONCLUSIONS: The use of laser phototherapy on the root surface and at the entrance of the alveolus prior to replantation had a positive biomodulative effect on alveolar repair after tooth replantation in rats.

Effect of laser (λ 660 nm) and LED (λ 630 nm) photobiomodulation on formocresol-induced oral ulcers: a clinical and histological study on rodents.

The aim of this study was to evaluate, clinically and histologically, the influence of laser and LED photobiomodulation in the healing of formocresol-induced oral mucosa ulcers of rats. We used 60 Wistar rats in which oral ulcers were induced on the gingiva of the lower incisors. Forty-eight hours after inducing the ulcers, the animals were divided into three groups: laser, LED, and untreated. Animals from the laser group received irradiation with GaAlAs, 660 nm, CW, 40 mW, φ 4 mm(2), 4.8 J/cm(2). Animals from the LED group received irradiation with InGaAIP, 630 nm, 150 mW, 4.8 J/cm(2), 0.8 cm spot. Forty-eight hours after oral ulcer induction, both irradiations were applied in a punctuate manner in the center of the ulcer at 48-h interval until the end of the experimental period. The animals were killed at 3, 5, 7, and 11 days after day 0. The results of the clinical evaluation showed that the laser and LED phototherapies were able to accelerate the healing of formocresol-induced oral ulcers, which occurred first in the laser group (ANOVA, p < 0.05). Histologically, there was a slight variation between LED and laser therapy; therefore, the laser group proved to be effective in accelerating wound healing, especially at 5 days, whereas the LED group was more effective at the end of the experimental period. It was concluded that laser and LED photobiomodulation were effective in accelerating the healing of formocresol-induced oral ulcers in both clinical and histological aspects.

Assessment of different energy delivery settings in laser and LED phototherapies in the inflammatory process of rat's TMJ induced by carrageenan.

Temporomandibular disorders (TMDs) are mostly inflammatory conditions widespread in the population. Previous studies have shown positive effects of either laser or light-emitting diode (LED) phototherapies on treating TMDs, but their action and mechanism in the inflammatory infiltrate of the temporomandibular joint are still poorly understood. The aim of this study was to assess, through histological analysis, the effectiveness of using laser light (λ 780 nm, 70 mW, continous wave (CW), 10 J) and LED (λ 850 ± 10 nm, 100 mW, CW, 10 J) on the inflammation of the temporomandibular joint of rats induced by carrageenan. Forty-five animals were divided into three groups with five animals each according to the experimental times of 2, 3, and 7 days: inflammation, inflammation+laser phototherapy, and inflammation+LED phototherapy. The first irradiation was performed 24 h after induction with an interval of 48 h between sessions. After animal death, specimens were processed and stained with hematoxylin-eosin (HE) and picrosirius. Then, the samples were examined histologically. Data were statistically analyzed. The inflammation group showed mild to moderate chronic inflammatory infiltrate between bone trabecules of the condyle. Over the time course of the study in the laser group, the region of the condyle presented mild chronic inflammation and intense vascularization. In the LED group, the condyle showed aspects of normality and absence of inflammation in some specimens. In all the time points, the laser-irradiated groups showed greater amount of collagen deposition in the condyle (p = 0.04) and in the disc (p = 0.03) when compared to the inflammation and LED groups, respectively. Laser- and LED-treated groups demonstrate a smaller number of layers of the synovial membrane when compared to the non-irradiated groups. It was concluded that, in general, laser and LED phototherapies resulted in a reduction of inflammatory infiltrate in the temporomandibular joint of rat.

Do laser/LED phototherapies influence the outcome of the repair of surgical bone defects grafted with biphasic synthetic microgranular HA + ß-tricalcium phosphate? A Raman spectroscopy study.

The treatment of bone loss is difficult. Many techniques are proposed to improve repair, including biomaterials and, recently, phototherapies. This work studied bone mineralization by Raman spectroscopy assessing intensities of Raman peaks of both inorganic (∼ 960, ∼ 1,070 cm(-1)) and organic (∼ 1,454 cm(-1)) contents in animal model. Six groups were studied: clot, laser, light-emitting diode (LED), biomaterial (HA + ß-tricalcium phosphate), laser + biomaterial, and LED + biomaterial. Defects at right tibia were performed with a drill. When indicated, defects were further irradiated at a 48-h interval during 2 weeks. At the 15th and 30th days, the tibias were withdrawn and analyzed. The ∼ 960-cm(-1) peak was significantly affected by phototherapy on both clot- and biomaterial-filled defects. The ∼ 1,070-cm(-1) peak was affected by both time and the use of the LED light on clot-filled defects. On biomaterial-filled defects, only the use of the laser light significantly influenced the outcome. No significant influence of either the time or the use of the light was detected on clot-filled defects as regards the ∼ 1,454-cm(-1) peak. Raman intensities of both mineral and matrix components indicated that the use of laser and LED phototherapies improved the repair of bone defects grafted or not with biphasic synthetic microgranular HA + ß-tricalcium phosphate.

Effects of LED phototherapy on relative wound contraction and reepithelialization during tissue repair in hypothyroid rats: morphometric and histological study.

The aim of this study was to assess morphometrically and histologically, the effects of light-emitting diode (LED) (λ630 ± 20 nm) phototherapy on reepithelialization and wound contraction during tissue repair in hypothyroid rats. Thyroid hormone deficiency has been associated with disorders of tissue repair. LED phototherapy has been studied using several healing models, but their usefulness in the improvement of hypothyroidism wound healing remains unknown. Under general anesthesia, a standard surgical wound (1 cm(2)) was produced on the dorsum of 48 male Wistar rats divided into four groups of 12 animals each: EC-control euthyroid, ED-euthyroid + LED, HC-control hypothyroid, and HD-Hypothyroid + LED. The irradiation started immediately after surgery and was repeated every other day for 7 and 14 days. Photographs of the wound were taken at the day of the surgical procedure and on days 8 and 15 after surgery, when animals' deaths occurred. The specimens were removed, routinely processed, and stained with hematoxylin/eosin. Seven days after the surgery, it was possible to observe statistically significant reductions in the wound area of the irradiated euthyroid group, in comparison to hypothyroid group, irradiated and non-irradiated (ANOVA, p < 0.05). The reepithelialization was significantly higher in the euthyroid and hypothyroid groups irradiated with LED than in the non-irradiated groups (Fisher's test, p < 0.05). No significant difference was found in the experimental period of 14 days among the groups. The hypothyroidism delayed wound healing and the LED phototherapy, at these specific parameters, improved the process of reepithelialization in the presence of hypothyroidism.

[The evolution of inequalities in the distribution of dentists in Brazil]. / Evolução das desigualdades na distribuição de dentistas no Brasil.

The scope of this article is to analyze the evolution of the distribution of dentists and undergraduate courses in Dentistry in Brazil between 1960 and 2022, based on institutional data and its correlation with economic and demographic data. The proportions between number of dentists and population were calculated for the federative units in different periods, and the Herfindahl-Hirschman Index (HHI) was used. to determine the concentration of dentists, population and undergraduate courses in Dentistry. The Pearson test was used, with a significance level of 95%, to test the correlation between variables. In the period from 1960 to 2022, the ratio of dentists per 10,000 inhabitants increased from 3.3 to 16.9. Moreover in 2022, the federative units with the highest average household income per capita were closely correlated with the highest concentration of dentists (R2= 0.90; p < 0.00). However, from 1975 to 2022, the concentration of dentists measured by the HHI dropped from 45.1 to 33.4. The decrease in the geographic concentration of Dentistry courses was even more pronounced, with the HHI rising from 39.3 in 1991, to 25.6 in 2022.

O objetivo deste artigo é analisar a evolução da distribuição de dentistas e cursos de graduação em odontologia no Brasil entre 1960 e 2022, a partir de dados institucionais e de sua correlação com dados econômicos e demográficos. Foram calculadas as proporções entre número de dentistas e população para as unidades federativas em diferentes períodos, e para determinar a concentração de dentistas, da população e dos cursos de graduação em odontologia,foi utilizado o índice Herfindahl-Hirschman (HHI). Para testar a correlação entre variáveis foi empregado o teste de Pearson, com um nível de significância de 95%. Entre 1960 e 2022, a proporção de dentistas por 10 mil habitantes aumentou de 3,3 para 16,9. Ainda em 2022, as unidades federativas com maior renda média domiciliar per capita estavam fortemente correlacionadas à maior concentração de dentistas (R2 = 0,90; p < 0,00). Entretanto, de 1975 a 2022, a concentração de dentistas medida pelo HHI caiu de 45,1 para 33,4. A diminuição da concentração geográfica dos cursos de odontologia foi ainda mais pronunciada, tendo o HHI passado de 39,3 em 1991 para 25,6 em 2022.

Public Dental Service Access Policies for People with Autism Spectrum Disorder (ASD) in Salvador, Bahia, Brazil: A Pre-Evaluation Study.

This study sought to carry out a systematic and preliminary evaluation of the policies on access to public dental services for people with ASD in a Brazilian city. The study, conducted between November/2019 and February/2020, was developed through document analysis, the design of the theoretical logical model of the policies, and seven semi-structured interviews with key informants. The sample was intentionally selected. We also considered the answers to 108 questionnaires from a pilot study on the access of people with ASD to dental services applied to caregivers, dentists, and non-dental professionals. No refusals were recorded. The availability study showed that the policies' objectives were not being achieved in terms of care network organization: there were no institutional flows, personal contacts were used between professionals to guarantee access to secondary attention, there was no specific training for the dentists about ASD, and the oral health care network was unknown to non-dentist professionals and caregivers. Most people with ASD have visited the dentist at least once in their lives, but a large percentage of those within this study did not do so in the last year. This study identified difficulties in implementing policies and suggested possible strategies for overcoming them as dimensions and subdimensions for evaluation.

Oral health-care practices and dental assistance management strategies for people with autism spectrum disorder: An integrative literature review.

ABSTRACT: Autism spectrum disorder requires a careful approach from professionals and a favorable clinical environment for dental care and assistance. This article aims To perform a literature review about oral health among people with autism spectrum disorder and dental management strategies for this group. An integrative literature review was carried out in three databases, associating the descriptors: (autism or autism spectrum disorder) with (oral health or oral diseases) and (dental care or dental services). After identification and screening steps, 32 articles were included in the study. The most prevalent subjects were oral health conditions, parents' understanding and practical attitudes about oral health, treatment and management strategies, and the use of technology. The principal barriers to dental care were the scarcity of specialized professionals, unpreparedness in the referral system, poor accessibility of the clinics, and lack of specific care protocols. The world literature on the subject is scarce, and there is still a need for investment and scientific production due to the incidence of autism in the world population and the maintenance of difficulties and barriers in offering quality health care to this group.

Investigation of Malocclusion and Associated Factors in Preschoolers: A Cross-Sectional Questionnaire Study.

This study aims to describe the prevalence of malocclusion and identify associated factors in preschool children. Completed in 2022-2023, this cross-sectional study included 523 children aged 26 to 80 months in municipal schools in Salvador. An oral examination was carried out on the children, and a questionnaire was self-administered by the parents. Descriptive analyses and multivariate logistic regression (the backward method, p-value ≤ 0.05, 95% CI) were conducted. The majority of children were female (51.82%), over 54 months old (52.2%), Black or mixed race (90.63%), and not affected by COVID-19 (92.35%). The prevalence of malocclusion was 43.21%, with open bite as the most common condition. There was a significant association between malocclusion and screen time (OR: 1.34; p: 0.116; CI: 1.0-1.94), physical/psychological aggression (OR: 2.55; p: 0.031; CI: 1.0-5.98), consumption of ultra-processed foods (OR: 1.77; p: 0.003; CI: 1.22-2.57), digital suction (OR: 3.1; p: 0.001; CI: 1.56-6.16), and the habit of biting objects (OR: 1.56; p: 0.121; CI: 1.0-2.73). The promotion of comprehensive health in early childhood and psychosocial interventions are recommended, aiming to reduce screen time, aggression, consumption of ultra-processed foods, thumb sucking, and the habit of biting objects to prevent malocclusion.

Chronic Sclerosing Sialadenitis of the Submandibular Gland and its Histopathological Spectrum in the IgG4-Related Disease: a Series of 17 Cases.

PURPOSE: This study aimed to characterize the histopathological immunohistochemical features of chronic sclerosing sialadenitis, emphasizing the IgG4-related disease. METHODS: Seventeen cases of chronic sclerosing sialoadenitis were examined for histopathological aspects, (inflammation, fibrosis, glandular parenchyma, and lymphoid follicles) and immunohistochemistry (BCL2, CD3, CD20, CD34, CD163, p63, cyclin D1, mast cell, SMA, S100A4, IgG, and IgG4) which were scored. IgG4-related disease features were investigated. Demographic and clinical data were also collected. RESULTS: Males predominated (10:7), with an average lesion size of 3.9 cm. Common histopathological findings included reduced acinar parenchyma, lymphoid follicle formation, and ductular proliferation. CD3-positive T lymphocytes and CD34- and SMA-positive stromal fibroblasts were abundant. Nine cases (53%) showed sialoliths and three cases met the criteria for IgG4-related disease. CONCLUSION: CSS of the submandibular gland represents a reactive pattern rather than IgG4-RD as only 3 cases seemed to be related to IgG4-RD. The immunohistochemical profile revealed an abundant population of CD3-positive T lymphocytes, as opposed to regulatory proteins such as cyclin D1, demonstrating that populations of CD34- and SMA-positive stromal fibroblasts contribute to the fibrosis characteristic of CSS. In addition, our results provide a comprehensive insight into the study of CSS and its relationship with IgG4-RD.